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Expert Q&A: Eating to Control High Blood Pressure

An interview with Dean Ornish, MD.

Which foods are the worst sodium offenders?

Table salt, of course, but sodium is found in a lot of processed foods. Most processed foods are high in sodium, even though you may not think of them as salty foods.

What changes would you make to the DASH diet?

DASH is a good diet, but it doesn't go far enough for people who are trying to reverse heart disease.

In my new book, The Spectrum, we talk about how you really do have a spectrum of choices. The more you need to change, the more you have to change. It's the old "ounce of prevention, pound of cure."

The point is that we need to personalize a way of eating and living that is right for us based upon our needs, our genes, and our preferences. If you just want to lose a few pounds or get your blood pressure, or cholesterol, or blood sugar down, you can start by making just a few changes.

DASH is a good place to begin. If that is not enough to bring your blood pressure down, now you have a choice: You can go on drugs for the rest of your life, or you can make even bigger lifestyle changes.

Not everybody needs to make big changes. And it is not just diet. There is also a spectrum of exercise and a spectrum of stress management.

What is the advantage of eating a mostly plant-based diet in managing hypertension?

It is not entirely clear why animal protein, particularly red meat, raises blood pressure. But we know that it does.

Dr. Frank Sacks, one of the originators of the DASH diet, did a study where he gave people muffins and measured their blood pressure. The muffins all tasted the same, but he put animal protein in one set of muffins. Sure enough, blood pressure went higher in the group that ate the animal protein, even though they didn't know they were eating it.

Does exercise have an impact in preventing or controlling hypertension?

Of course. What kind of exercise? The kind you enjoy. What is sustainable is pleasure and joy and freedom. If you enjoy exercise, you are going to do it.

And people will often do things for their kids that they would not do for themselves. I am not one of those people who particularly loves to exercise, but I do it on a regular basis because I love my wife, I love my children, and I want to be around to enjoy them fully.

The hardest thing is getting started. A lot of people think, "Man, I've gotta run a marathon or at least five miles three times a week -- or I might as well just roll over in bed." That isn't the case.

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