Research has shown that following a healthy eating plan can both reduce the risk of developing high blood pressure and lower an already elevated blood pressure.

Vegetarian Diet

Vegetarians, in general, have lower blood pressure levels and a lower incidence of hypertension and other cardiovascular diseases. Experts postulate that a typical vegetarian’s diet contains more potassium, complex carbohydrates, polyunsaturated fat, fiber, calcium, magnesium, vitamin C and vitamin A, all of which may have a favorable influence on blood pressure.


A high-fiber diet has been shown to be effective in preventing and treating many forms of cardiovascular disease, including hypertension.
The type of dietary fiber is important. Of the greatest benefit to hypertension are the water soluble gel-forming fibers such as oat bran, apple pectin, psyllium seeds, and guar gum. These fibers, in addition to be of benefit against hypertension, are also useful to reduce cholesterol levels, promote weight loss, chelate out heavy metals, etc.

Take one to three tablespoons of herbal bulking formula containing such things as oat fiber, guar gum, apple pectin, gum karaya, psyllium seed, dandelion root powder, ginger root powder, fenugreek seed powder and fennel seed powder.


Sucrose, common table sugar, elevates blood pressure. Underlying mechanism is not clearly understood. It is possible that sugar increases the production of adrenaline, which in turn, increases blood vessel constriction and sodium retention.

Take a diet that is rich in high potassium foods (vegetables and fruits) and essential fatty acids. Daily intake of potassium should total 7 grams per day. The diet should be low in saturated fat, sugar and salt. In general, a whole food diet emphasizing vegetables and members of the garlic/onion family should be consumed.

In an NIH sponsored research called “Dietary Approaches to Stop Hypertension (DASH),” researchers tested the effects of nutrients in food on blood pressure. The results showed that elevated blood pressures were reduced by an eating plan that emphasized fruits, vegetables, and low-fat dairy foods and was low in saturated fat, total fat, and cholesterol. The DASH diet included whole grains, poultry, fish, and nuts. It employed reduced amounts of fats, red meats, sweets, and sugared beverages.

Reduce Salt and Sodium in Your Diet

A key to healthy eating is choosing foods lower in salt and sodium. [Brother Bru Bru’s has 0 mg Sodium.] Before the widespread availability of medication to control high blood pressure, people with serious hypertension had only one treatment option, a drastically salt-reduced, low-calorie “rice diet.” Some people can significantly lower their blood pressure by avoiding salt.

Studies show that people in countries that use a great deal of salt in their cooking tend to have higher blood pressures than people in countries that use little salt. For example, the Japanese, whose cuisine is among the saltiest in the world, also have the highest blood pressure; and so do Americans. Americans take it for granted that blood pressure will rise as we age. But in countries with low per-capita salt intake, blood pressure does not rise significantly after puberty. For example, blacks in Africa, who typically eat a low-salt, high-fiber diet, have relatively low blood pressure, but for African-Americans, just the opposite is true. Nearly 50 percent of all African-Americans have high blood pressure, often beginning early in life.

Excessive consumption of dietary sodium chloride (salt), coupled with diminished dietary potassium, induces an increase in fluid volume and an impairment of blood pressure regulating mechanisms. This results in hypertension in susceptible individuals.

A high potassium-low sodium diet reduces the rise in blood pressure during mental stress by reducing the blood vessel constricting effect of adrenaline. Sodium restriction alone does not improve blood pressure control; it must be accompanied by a high potassium intake.

Most of us consume more salt than we need. NIH recommends limiting the sodium consumption to less than 2.4 grams (2,400 milligrams [mg] ) of sodium a day. That equals 6 grams (about 1 teaspoon) of table salt a day. The 6 grams include ALL salt and sodium consumed, including that used in cooking and at the table. Recent research has shown that people consuming diets of 1,500 mg of sodium had even better blood pressure lowering benefits. So, your doctor may advise eating less salt and sodium if you are suffering from high blood pressure. The lower-sodium diets also can keep blood pressure from rising and help blood pressure medicines work better.

In a clinical study, researchers looked at the effect of a reduced dietary sodium intake on blood pressure as people followed either the DASH diet or a typical American diet. Results showed that reducing dietary sodium lowered blood pressure for both the DASH diet and the typical American diet. The biggest blood pressure-lowering benefits were for those eating the DASH diet at the lowest sodium level (1,500 milligrams per day). This study showed the importance of lowering sodium intake in your diet.

Watch what you eat. Do not add additional salt to your food. If you have high blood pressure, avoid eating certain highly processed, overly salted foods, such as frozen pizza, canned salted vegetables, meals from fast-food restaurants, and the like.

Beneficial Vegetables and Spices for Hypertension

A number of common vegetables and spices have beneficial effects in controlling hypertension. Incorporate these into your cooking. Alternately, you can make a tea or a vegetable soup.

Celery (Apium graveolens). Oriental Medicine practitioners have long used celery for lowering high blood pressure. There are some experimental evidence that shows that celery is useful for this. In one animal study, laboratory animals injected with celery extract showed lowered blood pressure. Eating as few as four celery stalks was found to be beneficial in lowering blood pressure in human beings.

Garlic (Allium sativum). Garlic is a wonder drug for heart. [Brother Bru Bru’s is loaded with Garlic.] It has beneficial effects in all cardiovascular system including blood pressure. In a study, when people with high blood pressure were given one clove of garlic a day for 12 weeks, their diastolic blood pressure and cholesterol levels were significantly reduced. Eating quantities as small as one clove of garlic a day was found to have beneficial effects on managing hypertension. Use garlic in your cooking, salad, soup, pickles, etc. It is very versatile.

Onion (Allium cepa). Onions are useful in hypertension. What is best is the onion essential oil. Two to three tablespoons of onion essential oil a day was found to lower the systolic levels by an average of 25 points and the diastolic levels by 15 points in hypertension subjects. This should not be surprising because onion is a cousin of garlic.

Tomato (Lycopersicon lycopersicum). Tomatoes are high in gamma-amino butyric acid (GABA), a compound that can help bring down blood pressure.

Broccoli (Brassica oleracea). This vegetable contains several active ingredients that reduce blood pressure.

Carrot (Daucus carota). Carrots also contain several compounds that lower blood pressure.

Saffron (Crocus sativus). Saffron contains a chemical called crocetin that lowers the blood pressure. You can use saffron in your cooking. (It is a very popular spice in Arabic cooking.) You can also make a tea with it. Many Indians add a pinch of saffron in the brewed tea to give a heavenly flavor. Unfortunately, it is very expensive.

Assorted spices
Spices such as fennel, oregano, black pepper, basil and tarragon have active ingredients that are beneficial in hypertension. Use them in your cooking.

Gluten seems to be the food ingredient non grata these days. Bakers are coming up with recipes for gluten-free cupcakes and baguettes. Anheuser-Busch sells Redbridge, a gluten-free beer made from sorghum. And, of course, times being what they are, you can easily slip into an Internet swirl of blogs and Twittering about gluten-free foods. It’s not just talk: cash registers are ringing. By some estimates, the sales of gluten-free foods have tripled since 2004.

Gluten-free food has become more popular partly because doctors are diagnosing more cases of celiac disease, an autoimmune disorder whose symptoms are triggered by gluten, the protein content in wheat, barley, rye, and spelt (an ancient form of wheat that’s catching on as a health food). Celiac specialists say the disease isn’t diagnosed as often as it should be. As a result, many people suffer with it for years, often after getting other — and incorrect — diagnoses and useless treatments.

But a growing number of the people dodging gluten fall into a gray area: they don’t have celiac disease but seem to be unable to digest gluten properly. There are no tests or strict criteria for this problem, aside from simple trial and error with a gluten-free diet. Often people self-diagnose. It’s hard to know what’s going on. Some people may be getting caught up in a food fad. But many others probably do have a real problem digesting gluten or perhaps the sugars in some of these grains, a condition akin to the lactose intolerance that makes it hard for many people to digest dairy foods. Their problem is not as well-defined or well-understood as celiac disease but they have a problem nonetheless.

There’s a third group of gluten-free converts: people who are blaming gluten for a wide range of medical conditions, not just gastrointestinal distress. For example, there’s a fairly loud Internet “buzz” about autistic children improving once they’re on a gluten-free diet.

There’s good, solid evidence of an overlap between celiac disease and other autoimmune disorders, particularly type 1 diabetes. And celiac disease and other autoimmune disorders sometimes have neurological effects — peripheral neuropathy, for example, which involves nerve damage that results in numbness and pain.

But based on what is currently known, it’s a big leap to attributing autism and other problems to gluten, and an even bigger one to prescribing gluten-free eating as a treatment. It’s possible that some people benefit from a gluten-free regimen for reasons that have less to do with gluten and much more to do with the structure involved in planning and sticking to such a strict eating plan.

Misreading the situation

Gluten is an imprecise term that shifts meaning depending on the context. Gluten comes, not surprisingly, from the Latin word for glue, and cookbooks define it as the protein-based substance that makes dough resilient and stretchy. If you’re making bread, you want gluten in the dough, so that when it’s baking the walls of the little air pockets formed by yeast expand but don’t burst open. But if you’re making cookies or a pie crust, you want to keep the gluten content of the dough and batter low. Otherwise, your results will be tough and gummy.

In the context of celiac disease, gluten refers to the protein of grains capable of provoking an autoimmune response. Other grains also contain protein, but wheat, barley, rye, and spelt contain varieties that aren’t broken down by digestive enzymes. In wheat, the difficult-to-digest protein is gliadin; in rye, it’s secalin; and in barley, hordein.

These proteins don’t faze the guts of most of us. But in people with celiac disease, when they get absorbed into the walls of the small intestine, the immune system misreads the situation, views them as intruders, and unleashes a furious inflammatory response that damages tissue (see illustration). The inside of a normal, healthy small intestine is carpeted with millions of fingerlike projections called villi that produce digestive enzymes and soak up nutrients. The misguided immune response triggered by the gluten proteins sometimes attacks these villi, so they lose their slender shape and become short and stubby, even flat. When that happens, the villi produce fewer digestive enzymes and absorb fewer nutrients.

Symptoms — classic and non

The classic and most immediately noticeable symptoms of celiac disease are, not surprisingly, gastrointestinal: bloating, flatulence, and diarrhea, sometimes with smelly stools. People who can’t digest gluten or grain sugars may have similar symptoms.

Celiac disease can severely impair the absorption of nutrients. In children, this may lead to stunted growth; in adults, the consequences include anemia (because iron isn’t being absorbed) and weaker bones (because calcium and vitamin D aren’t getting into the body). Anemia causes fatigue and malaise, but some people with celiac disease feel that way without anemia.

Doctors sometimes miss the celiac disease diagnosis because they’re looking for the classic gastrointestinal symptoms, not the vaguer ones that stem for the most part from malabsorption of nutrients.

One major difference between celiac disease and grain-related digestion problems is that when it’s just a digestion problem it typically doesn’t lead to malabsorption and nutritional deficiencies.

Women with untreated celiac disease have higher-than-normal rates of menstrual abnormalities and infertility. A large study published in 2007 found an increased risk of pancreatitis in people with celiac disease. It’s not clear whether a cause-and-effect relationship can be inferred from these associations or if celiac disease and these conditions happen to be consequences of a shared, common cause.

According to some research, several of the nongastrointestinal conditions associated with celiac disease might be caused by an overabundance of antibodies that the immune system churns out, especially those it produces in response to an enzyme in the small intestine called tissue transglutaminase. The antibodies travel to other parts of the body through the bloodstream. Perhaps the clearest example of one of these antibody-related symptoms is a skin condition, dermatitis herpetiformis, which causes itchy red bumps. Less certain is whether the anti–tissue transglutaminase antibodies might get into the brain and cause neurological problems, such as loss of muscle control (ataxia).

A blood test and a biopsy

Compared with other autoimmune disorders (such as Crohn’s disease and rheumatoid arthritis), the diagnosis of celiac disease is pretty straightforward. In the United States, the issue has been getting doctors to consider the celiac diagnosis as a possibility. That’s changing. For example, the guidelines for irritable bowel syndrome were revised to include testing for celiac disease.

The diagnosis begins with a blood test for the antibodies generated by the immune response that gluten provokes. Tests exist for several different types of antibodies, but the one for the antibodies against the tissue transglutaminase enzyme is the most reliable and accurate. If the blood test is positive, the next step is biopsy of tissue from the small intestine to see if the villi have been damaged. Collecting the biopsy involves snaking an endoscope — a flexible tube with a tiny camera on the tip — down the throat and through the digestive tract and snipping out small pieces of tissue that can be examined under a microscope.

Dr. Daniel Leffler, a celiac disease expert at Harvard-affiliated Beth Israel Deaconess Medical Center in Boston, says the biopsies show, on average, that over 90% of people with positive antibody tests and celiac symptoms have intestinal damage, and the presumption is that they have celiac disease. But if the biopsy shows a lack of intestinal damage, that usually rules out celiac disease as a diagnosis.

In people with symptoms, judging whether there’s a favorable response to a gluten-free diet isn’t difficult: the turnaround from illness to health can be quite dramatic. But Dr. Leffler notes that many — indeed, perhaps most — people with a positive antibody test and intestinal damage do not have symptoms or have atypical ones that are subtle and vague. These patients raise some important questions. Is this a case of test results in need of a disease, rather than the other way around? And from the patient’s perspective, why bother with a diet that’s inconvenient — despite the growing number of choices — and expensive if you don’t have symptoms?

Celiac disease experts have a three-part answer. First, if doctors and patients were more aware that problems like anemia and fatigue can be traced back to celiac disease, they’d see that a gluten-free diet improves these symptoms. Second, if symptoms are subtle, so might be the improvement. Third, like many so-called silent diseases, celiac disease may not have showy symptoms, but if left alone, it may result in serious problems down the line related to poor nutrition. And some data suggest that the risk of developing other autoimmune conditions (including thyroid disorders like Hashimoto’s thyroiditis and Graves’ disease) may be related to how long someone with celiac disease has been eating gluten.

The super six

We’re often too quick to depend on pills instead of first working to change our diet and exercise habits. But with celiac disease, there’s no pill, and a fairly radical change in diet is the only treatment. Ironically, doctors who treat celiac disease lament the lack of pharmaceutical industry involvement. Drug companies have started to take some interest in the disease, and treatments that would block the absorption of gluten are being investigated, but none so far are close to gaining FDA approval.

Gluten-free eating is a two-way street: getting the gluten out while bringing in healthful — and palatable — alternatives. Some foods are obviously made with wheat and the other gluten-containing grains. Conventional bread, bagels, pizza — they’re out if you have celiac disease. But until you need to avoid gluten, you probably don’t realize how ubiquitous it is. Gluten is used as a thickening agent and filler in everything from ketchup to ice cream. The inactive ingredients in many medications are gluten-based. And even when gluten isn’t an ingredient, it may inadvertently get into a food because a wheat-based food was processed in the same factory, or wheat was grown in a nearby farm field. At home, wooden utensils and toaster ovens are gluten “hot spots.” Oats don’t contain gluten, but many people with celiac disease avoid them because of contamination problems.

The gluten-free diet has traditionally depended on starch from rice, corn, and potatoes. Food makers have also learned how to use xanthan and guar gums to replace gluten’s elasticity: a common complaint about gluten-free baked goods is that they are powdery. But these formulations can also leave diets short of fiber and B vitamins. Melinda Dennis, the nutrition coordinator at the Beth Israel Deaconess Medical Center Celiac Center, encourages patients to eat foods made with unconventional but nutritionally well-rounded substitutes, including amaranth, buckwheat (no relation to wheat), millet, quinoa, sorghum, and teff. She calls them the “super six” because of their high vitamin and fiber content.

Eating out is one of the biggest issues for people with gluten problems, says Dennis. Vegetables get contaminated because they are steamed over pots of pasta water. Fish and chicken are floured to hold seasonings. But many restaurants are beginning to offer gluten-free items. And there are some celiac-friendly cuisines, even if they are not overtly gluten-free. Dennis put Ethiopian (which uses teff), Indian, Mexican, and Thai in that category.

Harvard Health Letter, June 2009