About 35% of the Asian adult population suffers from hypertension or High Blood Pressure. Hypertension raises risk of heart disease, stroke and kidney disease. However, simple dietary awareness and measures, like following the DASH diet, can help control as well as prevent its risks. By Ujjwala Baxi, dietitian and diabetes educator
DASH diet, i.e. Dietary Approach to Stop Hypertension, comprises foods that are higher on nutrients like calcium, potassium, magnesium, protein and fibre and lower in saturated fat and total fat.
A panel of physicians assembled by US News & World Reports magazine rated the DASH diet the best diet regimen to follow for its balance of healthy foods and efficacy. The DASH diet is also recommended by the National Heart Lung and Blood Institute (NHLBI).
The DASH eating plan emphasises:
- Vegetables, fruits, and fat-free or low-fat dairy products
- Includes whole grains, fish, poultry, beans, seeds, nuts, and vegetable oils
- Limits sodium, sweets, sugary beverages and red meats
The DASH diet recommends menus with 1500-2300 mg/day of sodium (6g of salt a day). This is about a teaspoon of salt.
According to NHLBI, research showed that following a DASH plan containing 2,300 milligrams (mg) of sodium per day lowered blood pressure. Following a DASH plan containing 1,500 mg of sodium lowered blood pressure even more (systolic blood pressure was lowered by about 7 to 12 mmHg). (http://www.nhlbi.nih.gov/health/health-topics/topics/dash/benefits.html). Following this diet may enable some to take a lower dosage of antihypertensive medication.
Please note: If you are taking medicine to control high blood pressure, you should keep taking it. However, you should tell your doctor that you're now following the DASH eating plan.
The DASH diet is also believed to lower risk of diabetes and several types of cancer according to research, among them a study published in the American Journal of Epidemiology in September 2011.
Where’s the salt?
When it comes to Asian cuisine, delicacies are often accompanied by chutneys, sauces, dressings, fritters and papads to add flavour to the main course. Even tiny helpings of these contribute to “disguised salt intake” that increases blood pressure over a period of time.
Do you know how much salt intake is recommended per day by the World Health Organisation (WHO) and how much we actually end up consuming?
WHO recommends 2000mg of sodium a day (6g of salt) whereas the average consumption among the Asian populations goes up to 12-14g of salt a day. This is double the recommendation! Unknowingly, we are harming our health every day.
A few wise choices can go a long way towards keeping us healthy. Here, some pointers to help you shop and eat healthily:
- Prepare your meals at home rather than relying on store-bought foods, takeways or eating out. This puts you in charge of what you are feeding your body and that of your family. You are in charge of how much salt, sugar, saturated fats and fibre you are consuming.
- Know that foods labelled ‘ready to eat’ are loaded with salt, sugar and fat.
- Choose foods that are labelled 'low sodium' or 'low salt' foods. A low sodium or low salt claim can only be made when a food has no more than 120 milligrams of sodium per 100 grams of food. You can also look for 'reduced' sodium/salt, sodium/salt 'free', and 'no added' sodium/salt. Reduced sodium/salt means the food must have at least 25% less sodium/salt than a comparable food.
- Limit consumption of canned foods like beans, vegetables, soups, stocks and baby foods due to high levels of Mono Sodium Glutamate.
- Choose food containers that are BPA-free. BPA is directly linked to HBP in adults and aggressive behaviour in children. Bisphenol A (BPA) is a chemical that is used in the production of food and drink packaging, eg, water and infant bottles, food storage containers and polycarbonate tableware. Bisphenol A can leach into food from the protective epoxy resin coatings of these containers. The degree to which BPA leaches from polycarbonate bottles into liquid may depend more on the temperature of the liquid or bottle, than the age of the container. (http://www.niehs.nih.gov/health/topics/agents/sya-bpa/)
- Consume potassium-rich foods like vegetables, fruits, whole grains, beans that help control blood pressure.
- Drink enough water, especially with consumption of sugary or salty items.
- Use herbs instead of salt and sugar to flavour your food.
- Refrain from adding salt while cooking rice and noodles
- Limit foods heavy in coconut milk or cream curry sauce
Whether you’re eating Chinese, Indian or Thai, keep it healthy with the following tips:
When eating Chinese
- Avoid adding soy sauce and other sauces to your dish
- Choose steamed or stir-fried vegetables with tofu or fish
- Choose whole wheat or buckwheat noodles
- Choose dishes that are simmered, steamed or stir-fried
- Choose steamed brown rice instead of white rice
- Limit fried items such as egg rolls, sweet and sour dishes, cured meats and salted fish
- Know that wonton or hot and sour soup are typically high in sodium
- Good options include buckwheat noodles or brown rice with vegetables like bak choy, mushroom or kai lan, chicken or lean meats, seafood and tofu
When eating Indian
- Choose small portions of roasted lean meat, poultry or fish over rich curries with cream or coconut milk
- Limit savoury snacks like sev, papads, pani puri. Instead choose bhel with green chutney.
- Some of the healthier options are dal, rasam, lentil soup, mulligatawny soup (without cream), dosas, idlis
- North Indian items like chole, paneer, tikkas, tandoori chicken or fish, stuffed parathas, biryani can be made healthier by reducing the fat content.
- Don’t add salt to atta when making rotis
- Raita - yoghurt with cucumber, onion and spices is a great accompaniment.
- Limit papad, pickles, coconut chutneys
When eating Thai
- Limit fried items such as spring rolls or crispy noodles
- Ask that coconut milk dishes be made with half the usual amount
- Seek out entrees with more vegetables and small amounts of meat
- Choose fresh salad rolls with a little peanut sauce, Thai salads, bean thread noodles with chicken, fish, lean meat, or tofu and vegetables
For more information on DASH diet, visit http://dashdiet.org
