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Dietary Management
For management of hypertension one should follow the following principles:
  • Attain ideal body weight
  • Modify diet to make it low in fat with ample fruits and vegetables
  • Reduce sodium intake
  • Limit alcohol and cessation of smoking
  • Increase physical activity
Nutritional Guidelines

Energy
  • An obese patient must be reduced to normal body weight with low calorie.
  • About 20 Kcal/Kg of ideal body weight for sedentary and 25 kcal/kg weight for moderately active worker.
Fiber
Protein

60 g of protein should be taken to maintain adequate nutrition.

Fats
  • As hypertensives are prone to arthrosclerosis it is advisable to avoid high intake of animal or saturated fat.
  • A low fat diet is advised.
Potassium (K)
  •  Potassium’s role is  the result of a complex interplay with sodium, calcium and magnesium.
  •  Low levels of K cause the body to retain sodium and water and elevate BP.
  •  3500 mg of potassium is required daily thus fruit and vegetables need to be taken liberally.
Sodium
  • The easiest way to prevent hypertension is to lower the sodium intake as a precautionary measure itself.
  • Lower the sodium intake greater would be the lowering of pressure.
  • Thus the goal of a normotensive should be to reduce sodium intake to 2400 – 1800 mg that is equivalent to 6000 mg of table salt.
  • This would result in a modest weight loss among the overweight and obese subjects as excess sodium intake causes fluid retention and also keep hypertension at bay.
Tips to keep Sodium intake in check
  • Do not use table salt. Only use limited salt while cooking.
  • Do not use ajinomoto (mono sodium glutamate. Avoid eating Chinese food outside.
  • Restrict bakery products like breads, biscuits, cakes pastries as they use baking powder (sodium bicarbonate, sodium benzoate)
  • Avoid highly salted foods such as potato chips
  • Avoid salt preserved foods like pickles, canned foods
  • Avoid spiced foods such as ketchup and sauce
  • Avoid cheese, salted butter, peanut butter
  • Avoid the use of frozen foods as salt has been added while processing them like frozen peas etc.
  • Avoid use of prepared mixes and convenience foods
  • Avoid chutneys, papad, salty mouth fresheners
  • Do not add salt while boiling vegetables, dals, rice etc
  • Do not add salt to the flour while making chapattis, phulkas or parathas
  • Restrict dairy intake as it is rich in sodium
Sodium Content of some commonly consumed foods
Low Sodium Medium Sodium High Sodium
<25 mg 25-50 mg 50-100 mg >100 mg
Amla, bitter gourd, bottle gourd, brinjal, cabbage, colocasia, cow pea, cucumber, beans, French beans, grapes, guava, honey, horse gram, ladies finger, maida, milk buffalo, oil, onion, papaya, peas, plantain potato, pumpkin, ragi, sapota, semolina, Sugar, sweet potato, tomato ripe, vermicelli, wheat, yam Apple, banana, Bengal gram (whole), black gram dal, broad beans, caroots, cream, green gram dal, lentil whole, mango green, mango ripe, mutton, pineapple, raddish white, raisins, red gram dal, tomato green Watermelon, beetroot, beef, Bengal gram dal, cauliflower, chicken, coriander leaves, fenugreek, field bean, lettuce, liver, prawn, red gram (tender) Amaranth, bacon, egg, knolkhol, lobster, spinach

Salt and Sodium Conversions
Milligrams of Sodium × 2.5 = Milligrams of salt
Milligrams of salt × 0.40 = Milligrams of Sodium
Milligrams of Sodium = Milliequivalents of Sodium
23 (atomic wt of Na)
Milliequivalents of Sodium × 23 = Milligrams of Sodium
Milliequivalents of Sodium × 58.5 = Milligrams of table salt  (NaCl)

DASH Diet
(Dietary Approaches to stop Hypertension)

  • High amounts of Fruits and Vegetables
  • Inclusion of fish
  • Inclusion of low fat milk
  • Reduction in fat intake
  • Reducing sodium intake
 
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