B G I S ARIYARATHNE

1. Therapeutic Diet
For
Hypertensive Disorders

2. DASH diet
Dietary Approaches to Stop Hypertension
• Is a heart healthy diet that proven to lower,
high blood pressure naturally.
• Helps to cut back on salt and sugar, while
maintaining a balanced and healthy diet.
(Dietary guideline and nutrition therapy for special diseases)

3. Grains 6-8 servings/day
Fresh fruits & Vegetable
4-5 servings each/day
Lean protein
6 or less servings/day
Legumes or nuts
4-5 servings/ week
Fats and sweet
limited
Low fat dairy
2-3 servings/day

4. Cereals – 6-8 servings/day
• Average requirement of calories from cereal is 1200 – 1500
per day. (depending upon age, sex, activity level and other
related diseases)
• Consuming whole grains in recommended
• Three meals (with 2 snacks if necessary) can be taken for a
day
• Eg: Rice, Wheat, Kurakkan, Corn

5. Fruits and vegetables - 4 - 5 servings/day
favors control of hypertension
high content of fiber
low in fat
low calorie content
rich sources of antioxidants
rich in potassium
Recommendations
4 – 5 servings (400g) /day
Choose a variety

6. Fruits
Banana
Orange
Grapefruit
Avocado
Vegetables
Tomato
Spinach
Beetroot

7. Protein – 6 or less servings/day
• Vegetarian proteins
high content of fiber & no cholesterol or saturated fats
Eg; pulses and legumes –
Soy ,Chick pea, green gram,
cowpea, ulundu, dhal…

8. Protein ctd……..
• Fish
contains healthy fats , omega 3 fatty acids
Eg: Sea fish, Shell fish, Sardines,
Salmon,
•Lean meats
Eg: Skinless chicken
& turkey,
Red meat(fat trimmed off)

9. Protein cnt….
 Dairy products
low-fat or non-fat milk & milk products
Eg: Milk, Curd, Yoghurt,

10. Fats
• Limiting daily fat intake up to 20% of calorie
consumption,
• Dietary fat should be consumed through
polyunsaturated & mono unsaturated fatty acids
( e.g. fish, cashew & peanuts, avocado and unsaturated
oils (soybean oil, olive oil )
Saturated fat - no more than 7 % of daily calories,
(16g ~ 1 tbsp)
Eg: Butter, cheese, palm oil, coconut oil..
• Avoid sources of trans fat completely.

11. Blood Pressure Lowering Action of
Nitric Oxide

12. Action of Nitric Oxide
 Dilate blood vessels
 Increase blood flow
 Decrease plaque formation
Best foods to boost nitric oxide
Eg; beet root,
garlic,
leafy greens,
citrus fruits, pomegranate,
nuts and seeds

13. Nitric Oxide - research evidences
The nitrates in beetroot juice lowered blood pressure within
24 hours.
 One study concluded that drinking a cup of pomegranate
juice once a day for 4 weeks helps lower BP over the short
term.
 Both human & animal studies indicate garlics’ ability to
increase nitric oxide levels may have effect an lowering blood
pressure.

14. • One study showed spinach increased salivary
nitrate level eightfold and decreased systolic
blood pressure.
• Nuts & seeds are high in arginine (amino acid)
one study in 2771 people showed higher intake
of arginine rich foods increase nitric oxide in
blood.

15. Watermelon is one of best sources of citrulline that convert
to arginine and ultimately nitric oxide in the body.
A study in eight men showed drinking 300ml watermelon
juice for 2 weeks increase nitric oxide in blood.
 17 studies found DASH diet reduced blood pressure on
average by 6.74 mmHg for systolic blood pressure and 3.54
mmHg for diastolic blood pressure.

16. Sodium (Na)
Sodium is the substance that may cause one’s blood
pressure to increase.
Sources of sodium present
Salt (NaCl)
Monosodium glutamate (MSG)

17. Accepted salt intake
• Normal person - 5 g (< 1 tsp) / day (2300 mg
sodium)
• Hypertensive - 2/3 tsp /day (1500 mg sodium)
• Reducing Na intake <2000mg/day is more beneficial
for blood pressure than reducing Na intake
>2000mg/day.
(WHO guideline,sodium intake for adult), (FBDG)

18. • Limit salt consumption when food preparation.
• Encouraged to purchase low salt / sodium free /
unsalted products instead of salty foods (Avoid
processed food)
• Use of various condiments / herbs & spices (e.g.
cinnamon, curry leaves, ginger, etc.) instead of too
much salt for improving taste.
• Eat natural fruit & vegetables
Dietary Modifications in salt consumption

19. Potassium (K)
• Blood pressure inversely relates with potassium
intake.
• Potassium has vasodilation effect.
• Recommended daily Potassium
intake >3510 mg (For adult)
• Taking vegetables & fruit rich with K
is beneficial in lowering blood
pressure.
(WHO guideline,potasium intake for adult)
(Dietary Approach to Stop Hypertension)

20. Food item Potassium in 100g
(Average amount)
Beans & peas 1300mg
Vegetables –
spinach, cabbagee,parsley
550mg
Nut 600mg
Fruits –
Banana, Orange, Papaya,
Pomegranate
300mg
Potassium rich foods

21. Meal Item Servings Energy(cal) Na(mg) K(mg)
Breakfast Chick pie
Coconut-(scraped)
Banana
1 1/4 cup
2 table spoons
(tbs)
2
445
70
210
24
81
-
1075
103
844
Morning
snack
Papaya 1 slice 60 4.2 360
Lunch Red rice
Fish curry
Spinach salad
Beans
Beetroot
Grapes
1 1/2 cup
30 g
1 cup
3 tbs
3 tbs
15
510
50
07
40
12
12
2
23.5
23.7
0.5
16
0.3
254
261
167
90
81
28.6
Sample diet plan for Hypertensive patient - Adult

22. Meal Item Servings Energy
(cal)
Na
(mg)
K
(mg)
Evening
snack
Fat free milk 1 glass 122 110.9 419
Dinner String hoppers
Dhal curry
Egg – Boiled
Orange
15
5 tbs
1
1
490
50
155
47
4.66
12.2
93.8
-
0.16
99.3
69
490
(Add during
cooking)
Salt 1/2tsp - 1100
Total 2280 1496.76 4340

23. Summary
Increase Fruits &
Vegetable
Fiber,
Potasium,
Calcium
Reduce
Salt
intake
Total fat
Avoid Alcohol
Saturated
&
Trance fat