the Impact of Diet on Hypertension and Heart Health

The relationship between diet and cardiovascular health, particularly hypertension?

Hello, Dietitian Tsai.
I often have doubts and questions regarding health reports about diet that I see in newspapers, magazines, online, and on television.
I would like to consult you through this online platform and hope to receive some answers.
I am nearly seventy years old, with a height of 170 cm and a weight of 74 kg.
I have symptoms of hypertension, usually ranging from 130 to 150.
Last month, I had my blood tests done: fasting blood glucose was 112 mg/dL, postprandial blood glucose was 137 mg/dL, and glycated hemoglobin (HbA1c) was 6.3% (for your reference).
My doctor advised me to eat half a bowl of rice, stating that white rice contains sugar and should not be consumed in large amounts.
He suggested eating smaller, more frequent meals.
I usually eat about 1.5 bowls of rice, based on feeling full.
Is this too much? I often feel hungry again about two hours after eating.
For breakfast, I typically have toast with butter, sometimes mixed with peanut butter and a slice of strawberry (I occasionally substitute with other spreads).
I am particularly concerned that my toast with butter might be a potential "silent killer" causing cardiovascular blockage.
Additionally, I drink a cup of coffee with milk daily (one teaspoon of coffee mixed with milk powder, filling a mug about 80-90% full) and add a small amount of sugar.
My wife says this is too much and could lead to diabetes.
I do not smoke, drink alcohol, or overeat, and I pay attention to cleanliness and good food.
Could my current dietary habits lead to diabetes? I am quite selective with food, often being perceived as someone who prefers overly salty or sweet flavors, but I simply focus on achieving the right balance of taste.
I have provided this information for your reference.
When you have time, please help clarify my concerns and provide guidance.
I would greatly appreciate it.
Thank you in advance!

Suo Sang, 60~69 year old female. Ask Date: 2013/02/13

Dr. Cai Xiuwen reply Nutrition

Hello! Based on your height and weight, your Body Mass Index (BMI) is 25.6 (the standard range is 18.5-24).
Your ideal weight is 63.6 kg, indicating that you are slightly overweight.
It is recommended that your systolic blood pressure be maintained between 110-120 mmHg.
Your fasting blood glucose level is 112 mg/dL and your postprandial blood glucose level is 137 mg/dL (the standard fasting range is 80-100 mg/dL), indicating that your blood sugar is somewhat elevated, but it has not yet reached the diagnostic criteria for diabetes.
Currently, the causes of diabetes are still under research.
It is generally understood to result from a combination of genetic and environmental factors.
For individuals with a family history of diabetes, it is important to reduce the following risk factors: obesity, hyperlipidemia or hypertension, prolonged lack of exercise, smoking, excessive alcohol consumption, and mental stress, all of which can increase the risk of developing diabetes.
The majority of diabetes cases are attributed to genetic predisposition and obesity, which can lead to slower metabolism and gradually elevated blood sugar levels.

Generally speaking, as people age, blood sugar, blood lipids, and blood pressure may slightly increase, but it is crucial to monitor whether these levels exceed the standard values.
Maintaining these levels within the normal range can help reduce the risk of chronic diseases.
If your blood sugar and blood lipids are normal and you maintain adequate physical activity, enjoying some treats in moderation is acceptable.
A positive mental outlook is also an important part of maintaining health; however, it is essential to be mindful of the frequency and quantity of indulgent foods.
If levels are elevated, it is advisable to limit such treats to once every one to two weeks and to consume plenty of fresh fruits and vegetables.
Based on your current height and weight, it is recommended that you consume approximately 1900 calories per day.
A serving of 1.5 bowls of staple food per meal is appropriate.
However, it seems that your breakfast may lack sufficient vegetables and fruits; it is suggested that you increase your intake of leafy greens or cucumbers.
Coffee with milk or milk powder is good, but it is recommended to use skim milk powder instead of creamers.
If you feel hungry after meals, consider replacing snacks with fruits.
Butter contains saturated fatty acids, and excessive consumption may affect cholesterol levels, so long-term intake is not recommended.
Increasing physical activity can also help improve blood circulation and enhance vascular elasticity.
Overall, your dietary habits are good, but strengthening certain aspects of your diet and exercise routine could be beneficial.
Wishing you good health! This information is provided by Dietitian Tsai Hsiu-Wen from Nantou Hospital, Department of Health.

Reply Date: 2013/02/13

More Info

Hello! Thank you for your detailed inquiry regarding diet and its impact on hypertension and heart health. Given your age, height, weight, and the health concerns you've mentioned, it's important to address your dietary habits and how they relate to your blood pressure and overall cardiovascular health.

Firstly, managing hypertension often involves dietary modifications, particularly focusing on the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes the consumption of fruits, vegetables, whole grains, and lean proteins while reducing sodium intake. Your blood pressure readings of 130-150 indicate that you are in the prehypertensive to stage 1 hypertensive range, which means dietary changes can significantly benefit your health.

Regarding your carbohydrate intake, particularly from white rice, it's essential to monitor portion sizes. The recommendation to consume half a bowl of rice is based on the need to manage blood sugar levels, especially since you have elevated blood sugar readings. Consuming 1.5 bowls of rice may be excessive, particularly if you find yourself hungry shortly after eating. It might be beneficial to replace some of that rice with non-starchy vegetables, which can provide volume and nutrients without the same impact on blood sugar.

Your breakfast choices, such as toast with butter or peanut butter, can also be reconsidered. While peanut butter can be a good source of protein and healthy fats, it's important to choose natural varieties without added sugars or hydrogenated oils. The butter, on the other hand, is high in saturated fats, which can contribute to cardiovascular issues if consumed in excess. Opting for whole grain toast and using avocado or a small amount of olive oil instead could be healthier alternatives.

As for your coffee with milk and sugar, moderation is key. While a small amount of sugar may not significantly impact your blood sugar levels, it’s wise to limit added sugars in your diet. Consider reducing the sugar gradually to see if you can adjust to less sweetness over time. Additionally, using low-fat or non-fat milk can help reduce calorie and saturated fat intake.

It's also important to consider the overall balance of your diet. Since you mentioned being selective about your food and sometimes preferring salty or sweet flavors, it might be beneficial to explore herbs and spices as alternatives to enhance flavor without adding salt or sugar. This can help in managing both blood pressure and blood sugar levels.

Lastly, regular physical activity is crucial for managing hypertension and improving heart health. Aim for at least 150 minutes of moderate-intensity aerobic exercise each week, such as brisk walking, swimming, or cycling. This can help lower blood pressure, improve heart function, and enhance overall well-being.

In summary, focusing on a balanced diet rich in whole foods, monitoring portion sizes, and reducing sodium and added sugars can significantly impact your hypertension and heart health. It may also be beneficial to consult with a registered dietitian who can provide personalized guidance based on your specific health needs and preferences. Remember, managing hypertension is a lifelong commitment, and small, consistent changes can lead to significant improvements in your health over time. Thank you for reaching out, and I wish you the best on your journey to better health!

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