Those with hypertension are recommended to make eating fruits and veggies a foundational part of their treatment. A 5-year interventional randomized controlled trial published in The American Journal of Medicine has found that a diet rich in fruits and vegetables has been found to help lower blood pressure, reduce cardiovascular risk, and improve kidney health due to their base-producing effects.
Hypertension can have adverse outcomes, and despite efforts to improve treatment, hypertension-related chronic kidney disease and its cardiovascular mortality rates are increasing. In fact, heart disease is the number one reason that those with chronic kidney disease die.
Food as medicine
The Dietary Approaches to Stop Hypertension (DASH) Diet is rich in both fruits and vegetables and it is the first-line treatment diet recommended for primary hypertension. Despite the design of this meal plan, it is under-prescribed, and when it is prescribed it is not adhered to very well despite the growing body of supportive epidemiological data. The DASH Diet and others such as the Mediterranean Diet that are rich in fruits and veggies are associated with lower blood pressure, lower risk for and progression of chronic kidney disease, lower cardiovascular disease (CVD) risk, and lower CVD mortality.
“As a nephrologist (kidney doctor), my acid-base laboratory studies ways by which the kidney removes acid from the blood and puts it into the urine. Our animal studies showed years ago that mechanisms used by kidneys to remove acid from the blood can cause kidney injury if the animals were chronically (long term) exposed to an acid-producing diet. Our patient studies showed similar findings: that is, an acid-producing diet (one high in animal products) was kidney-harmful, and one that is base-producing (one high in fruits and vegetables) is kidney-healthy. Other investigators showed that a diet high in fruits and vegetables is heart-healthy. We hypothesized that one way that fruits and vegetables are both kidney- and heart-healthy is that they reduce the amount of acid in the diet and therefore the amount of acid that kidneys have to remove from the body,” said lead investigator of the study Donald E. Wesson, MD, MBA, Department of Internal Medicine, Dell Medical School — The University of Texas at Austin.
Testing the hypothesis
To test their hypothesis, 153 participants with hypertension were divided into three groups: Participants adding 2-4 cups of base-producing fruits and vegetables in addition to their usual daily food intake; participants prescribed NaHCO3 (acid-reducing sodium bicarbonate, which is common baking soda) tablets in two daily doses of 4-5 650 mg tablets, and study participants receiving standard medical care from primary care clinicians as controls. Results show that both fruits and vegetables and NaHCO3 improved kidney health, but only fruits and vegetables, and not NaHCO3, reduced blood pressure and improved indices of CVD risk.
“Importantly, fruits and vegetables achieved the latter two benefits with lower doses of medication used to lower blood pressure and reduce cardiovascular disease risk. This means that one can get the kidney health benefits with either fruits and vegetables or NaHCO3, but we get the blood pressure reduction and reduced cardiovascular disease risk with fruits and vegetables, but not with NaHCO3. This supports our recommendation that fruits and vegetables should be ‘foundational’ treatment for patients with hypertension, because we accomplish all three goals (kidney health, lower blood pressure, and reduced cardiovascular disease risk) with fruits and vegetables, and we can do so with lower medication doses,” said co-investigator Maninder Kahlon, PhD, Department of Population Health, Dell Medical School — The University of Texas at Austin.
Dietary intervention
“Dietary interventions for chronic disease management are often not recommended and even less often executed because of the many challenges to get patients to implement them. Nevertheless, they are effective, and in this instance, kidney and cardiovascular protective. We must increase our efforts to incorporate them into patient management and more broadly, make healthy diets more accessible to populations at increased risk for kidney and cardiovascular disease,” concluded Wessen.
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References/Sources/Materials provided by:
http://dx.doi.org/10.1016/j.amjmed.2024.06.006
https://worldhealth.net/news/vicious-twins-hypertension-and-obesity-america/
https://worldhealth.net/news/more-evidence-dash-diet-good-heart-health/
https://worldhealth.net/news/best-overall-diets-2024-report/
