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The question

I have high-normal blood pressure. Are there certain foods that can lower it? I want to avoid taking medication.

The answer

Making changes to your diet – and losing excess weight if needed – can help you get your blood pressure under control. And it's important that you do.

It's estimated that 60 per cent of people with prehypertension (high-normal blood pressure) will develop hypertension within four years if lifestyle changes aren't made to lower blood pressure.

Blood pressure is determined using a sphygmomanometer, an instrument that measures the force of the blood against the blood vessel walls.

It is expressed in two numbers: Systolic pressure, the upper number, is the pressure when the heart contracts; diastolic pressure, the lower number, is the pressure when the heart is relaxed.

A blood pressure of 130-139/85-89 millimetres of mercury (mm Hg) is considered prehypertension. Healthy adults should have a blood pressure in the range of 120/80 mm Hg, although that target varies with age and other health conditions.

Blood pressure for people with diabetes should be less than 130/80.

The diet I recommend to treat high blood pressure is called the DASH diet (DASH stands for Dietary Approaches to Stop Hypertension). The diet emphasizes fruit, vegetables, whole grains and low-fat dairy products, food choices high in fibre, calcium, magnesium and potassium – nutrients linked with lower blood pressure. It's also low in refined carbohydrates and saturated fats, which can cause salt retention and elevate blood pressure.

To adopt a DASH-style diet, aim to eat four to five vegetable servings (half cup cooked/raw, one cup salad greens), four fruit servings (one medium fruit, half cup chopped fruit) and two to three low-fat dairy servings (one cup skim milk, three-quarters of a cup of yogurt – 0 to 1 per cent milk fat) each day. To boost your magnesium intake, include nuts and legumes in your diet at least four times a week.

You'll find the various calorie levels of the DASH diet on the Internet. If you need to lose weight, choose a calorie level of 1,600 (for women) or 2,000 (for men). If you're very active, you may need to eat more. Losing as little as 10 per cent of your body weight can help prevent you from developing hypertension.

Increase your intake of potassium, a mineral that helps blood vessels relax. It also causes the kidneys to excrete more sodium, preventing blood pressure from rising. Potassium-rich foods include bananas, apricots, prune juice, cantaloupe, honeydew, spinach, Swiss chard, baked potatoes, lentils, black beans and kidney beans.

If you like celery, add a few stalks to your daily diet. Eat it raw as a snack or juice it. Research suggests its combination of nutrients and phytochemicals helps lower blood pressure.

It's also important to keep your daily sodium intake to less than 2,300 milligrams. (Adults need only 1,200 to 1,500 milligrams each day.) Read nutrition labels to choose foods lower in sodium. Foods with a daily value (DV) of 5 per cent or less are low in sodium; foods with a DV of 15 per cent or greater are higher in sodium. Prepare and eat more unprocessed, homemade foods. Many restaurant and take-out meals are laden with sodium.

Finally, limit alcohol. If you drink, limit yourself to one to two drinks per day to a weekly maximum of nine for women and 14 for men. Drinking more than two drinks per day boosts blood pressure and increases the long term risk of developing hypertension.

Send dietitian Leslie Beck your questions at dietitian@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail website. Your name will not be published if your question is chosen.

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