Putting Research Connecting BMI & Dementia in Its Proper Context

Being Too Fat or Too Thin in Midlife Raises the Risk for Alzheimer's

Evelyn Smith

M. S. in Library Science, University of North Texas (2012)

An article published today in the English tabloid, the Daily Mail, has set me on a quest to verify if its claims are true--that individuals with a low Body Mass Index are more likely to develop Alzheimer's and other types of dementia than those who are overweight. Since no article on Alzheimer's, or any other medical issue, should exist, in isolation, I have surveyed both popular articles found Online as well as abstracts of peer-reviewed research. From what I have been able to determine, both those who are obese and the exceptionally slim in middle age stand a better chance of being diagnosed with Mild Cognitive Impairment and eventually developing Alzheimer's Disease primarily because obesity is also responsible for chronic diseases like Type 2 diabetes and cardiovascular disease that make it all the more likely that a middle-aged man or woman will be diagnosed with late-stage Alzheimer's later in life.

Thus, no one is exempt from trying to maintain a Mediterranean-style diet and getting off the couch for at least thirty minutes of aerobic exercise five days a week. As for maintaining a normal BMI index between 21 and 25, that means that American women need to start dieting when they can no longer fit into a Misses size 14.  For a 5 foot 6 inch woman, that means losing seven pounds. Then again, the truly thin put a similar strain on their bodies. Accordingly, after reading this response to the Daily Mail article, most readers will want to throw away any junk food in the house and instead of watching TV or surfing the Web decide to take the dog for a long walk.

Hope, Jenny. (2015 April 10). Could being skinny in middle age raise your risk of dementia? Underweight people third more like to develop diseases. Daily Mail. Retrieved from http://www.dailymail.co.uk/news/article-3032915/Could-skinny-middle-age-raise-risk-dementia-Underweight-people-likely-develop-diseases.html

A study recently published in The Lancet Diabetes and Endocrinology Journal contradicts earlier research linking a high Body Mass Index, 25 BMI and over, with Alzheimer's, for it finds that being underweight in middle age raises the risk of dementia by 30 percent (Hope, 2015, April 10, para. 1-5 & 16). Accordingly, general practitioners may need to rethink how to best identify those patients that are most at risk, paying particular attention to the causes and consequences of this link, according to research Stuart Pocock (Hope, 2015, April10, para. 5-6).

To establish a correlation between BMI and Alzheimer's, London researchers examined two decades worth of data on 958,191 patients with the average BMI of 26.5 and the average age of 55. After a nine-year followup, physicians diagnosed patients with dementia (Hope, 2015, April 10, para. 9-12).

Patients with a BMI of less than 20 percent were 34 percent more likely to develop dementia than those of normal weight with a BMI between 21 and 24.99 (Hope, 2015, April 10, para. 12-13). Moreover the truly obese with a BMI of 40 or greater were the least likely to develop Alzheimer's (Hope, 2015, April 10, para. 14).

Then again, physicians treating “grossly obese” patients may have paid more attention to their obvious health risks—like diabetes and cardiovascular disease—than those whose patients were severely underweight. Thus, the Lancet study may reveal more about the diagnostic practices of British GP's than it does about the possibility of developing Alzheimer's (Hope, 2015, April 10, para. 16-18). Previous research has linked obesity with an increased risk of dementia, so the best game plan for preventing Alzheimer's—along with chronic diseases influenced by lifestyle—remains exercising regularly and maintaining a healthy, [low-fat, Mediterranean-style] diet (Hope, 2015, April 10, para. 19 & 22).

See also:

Normal weight ranges: Body mass index (BMI). (2015). American Cancer Society. Retrieved from http://www.cancer.org/cancer/cancercauses/dietandphysicalactivity/bodyweightandcancerrisk/body-weight-and-cancer-risk-adult-bmi

US standard clothing size. (2015). Wikipedia. Retrieved from http://en.wikipedia.org/wiki/US_standard_clothing_size

Where does your BMI fall?

Popular articles that relate both being underweight and overweight with an increased risk of dementia nicely balanced out The Daily Mail article.

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Annotated Popular Articles Connecting BMI with Dementia Risk

Conis, Elena. (2008, June 9). If you're too heavy or too thin, dementia risks may rise. Weight Loss: A How-to Guide/ Explain This. Los Angeles Times. Retrieved from http://articles.latimes.com/2008/jun/09/health/he-explain

Being obese as well as being too thin can increase the risk of dementia, according to a study conducted by Yauta Wang and fellow researchers at Johns Hopkins University and the University of Iowa and published in Obesity Reviews: Thus, if body weight is plotted on a U-shaped graph, having a BMI of 30 or higher increases the risk of dementia by 40 percent as does having a BMI of less than 18.5. Additionally, middle-aged obesity alone eventually increases the risk of dementia in the very elderly by 80 percent (Conis, 2008, June 9, para. 1-4).

To determine these findings, Wang and colleagues took another look at longitudinal studies published before 1995 that investigated the link between dementia and body weight in adults aged 40 and over and came up with 10 relevant studies—all of which “produced a mixed bag of results”, However, their analysis concluded that controlling for obesity could reduce Alzheimer's by 20 percent (Conis, 2008, June 9, para. 5-7). Nevertheless, Wang doesn't want anyone “to over interpret the findings”, although a review of decade long studies evaluating adults before they turn 60 does show a strong connection between obesity and dementia (Conis, 2008, June 9, para. 8-9). Wang, however, admitted that researchers as yet don't know how obesity affects cognitive decline, although it might simply indicate other risk factors for dementia like a lack of physical activity and depression (Conis, 2008, June 9, para. 10).

Dybuncio, Monica. (2011, November 22). Is being thin a warning sign of Alzheimer's? CBS News. Retrieved from http://www.cbsnews.com/news/is-being-thin-a-warning-sign-of-alzheimers/

Researchers from the University of Kansas School of Medicine published in the November 22, 2011 issue of Neurology document that biological markers for Alzheimer's are more common in thin patients than their heavier counterparts (Dybuncio, 2011, November 22, para. 2).

After examining 506 healthy patients using brain imaging and cerebrospinal fluid tests, researchers found that 85 percent of those who had a BMI below 25 showed signs of brain plaque, compared with 48 percent of those who were overweight (Dybuncio, 2011, November 22, para. 3).

Dr. Jeffrey Burns, the associate director of the University of Kansas Alzheimer's Disease Center, speculates that “this might be due to damage in the area of the brain called the hypothalamus that plays a role in regulating energy metabolism and intake”, although Dr. Burns also suggested that more studies are needed to confirm the hypothesis that thinness might indicate an eventual diagnosis of Alzheimer's (Dybuncio, 2011, November 22 para. 4).

The Kansas study also emphasizes that while biomarkers for Alzheimer's can be found by brain scans, the early signs of Alzheimer's may manifest themselves in other parts of the body as well since the brain regulates hunger, fullness, and blood flow (Dybuncio, 2011, November 22, para. 5).

Kounang, Nadia. (2012, January 2). Study:: Fat hormone increases risk of dementia in women. The Chart. CNN. Retrieved from http://thechart.blogs.cnn.com/2012/01/02/study-fat-hormone-increases-risk-of-dementia-in-women/

The increased production of the adiponectin hormone, particularly in women, which produces excess weight around the waist may pose a risk factor for Alzheimer's and other types of dementia (Kounang, 2012, January 2, para. 1-2).   While fat cells that help regulate the body's response to insulin produce adiponectin to lower the risk of Type 2 diabetes, older women diagnosed with dementia also have higher levels of this hormone. In other words, while researchers expected adiponectin to protect older women from dementia, it had the opposite effect (Kounang, 2012, January 2, para. 4-5).

In this longitudinal study, researchers followed 841 volunteers who had originally enrolled in the Framingham Heart study that begin track over 5,000 participants so that researchers could learn the factors that led to heart disease starting in 1948. Beginning in the 1980s, they observed 541 women over the next 13 years, 159 of whom developed some form of dementia. A statistical analysis of their findings showed that increased levels of adiponectin increased the risk of dementia by 60 percent and for Alzheimer's by 90 percent (Kounang, 2012, January 2, para. 6-7).

The study also suggested that a link between nutrition and dementia since adiponectin levels inversely correlate with BMI: Conversely, older women (over age 75) with higher BMIs had lower levels of adiponectin and lower rates of dementia. Unfortunately, not enough male survivors were available to participate in this follow-up to the orginal Framingham Heart Study to determine if the same correlation held true for older men (Kounang, 2012, January 2, para. 8-9).  Even so, for women over 60—and most probably for all adults over and under 60 as well—being too thin along with being too fat “may not be a good thing” for either the mind or body (Kounang, 2012, January 2, para. 10).

Nordqvist, Christian. (2011, November 22). Alzheimer'--Is being thin an early sign? MNT [Medical News Today]. Retrieved from http://www.medicalnewstoday.com/articles/238042.php

During the earliest stages of Alzheimer's (years before the individual even develops Mild Cognitive Impairment), individuals are more likely to be thin rather than obese while overweight, middle-aged adults stand a higher chance of developing Alzheimer's later in life, according to a University of Kansas Alzheimer's Center Study that has established a link between Body Mass Index (BMI) and Alzheimer's (Nordqvist, 2011, November 22, para. 1).

Using biomarkers that detect Alzheimer's symptoms years before the disease otherwise starts to show itself, Jeffery M. Burns and his colleagues performed brain imaging techniques on and obtained cerebrospinal fluid from 506 participants enrolled in the Alzheimer's Disease Neuroimaging Initiative—a population that included those with no memory problems as well as individuals diagnosed with Mild Cognitive Impairment and Alzheimer's (Nordqvist, 2011, November 22 para. 2-4). Participants diagnosed with Alzheimer's had a lower BMI than those without the biomarkers. Additionally, 85 percent of the study participants diagnosed with MCI had a BMI below 25 compared with the 48 percent of those MCI diagnosed individuals who were overweight (Nordquvist, 2011, November 22, para. 5-6).

Body weight and dementia risk—the evidence. (2014). Your Brain Matters. Retrieved from http://yourbrainmatters.org.au/body-weight-and-dementia-risk-%E2%80%93-evidence

Clinical evidence associates central obesity (or an apple-shaped body) with an increased risk of developing dementia. Furthermore, researchers have yet to determine whether midlife weight loss lessens the risk (Body weight, 2014, para. 1). In early old age, from 65 to 75, however, a U-shaped relationship exists between BMI and dementia risk, for both those over and underweight are more at risk. However, research has linked a lower BMI and weight loss with dementia in older adults over age 75. Moreover, weight loss may predate the onset of dementia by more than 10 years (Body weight, 2014, para. 2-3).

A review of the findings on the relationship between BMI and dementia throughout the lifespan is as follows:

• Central adiposity in middle age predicts dementia in old age;
  

• The relation between high adiposity and dementia decreases with older age;

• Waist circumference--a measure of central adiposity--may better predict dementia than a high BMI does;

• Lower BMIs in midlife predict dementia in the elderly (over age 75);

• Weight loss may precede dementia diagnosis by decades.
  

(Luchsinger, J. A., 2009, p. p. 25-21)

Considering these findings, maintaining a healthy weight--neither too fat or too thin--is the best strategy for all adults to follow for “optimizing” brain health since not being overweight lowers blood pressure as well as improving blood lipids levels and insulin resistance (Body weight, 2014, para. 5). The reason: Insulin resistance and hyperinsulemia associated with obesity may reduce the clearance of beta amyloid plaque from the brain while medical research has long linked obesity with an increased risk for cardiovascular disease, which, in turn, raises the risk of developing dementia (Body weight, 2014, para. 6).

Reference:

Luchsinger, J. A. and Gustafson, R. D. (2009, January). Adiposity and Alzheimer's Disease. Current Opinion in Clinical Nutrition and Metablic Care, 1, 15-21. doi: 10.1097.MMC06013e32831c8c71. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19057182

Online articles intended for a general audience, in turn, point the way to peer-reviewed articles published in medical journal that furnish a scientific foundation for attention-getting articles.

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Peer-Reviewed Studies Correlating BMI with Dementia Risk

Apple-shaped bodies indicate a high BMI.

Anstey, K. J., Cherbuin, M., and Budge, M., et al. (2011, May). Body mass Index in midlife and late-life as a risk-factor for dementia: A meta-analysis of prospective studies. Obesity Review, 12(5). doi: 10.1111/j.1467-789X.2010.00825.x. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21348917

A meta-analysis of 16 articles reporting on 15 prospective studies whose follow-ups ranged from 3.2 to 36 years, sampling 25,624 participants found that those who were obese in midlife were more likely to be diagnosed with dementia; however, a continuous BMI in late life didn't necessarily equate with dementia. Researchers concluded that either being underweight or overweight in midlife increased the risk of developing dementia.

Berti, V., Murray, J., and Spector, N., et al. (2015). Nutrient patterns and brain biomarkers of Alzheimer's disease in cognitively healthy individuals. The Journal of Nutrition Health and Aging, 19 (4), 413-23. doi: 10.1007/s1260-014-0534-0. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25809805

In a cross-sectional study, researchers followed 52 cognitively normal individuals, assessing their dietary intake of 35 nutrients associated with cognitive function and Alzheimer's. The study linked specific dietary nutrient patients with biomarkers of Alzheimer's in currently cognitively healthy individuals, thus indicating that dietary interventions may reduce Alzheimer's risk.

Chen, Y. C., Chen, T. F., and Yip, P. K. (2010, February). Body Mass Index (BMI) at an early age and the risk of dementia. Archives of Gerontology and Geriatrics, Suppl 1:S48-52. doi: 10.1016/S0167-4943(10)70013-3. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20171457

In a case-controlled study of 286 dementia patients and 268 cognitively-healthy controls between 2007 and 2009 that collected BMI information from questionnaires and previous medical records, men and women who had too low a BMI in their 20s and 40s had a significantly increased risk for Alzheimer's and vascular dementia compared with those with a normal BMI while women with a high BMI during their 20s and 40s increased their risk for vascular dementia. However, since the risk of dementia followed a U-shaped curve, those individuals with the lowest BMI's from their 20s through their 40s were more likely to develop Alzheimer's and vascular dementia.

Chu, Leungwing. (2012, July). Low BMI predicts incident Alzheimer's Disease in older adults with amnestic Mild Cognitive Impairment: A three-year perspective cohort study. Alzheimer's & Dementia, 8(4), Supplement, pp. 323. [Full text]. doi: http://dx.doi.org/10.1016/j.jalz.2012.05.892. Retrieved from http://www.alzheimersanddementia.com/article/S1552-5260(12)01024-2/fulltext#

University of Hong Kong researchers followed Chinese adults aged 55 to 93 diagnosed with Mild Cognitive Impairment, during which time, 25.4 percent progressed to Alzheimer's Disease, and after adjusting for age, sex, and apolipoprotein E genotype, researchers found that a low BMI and ischemic heart disease were independent predictors that indicated that MCI would eventually progress to Alzheimer's Disease.

Crook, Benjamin B., Johnson, David K., and Burns, Jeffrey M. (2010, April-June). Body Mass Index and cognitive decline in Mild Cognitive Impairment. Alzheimer's Disease Associative Disorders, 24(2), 126-130. doi: 10.1097/WAD.0b013e3181abbf3f. [Full text]. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068614/

University of Kansas researchers conducted neuropsychological and clinical evaluations at baseline, six months, and one year on 286 individuals diagnosed with Mild Cognitive Impairment who were also enrolled in the Alzheimer's Disease Neuroimaging Initiative while also using height and weight to calculate BMI. The study associated lower baseline BMI with significant declines in cognitive performance using the Mini—Mental-State-Examination, the Alzheimer's Disease Assessment Scale Cognitive subscale and a global cognitive composite. They thus concluded that a lower BMI correlates with a more rapid cognitive decline in those patients diagnosed with MCI (Abstract, para. 1-4).

Note: While the abstract adequately summarizes this article, it is also important to read its first full paragraph that notes that while research has associated a high BMI  (25 and higher) in midlife with an increased risk of Alzheimer's, after age 65, a lower BMI (18.5 and lower) correlates with an increased risk of developing dementia (Crook, 2010, April-June, para. 1).

Dahl, A. K., Hassing, L. B., and Fransson, E. T., et al. (2013, February) Body Mass Index across midlife and cognitive change in late life. International Journal of Obesity (London), 37(2), 296-302. doi: 10.1038/ijo.2012.37. [Free article]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22450854

Investigating the association between a high BMI in midlife (from 40 to 60 years) and cognitive decline, Swedish researchers documented that individuals who were overweight in early midlife displayed a significantly lower cognitive performance in late life as well as a steeper decline in mental abilities. However, those who were either underweight or overweight in late midlife had lower cognitive abilities late in life. Additionally, a declining weight across midlife rather than maintaining a low weight late into midlife correlated with lessened thinking skills.

Elwood, P., Galate, J., and Palmer, S., et al. (2013, December 9). Healthy lifestyles reduce the risk of chronic diseases and dementia. Evidence from the Caerphilly cohort study. PloS One, 8(12), doi: 10.1371/journal.pone.0081877. e-collection 2013

Following 2,235 men aged 45-59 in Caerphilly, Wales, for 30 years beginning in 1979 showed that a healthy lifestyle (non-smoking, an acceptable BMI, a high fruit and vegetable intake, regular physical activity, and low to moderate alcohol consumption) delayed vascular disease for 12 years and reduced all-cause mortality for men following at least four of the five healthy living protocols while it also reduce the incidence of cognitive impairment.

Garcia-Ptacek, S., Faxen-Irving, G., and Cermakova, P. (2014, November). Body Mass Index in dementia. European Journal of Clinical Nutrition. 68 (11) 1204-09. doi: 10.1038/ejcn.2014.199. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25271014

Higher BMIs correlate with impaired cognition while middle age obesity corresponds with an increased risk of dementia in old age. However, in the oldest elderly (over age 75), higher BMIs indicate better cognition and decreased mortality. Thus, lifelong trends might better offer a more accurate cognitive forecast than single BMI measurements.

Gelber, R. P., Petrovitch, H., and Masaki, K. H., et al. (2012, January). Lifestyle and the risk of dementia in Japanese-American men. Journal of the American Geriatric Society, (60(1), 118-23. doi: 10.111/j.1532-5415.2dl.03768.x. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22211390

When the Honolulu-Asia Aging Study followed 3,468 Japanese-American males whose mean age was 52 between 1965 and 1968 for 25 years, researchers determined that those men with the lowest risk for Alzheimer's displayed the following midlife habits: 1) not smoking, 2) a BMI of less than 25.0 kg and more than 18.5 kg, 3) physically active, 4) follows a healthy diet, based on the ratio of monounsaturated to saturated fats. For the 6.4 percent diagnosed with dementia, a high BMI was “most strongly associated” with a risk for dementia. Men who adhered to all four low-risk characteristics had the lowest incidence for dementia.

Mattson, M. P. (2015, March). Lifelong brain health is a lifelong challenge: From evolutionary principles to empirical evidence. Aging Research Reviews, 20C:37-45. doi: 10.1016/j.arr.2014.12.011. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25576651

Because the brain evolved to ensure success in acquiring food, the brain functions best when humans are hungry and physically active. Thus, studies using both animal models and humans demonstrate the benefits of regular exercise and intermittent fasting on cognitive function. However, a “sedentary and overindulgent lifestyle” leads to obesity, diabetes, and cardiovascular disease—all of which increase the risk of developing Alzheimer's.

Naderal, E. K., Radcliffe, S. H., and Dale, M. C.(2009, November 18). Review: Obesity and Alzheimer's Disease: A link between body weight and cognitive function in old age. American Journal of Alzheimer's Disease & Other Dementias, 24(6), 445-449. doi: 10.1177/1533317509348208. Sage Journals. Abstract only. Retrieved from http://aja.sagepub.com/content/24/6/445.short

Research has yet to determine the link between obesity and cognitive impairment, but its “negative impact on cognitive function” may result from the vascular defects, impaired insulin metabolism, and defects in the glucose transport mechanism in the brain that a high BMI causes.

Profenno, L.A., Porsteinsson, A. P., and Faraone, S. V. (2010, March 15). Meta-analysis of Alzheimer's disease risk with obesity, diabetes, and related disorders. Biological Psychiatry, 67(6), 5-5-512. [Abstract only]. Science Direct. Retrieved from http://www.sciencedirect.com/science/article/pii/S0006322309002261

After reviewing longitudinal and epidemiological studies on BMI, diabetes, metabolic syndrome, and glucose insulin levels, a meta-analysis concludes that both obesity and diabetes “significantly and independently” increase the risk of late-onset Alzheimer's, although the level of risk is less than those with the APOE4 allele: “Physiological changes common to obesity and diabetes plausibly promote Alzheimer's.”

Rantanen, K. K. Strandberg, A. Y., and Pitkala, K., et al. (2014, December). Cholesterol in midlife increases the risk of Alzheimer's Disease during an up to 43-year follow-up. European Geriatric Medicine, 5(6) 390-394. doi: 10.1016/j.eurger.2014.05.002. Science Direct. [Abstract only]. Retrieved from http://www.sciencedirect.com/science/article/pii/S1878764914000795

Surveying the cholesterol levels of 3,293 men of whom 205 had verified Alzheimer's, this follow-up of the Helsinki Businessman Study, which has kept track of male Finnish business executives since 1964, revealed that those men ultimately diagnosed with Alzheimer had a higher total cholesterol level than their controls, chosen in 2007. Moreover, higher cholesterol levels corresponded with a 22 percent increased risk for developing Alzheimer's.

Titova, O. E., Ax, E., and Brooks, S. J. (2013, December). Mediterranean diet habits in older individuals: Associations with cognitive functioning and brain volumes. Experimental Gerontology, 48 (12),1443-8. doi: 10.1016/j.exger.2013.10.002. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24126083

Keeping weekly food diaries, Uppsala, Sweden, seniors recorded their dietary intake whereupon five years later they underwent a cognitive test battery used to screen for dementia while volumetric magnetic resonance imaging determined their brain volume. Low consumption of meat and meat products correlated with better performances on the 7MStest and a greater brain volume.

Tolpanen, A. M., Ngandu, T., and Kareholt, I., et al. (2014). Midlife and late-life body mass index and late-life dementia: Results from a perspective population based cohort. Journal of Alzheimer's Disease: JAD, 38(1), 201-09. doi: 10.3233/JAD-136698. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23948937
The association of midlife BMI (mean age 50.2) and late-life BMI (mean age 71.2) and the incidence of dementia later (mean-age75.7) in a longitudinal study based on cardiovascular risk conducted in Eastern Finland with a follow-up of 2 years found a link between a higher BMI midlife and a higher risk of dementia and Alzheimer's Disease while a lower BMI in late-life correlated with a higher risk for dementia.

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The links furnished on this Web page represent the opinions of their authors, so they complement—not substitute—for a physician’s advice.

A Low-fat Diet & Daily Exercise Bring Down Blood Pressure

Popular Tips for Controlling Blood

Pressure: What Diet & Exercise Can Do

Evelyn Smith

MS in Library Science, University of North Texas, 2012

Since vascular dementia makes up ten percent of all dementia cases, middle-aged and older adults should review these tips for helping to control hypertension (Types of dementia, 2015, para. 5). Admittedly, some of the tips for lowering the risk of Alzheimer's disease--such as watching blood sugar by reading product labels, limiting carbohydrates and choosing healthy fats, like olive oil and wild fish, cramming a minimum of 20 minutes of sustained aerobic exercise into a daily routine, and lowering cholesterol levels—might also lower blood pressure (Rushlow, 2014, October 21, para. 78, & 10). 

Although concentrating on blood pressure might seem to take older adults back to the days when dementia was synonymous with “hardening of the arteries”, many of the tips for delaying or preventing Alzheimer's, such as engaging in continuous aerobic exercise and keeping a heart-healthy Mediterranean-style diet also substantially lower blood pressure naturally. Anstey, Cherbuin, and Pushpani, for example, identify eleven risk factors for Alzheimer's that include a high body mass index (BMI) and a high serum cholesterol level, diabetes, smoking, and heavy alcohol intake as well as four protective factors, such as participating in high levels of physical activity and regularly eating fish, that affect both cardiovascular health and the chance of developing Alzheimer's or other types of dementia (Anstey, 2013, August, Abstract).


References:

Anstey, K. J., Cherbuin, N., Pushpani, M. H. (2013, August). Development of a new method for assessing global risk of Alzheimer’s Disease for use in population health approaches to prevention.

Prevention Science. 14(4), 411-421. doi: 10.1007/s11121-012-031301. [Free article]. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696462/

Rushlow, Amy. (2014, October 21). Five ways to lower your risk for Alzheimer's disease. Yahoo. Retrieved from https://www.yahoo.com/health/5-ways-to-lower-your-risk-for-alzheimers-disease-100615378227.html

Types of dementia.(2015). Ala.org. Alzheimer's Association. Retrieved from http://www.alz.org/dementia/types-of-dementia.asp

Accordingly, anyone interested in delaying or preventing dementia should also look into tips for lowering blood pressure, followed by longitudinal studies that back up the recommendations as well as some occasional helps to help readers achieve their heart and cardiovascular system-healthy goals:

Action items to help lower your blood pressure. (2003). Your Guide to Lowering Blood Pressure. (2003). National Heart, Lung, and Blood Institute. p. 17. Retrieved from http://www.nhlbi.nih.gov/health/resources/heart/hbp-guide-to-lower

• Maintain a healthy weight;*
• Be physically active [Exercise aerobically for at least 30 minutes at least five days per week];*
• Follow a healthy [DASH] eating plan;*
• Reduce sodium in your diet;
• Drink alcohol only in moderation;
• Take prescribed drugs as directed.

(NHLBI, 2003, p. 17)



*Aerobic Exercise & a Low Fat Diet Reduces Hypertension

Couple diet and exercise to reduce both your blood pressure and your waist line.

So who needs to watch out for high blood pressure?


Hypertension risk groups. (2014, March 30). Resperate. Retrieved from http://www.resperate.com/hypertension/hypertension-risk-groups?utm_source=RESPeRATE+USA&utm_campaign=a4306ea230-LP_News_recipe_US_2015_4_16&utm_medium=email&utm_term=0_ac3cc1206e-a4306ea230-297127657&ct=t(LP_News_recipe_US_2015_4_16)


The overweight (or those with a BMI over 25) as well as women and those in lower income groups are most likely to have high blood pressure. Moreover, according to a World Health Organization study, high blood pressure is responsible for 12.5 percent of all deaths worldwide (Hypertension, 2014, March 30, para. 1-2).


Risk factors for high blood pressure:

• Obesity;
  
• Low income;
  
• Female gender: High-income older women are more likely to try to actively control their blood pressure;
  
• Heavy drinking

(Hypertension, 2014, March 30, para. 3-4)

People from all walks of life in hypertension risk groups


Even more those who know they suffer from hypertension, the death rate for high blood pressure is “strikingly high” in low and middle-income countries. The WHO study also underlines the necessity of monitoring blood pressure after age 40 since hypertension is a silent killer (Hypertension, 2014, March 30, para. 5).


Hypertension risk groups for secondary hypertension


Underlying conditions—like Cushing's, Lupus, type 2 diabetes, and kidney disease as well as taking oral contraceptives—can cause secondary high blood pressure. Cocaine and amphetamines also raise blood pressure (Hypertension, 2014, March 30, para. 6).
Accordingly, along with regularly monitoring for hypertension, adhering to a Mediterranean style diet  along with fitting at least 30 minutes of aerobic exercise into a daily schedule, and loosing weight, so the Body Mass Index falls below 25, goes a long way toward controlling high blood pressure:

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Asikainen, T. M., Kukkonen-Harjula, K., and Miilunpalo, S. (2004). Exercise for health for early postmenopausal women: A systematic review of randomised controlled trials, 34(11), 753-78. Sports Medicine (Auckland, New Zealand). [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15456348

A systematic review of randomized, controlled exercise trials of post menopausal women aged 50 to 65 years reveals that early postmenopausal women can benefit from 30 minutes of moderate walking daily combined with a resistance training program twice a week, thus improving their flexibility, balance and coordination and decreases hypertension as well as lowering the abnormal amount of cholesterol and fat in the blood.
 

Bacon, S. L., Sherwood, A., and Hinderliter, A. (2004). Effects of exercise, diet and weight loss on high blood pressure. Sports Medicine (Auckland, New Zealand), 34(5), 307-16. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15107009

• Exercise alone reduces systolic and diastolic blood pressure approximately 3.5 and 2.0 mm Hg respectively.
  
  
• Following a DASH diet that emphasizes low-fat dairy products and fruits and vegetables, reduces SBP and DBP 5.0 and 3.0 mm Hg respectively when compared with following a standard American diet.

• Losing weight decreases SBP by 12.5 and DBP 7.9 mm Hg.*

Both exercise and weight loss decrease left ventricular mass and wall thickness, reducing arterial stiffness and improving the functioning of the inner lining of the blood vessels.

Fleet, J. C. (2001, September). DASH without the dash (of salt) can lower blood pressure. Nutrition Reviews, 59(9), 291-3. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11570432

The original DASH diet require the dieter to reduce his or her sodium intake or lose weight to be effective, but recent findings show that combining the original DASH diet with sodium reduction more effectively lowers blood pressure than following the original DASH diet plan alone. The DASH diet emphasizes fruits, vegetables, and low-fat dairy products.

Glassberg, H. and Balady, G. L. (1999,September-October). Exercise and heart disease in women: Why, how, and how much? Cardiology in Review, (5) 301-8. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11208241

One quarter of all American adults are sedentary, and 1/3 of all women don't take part in any leisure time physical activity. Studies, however, note that women who exercise reduce their blood pressure and improve their lipid profiles while lowering their likelihood of developing diabetes. The Centers for Disease Control, the American Heart Association, and the American College of Sports Medicine thus recommend that everyone should participate in weight-bearing, aerobic exercise at least three to five days per week. Aerobic exercise can also help to prevent osteoporosis in women.

Hagberg, J. M., Park, J. , and Brown, M. D. (2000, September). The role of exercise training in the treatment of hypertension. Sports Medicine (Auckland, New Zealand), 30(3), 193-206. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10999423

Exercise decreases blood pressure in approximately 75 percent of all individuals diagnosed with hypertension. Women are more likely to reduce blood pressure through exercise than men, and the middle aged accrue more benefits from exercise than young adults and the elderly. Low to moderate exercise also more efficiently reduced blood pressure than high intensity exercise, and the more one exercises, the greater his or her healthy benefits will be. However, a single exercise session can reduce blood pressure for a 24-hour period.

Ishikawa-Takota, K.Ohta,T, and Tanaka, H. (2003, August).  How much exercise is required to reduce blood pressure is essential to reduce blood pressure in essential hypertensives? A dose-response study. American Journal of Hypertension, 16 (8), 629-33. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12878367

Previously sedentary individuals diagnosed with hypertension can significantly decrease their blood pressure by modestly increasing their physical activity, according to the results of an eight-week exercise program of 207 untreated subjects diagnosed with stage one or two hypertension. Researchers divided participants into a control group whose members exercised only 30 to 60 minutes per week, volunteers who exercised from 61 to 90 minutes a week, 3) participants who exercised from 91 to 120 minutes per week, and 4) individuals who exercised over 120 minutes per week. Systolic and diastolic blood pressure at rest didn't change for the control group, but individuals in all other groups experienced a significant reduction in systolic and diastolic blood pressure.

Lakka, T. A. and Bouchard, C. (2005). Physical activity, obesity and cardiovascular diseases. Handbook of Experimental Pharmacology, (170), 137-63. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16596798

Regular physical activity for 45 to 60 minutes daily prevents unhealthy weight gain and obesity whereas sedentary behaviors . . . promote them.” The “optimal approach”, however, in weight production programs combines regular physical exercise and a restriction of calories. A minimum of 60 minutes of moderately intense physical exercise, however, may be needed to avoid or limit weight gain in the formerly obese.

Lin, P. H., Ackin, M., and Champagne, C., et al. (2003, April). Food group sources of nutrients in the dietary patterns of the DASH-sodium trial. Journal of the American Dietetic Association, 103(4),488-96. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12669013

The DASH dietary pattern recommends that dieters drastically cut their intake of meat, but they should increase their servings of fruits and vegetables. That means consuming four to five servings of fruits, four to five servings of vegetables, two to three servings of low-fat dairy products daily while limiting servings of beef, poultry or fish to twice a day, making up for this with four to five servings of legumes, nuts, and seeds weekly.

Lin, P. H., Appel, L. J., and Funk, K. (2007, September ). The PREMIER intervention helps participants follow the Dietary Approaches to Stop Hypertension dietary pattern and the current Dietary Reference Intakes recommendations. Journal of the American Dietetic Association 107 (9), 1541-57. [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17761231

This 18-month, randomized, controlled trial followed 810 participants aged 25 and older with a BMI between 18.5 and 45.0, who were not taking anti-hypertension medications and had been diagnosed with pre-hypertension or stage one hypertension (SBP 120 to 159 mmHG and DBP 80 to 95 mm Hg). Both the intervention group controls and those participants who followed the intervention protocols as well as the DASH diet plan substantially reduced their total fat, saturated fat, and sodium intake and ramped up their intake of fruits, vegetables, and dairy products. However, only those individuals who followed the established intervention plan plus the DASH diet plan significantly increased their intake of DASH specific food groups, rich in potassium fiber, calcium, and magnesium. Researchers thus concluded that a greater emphasis on “nutrient dense” food with improve future dietary interventions.

Mendes, R., Sousa, N., and Garrido,N., et al. (2014, November 12).  Can a single session of a community-based group exercise program combining step aerobics and body weight resistance exercise acutely reduce blood pressure? Journal of Human Kinetics, 43,49-56. doi: 10.2478/hukin-2014-0089. [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25713644

A single, 50-minute session of exercise combining step aerobics and body resistance training significantly reduced post exercise blood pressure in a group of 23 healthy young women in their 30s. The program consisted of a five minute warm up of aerobic dance exercise, 30 minutes of step aerobics, 10 minutes of resistance exercise training, and a five-minute cool down of breathing and flexibility exercises.

Poirier, P. & Desprės, J. P. (2001, August). Exercise in weight management of obesity. Cardiology Clinics, 19(3), 459-70. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11570117

When an obese individual's BMI is greater than or equal to 30 km/m2, mortality rates from all causes, especially cardiovascular disease, increases by 50 to 100 percent. Thus, strong evidence exists that weight loss in the over weight improves risk factors for diabetes and cardiovascular disease. Weight loss reduces blood pressure in overweight hypertensive and nonhypertensive [or prehypertensive] patients, reduces serum TG levels, increases high-density lipoprotein cholesterol levels, and may reduce low-density lipoprotein cholesterol concentrates . . . Therefore, “30 to 45 minutes of physical activity of moderate intensity should be encouraged. All adults should set a long-term goal to accumulate at least 30 minutes of moderate-intensity exercise on most, and preferably all days . . .” Finally, those trying to lose weight after consulting a physician should set a realistic weight loss goal of approximately 0.5 to one pound per week.

Schwartz, J.B. (2015,April). Primary prevention: Do the elderly require a different approach? Trends in Cardiovascular Medicine, 25(3), 228-239. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25560975

While trial data remains sparse for adults aged 75 to 80, primary prevention strategy decisions at this stage of life should consider estimated life expectancy and over all function as well as examine cardiovascular event risks and access a benefit to harm ratio. Even so, limited data supports the use of moderate aerobic exercise to lower systolic hypertension, thus reducing the risk of cardiovascular disease and dementia while also taking into consideration the possibility that participants might fall and injury themselves while exercising. While trial data on exercise alone is not available, a review of “multi-system benefits” proves that exercise should continue to be part of a preventive regime in the eldest elderly.

Solfriezzi, V., Panza, F., and Frisandi, V. (2011, May). Diet and Alzheimer's disease risk factors of prevention: The current evidence. Expert Review of Neurotherapeutics, 11(5):677-708. doi: 10.1586/ern.11.56. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21539488

Elevated saturated fats may help increase the effects of age-related cognitive decline while current evidence links regular fish consumption [usually amounting to at least two servings of fish rich in omega 3 fatty acids weekly] reduces the risk of dementia as does light to moderate alcohol consumption [That amounts to a glass of red wine with the evening meal]. Poorer cognitive function and an increased risk of vascular dementia correlates with a low consumption of dairy products, although research also links the consumption of whole fat dairy products with cognitive decline. Adherence to a Mediterranean diet slows cognitive decline as the elderly progress from Mild Cognitive Impairment to full-blown Alzheimer's. Hence findings encourage eating more fish, non-starchy vegetables and fruits in a diet low in foods with added sugar.

____________

Bauer, Joy. (2014). Eight foods that help lower blood pressure. Joy Bauer. Retrieved from http://www.joybauer.com/high-blood-pressure/best-foods-for-high-blood-pressure.aspx

• Skim milk: The calcium and Vitamin D in skim milk can lower blood pressure from three to ten percent (Bauer, 2014, p. 1).
• Spinach: The potassium, folate, and magnesium in spinach can help lower blood pressure (Bauer, 2014, p. 2).
• Sunflower seeds: Unsalted sunflower seeds are “a great source of potassium” Bauer, 2014, p. 3).
• Beans: The soluble fiber, magnesium, and potassium found in black, white, navy, lima, pinto, and kidney beans lowers blood pressure and improves cardiovascular health (Bauer, 2014, p. 4).
• Baked white potatoes: Potatoes contain both magnesium and potassium. When a body's potassium levels are low, it contains too much salt (Bauer, 2014, p. 5).
• Bananas: Bananas are “packed with potassium” (Bauer, 2014, p. 6).
• Soybeans: Soybeans contain potassium and magnesium (Bauer, 2014, p. 7).
• Dark chocolate: Eating just 30 calories or a single square of dark chocolate daily lowers blood pressures without gaining weight after 18 weeks (Bauer,2014, p. 8).

5 natural ways to lower high blood pressure. (2015). WebMD. Retrieved from http://www.webmd.com/hypertension-high-blood-pressure/natural-7/default.htm

1. DASH [Dietary Approaches to Stop Hypertension diet] towards lower blood pressure:

• Emphasize fruit, vegetables, and low-fat dairy selections;
• Cut back on saturated fat, cholesterol rich, and trans foods;
• Consume more whole grains, fish, poultry, and nuts;
• Limit sodium, sweets, sugary drinks, and red meats.

2. Reduce salt intake:*

• Don't automatically reach for the salt;
• Read labels when shopping;
• Select fewer processed and packaged foods;
• Ask restaurant chefs not to add salt to menu selections, or choose lower sodium options on restaurant menus.

2. Realize that drinking moderately to lower blood pressure depends on other lifestyle factors.
3. Develop a sensible weight-loss plan:

• Set weight loss goals after deciding whether to participate in a structured program or to simply limit portion sizes;
• Understand weight loss personalities: Impulsive, oblivious, uptight, tenacious, or sociable;
• Double-up on diet and exercise: Only a combination of diet and exercise leads to weight loss.

2. Adopt a safe exercise plan:

• Moderate aerobic exercise for at lest 30 minutes daily at least five days per week confers blood pressure lowering benefits.
• To stick with an exercise regime, “make it fun” and if possible, “exercise with a friend”.

*Decreasing Salt Intake

Most salt comes from processed foods.

He, F. J., Li, J., and MacGregor, G. A. (2013, April). Effect of long-term modest salt reduction on blood pressure. The Cochrane Database of Systematic Reviews, 4, CD004937. doi: 10.1002/146551858.CD004937.pub2. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23633321

This meta-analysis searched Medline, Embase, the Cochrane Hypertension Group Specialized Register, the Cochrane Central Register of Controlled Trials, and a reference list of relevant articles for randomized trials that focused on a “modest” reduction of salt intake and a duration of at least four weeks and found that a modest reduction in salt intake for at least a month's reduction causes a significant drop on blood pressure in hypertensive participants as well as those with normal blood pressure irrespective of their gender and ethnicity.

Rebholz, C. M., Gu, D., & Chen, J., et al. (2012, October 1). Physical activity reduces salt sensitivity of blood pressure: The Genetic Epidemiology Network of Salt Sensitivity Study. American Journal of Epidemiology, Suppl. 7, S106-13. doi: 10 1093/aje/kws266. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23035134

A dietary study conducted between October 2003 and July 2005 that included a seven-day low-sodium intervention followed by a seven-day high sodium intervention adhered to by 1,906 rural northern Chinese age 16 and over found that physical activity may be “particularly effective” in lowering blood pressure” among those individuals who are “salt sensitive”.

Seasoning without salt. (2015). Sutter Health. Palo Alto Medical Foundation. Retrieved from http://www.pamf.org/heartfailure/lifestyle/diet/seasoning.html

Try seasoning potatoes with pepper, parsley, onion, green peppers, chives, or pimento (Seasoning without salt, 2015, para. 2).

Yang, Q., Liu,T.,and Kuklina, E.V., et al. (2011, July 11). Sodium and potassium intake and mortality among US adults: Prospective data from the Third National Health and Nutrition Examination Survey. Archives of Internal Medicine, 171*13), 1183-91 doi: 10.1001/archintermed.2011.257. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21747015

The Third National Health and Nutrition Examination Survey Linked Mortality File (1998-2006), a prospective cohort study of a nationally representative sample of 12,267 American adults associated higher sodium intake with all causes of mortality. Conversely, it also associated lower mortality risk with higher potassium intake. Moreover, the individual's sex, ethnicity, BMI, hypertension status, education and physical activity levels didn't really differ. Accordingly, the findings suggest that a higher sodium to potassium ratio correlates with an increased risk of cardiovascular disease and all-cause mortality while a higher sodium intake corresponds with an increased mortality rate in the general United States population.

Zhang, Z., Cogswell, M. E., and Gillespie, C., et al. (2013, October 10). Association between usual sodium and potassium intake and blood pressure and hypertension among U. S. adults: NHANES 2005-2010. PloS One, 10, 8(10), e75209. doi: 10.1371/journal/pone.0075289. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24130700

After analyzing data on 10,563 study participants over age 20, who were neither taking medication to control their blood pressure, nor were on a low-salt diet, the National Health & Nutrition Examination Survey found that the average intake of sodium, potassium, and sodium-to-potassium ratios were 3,569 mhld, 2,745 mgld, and 1.41 mgld respectively, so researchers thus concluded that the nigh sodium and low potassium consumption levels correlated with hypertension.

Hagberg, James M. (2011). ACSM information on . . . Exercising Your Way to Lower Blood Pressure. American College of Sports Medicine. Retrieved from https://www.acsm.org/docs/brochures/exercising-your-way-to-lower-blood-pressure.pdf

A Complete Physical Activity Program:

Include aerobic and strength training activities in an exercise program, but not necessarily in the same session, thus maintaining or improving cardiovascular, respiratory and muscular fitness (Hagberg, 2011, p. 1, para. 1). The ACSM recommends 30 minutes of moderately intense physical activity five days a week or 20 minutes of vigorous activity three days a week to maintain cardiovascularhealth (Hagberg, 2011, p. 1, para. 2).

Aerobic exercise includes walking, running, stair climbing, cycling, rowing, cross-country skiing, and swimming (Hagberg, 2011, p. 1, para. 3). Strength training should be performed at least twice weekly, performing 8 to 12 reps of eight to ten different exercises that target all muscle groups (Hagberg, 2011, p. 1, para. 4).

Treatment Choices:

• Once under medications, individuals with hypertension can further decrease their blood pressure through physical activity.
• Mild to moderate hypertension can also benefit from healthy lifestyle changes, such as increasing physical activity, decreasing salt intake improving diet, and losing weight.
• Exercise decreases systolic and diastolic blood pressure levels from five to seven points as early as from three to four weeks after starting an exercise program.
• Physical activity also helps control weight and improve blood pressure, cholesterol, and glucose levels.
• Individuals diagnosed with ”pre-hypertension” (120 to 139 systolic pressure and 80 to 89 diastolic pressure also need to exercise regularly.

(Hagberg, 2011, p. 1, para. 6)

How Should You Exercise?

Beneficial exercises include brisk walking, taking the stairs, moderate to vigorous yard or house work, jogging, swimming, and cycling. Moderate exercise may reduce blood pressure as much as strenuous activity. The side affects of exercise, however, are “generally positive” (Hagberg, 2011, p. 2, para.1-4).

Ways to Improve Your Health:

Physical activity can be added without making major lifestyle changes (Hagberg, 2011, p. 2, para.5). Simple changes include parking further away from destinations, taking the stairs, going for a walk on the lunch hour, walking to a restaurant for lunch, taking children to the park, mall walking in bad weather, waking up 30 minutes early to exercise, and varying physical activities to make exercise interesting (Hagberg, 2011, p. 2, para. 6).

Staying Active Pays Off:

Moderate physical activity significantly contributes to longevity, but exercise can also help dieters stay on a diet and lose weight (Harberg, 2011, p. 2, para. 7-8).

The First Step:

Ask some important questions that will access cardiovascular health before increasing physical activity (Harberg, 2011, p. 2, para. 9).

Harding, Anne. (2015). 10 natural ways to lower blood pressure. Health.com. Health Media Ventures. Retrieved from http://www.health.com/health/gallery/0,,20488689,00.html

Lifestyle changes can lower blood pressure, possibly eliminating the need for prescription drugs. Everyone, however, who suffers from high blood pressure should look for natural ways to lower high blood pressure (Harding, 2015, p. 1).

1. Exercise more: By exercising aerobically 30 minutes daily most days per week, systolic blood pressure (the top number) can be lowered three to five points, and diastolic blood pressure (the bottom number) can be lowered two to three points. Pick an enjoyable activity and stick with it (Harding, 2015, p. 2). Thus, everyone—whether one suffers from hypertension or not—should take part in brisk aerobic exercise for at least 30 minutes at a time five or six days per week;
2. Eat bananas [or other foods high in potassium]: Select from choices like baked potatoes with their skins, orange juice and non-fat yoga (Harding, 2015, p. 3);
3. Cut salt: Individuals already diagnosed with hypertension should limit their salt intake to 1,500 milligrams daily, sticking with whole foods and checking nutritional labels for sodium content (Harding, 2015, p. 4);
4. Don't smoke: Smokers average a higher risk for hypertension because lifestyle factors often associated with smoking; for example, heavy alcohol consumption and lack of exercise, increase blood pressure (Harding, 2015, p. 5);
5. Lose weight: Since extra weight makes the heart work harder, losing weight lightens its cardiovascular work load (Harding, 2015, p. 6);
6. Cut back on alcohol: Drinking too much can elevate blood pressure. Accordingly, excess drinking in both men and women increases the risk of hypertension (Harding, 2015, p. 7);
7. De-stress: Look for ways to manage stress (Harding, 2015, p. 8);
8. Yoga: Yoga instruction teaches measured breathing that reduces hypertension, which reduces hypertension since it modifies the autonomic nervous system (Harding, 2015, p. 9);*
9. Skip caffeine: The caffeine in coffee, and to a lesser extent the caffeine in tea and soda, causes short spikes in hypertension, so those diagnosed with hypertension should limit their intake to two or less servings of caffeine daily (Harding, 2015, p. 10); *
10. Meditate: Daily meditation, whether it features chanting, breathing, or visualization, lowers blood pressure (Harding, 2015, p. 11).*

*Yoga & Meditation

Yoga and meditation reduce stress, lowering blood pressure. 

Bai, Z., Chang, J. & Chen, C., et al. (2015, February 12). Investigating the effect of transcendental meditation on blood pressure: A systematic review and meta-analysis. Journal of Human Hypertension. doi: 1038/jhh.2015.6. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25673114

After searching Medline, Embase, Cochrane Library, Web of Science, and Chinese bio-medical literature databases for articles on Transcendental Meditation through 2014, researchers first used the Cochrane Collaboration's quality assessment tool, researchers zeroed in on 12 studies that compared with TM groups with control groups. They then discovered that TM had a greater effect on systolic blood pressure among older participants, those with a higher initial blood pressure rate, and women. As for controlling diastolic blood pressure, TM works only as a short-term interventions for those individuals already diagnosed with higher blood pressure.

Chu, P., Gotink, R. A., and Yeh, G. Y. , et al. (2014, December 15). The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials. European Journal of Preventive Cardiology, pii: 204787314562741. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25510863

After reviewing 1,401 electronic records written in English found via Medline, EMBase, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials, researchers found that compared to non-exercise controls, yoga significantly improved body mass index, systolic blood pressure, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Significant changes also took place in body weight, diastolic blood pressure, total cholesterol, triglycerides, and heart rate. However, no significant differences existed between yoga and exercise in their ability to bring down blood pressure.

Mashyal, P., Bhargav, H., & Raghuran, N. (2014, October-December). Safety and usefulness of Laghu shankha prakshalana in patients with essential hypertension: A self-controlled clinical study. Journal of Ayurveda and Integrative Medicine, 594), 227-35. doi:10.4108/9759475.131724. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25624697

This Bengalurui, India, self-controlled study recruited 32 patients diagnosed with mild to moderate hypertension to participate in a residential yoga therapy program. Patients took part in a daily routine that featured six hours of yoga therapy that included physical poses, relaxation sessions, pranayana and meditation as well as the drinking of warm water. Participants significantly reduced their systolic and diastolic blood pressure and pulse rates immediately following yoga sessions. Moreover, after a week of yoga therapy they also significant saw a drop in their blood pressure.

Raven, Kathleen. (2013, October 4). Meditation alone doesn't lower blood pressure study. Health. Reuters. Retrieved from http://www.reuters.com/article/2013/10/04/us-meditation-idUSBRE9930XU20131004

Eight weeks of mindfulness meditation performed by those diagnosed with pre-hypertension, but who as of yet weren't taking any medication, didn't have any affect. However, researchers theorized that meditation therapy might help patients already taking blood pressure medications take them more consistently (Raven, 2013, October 4, para. 2 & 5).

The 101 participants in the study averaged a blood pressure of 135/82 mm Hg, above normal, but not yet “high”. Half started mindfulness-based stress reduction (MBSR) immediately, but half were wait listed to take the class later (Raven, 2013, October 4, para. 9-10). Mindfulness participants, aged 20 to 75, attended eight weekly sessions as well as a day-long retreat and received instructions to practice stress reduction therapy for 45 minutes daily. Additionally, they received counseling that amounted to standard-issue medical advice: Use less salt, quit smoking, and exercise more (Raven, 2013, October 4, para. 11-12). A 2007 study published by the US Agency for Healthcare Research Quality found that Zen Buddhist meditation and Qi Gong “significantly reduced” blood pressure (Raven, 2013, October 4, para. 17).

Telles, S., Sharma, S. K., and Balkrishna, A. (2014, November 19). Blood pressure and heart rate variability during yoga-based alternate nostril breathing practice and breath awareness. Medical Science Monitor Basic Research, 20, 184-93. doi: 10.12659/MSMBR.892963. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25408140

Researchers evaluated heart-rate variability, non-invasive arterial blood pressure, and respiration rate during Alternate Nostril Yoga Breathing (ANYB) and breath awareness sessions of 26 male volunteers with the mean age of 23.8 years, assessing their performance five minutes before the 25 minute yoga routines began, 15 minutes into the exercise, and five minutes afterward, and they found that during ANYB, the participants experienced a significant decrease in systolic blood pressure as well as their respiration rate.

*Increasing Potassium Intake



Bananas aren't the only foods rich in potassium.

Miller, Brian. (2015). 15 foods that are high in potassium. User's Manual: Your Heart Health. Health.com. Retrieved from http://www.health.com/health/gallery/0,,20721159,00.html

Decreasing salt in taking and adding potassium-rich foods to a diet may cut the risk of stroke by 21 percent. Since potassium protects blood vessels from oxidation damage and keeps the walls of blood vessels from thickening. While taking too much potassium as a supplement can be dangerous, a potassium enhanced heart-healthy diet can provide the 4,700 milligrams of potassium adults need each day (Miller, 2015. p. 1).

The following foods are rich in potassium: sweet potatoes, tomato sauces, beet greens, beans, yogurt, clams, prunes, carrot juice, molasses, cod, halibut, tuna, and rainbow trout,soybeans, winter squash, bananas, milk, and orange juice (Miller, 2015, p. 2-16).

Potassium and your heart. (2014). Heart Disease. Health Center. WebMD. Retrieved from http://www.webmd.com/heart-disease/potassium-and-your-heart

Potassium triggers the heart to squeeze blood through the body, additionally enabling muscle movement and nerve function as well as helping the kidneys to carry blood (Potassium and your heart, 2014, para. 1-2). Fruits and vegetables are the best sources of potassium, although potassium is also found in dairy products, whole grains,meat, and fish (Potassium and your heart, 2014, para. 3). A diet rich in potassium lowers systolic blood pressure by ten points while taking potassium supplements only lowers SBP lowers it by just eight points. Many diets that lower cholesterol levels also are high in potassium (Potassium and your heart, 2014, para. 6-7). The US Department of Agriculture recommends that healthy individuals consume 4,700 milligrams of potassium daily (Potassium and your heart, 2014, para. 9).

Weaver, C. M. (2013, May 1). Potassium and health. Advances in Nutrition (Bethesda, MD), 4(3), 368S-77S. doi: 10.3945/an.112.003533. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23674806

A 2010 advisory committee found a short fall in United States potassium consumption while moderate evidence associated potassium intake with lower blood pressure. Adequate potassium levels also mitigate age-related bone loss and the reduces kidney stones. Americans thus need to increase their potassium intake above current levels for optional health, although the affect of increased fruit and vegetable consumption for short periods of time has proved disappointing. Simultaneously, western diets have led to a decrease in potassium intake with the reduced consumption of fruits and vegetables. Consuming white vegetables, like potatoes, however, correlates with a decrease in the risk of stroke. Potatoes remain the highest source of dietary potassium provided the diner limits salt intake.* Moreover, a low-potassium to sodium ratio strongly correlates with cardiovascular risk.

Why potassium helps to lower blood pressure. (2008). Salt and blood pressure. Blood Pressure UK. Retrieved from http://www.bloodpressureuk.org/microsites/salt/Home/Whypotassiumhelps

Potassium helps to lower blood pressure by “balancing out the negative effects of salt”. Salt conversely reduces the kidneys' ability to remove excess fluid. It's best to get potassium from natural sources and avoid supplements (Why potassium, 2008, p. 1). Five servings of fruits and vegetables daily should provide enough potassium to lower blood pressure while also cutting the risk of certain cancers, bowel problems, heart attacks, and stroke. Potatoes, sweet potatoes, bananas, tomato sauce without the added salt and sugar, orange juice, tuna, yogurt, and fat-free milk all are sources of potassium (Why potassium, 2008, p. 2).

___________

Prevention and Treatment of High Blood Pressure. (2014, August 4). American Heart Association. Retrieved from http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Prevention-Treatment-of-High-Blood-Pressure_UCM_002054_Article.jsp

If I have high blood pressure, what can I do take care of myself?

Those diagnosed with high blood pressure [as well as prehypertension] can control their blood pressure in eight ways:

• Eat a better diet, which may include reducing salt;
• Enjoy regular physical activity;
• Maintain a healthy weight;
• Manage stress;
• Avoid tobacco smoke;
• Comply with medication prescriptions;
• If you drink, limit alcohol;
• Understand hot tub safety.*

(Prevention & treatment of HBP, 2014, August 4, para. 1)

Lifestyle modifications are essential since by adopting a heart-healthy lifestyle, those at risk can

• reduce high blood pressure
• prevent or delay its development;
• enhance the effectiveness of blood pressure medications;
• lower the risk of heart attack, heart disease, stroke, and kidney disease.

(Prevention & treatment of HBP, 2014, August 4, para. 2-4)

Here's how to do your part:

• Be informed;
• Do your part to reach your treatment goals;
• Change your life and reduce your risks;
• Take medication if it is prescribed for you [if blood pressure is 140/90 or higher].

(Prevention & treatment of HBP, 2014, para. 5-9)

Once a treatment program becomes routine, maintaining a lower blood pressure is easier (Prevention & treatment of HBP, 2014, para. 10).

Managing blood pressure is a lifetime commitment, so take a pledge to do so (Prevention & treatment of HBP, 2014, para. 11).

*Practicing Hot Tub Safety

Those with high blood  pressure should limit hot tub use.

Hot tub and sauna use and high blood pressure. (2014, August 14). Step 5: Prevention and Treatment. American Heart Association. Retrieved from 
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Hot-Tub-and-Sauna-Use-and-High-Blood-Pressure_UCM_301887_Article.jsp

Individuals with high blood pressure “should tolerate” saunas and hot tubs if they aren't having a hypertensive crisis (Hot tub & sauna use, 2014, August 14, para. 1). Heat from these sources opens up blood vessels in a process known as vasodilation that also happens after taking part in brisk aerobic exercise (Hot tub & sauna use, 2014, August 14, para. 2). Those diagnosed with high blood pressure shouldn't move back and forth between cold water and a hot tub or sauna since this could increase blood pressure. They also shouldn't drink alcohol while using a sauna or hot tub (Hot tub & sauna use, 2014, August 14, para. 3).

Hot tubs can land your heart in hot water. (2014, July 3). Health Hub. Cleveland Clinic. Retrieved from http://health.clevelandclinic.org/2014/07/hot-tubs-can-land-your-heart-in-hot-water/

Sudden or extended immersion in hot water can superheat the body and stress the heart (Hot tubs, 2014, July 3, para. 1). Accordingly, if older and middle-aged adults with potential cardiovascular problems receive the go ahead to soak in a hot tub, they must regulate water temperature, limit soaking time to no more than ten minutes, and stay hydrated by drinking water (Hot tubs, 2014, July 3, para. 4).

When the body super heats, blood vessels dilate to cool the body, diverting blood away from the body core to the skin, so the heart rate and pulse increase to counteract a drop in blood pressure (Hot tubs, 2014, July 3, para.7). For those individuals with cardiovascular disease, this could over tax the heart leading to a loss of adequate blood pressure, a corresponding increase in blood pressure, dizziness or faintness, nausea, abnormal heart rhythm, inadequate blood flow to the heart or body, and heart attack (Hot tubs, 2014, July 3, para. 5). Beta blockers and diuretics can further contribute to the hot tub user's medical problems (Hot tubs, 2014, July 3, para.6). Anyone using a Jacuzzi or hot tub should make sure the water temperature isn't too high,should stay hydrated, and soak for only brief periods of time (Hot tubs, 2014, July 3, para. 8).

10 ways to control blood pressure without medication. (2012, July 19). Diseases and Conditions: High blood pressure (hypertension). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/ART-20046974?pg=1

1. Lose extra pounds and watch your blood pressure:*

• Men are at risk if their waist measures more than 40 inches or 102 centimeters; Asian men are at risk if their waistline measures more than 36 inches or 91 centimeters;
• Women are at risk if their waistline measure more than 35 inches or 91 centimeters—that's a Misses 16. Asian women are at risk if their waistline measures more than 32 inches or 81 centimeters—that's a Misses 10.

2. Exercise regularly:

• Aerobic exercise at least 30 to 60 minutes regularly most days a week lowers blood pressure by four to nine millimeters of mercury. However, those at risk should avoid only being a “weekend warrior”.

3. Eat a healthy diet:

• Keep a food diary;
• Boost potassium;
• Be a smart shopper: Read labels and avoid processed foods;
• Cut yourself some [occasional] slack.

4. Reduce sodium in your diet:

• Europeans and Asians under age 51 should limit sodium to 2,300 milligrams a day or less; all African Americans and everyone over age 51 should limit sodium intake to 1,500 milligrams daily.
• Track how much salt is in your diet: Record what you eat and drink.
• Eat fewer processed foods: Limit or eliminate potato chips, frozen foods, bacon, and lunch meats.
• Don't add salt: Use herbs or spices instead.

5. Limit the amount of alcohol you drink:

• Don't start drinking alcohol if you normally don't drink. Moderate drinking (one drink per day), however, can reduce blood pressure in those who do drink.
• Track drinking patterns;
• Consider tapering off;
• Don't binge [drink].

6. Avoid tobacco products and second-hand smoke;
7. Cut back on caffeine;
8. Reduce your stress;
9. Monitor your blood pressure at home and make regular doctor appointments:

• Schedule regular appointments with a primary care physician once or twice yearly.

10. Get support from family and friends.

(10 Ways, 2012, July 19, p. 1-2)

*Weight Management

Waist size predicts hypertension.

Obesity management interventions delivered in primary care for patients with hypertension or cardiovascular disease: A review of clinical effectiveness. (2014, July). Canadian Agency for Drugs and Technologies in Health. [Excerpt only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25473691

Since patients diagnosed with hypertension often fail to translate behavioral changes associated with weight loss into long-term behavioral maintenance, prescribing anti-obesity drugs might be a good strategy for those patients that can safely tolerate this strategy. Weight loss improves cardiovascular risk factors like glycemic control and the reduction of cholesterol levels. Weight loss, in turn, increases physical activity, reduces the risk of atherosclerosis, cardiovascular events, stroke, and type 2 diabetes. A reduction in triglycerides and an increase in HDL cholesterol occurs with as little as a five to ten percent reduction in body weight.

Tyson, C.C., Appel, L. J., & Vollmer, W. M., et al. (2013, July). Impact of 5-year weight change on blood pressure: Results from the Weight Loss Maintenance trial. Journal of Clinical Hypertension.(Greenwich, Conn.), 15(7), 458-64. doi: 10.1111.jch.12018. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23815533

Researchers evaluated participants in a longitudinal weight loss maintenance regime for weight loss, weight stability, and weight gain at a year, 30 months, and five years, respectively, observing correlations between weight change and diastolic and systolic blood pressure. Mean systolic blood pressure increased in participants who either gained weight or maintained a stable weight, but they didn't increase in the weigh loss group while diastolic blood pressures remained stable for five years. These results thus suggest that continued gradual, modest weight loss may sufficiently lower blood pressure in the long term.

Waist size matters. (2015). Obesity Prevention Source. School of Public Health. Harvard University. Retrieved from http://www.hsph.harvard.edu/obesity-prevention-source/obesity-definition/abdominal-obesity/

How Abdominal Fat Increases Disease Risk

More than sixty years ago a French physician associated larger waists with a higher risk of premature cardiovascular disease (Vague, J., 1947, La diffrentiation sexuelle. Facteur determinant des formes de l'obesity. Press Med., 30, 339-40). Since then, follow-up studies have verified his finding while linking abdominal-obesity with the risk of developing type 2 diabetes even after controlling for Body Mass Index (BMI) (Waist size, 2015, para. 1).

Apple- and Pear-shaped Body Types

Abdominal obesity results in an apple-shaped body type. However, two popular ways to determine abdominal obesity are measuring the waist's circumference and determining waist size compared to hip-size, or the waist-to-hip ratio (Waist size, 2015, para. 2-3).

Even in those individuals who aren't otherwise overweight but who have a large waist are at a higher risk for health problems than those with a narrower waist. The Nurses' Health Study (2008),

which looked at the relationship between waist size and deaths from heart disease and cancer in middle-aged women, for example, found that after 16 years women who had the largest waist sizes (35 inches or higher) doubled their risk of heart disease when compared with those women who had the smallest waist size (less than 28 inches). Moreover risks increased with every added inch to the waist (Waist size, 2015, para. 4-5). Even women was a normal BMI were at risk if they carried more of their body weight around the waist (Waist size, 2015, para. 6). The Shanghai Women's Health Study (2007) came up with the same findings (Waist size, 2015, para. 6).

Larger waists are so risky because the fat surrounding the liver and other abdominal organs is metabolically active, thus releasing fatty acids, inflammation, and hormones that lead to higher LDL cholesterol, triglycerides, blood glucose levels, and a rise in blood pressure (Waist size, 2015, para. 7).

Which Is Best: Waist or Waist-to-Hip?

A 2007 study associated both waist-to-hip and weight circumference with cardiovascular risk while additional studies have found they predict future type 2 diabetes, heart disease, and cancer diagnoses (Waist size, 2015, para. 8-9).

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13 ways to lower blood pressure naturally. (2014 August1). Prevention. Retrieved from http://www.prevention.com/health/how-lower-blood-pressure-naturally

1. Go for power walks: Walk briskly for at least 30 minutes daily;
2. Breathe deeply: Practice qigong, yoga, or tai chi;
3. Pick potatoes: Regularly include potassium-rich foods, like potatoes, in a heart-healthy diet;*
4. Be salt smart: Cut sodium by stirring away from processed foods;
5. Indulge in dark chocolate [in moderation];.
6. Take a supplement: Ask the family doctor about taking coenzymeQ10;
7. Drink a little alcohol: Moderate drinking lowers blood pressure;
8. Switch to decaf coffee;
9. Take up [hibiscus] tea;
10. Work a little less [more than 41 hours per week];
11. Relax to music: Listen to soothing, classic, Celtic, or Indian music for 30 minutes daily];*
12. Seek help for snoring;
13. Jump for soy [as well as nuts].

Obviously, all cooked foods need to be broiled, grilled, or boiled rather than fried.

*Taking up Hibiscus Tea:

Drinking hibiscus or tisane tea lowers blood pressure.

Hibiscus. (2015). Find a Vitamin Supplement. WebMD. Retrieved from http://www.webmd.com/vitamins-supplements/ingredientmono-211-HIBISCUS.aspx?activeIngredientId=211&activeIngredientName=HIBISCUS

Some researchers think hibiscus might be an effective treatment for high blood pressure. WebMD reviews rate it “possibly effective” along with such common alternative treatments for high blood pressure and hypertension as co-enzyme Q-10, fish oil, and potassium while not enough evidence exists to truly evaluate whether soy is an effective treatment for high blood pressure.

Hopkins, A. L., Lamm, M. G., and Funk, J. L. et al. (2013, March). Hibiscus sabdarrffa L. in the treatment of hypertension & hyperlipidemia: A comprehensive review of animal and human studies. Fitoterapia, 85 (84-94). doi: 10.2026/j.fitnote.2013.01.003. [Abstract only]. Retrieved from

http://www.ncbi.nlm.nih.gov/pubmed/23333908

Hibiscus sabdarrffa is a home remedy for treating hypertension and hyperlipidenia without adverse side effects unless less taken in high doses, although it does act as a diuretic. Animal studies show that Hibiscus sabdarrffa extract reduces blood pressure in a dose dependent manner, and randomized clinical trails show that hibiscus tea significantly lowers systolic and diastolic blood pressure in adults with prehypertenson as well as moderate hypertension and type 2 diabetes, making it at least as effective at lowering blood pressure at Captropril, but less efficient than Lisinopril.

McKay, D. L., Chen, C.Y., and Saltzman, E., et al. (2010 February). Hibiscus sabdariffa L. tea (tisane) lowers blood pressure in pre-hypertensive and mildly hypertensive adults. The Journal of Nutrition, 140(2), 298-303. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20018807

A randomized, double-blind placebo controlled six week trial of 65 pre- and mild hypertensive adults age 30 to 70 not taking blood pressure lowing medications found that daily drinking three 240 milliliter servings of hibiscus tea lowered systolic blood pressure when compared with a placebo. Tea sippers with a high systolic blood pressure at baseline exhibited a greater response to hibiscus tea.

*Relaxing to Music:

Classical Indian music lowers blood pressure.

Brookes, Linda. (2005). Significantly new definitions, publications, risks, benefits: Music can reduce blood pressure, depending on the tempo. Medscape Multispecialty. Retrieved from http://www.medscape.org/viewarticle/514644_6

Listening to music with a fast tempo increases blood pressure while listening to slower music lowers it. Introducing a pause, in turn, lowers blood pressure even further, and these effects particularly apply to individuals who have had musical training, according to a study published in the British medical journal, Heart (Brookes, 2005, para. 1). Study participants in Italy and the United Kingdom listened to six selections played in random order whereupon researchers documented that faster tempos and simpler rhythmic structures increased ventilation, breathing rate, systolic and diastolic blood pressure, mid-cerebral artery flow velocity and heart rate while slow music exercised less effect, although Indian raga induced a “significant drop” in heart rate (Brookes, 2005, para. 2-4).

Stephenson, Jason. (2013, November 28), How to naturally lower blood pressure and lose stress fast. Youtube. (30.05 minutes). Retrieved from https://www.youtube.com/watch?v=_vEoi4B-ca

------. (2013 December 1). Hypnotic music: Trance music for meditation helps to lower blood pressure eases chronic pain. Youtube. (45.00 minutes. Retrieved from https://www.youtube.com/watch?v=O8viwR35FrI

*Jumping for Soy:

Soy can lower blood pressure, but it does have its own hazards.

Mohammadifard, N. , Salehi-Abarghovei, A., and Salas-Salvado, J. (2015, March). The effect of tree nut, peanut, and soy nut consumption on blood pressure: A systematic review and meta-analysis of randomized controlled clinical trials. The American Journal of Clinical Nutrition. pii. Ajcn091595. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25809855

Scanning Medline, SCORPUS, ISI Web of Science, and Google Scholar between 1958 and October 2013, researchers found that nut consumption leads to a “significant reduction” in systolic blood pressure in study participants without type-2 diabetes. Pistachios most effectively reduced systolic and diastolic blood pressure.

Stradling, C., Hamid, M., & Fisher, K., et al. (2013, December). A review of dietary influence on cardiovascular health: Part 1. The role of dietary nutrients. Cardiovascular & Hermatalogical Disorders Drug Targets, 13(3), 208-30. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24304234

Upon searching the Cochrane Library database between 2006 and 2012, researchers found evidence that “underpins current dietary cardiovascular guidelines—replacing saturated and unsaturated fat, consuming whole grains or carbohydrates of low on the glycaemic index, increasing the consumption of fruit, cruciferous vegetables, nuts, and oily fish. Additionally, adding soya protein to one's diet and reducing sodium intake reduces cardiovascular disease risk. Furthermore, dietary changes, such as consuming fewer animal and processed foods, results in a reduction in saturated fats.

____________

Selected Research Studies on the Affect

 of Diet upon Blood Pressure

Research also suggests that a diet that emphasizes fruits and vegetables as well as including at least two servings of oily fish per week in the diet help to lower blood pressure and improve cardiovascular health and ward off Alzheimer's at the same time.

Afolayan, A. J. & Wintola, O. A. (2014, April 3). Dietary supplements in the management of hypertension and diabetes—a review. African Journal of traditional, complementary, and alternative medicines: AIRCAM/African Networks on Ethnomedicines, 11(3), 248-58. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25371590

Orthodox drugs used in the treatment of hypertension and diabetes may produce adverse side affects like headaches, nausea, vomiting, stomach pain, constipation, diarrhea, weakness, fatigue, and erectile dysfunction. However, relying on vitamins, minerals, amino acids, herbs and other botanical treatments as well as a diet that emphasizes fruits and vegetables in many instances provide safer and less expensive alternatives to conventional pharmaceuticals particularly in third-world countries.

Mori, T. A. (2014, September). Omega-3 fatty acids and cardiovascular disease: Epidemiology and effects on cardiometabolic risk factors. Food & Function, 5(9) 2004-19. doi: 1039/c4fo009d. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25062404

Clinical and epidemiological studies support evidence that polyunsaturated omega-3 fatty acid from fish and recommended dosages of fish oil protects the cardiovascular system, favorably influencing risk factors for blood pressure, vascular reactivity, and cardiac function without being associated with any adverse effects, including the risk of heavy bleeding. Health professions thus recommend two serving of fish weekly. The general population should incorporate these servings of fish in a diet plan that increases the consumption of fruits and vegetables while moderating salt intake.

Rees, K. Hartley, L., and Floers, N. et al. (2013, August). 'Mediterranean' dietary pattern for the prevention of cardiovascular disease. The Cochrane Database of Systematic Reviews, 12(80. CD009825. doi: 1002/14651858.CD009825.pub2. [Abstract only]. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23939686

After the Seven Countries Study found in the 1960s that countries surrounding the Mediterranean experienced lower cardiovascular disease mortality rates than Northern Europe and North America, observational studies confirmed these findings, but clinical evidence documenting the diet's benefits for the most part was lacking until researchers searched electronic databases from 1946 to 2012. A Mediterranean diet by definition has a high monounsaturated to saturated fat ratio and features low to moderate red wine intake as well as a high consumption of legumes, grains, cereals, fruits, and vegetables while severely limiting meat and meat products while increasing the amount of fish eaten, and only consuming dairy products in moderation. Researchers eventually included 11 trials and 15 papers in their survey, and this limited evidence suggests that following a Mediterranean diet may benefit cardiovascular health.

Wanjek, Christopher. (2015, March). 'MIND ' your diet and protect against Alzheimer's. Yahoo.com. Retrieved from http://news.yahoo.com/mind-diet-protect-against-alzheimers-144212880.html

Following the MIND diet as documented in the Online March issue of Alzheimer's and Dementia, results in a 35 percent reduction in the risk of Alzheimer's (Wanjek, 2015, March 25, para. 2, 4, & 11). The MIND diet, which combines the DASH and Mediterranean diets, emphasizes green leafy vegetables, along with other vegetables, nuts, berries, beans, whole grains, fish poultry, olive oil, and wine. Conversely, MIND dieters should avoid red meat, butter and stick margarine, cheese, pastries, and sweets (Wanjek, 2015, March 25, para. 10).

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Addendum

August 31, 2015

The American Heart Association recommends that healthy adults eat two servings of Omega-3 fatty fish weekly, although the University of Maryland Medical Center cautions that three servings of Omega-3 fish week may raise the rise of hemorrhagic stroke.  The Website also cautions that it’s important to consult a physician before taking more than three grams of Omega-3 fatty fish capsules daily (Omega 3 fatty acid, 2015, para. 8 & 21). 

Fish and Omega-3 fatty acid. (2015, June 15). American Heart Association http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Fish-and-Omega-3-Fatty-Acids_UCM_303248_Article.jsp

Omega 3 fatty acids. (2015).  University of Maryland Medical Center.  Retrieved from http://umm.edu/health/medical/altmed/supplement/omega3-fatty-acids

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The links furnished on this Web page represent the opinions of their authors, so they complement—not substitute—for a physician’s advice.