Nutritional Pearls: What Snack Could Help Lower Blood Pressure?
Max is a 45-year-old man with mild hypertension. He says he has been struggling to cut down on the salty foods that he loves.
He asks if you have any advice to help wean him off of salty, savory snacks.
How do you advise your patient?
What is the correct answer?
(Answer and discussion on next page)
Dr. Gourmet is the definitive health and nutrition web resource for both physicians and patients with evidence-based resources including special diets for coumadin users, patients with GERD/acid reflux, celiac disease, type 2 diabetes, low sodium diets (1500 mg/d), and lactose intolerance.
Timothy S. Harlan, MD, is a board-certified internist and professional chef who translates the Mediterranean diet for the American kitchen with familiar, healthy recipes. He is an assistant dean for clinical services, executive director of The Goldring Center for Culinary Medicine, associate professor of medicine at Tulane University in New Orleans, faculty chair of the all-new Certified Culinary Medicine Specialist program, and co-chair of the Cardiometabolic Risk Summit.
Now, for the first time, Dr. Gourmet is sharing nutritional pearls of wisdom with the Consultant360 audience. Sign up today to receive an update from the literature each week.
Answer: For patients that are salty/savory snackers, recommend nuts—especially pistachios—as their go to snack.
Not only are nuts part of the Mediterranean Diet, there's been quite a bit of research on nuts themselves and into specific types of nuts, including walnuts, pistachios, and almonds. Adding nuts to your diet has been associated with reducing your risk of type 2 diabetes (even without losing weight), improving your cholesterol scores, and reducing your risk of death from any cause.
_______________________________________________________________________________________________________________________________________________________________
RELATED CONTENT
Could Nuts and Olive Oil Protect Cognitive Function?
Could Eating Nuts Lower Mortality Risk?
_______________________________________________________________________________________________________________________________________________________________
Eating nuts has also been associated with a lower risk of high blood pressure along with heart disease risk factors like diabetes and poor cholesterol scores. In an effort to link nut intake directly to blood pressure, an international team of researchers performed a meta-analysis of multiple studies that looked at nut consumption and also reported on the participants' blood pressures.1
The Research
The 21 studies they included in their analysis were all randomized controlled trials (the gold standard of clinical research), specifically focused on the effects of consuming single or mixed nuts on systolic blood pressure or diastolic blood pressure, and included adults 18 or over. For the purposes of their research the scientists included walnuts, almonds, pistachios, cashews, hazelnuts, macadamia nuts, pecans, peanuts, and soy nuts in their definition of nuts, even though technically peanuts and soy nuts are legumes.
The pooled results included 1,652 men and women between the ages of 18 and 86 from studies that lasted anywhere from 2 to 16 weeks.
The Results
They found, somewhat surprisingly, that almonds, walnuts, cashews, peanuts, and soy nuts, when considered by themselves or as part of mixed nuts, had no significant effect on systolic blood pressure.
Pistachios, however, seemed to help reduce both systolic and diastolic blood pressures in amounts that can be considered clinically significant: as much as 3 points lower for systolic blood pressure and 2 points lower for diastolic blood pressure.
The authors note that the preparation of the nuts varied across the different source studies: some were roasted with oil, some dry-roasted, some salted, etc. That may have an effect on the results. What you can be sure of is that nuts are great—and pistachios may be best, at least for blood pressure control. For our patients that are salty/savory snackers, recommend nuts as their go to snack
Reference:
1. Mohammadifard N, Salehi-Abargouei A, Salas-Salvado J, et al. The effect of tree nut, peanut, and soy nut consumption on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. Am J Clin Nutr. 2015;101:966-82.