Special Diets
Special diets address specific health needs: The DASH diet combats hypertension with low sodium and nutrient-rich foods. Heart Healthy diets emphasize whole grains and lean proteins for cardiovascular wellness. Obesity and Weight Loss diets focus on calorie control for sustainable weight reduction. Renal diets for Chronic Kidney Disease (CKD) limit phosphorus, potassium, and sodium to ease kidney strain, highlighting kidney-friendly foods for disease management.
Dietary Approach to Stop Hypertension (DASH) Diet
DASH emphasizes fruits, vegetables, low-fat dairy products, whole grains, poultry, fish, and nuts. DASH is formulated initially for high blood pressure, one of the significant risk factors for heart attack. Therefore, diets contain only small amounts of red meat, salt, saturated and total fat, sweets, and sugar-containing products.
Salt intake is paramount to control high blood pressure, and the DASH diet plan recommends no more than 1,500 to 2,000 mg per day.
Hypertension in the United States
In 2018, nearly half a million deaths in the United States included hypertension as a primary or contributing cause. [1] Almost half of all adults in the United States (108 million, or 45%) have hypertension, defined as a systolic blood pressure ≥ 130 mm Hg or a diastolic blood pressure ≥ 80 mm Hg, or are taking medication hypertension. [2] Only about 1 in 4 adults (24%) with hypertension have their condition under control.[2]
What is normal blood pressure?
Normal blood pressure is defined as a systolic pressure below 120 mmHg and a diastolic pressure below 80 mmHg.
Potential benefits DASH
Obesity and high blood pressure are well-known risk factors for coronary artery disease. Although DASH is not designed to reduce weight, one could use it to control blood pressure and body weight by simply adding exercise or controlling calorie deficit. [5,6]
Given the tremendous burden of high blood pressure in the United States, DASH-Sodium Collaborative Research Group performed a high-quality trial to understand daily food’s impact on blood pressure control. A total of 412 participants were randomly assigned to eat either a control diet typical of intake in the United States or the DASH diet. Low salt DASH diets showed an incredible result with a reduction of 7.1 mm Hg lower in participants without hypertension and 11.5 mm Hg lower in participants with hypertension.[3]
An interesting finding from the DASH trial was that diet control alone could reduce blood pressure even in those with normal blood pressure. [3] Another trial, TOHP, verified the reduction in dietary sodium was associated with a better cardiovascular outcome. [4]
As the DASH diet includes fruit and vegetable content primarily, it could potentially decrease the risk of cancer, metabolic syndrome, and diabetes. [7-9] Moreover, a DASH-like diet can significantly protect against coronary heart disease, stroke, and heart failure risk by 21%, 19%, and 29%, respectively.[10]
How to apply it in daily life and what to eat?
DASH diet doesn’t apply to any specific type of food; instead, it recommends different food groups. 2019 AHA guidelines on lifestyle management to reduce cardiovascular risk suggests no more than 1500 mg/d, but aim for at least a 1000-mg/d reduction in most adults.[11]
Need to remind that dietary sodium can be difficult to track for patients, and patients must understand that limiting processed and fast foods will reduce their sodium intake to a far greater extent than ceasing to use salt in their cooking.
How to calculate a serving?
A serving should include:
- 1 slice of whole-grain bread
- 1 ounce (28 grams) of dry, whole-grain cereal
- 1/2 cup (95 grams) of cooked rice, pasta, or cereal
Original DASH diet plan [12]
Grains and grain products (include at least three whole-grain foods each day):
- Number of servings for 1600 – 3100 Calorie diets: 6 – 12
- Servings on a 2000 Calorie diet: 7 – 8
Fruits:
- Number of servings for 1600 – 3100 Calorie diets: 3 – 6
- Servings on a 2000 Calorie diet: 3 – 5
Vegetables:
- Number of servings for 1600 – 3100 Calorie diets: 4 – 6
- Servings on a 2000 Calorie diet: 4 – 5
Mostly low fat or non-fat dairy foods:
- Number of servings for 1600 – 3100 Calorie diets: 2 – 4
- Servings on a 2000 Calorie diet: 2 – 3
Lean meats, fish, or poultry:
- Number of servings for 1600 – 3100 Calorie diets: 1.5 – 2.5
- Servings on a 2000 Calorie diet: Two or less
Nuts, seeds, and legumes:
- Number of servings for 1600 – 3100 Calorie diets: 3 – 6 per week
- Servings on a 2000 Calorie diet: 4 – 5 per week
Fats and sweets:
- Number of servings for 1600 – 3100 Calorie diets: 2 – 4 per week
- Servings on a 2000 Calorie diet: limited
References
Heart Healthy Diet
Heart disease is the leading cause of death in United States and one person dies every 36 seconds in USA.[1] Moreover, the burden on health care is tremendous and cost about $219 billion each year from 2014 to 2015. [2] coronary artery disease is the most common type of heart disease, killing 365,914 people in 2017. [3]
What is a heart healthy diet?
Heart healthy diet is an art of balancing your foods: what you should eat vs can’t eat (most likely your favorite foods). Heart healthy diet should include the following:
- Fresh fruits, Nuts, and vegetables
- Leafy greens (spinach, collard greens, kale, cabbage, broccoli, and carrots)
- Fruits: apples, bananas, oranges, pears, grapes, and prunes
- Various Nuts: walnuts, almonds, and pine nuts
- Seeds (sesame, sunflower, pumpkin, or flax), tofu
- Whole grains:
- plain oatmeal, brown rice, and whole-grain bread or tortillas
- Healthy fats:
- Canola, corn, olive, safflower, sesame, sunflower, and soybean oils (not coconut or palm oil)
- Avocados
- Low fat protein:
- 95% lean ground beef or pork tenderloin or skinless chicken or turkey
- Eggs
- Legumes
- Fish (salmon, tuna, and trout)
What to limit?
Heart healthy food should limit saturated and trans fats, salt, alcohol, and sugars such as sweetened drinks, snacks and sweets. If you drink alcohol, you should do it in moderation. 2019 AHA guidelines recommend no more than 1500 mg/day of sodium but aim for at least a 1000-mg/d reduction in most adults.
Maintain a Healthy Body Weight
One way to track your body weight is to use BMI, called body mass index. The ideal BMIS should be 18-24.9, and everyone should attempt to achieve the goal weight. However, the benefit of weight loss can be seen even if there is a loss of ~5-10% of your weight.
References
Obesity & Weight Loss Diet
In the last decades, the global prevalence of
overweight and obesity rose by about 28% in adults and 47% in children, from 857 million in 1980 to 2.1 billion in 2013.[1] Data from the National Health and Nutrition Examination Survey reveal that the prevalence of abdominal obesity in the United States increased by about 6% in men and women over the period of 10 years (1999-2008). [2] In a simple term, obesity is mostly due to excess calorie intake for an extended period. Extra calories intake in USA is considered due to calories rich dietary patterns, as well as increase in sedentary lifestyle and overall, it has been estimated to be ~400 kcal/day in the United States. [3]
How to Lose Weight Safely
First, you should replace refined carbs with whole grains. If you start eating more complex carbohydrates along with a low carb diet plan, it will be beneficial not only from higher fiber content with slow digestion but also keep you stratified without feeling hungry.
Vegetables
Leafy vegetables are known to be rich sources of vitamins, and nutrients without significantly increasing calories
Protein
Healthy protein is an essential component of foods to keep you healthy and provide adequate nutrition to your muscles. Due to slower digestion of protein, it can help to reduce food cravings, late night snack
without feeling hungry. Daily recommended protein intake: 0.8g per kg of body weight, regardless of age. [4] Red meat (Beef, lamb, and pork) may have more unhealthy fat (saturated fat) that Fish, chicken, legumes. Therefore, choosing healthy protein source is important.
Healthy protein sources include:
- Meat: Chicken, Trimmed lean meats, Turkey
- Fish and seafood: salmon, trout, and shrimp
- Eggs: whole eggs with the yolk
- Plant-based: beans, legumes, quinoa, tofu
- Healthy Fats
Not all fats are unhealthy. Our body needs healthy fats daily, so choosing healthy fats source is important. Of these, olive oil and avocado oil are the good choices to start in your diet plan.
The benefit of being active and exercising is undeniable. Even though you have been sedentary for years, we all must start from somewhere. First, walking, swimming, cycling are good exercises to start.
Lifting weight also has a very good effect on your body’s metabolism while burning a lot of calories.
Renal Diet for Kidney Diseases
There are five stages of kidney disease. Stage 1 and 2 are the early stages of kidney disease. When you get to stage 3, only half of the kidney is left. In Stage 4 and Stage 5, your kidneys have suffered a lot of damage and may eventually require hemodialysis.
As the kidney plays a significant role in handling electrolytes and fluid balances in the body, it is imperative to closely watch the diets to reduce electrolyte imbalances and prevent wastes accumulation.
The renal diet is low in sodium, phosphorus, potassium, and calcium while emphasizing consuming high-quality protein and limiting fluid intake.
What does the renal diet compromise of?
What should be included in renal diets?
- Consume smaller portion of meat, poultry and fish
- avoid alcohol
- limit fat, sugars and added sugars
- Avoid sodium
As a damaged kidney cannot filter out extra sodium, it can cause elevated blood pressure. It’s recommended to limit sodium to less than 2,000 mg per day. [1,2]
If the potassium level is high in your blood test (a common finding in a renal patient), try to limit on;
- bananas, melons, oranges, and dried fruit
- potatoes, tomatoes, and avocados
- dark leafy vegetables
- brown and wild rice
- dairy foods
- beans, peas, and nuts
- bran cereal, whole wheat bread, and pasta
- salt substitutes
- meat, poultry, pork, and fish
Recommended daily potassium limit is less than 2,000 mg per day. [3]
If the phosphorus level is high in the blood test, the following food should be avoided or consume only a minimal amount if possible;
- dairy products
- nuts
- peanut butter
- dried beans, peas, and lentils
- cocoa, beer, and dark cola
- bran
Recommended dietary phosphorus limit is less than 800–1,000 mg per day. [4]
Do I need to limit fluid intake?
It depends on the stage of your kidney disease. Fluid restriction is very important in a higher degree of kidney disease, increasing the risk of fluid retention in the body.
Lifestyle Modification
- Daily exercise
- Avoid smoking or stop smoking
- Follow up with your physician regularly and take all prescribed medications
References