Healthy

eating habits
for patients with hypertension
A noncommunicable disease education manual for primary health care professionals and patients
Healthy
eating habits
for patients with hypertension
A noncommunicable disease education manual for primary health care professionals and patients
The Noncommunicable Disease Education Manual for Primary Health Care Professionals and Patients results from the contributions and hard work of many
people. Its development was led by Dr Hai-Rim Shin, Coordinator, and Dr Warrick Junsuk Kim, Medical Officer, of the Noncommunicable Diseases and Health
Promotion unit at the WHO Regional Office for the Western Pacific (WHO/WPRO/NCD) in Manila, Philippines.

WHO graciously acknowledges the intellectual contributions of Dr Jung-jin Cho, Co-director, Community-based Primary Care Project Committee and Professor,
Department of Family Medicine, Hallym University Sacred Heart Dongtan Hospital, Republic of Korea; Dr Hyejin Lee, Volunteer, WHO/WPRO/NCD (currently PhD
candidate, Department of Family Medicine, Seoul National University, Republic of Korea); Ms Saki Narita, Volunteer, WHO/WPRO/NCD (currently PhD candidate,
Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Japan); and Mr Byung Ki Kwon, Technical Officer, WHO/WPRO/NCD
(currently Director, Division of Health Promotion, Ministry of Health and Welfare, Republic of Korea).

Many thanks to Dr Albert Domingo, Dr Sonia McCarthy, Ms Marie Clem Carlos, Dr Katrin Engelhardt, Mr Kelvin Khow Chuan Heng and Dr Roberto Andres Ruiz
from the WHO Regional Office for the Western Pacific and Dr Ma. Charina Benedicto, Physician-in-Charge, Bagong Barangay Health Center & Lying-in Clinic,
Pandacan, Manila, Philippines for reviewing the draft publication.

Financial support for this publication was received from the Korea Centers for Disease Control and Prevention, Republic of Korea.

No conflict of interest was declared.

This is a translation of a manual published by the Ministry of Health and Welfare and Community-based Primary Care Project Committee in the Republic of Korea.
Some of the content has been adapted, with permission, to align with current WHO recommendations and policies. However, the views expressed in the manual
do not necessarily reflect the policies of the World Health Organization. The source publication was developed under the leadership of Dr Jung-jin Cho (also
mentioned above); Mr Hyunjun Kim, Co-director, Community-based Primary Care Project Committee and Director General, Bureau of Health Policy, Ministry of
Health and Welfare, Republic of Korea; and Dr Sunghoon Jung, Deputy Director, Division of Health Policy, Ministry of Health and Welfare, Republic of Korea.

All illustrations were provided by the source publication.

Photo credits
©Shutterstock: pages 1, 2, 7, 8, 11-16, 19, 20-28

ISBN 978 92 9061 799 0

© World Health Organization 2017
Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence.
 Noncommunicable disease education manual
for primary health care professionals and patients

Part 1 Prevention and management of hypertension

Module 1 Diagnosis and management
Module 2 Healthy lifestyles
Module 3 Healthy eating habits ◄ YOU ARE HERE
Module 4 Low-salt diet
Module 5 Physical activity
Module 6 Medication and management of associated diseases
Module 7 Complication prevention

Part 2 Prevention and management of diabetes

Module 1 Diagnosis and management
Module 2 Healthy lifestyles
Module 3 Healthy eating habits 1
Module 4 Healthy eating habits 2
Module 5 Physical activity
Module 6 Taking care of yourself in daily life
Module 7 Complication prevention

Part 3 Quit smoking

 How to use this manual
This book is one of fifteen modules of the “Noncommunicable disease education manual for primary health
care professionals and patients”. This manual is intended to provide health information on the prevention and
control of hypertension and diabetes.

This will be used in the form of a flip chart for health professionals to educate their patients with either
hypertension or diabetes.

Diagnosis and management for patients with hypertension

FOR PATIENTS
Blood pressure target
On one side of the flip chart is the ‘For patients’ page. This side has simple
Systolic blood
pressure
Diastolic blood
pressure
images and key messages that are easy to understand. However, health
professionals may need to provide education for patients to fully understand the
content.
Under Under

140
mmHg
90
mmHg

*Age more than 80: blood pressure to be controlled below 150/90 mmHg

11 FOR PATIENTS

Diagnosis and management for patients with hypertension

FOR PHYSICIANS
Blood pressure target
Patient education Professional information
On the other side of the flip chart is the ‘For physicians’ page. This side
•

•
Blood pressure below 140/90 mmHg is
generally advised to prevent complications.
However, blood pressure targets can be
Target blood pressure

• According to the Eighth Joint National

includes information that the health professional can read out to the patient
during counselling. Professional information is also provided for further
adjusted according to age, number and type of Committee (JNC8), those over age 80 are
risk factors, and associated diseases. advised that their target blood pressure should
be below 150/90 mmHg.
• Therefore, if you have hypertension, you should
consult your physician to set a target after • Target blood pressure should be below

understanding. A small image of the ‘For patients’ side is included so that the
evaluating your current health status and risk 140/90 mmHg for hypertension combined with
factors. cerebrovascular disease and atherosclerosis.
Systolic blood Diastolic blood • For those under age 80 maintain below 140/90
pressure pressure

health professional is aware of what the patient is looking at.

mmHg; those over age 80 maintain below
150/90 mmHg.
Under Under

140
mmHg
90
mmHg

*Age more than 80: blood pressure to be controlled below 150/90 mmHg

REFERENCE:
James, Paul A., et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8).
JAMA, 2014, 311.5: 507-520.

12 FOR PHYSICIANS

This publication is intended to serve as a template to be adapted to national context. Images and graphs
that have been watermarked should be replaced with images or graphs that represent the national
situation. If assistance is required, or if you have any questions related to the publication, please contact
the Noncommunicable Diseases and Health Promotion unit at WHO Regional Office for the Western Pacific
(wproncd@who.int).
 Table of contents
Module 3
Healthy eating habits for patients with hypertension

1 Lifestyle management: diet

3 Healthy foods to lower blood pressure
5 Why a low-fat diet?
7 Low-fat diet: less saturated fat
9 Low-fat diet: choosing healthy fats
11 Low-fat diet: reduce cholesterol
13 Low-fat diet: more fibre
15 Low-fat diet Q & A (1)
17 Low-fat diet Q & A (2)
19 Low-fat diet Q & A (3)
21 Specific plans for a low-fat diet
23 Choose healthy carbohydrates
25 Health risks of eating too much salt
27 Eat healthy
29 Take-home message
 Healthy eating habits for patients with hypertension

Lifestyle management: diet

Increase fruit Maintain healthy/ Reduce

and vegetable appropriate salt and fat
consumption weight intake

O:
H OTently
T eP qu d n
S ERes of ffrruits a
IN pm
l d
e ble s ’
exaonsumgeta
c v e

1 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Lifestyle management: diet

Patient education Professional information
• Managing your diet is very important in • When a patient with hypertension eats food
controlling hypertension. high in salt, the sodium in the salt increases
• Methods include reducing salt and saturated blood volume, resulting in higher blood
fat intake and consuming adequate amounts pressure.
of vegetables and fruits to maintain a healthy • It is very important to reduce salt intake from
weight. the estimated global level of 9-12 grams per
day to the recommended WHO maximum target
of 5 grams per day.
• This has demonstrated the potential to reduce
the global cardiovascular disease rate by 17%
and global stroke rate by 23%.
Increase fruit Maintain healthy/ Reduce
and vegetable appropriate salt and fat
consumption weight intake

O:
OT tly
T PHrequennd
ER of f its a
INSmples ed frbules’
exaonsumgeta
c ve

REFERENCES:
Strazzullo, Pasquale, et al. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ, 2009, 339: b4567.
World Health Organization. The joint WHO/FAO report on diet, nutrition and the prevention of chronic diseases. Geneva, 2003.
World Health Organization and World Economic Forum. From Burden to “Best Buys”: reducing the economic impact of non-communicable diseases in low- and middle-income countries, 2011.

2 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Healthy foods to lower blood pressure

How should I eat to lower

my blood pressure?
• Eat a wide variety from all food
groups.
• Eat adequate amounts of healthy
carbohydrates.
• Reduce saturated fats and trans fats. O:
H OT a d
T h P ow ul
• Reduce salt. ERple of eal w
o
S
IN m l m ed
exa l loca splay
ca di
typi be

3 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Healthy foods to lower blood pressure

Patient education
How should I eat to lower my blood pressure?

• Eat a wide variety from all food groups.

• Eat adequate amounts of healthy
carbohydrates.
• Reduce saturated fats and trans fats.
• Reduce salt.
O:
H OT a d
T h P ow ulo
ER le of al w
INSxampcal mleayed
e l lo sp
ica di
typ be

REFERENCES:
Ray, Kausik K., et al. The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain: a
comparison with ESC/EAS guidelines for the management of dyslipidaemias 2011. European Heart Journal, 2014, ehu107.
McGuire, Shelley. U.S. Department of Agriculture and U.S. Department of Health and Human Services (United States), Dietary Guidelines for Americans, 2010. Advances in Nutrition: an international
review journal, 2011, 2.3: 293-294.
Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute (United States). Your guide to lowering your blood pressure with DASH. DASH eating
plan, 2006.
World Health Organization. Salt matters for Pacific island countries: mobilizing for effective action to reduce population salt intake in the Pacific island countries. 2014.

4 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Why a low-fat diet?

Dyslipidaemia* prevention
• 50% of patients with high cholesterol
levels have hypertension
• Associated hypertension and
dyslipidaemia raise the risk of
cardiovascular complications
• It is important to maintain blood
cholesterol and triglyceride levels in
the normal range

* Dyslipidaemia
Abnormally elevated blood cholesterol and
triglyceride levels

5 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Why a low-fat diet?

Patient education Professional information
• For patients with hypertension, managing • Modifying lifestyles that have a bigger
dyslipidaemia is very important. effect scale (+++ being the highest) and
• Dyslipidaemia is when blood cholesterol and stronger evidence (A being the strongest) of
triglycerides are abnormally high. effectiveness in lowering blood cholesterol

• The risk of cardiovascular complications Lifestyle habit change Effect scale Strength of evidence
increases when a hypertension patient also has Less saturated fat +++ A
dyslipidaemia. Less trans fat +++ A
Food abundant in phytosterols +++ A
• Therefore, it is important to maintain blood Abundant dietary fibre intake ++ A
cholesterol and triglycerides within a normal Physical activity + A
range. Less cholesterol intake ++ B
Weight reduction + B
• For dyslipidaemia management, a low-fat,
low-cholesterol diet and regular exercise are
Dyslipidaemia* prevention
recommended first. If it is not controlled after
• 50% of patients with high cholesterol levels have
3–6 months of dietary restriction and regular hypertension
exercise, drug therapy is needed. • Associated hypertension and dyslipidaemia
raise the risk of cardiovascular complications
• It is important to maintain blood cholesterol and
triglyceride levels in the normal range

* Dyslipidaemia
Abnormally elevated blood cholesterol and triglyceride levels

REFERENCE:
Ray, Kausik K., et al. The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain: a
comparison with ESC/EAS guidelines for the management of dyslipidaemias 2011. European Heart Journal, 2014, ehu107.

6 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Low-fat diet: less saturated fat

Ways to achieve lower saturated fat intake
= regular and even intake from various food groups

Dietary factor Goal (% of total energy,

otherwise stated)
Adequate
Total fat 15–30%
amount
Saturated fat < 10%
Polyunsaturated fat 6–10%
Monounsaturated fat By differencea
Trans fatty acids < 1%
Regular
Cholesterol < 300 mg per day
time
Carbohydrate 55–75%b
Free sugarsc < 10%
Protein 10–15%d
Variety of
a
b
This is calculated as: total fat – (saturated fatty acids + polyunsaturated fatty acids + trans-fatty acids).
The percentage of total energy available after taking into account that consumed as protein and fat,
foods
hence the wide range.
c
The tern “free sugars” refers to all monosaccharides and disaccharides added to foods by the
manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and fruit juices.
d
The suggested range should be seen in the light of the Joint WHO/FAO/UNU Expert Consultation on
Protein and Amino Acid Requirements in Human Nutrition, held in Geneva from 9 to 16 April 2002.

7 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Low-fat diet: less saturated fat

Patient education
• Many studies have been published about the Goal (% of total energy,
relationship between fat intake and blood Dietary factor
otherwise stated)
pressure, one of which showed that saturated Total fat 15–30%
fat intake is associated with the risk of Saturated fat < 10%
cardiovascular diseases.
Polyunsaturated fat 6–10%
• The easiest way to cut the intake of saturated Monounsaturated fat By differencea
fat is to be in the habit of eating a variety of Trans fatty acids < 1%
food groups regularly. Cholesterol < 300 mg per day
Carbohydrate 55–75%b
Free sugars c
< 10%
Protein 10–15%d

Adequate amount Regular time Variety of foods

REFERENCE
World Health Organization (2003) Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation.

8 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Low-fat diet: choosing healthy fats

Reduce saturated fat, replace with unsaturated fat

Saturated Monounsaturated Polyunsaturated fat
fat fat Omega-6 Omega-3
• Animal fat (oxtail, • Olive oil • Corn oil • Fish oil (mackerel,
rib, bacon) salmon, herring,
• Canola oil • Safflower seed oil tuna)
• Dairy products
(milk, cheese, ice • Avocado oil • Sunflower oil • Seafood
cream) • Peanut oil • Soybean oil
• Coconut oil • Sesame oil • Perilla oil
• Palm oil (noodles, • Grape seed oil
crackers) • Canola oil
• Soybean oil • Nuts
• Butter
• Primrose oil

9 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Low-fat diet: choosing healthy fats

Patient education
• Substituting unhealthy fat (saturated) with healthy fat (unsaturated) is better than reducing total fat itself.
• If you cut fat intake just because you think “fat is bad” and instead eat more carbohydrates such as sugar,
white bread, white rice and potatoes, you will gain more weight and your blood triglyceride levels will
increase.
• While excess energy intake through too much fat causes obesity, it is still important to eat an adequate
amount of the right kind of fat (unsaturated).

Reduce saturated fat, replace with unsaturated fat

Saturated Monounsaturated Polyunsaturated fat
fat fat Omega-6 Omega-3
• Animal fat (oxtail, • Olive oil • Corn oil • Fish oil (mackerel,
rib, bacon) salmon, herring,
• Canola oil • Safflower seed oil tuna)
• Dairy products
(milk, cheese, ice • Avocado oil • Sunflower oil • Seafood
cream) • Peanut oil • Soybean oil
• Coconut oil • Sesame oil • Perilla oil
• Palm oil (noodles, • Grape seed oil
crackers) • Canola oil
• Soybean oil • Nuts
• Butter
• Primrose oil

REFERENCE:
McGuire, Shelley. U.S. Department of Agriculture and U.S. Department of Health and Human Services (United States), Dietary Guidelines for Americans, 2010. Advances in Nutrition: an international
review journal, 2011, 2.3: 293-294.

10 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Low-fat diet: reduce cholesterol

Eat less • Meat: remove skin, trim fat,

reduce processed meat intake
unhealthy fat • Reduce liver, intestine intake
• Milk, dairy products: eat low-
fat or fat-free milk

: :
O TO ds O TO ds
P lH fo o P l H fo o
E RTof locaat’ E RTof locaat’
S e
IN mpl igh inf S e
IN mpl igh inf
exa h exa h

11 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Low-fat diet: reduce cholesterol

Patient education
• It is important to cut down on fat because most patients with hypertension normally have dyslipidaemia
and need to control their weight. When you eat meat, try to avoid the fat.
• Reduce liver, intestine or processed meats consumption. Choose low-fat or fat-free dairy products.

Eat less • Meat: remove skin, trim fat,

reduce processed meat intake
unhealthy fat • Reduce liver, intestine intake
• Milk, dairy products: eat low-
fat or fat-free milk

: :
TO s TO s
P HOl food P HOl food
T ca T ca
ER of lo at’ ER of lo at’
INSmpleigh in f INSmpleigh in f
exa h exa h

REFERENCES:
McGuire, Shelley. U.S. Department of Agriculture and U.S. Department of Health and Human Services (United States), Dietary Guidelines for Americans, 2010. Advances in Nutrition: an international
review journal, 2011, 2.3: 293-294.
Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute (United States). Your guide to lowering your blood pressure with DASH. DASH eating
plan, 2006.

12 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Low-fat diet: more fibre

Eat more Fibre

dietary fibre • Prevents cholesterol absorption and synthesis.

• Decreases the absorption speed of carbohydrates.
• Decreases the incidence of complications and cancer.
• Aids the digestive system.
• Abundant in vegetables, fruits, grains and seaweeds.

13 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Low-fat diet: more fibre

Patient education
• Eating fibre has benefits, such as aiding weight loss, even if it does not reduce blood pressure directly.
Foods high in fibre are fruits, vegetables, oats, dry beans, seaweed and grains.
• Fibre also prevents absorption and production of cholesterol.
• It also has the positive effect of reducing the absorption rate of carbohydrates, as well as the incidence of
constipation and cancer.
• Some studies report decreasing blood pressure as a result of eating more dietary fibre, but this needs
more research.

Eat more dietary fibre

Fibre
• Prevents cholesterol absorption and synthesis.
• Decreases the absorption speed of carbohydrates.
• Decreases the incidence of complications and cancer.
• Aids the digestive system.
• Abundant in vegetables, fruits, grains and seaweeds.

REFERENCES:
McGuire, Shelley. U.S. Department of Agriculture and U.S. Department of Health and Human Services (United States), Dietary Guidelines for Americans, 2010. Advances in Nutrition: an international
review journal, 2011, 2.3: 293-294.
Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. Your guide to lowering your blood pressure with DASH. DASH eating plan, 2006.

14 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Low-fat diet Q & A (1)

Q
Can I have high cholesterol even if
I don’t eat meat or fatty foods?

A
People who have genetic factors
or eat too much saturated fat
hidden in processed foods can
also have high cholesterol.

Animal fat Produced

from foods in the liver
(Dietary factor) (Genetic factor)

15 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Low-fat diet Q & A (1)

Patient education Professional information
• There are many patients with dyslipidaemia • If blood cholesterol level is high, even though
who are vegetarian, but still have high blood the patient does not eat any fatty food, checking
cholesterol. the intake of confectionary and whether the
• It is often due to eating too much (non-animal) patient has familial hypercholesterolaemia or
saturated fat, causing an increase in cholesterol thyroid dysfunctions is required.
production.

Q
• Sources may include pastries, cakes and Can I have high cholesterol even if
biscuits. I don’t eat meat or fatty foods?

• You can also find saturated fat in vegetable oils

such as palm oil.

A
People who have genetic factors
• Moreover, if you have genetic diseases or eat too much saturated fat
like familial hypercholesterolaemia or have hidden in processed foods can
hypothyroidism, blood cholesterol could also have high cholesterol.
increase by inhibition of cholesterol metabolism.

Animal fat Produced

from foods in the liver
(dietary factor) (genetic factor)

REFERENCE:
McGuire, Shelley. U.S. Department of Agriculture and U.S. Department of Health and Human Services (United States), Dietary Guidelines for Americans, 2010. Advances in Nutrition: an international
review journal, 2011, 2.3: 293-294.

16 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Low-fat diet Q & A (2)

Q
Is vegetable oil OK?
Recommended oils
Higher in unsaturated fat:
olive oil
sesame oil
perilla oil

A
Some vegetable oils are high in
Non-recommended oils
saturated fat too.
Higher in saturated
and trans fat:
palm oil
coconut oil

17 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Low-fat diet Q & A (2)

Patient education Professional information
• Some types of vegetable oil can increase blood • Vegetable oils rich in saturated fat and trans fat
cholesterol. should be avoided because they increase blood
• Oils such as palm oil and coconut oil have a lot cholesterol.
of saturated fat. • Unsaturated fats reduce blood cholesterol, but
• Margarine is made from vegetable oil, but overeating can lead to weight gain.
should be avoided because of its abundance of • Therefore, restricting intake by 20% is
trans fats, even though it also contains a lot of recommended.
unsaturated fat. • This means that dyslipidaemia patients should
• Meanwhile, beans, corn and olives are rich in cut their total fat intake, as well as reduce the
unsaturated fat, so they normally act to reduce proportion of saturated fat.
the level of blood cholesterol.

Q
Is vegetable oil OK?
Recommended oils Non-recommended oils
Higher in unsaturated fat: Higher in saturated
olive oil and trans fat:

A
Some vegetable oils are high in sesame oil palm oil
saturated fat too. perilla oil coconut oil

REFERENCE:
McGuire, Shelley. U.S. Department of Agriculture and U.S. Department of Health and Human Services (United States), Dietary Guidelines for Americans, 2010. Advances in Nutrition: an international
review journal, 2011, 2.3: 293-294.

18 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Low-fat diet Q & A (3)

Q
Is it better not to eat any meat, egg,
or squid?

A
• Rather than pork, choose
chicken breast, fish and tofu.
• Squid, prawn, crab and egg
are high in cholesterol, but
at the same time reduce
cholesterol absorption – they
are safe to eat once in a while.
• Substituting healthy fat
(unsaturated) for unhealthy
fat (saturated) is better than
reducing total fat only.

19 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Low-fat diet Q & A (3)

Patient education

Q
• Patients with hypertension and dyslipidaemia Is it better not to eat any meat, egg, or squid?
should eat an adequate amount of protein.
• It is better to eat protein from chicken, fish and

A
tofu, than from beef or pork. • Rather than pork, choose chicken
• In the past, eggs, squid, prawns and crabs were breast, fish and tofu.
restricted because they are high in cholesterol. • Squid, prawn, crab and egg are high
in cholesterol, but at the same time
• However, they are also abundant in sterols reduce cholesterol absorption – they
that have the effect of blocking cholesterol are safe to eat once in a while.
absorption. • Substituting healthy fat (unsaturated)
for unhealthy fat (saturated) is better
• In conclusion, seafood and eggs that are known than reducing total fat only.
to be high in cholesterol can be consumed
as long as you don’t eat too much or too
frequently.

REFERENCE:
McGuire, Shelley. U.S. Department of Agriculture and U.S. Department of Health and Human Services (United States), Dietary Guidelines for Americans, 2010. Advances in Nutrition: an international
review journal, 2011, 2.3: 293-294.

20 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Specific plans for a low-fat diet

• Start cooking • Remove skin • Use • Buy low-fat

after removing before cooking unsaturated or fat-free
excess fat. or eating. vegetable oil products.
when cooking.
• Use methods • Eat less than • Check the fat
that reduce oil the size of your • Cook in ways content and buy
(grill rather than palm (60–90 g) that use less oil products with
fry). per day. such as grilling no saturated
and steaming. fat.
• Eat less than
the size of your
palm (60–90 g)
per day.

21 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Specific plans for a low-fat diet

Patient education

• Start cooking • Remove skin • Use • Buy low-fat

after removing before cooking unsaturated or fat-free
excess fat. or eating. vegetable oil products.
when cooking.
• Use methods • Eat less than • Check the fat
that reduce oil the size of your • Cook in ways content and buy
(grill rather than palm (60–90 g) that use less oil products with
fry). per day. such as grilling no saturated
and steaming. fat.
• Eat less than
the size of your
palm (60–90 g)
per day.

REFERENCE:
McGuire, Shelley. U.S. Department of Agriculture and U.S. Department of Health and Human Services (United States), Dietary Guidelines for Americans, 2010. Advances in Nutrition: an international
review journal, 2011, 2.3: 293-294.

22 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Choose healthy carbohydrates

• Excessive carbohydrates  increase in triglycerides

• Accumulation of fatty acids  obesity, arteriosclerosis
• Instead of white rice, instant noodles and white
bread, choose brown rice, rye bread and potatoes.

white rice multi-grain bread brown rice

23 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Choose healthy carbohydrates

Patient education
• Moderate intake of carbohydrates is recommended because they can increase serum triglyceride, leading
to obesity and arteriosclerosis.
• It is important to eat brown rice and whole grain bread rather than carbohydrates with a high glycemic
index such as white rice, instant noodles and white bread.

• Excessive carbohydrates  increase in triglycerides

• Accumulation of fatty acids  obesity, arteriosclerosis
• Instead of white rice, instant noodles and white
bread, choose brown rice, rye bread and potatoes.

white rice multi-grain bread brown rice

REFERENCES:
American Diabetes Association. Standards of medical care in diabetes—2015. Diabetes Care, 2015.
International Diabetes Federation. Global guideline for type 2 diabetes. Brussels: IDF Clinical Guidelines Task Force, 2012.

24 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Health risks of eating too much salt

high sodium intake = disease burden

Hypertension
Angina
Stroke
Cancer
Heart attack
Dementia
Kidney disease

25 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Health risks of eating too much salt

Patient education
• Consuming too much salt (sodium) can cause various diseases.
• It increases the risk of not only hypertension and cardiovascular diseases, but also chronic kidney
disease, osteoporosis, and gastric cancer.
• Risk rises as intake increases.
• Salt makes your body hold on to more water.
• This extra stored water raises your blood pressure and puts strain on your kidneys, arteries, heart and brain.

high sodium intake = disease burden

Hypertension
Angina
Stroke
Cancer
Heart attack
Dementia
Kidney disease

REFERENCE:
McGuire, Shelley. U.S. Department of Agriculture and U.S. Department of Health and Human Services (United States), Dietary Guidelines for Americans, 2010. Advances in Nutrition: an international
review journal, 2011, 2.3: 293-294.

26 FOR PHYSICIANS
 Healthy eating habits for patients with hypertension

Eat healthy

Reduce salt • Eat less soup broth.

intake • Eat less pickled and

processed foods.
• Eat fresh, local food.

:
O: O: O TOl foodr
OT ds
H oo H oo OT ds H ca o
T P lo ing
RT Plocal lft RT Plocal lft S ER f freshdress
E of a E of a IN o no ed
INSmple gh in s INSmple gh in s le
mp with ad
d
exa hi exa hi exa lad) sauce
(sa

27 FOR PATIENTS
 Healthy eating habits for patients with hypertension

Eat healthy
Patient education
• A balanced diet is very important for people with hypertension.
• It is also vital to eat less salt (sodium).
• For example, instead of drinking the soup broth, eat only the ingredients in the soup.
• Also cut back on pickled and processed foods like ketchup, sausages and ham.

Reduce salt • Eat less soup broth.

intake • Eat less pickled and

processed foods.
• Eat fresh, local food.

:
: : TO od
TO s TO s HOlocal fog or
HO food HO food T P in
T P cal T P cal ER fresh ress
ER of lo alt ER of lo alt INSple ofth no ddded
INSmple gh in s INSmple gh in s m wi a
exa hi exa hi e a lad) sauce
x
(sa

REFERENCES:
Weber, Michael A., et al. Clinical practice guidelines for the management of hypertension in the community. The Journal of Clinical Hypertension, 2014, 16.1: 14-26.
James, Paul A., et al. 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8).
JAMA, 2014, 311.5: 507-520.
Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute (United States). Your guide to lowering your blood pressure with DASH. DASH eating
plan, 2006.

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 Healthy eating habits for patients with hypertension

Take-home message
Healthy eating habits

Healthy eating habits

• Less saturated fat, adequate
unsaturated fat.
:
• Eat from various food groups O TO
H a
regularly. RT Pof howl would
E le a
INSxampcal mleayed
• Choose healthy carbohydrates. e l lo sp
p ica be di
ty
• Reduce salt.

29 FOR PATIENTS