The right foods can free you from your medications

Though I’m very active, doing both cycling and weight training and maintaining a fairly healthful diet, I still need to take medication for low-level high blood pressure and high cholesterol.

I’ve heard that pomegranate juice is a good natural way to lower blood pressure. Are there other foods that I could include in my diet that might allow me to eventually stop taking these medications?

John G.

Oak Park

Bravo for your exceptional exercise routine, which will help immensely in keeping your blood pressure and cholesterol in check. And although you’re sticking to a healthful diet, no doubt some improvements can be made. Two experts on nutrition offer suggestions for adding and subtracting key foods.

You probably don’t need any preaching about cutting down on salt, but we’ll do it anyway. It’s generally believed by health experts that salt expands the volume of blood, which in turn gives the heart a greater workload since it must pump more blood around the body. “We were designed to run on pretty low salt intake,” says Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health and co-author of “Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating.” He recommends those with high blood pressure stick to about 1,000 to 1,500 milligrams of salt a day.

That’s a fairly easy task if you’re eating only home-prepared food and are able to check nutrition labels to see amounts of sodium per serving. However, when you go out to eat, it’s anybody’s guess how much salt you’re consuming -- and we’ll guess it’s a lot. Restaurants tend to over-salt food, because most people think it tastes better, and they’re used to it.

While you can ask for some foods to be prepared without salt, you should also stay away from certain items that probably contain loads of the stuff.

According to Willet, that includes soups and starchy items, such as mashed potatoes and bread. Choose steamed vegetables, plain baked potatoes or rice, and meats without heavy sauces. Green salads are great too, but watch for salty extras such as croutons and hard cheeses, and keep an eye on the dressings -- some contain copious amounts of salt. Better to go with a basic oil and vinegar. Don’t even look at potato salad, macaroni salad or cole slaw.

You should eat foods high in potassium, because that mineral is believed to help excrete sodium from the body. It also may help relax blood vessels, leading to lower blood pressure.

Fruits and vegetables are high in potassium. As for your pomegranate juice, a popular brand has 430 milligrams of potassium per eight-ounce serving, about 12% of the recommended daily intake. However, it also packs 160 calories and 34 grams of sugars. A similar serving of orange juice has about the same amount of potassium and about 110 calories -- slightly less than pomegranate, but you still shouldn’t guzzle the stuff indiscriminately.

Calories aside, Willett cautions against getting much of your vitamins and minerals from juice: “It’s important to have a variety of fruits and vegetables,” he says, “and with juice, you’re not going to have the fiber and feeling of fullness that you would eating the whole fruit.”

When it comes to lowering your cholesterol, monitoring fat intake is the key here. Saturated fats and trans fats are the biggest culprits, and trans fats are especially bad, Willett says, because they not only raise “bad” LDL cholesterol but also lower “good” HDL cholesterol. Food manufacturers now must list trans fats on nutrition labels, making it easier to track it. But trans fats are also in a lot of fast foods.

Saturated fat, which raises LDL, is found mostly in animal products such as meat, chicken (especially the skin), some shellfish, and dairy products made with whole milk, such as cheese, ice cream, sour cream, and cream cheese. Lean animal proteins, such as fish and skinless white meat chicken and turkey, are best. Foods high in soluble fiber can help lower cholesterol, says David Grotto, a Chicago-area registered dietitian and spokesman for the American Dietetic Assn. “It has the ability to absorb things” such as cholesterol, he explains, “not allowing it to be coursing through the veins. It also helps you feel fuller, longer.” Good sources are oats, barley, bran, quinoa, apples, and beans.

Try this neat tip from Grotto: Puree cooked beans in a blender or food processor with some vegetable broth, then freeze in an ice-cube tray. Pop out the frozen cubes and add them to soups and stews for extra fiber.

Try to consume polyunsaturated and mono-saturated fats, which don’t seem to raise LDL cholesterol. Olive oil, seeds, avocados, vegetable oils and nuts are good sources, but don’t consume them with abandon, because the excess fat can pack on the pounds. The standard recommendation from the American Heart Assn. is that no more than 30% of total daily calories come from fat.

By tweaking your diet you may lower your blood pressure and cholesterol levels enough that your doctor allows you to taper off your medications.

However, there are no guarantees -- everyone’s body is different. Grotto suggests letting your doctor know that you eventually want to get off medication and are willing to try to do it via diet and exercise. “If patients came in and adopted healthy lifestyles, doctors would be all for that,” he says. “Yet many people are motivated when death is staring them in the face, and the motivation only lasts so long. But if you give your doctor full disclosure about your goals, I think you’ll be pleasantly surprised.”

-- Jeannine Stein