DASH Dietary Plan for a Chinese Patient with Hypertension

A Chinese woman presents with a newly diagnosed case of hypertension. This patient needs assistance in identifying a dietary regimen that will support them in reducing or eliminating hypertension. This discussion also assumes a 1600 calorie diet is desired (based on patient age, height, weight, and activity level).  As noted in the Dietary Approach to Stop Hypertension (DASH) diet, the basic plan calls for a diet with strong emphasis on daily servings of whole grains (3 whole grain foods; 6 servings of grain overall), 4 servings of fruits, 4 servings of vegetables; 2 servings of low-fat or nonfat dairy, 1.5 or 2 servings of lean meat, fish, or poultry, 3 servings of nuts, seeds, and legumes a week, and 2 servings of fats or sweets per day (DASH, 2011). These serving levels may vary somewhat from day to day, but the above levels should be the average levels.

In a Chinese patient, several dietary and lifestyle recommendations would be appropriate. First, whole grains are not common in Chinese food. One switch that could be made is from white rice to brown rice as well as switching from regular noodles to whole-grain noodles. Another key change needed is to reduce the amount of sodium in the diet, which in a Chinese diet means limiting many sauces such as soy sauce, oyster sauce, and so on. A change to low-sodium soy sauce, plus limiting the amount of soy sauce used in recipes would help in limiting sodium.  Using fish, poultry and limited amounts of lean meat as well as fresh vegetables is consistent with Chinese cuisine, but fruits are often very limited or absent. To increase the amount of Omega-3 fatty acids, changing to olive oil and including oily fishes (salmon, sardines, etc.) in the diet is also helpful,  Making an effort to eat fresh fruits would be important, including incorporating them into stir-fries, or simply adding them in the form of salads or similar side dishes. Finally, dairy is rarely included in Chinese cuisine, so an effort to include low-fat or nonfat cheeses, yogurt or similar products would be important. If dairy is a problem, at a minimum a calcium supplement should be added, especially one that includes vitamin D for improved absorption.

Some Chinese cultural traditions may also help beyond the DASH diet.  For example, evidence indicates that Qi gong is helpful in treating high blood pressure, as is any form of meditation; there is also strong scientific evidence that yoga is helpful in lowering blood pressure. In addition, a Chinese traditional medicine of hibiscus may also be helpful as a supplement (Ulbricht, 2010).

Less strong scientific evidence indicates that acupressure, Shiatsu, and acupuncture may also assist with hypertension (Ulbricht, 2010).