About 1 in 3 people in the US have high blood pressure, and the numbers aren’t that much better in other countries where people eat a lot of processed junk food. We’ve covered before how salt might not be the demon food here – in 2014, a major report from the Institute of Medicine even shot down the idea that reducing dietary salt is the One True Way to Prevent Hypertension.
But even if you think that salt has something to do with blood pressure, it’s pretty clear from the published research that a lot of other dietary factors also affect blood pressure. So putting salt to the side for a minute, take a look at 5 other areas where Paleo stands out as a great diet for controlling blood pressure.
1. Paleo Delivers Lots of Vitamin C
Vitamin C is an antioxidant: it helps fight oxidative stress and oxidative damage to blood vessels. And that turns out to be pretty great for blood pressure. This study found that dietary vitamin C, but not supplemental vitamin C, predicted lower risk of hypertension. The research concluded that “hypertension risk is reduced by improving overall diet quality and/or vitamin C status. The inverse association seen for dietary but not for supplemental vitamin C suggests that vitamin C status is preferably improved by eating foods rich in vitamin C.”
Low vitamin C levels don’t just make high blood pressure more likely; they also make it more deadly – people with high blood pressure and vitamin C under 28.4 μmol/L had a much higher risk of stroke than people with high blood pressure and decent vitamin C levels.
A surprising number of people eating an American-style diet have inadequate vitamin C intake. In this study of people from New Zealand, 50% had inadequate serum vitamin C levels, and 13% had levels below 23 µmol/L, or roughly the level that correlated with the highest risk of hypertension.
Paleo fixes this in the simplest way possible: more fresh plant foods. The best source of vitamin C is raw fruit and vegetables (high heat is damaging to vitamin C, so cooking foods reduces their vitamin C content). Think: carrot sticks, coleslaw, pineapple cubes for dessert, big salads with the whole kitchen sink thrown in…it’s almost impossible to be vitamin C deficient if you’re eating Paleo, so there’s no need to even make a special effort here – the diet takes care of vitamin C automatically.
2. Paleo is Designed to Reduce Inflammation
Inflammation is a critical factor in developing hypertension. Increased levels of pro-inflammatory proteins are bad; so are reduced levels of anti-inflammatory proteins. Chronic, low-grade inflammation damages blood vessels (arteries and veins) and increases the likelihood that a person will develop high blood pressure in time.
Inflammation can come from all different places, but diet-induced inflammation in particular is linked to an increased risk of developing high blood pressure.
In terms of how Paleo addresses this, tackling inflammation is one of the basic goals of the whole diet. It’s built in from the ground up, from the anti-inflammatory fats to the antioxidant-rich spices to cutting out inflammatory gut irritants. If you’re eating Paleo, you’re eating an anti-inflammatory diet, and your blood pressure is probably thanking you.
3. Paleo Limits Added Sugar
Recently, there’s been a big focus on dietary sugar and blood pressure, with several studies connecting added sugar to hypertension. Some of them seem to be using really ridiculous amounts of sugar – 25-30% of calories from added sugar – but as this paper points out, 13% of Americans consume at least 25% of their daily calories from added sugar. Among teenagers, it’s even worse. That kind of sugar intake should be abnormal, but it’s definitely not unusual in the US context, and there’s good evidence that it contributes to high blood pressure on a population level.
One easy way to test added sugar is to look at sugar-sweetened beverages (SSBs) like Coke and Pepsi, which are basically sugar water with a bit of caramel coloring. A meta-analysis of prospective cohort studies found that increasing SSB consumption increased risk of hypertension. Conversely, this study measured people’s SSB consumption and blood pressure at 0, 6, and 18 months. The people who reduced their SSB consumption also reduced their blood pressure, even after accounting for weight loss.
To make the sugar story even more interesting, this study suggested that sugar might interact with salt – which would make sense, since the same types of processed junk food associated with high blood pressure tend to be high in both sugar and salt.
In terms of Paleo, this one is a no-brainer: Paleo basically eliminates added sugar. Problem solved!
4. Paleo Foods are Rich in Potassium
This is covered in more depth here, but the short version is that sodium-potassium balance might be more important than the absolute amount of sodium in your diet. For example, in at least one study, high dietary salt consumption didn’t have any negative effect on blood pressure as long as people were getting enough potassium.
Potassium lowers blood pressure through a variety of different mechanisms. Just to name a couple, it increases the amount of sodium that your kidneys filter out of your body and also has hormonal effects that help the kidney adapt to changes in salt intake.
Today’s diet is much lower in potassium than our evolutionary diet, and just like vitamin C, potassium is often a nutrient that people eating a typical American diet are lacking. But Paleo doesn’t have that problem at all, because it’s full of potassium-rich foods, just like our ancestral diet. Bananas are the most famous potassium-rich food, but potatoes are actually a better source. And a whole lot of vegetables have significant potassium content – if you’re eating a nice wide variety of plant foods, potassium shouldn’t be an issue.
5. Paleo is Full of Nitrate-Rich Vegetables
Nitrate is an inorganic compound found in beets and leafy dark green vegetables, like spinach and chard. In humans, there’s quite a bit of evidence that foods rich in nitrate help to reduce blood pressure. For example, in this study, the researchers put 19 women on a diet full of nitrate-rich vegetables and watched their blood pressure drop. And in this one, the authors found the same benefit in 25 people of both sexes: a “Japanese Traditional Diet” containing lots of nitrate-rich vegetables lowered blood pressure, while the same diet without the nitrate-rich vegetables had no real benefit.
The most famous source of nitrate is probably beet juice – that’s why you’ll occasionally see beet “shots” or other beet-based supplements marketed for blood pressure, but these studies show that nobody needs special processed supplements to get enough nitrates – getting them from regular beets and dark leafy greens is good enough on its own.
Blood Pressure: Don’t Under-Think This
“Don’t overthink this” is usually good advice, but in this case, “don’t under-think this” might be more appropriate. “Salt = high blood pressure” is about as legitimate as “dietary fat = obesity” and “eggs = heart disease” – in other words, totally bunk. There are tons of other dietary factors – like vitamin C, potassium, nitrates, inflammation, and sugar – that affect blood pressure.
Even without getting into the weeds on the salt/sodium issue, Paleo addresses these other factors by providing lots of nutrient-rich fruits and vegetables, cutting out refined sugar, and addressing inflammation at the roots. That’s a much more comprehensive way to address blood pressure concerns than just fixating blindly on salt – and tastier, too!