Lifestyle Interventions for Elevated Blood Pressure
Cross Country/Track/Running: Our son was already on the middle school cross country team, but we encourage him to continue on the high school cross country team. Right after that visit, we agreed to have him join his Cross Country team in their summer running camp up in Julian, California. It was well worth the money, and he enjoyed the camaraderie as well. He began running 5-8 miles a day. Even now during the quarantine, he is still going for his runs for about 30 minutes during the day. Aerobic exercise is very important. For the most part, the children I see in clinic that have elevated blood pressure are not doing aerobic sports. If they are little and because we are in southern California, I recommend soccer. If they are in middle school or high school, I ask them to join cross country or track.
Lower the Salt and Processed Food in Their Diet: In general, I always recommend a low-salt and less processed food diet. This is easy to recommend but I realize very hard to implement. Families are battling big food companies and an entire society that has pushed us away from unprocessed grains and whole fruits and vegetables. Also, the economy that now requires most families to have both parents work full time and sometimes overtime to be able to support a normal middle-class lifestyle has decreased your available time to do the important task of feeding our children. This could be several blog posts. But I realized that in our family, it is many of the habits that come from Mr. Plastic Picker’s side. We had been very good about taking all the ramen out of the house, but it keeps on creeping back. I just had a heated conversation with my mother-in-law because she has been feeding our son ramen in the afternoon during quarantine home-schooling. She herself has hypertension and I think like most grandparents like to give the kids things she is no longer able to eat. The most important thing you can do is get the high-salt foods out of the house. If it’s not there, then your child (because teenagers are still children) will not be tempted. For us, it was the ramen, soy sauce, the packaged chips, and seaweed. Now I feel bad because we ordered pizza last night. But we have been having the kids eat lots of fresh fruit and I’ve been cooking more vegetables. Avoid fast food also. I analyzed the salt content of the “vegan food” options at Burger King once, and there is simply no way to eat low salt when you eat fast food.
Fresh Fruit and Vegetables: “A high intake of fruits, vegetables, and legumes (i.e., a plant-strong diet) is associated with lower BP.” This is such a simple sentence from the AAP 2017 Clinical Practice Guidelines but so important. This dovetails with Dr. Plastic Picker’s less plastic message as well. For all the guilt I feel about the ramen I let creep back into our son’s diet and the pizza, I’m hopeful because we have fundamentally increased the fresh fruits and vegetables in our lives over the last year. We just returned from our local Sprouts market, and even during COVID-19 – I was able to fill our grocery cart with mangos, apples, fresh green beans, bell peppers, zucchini, cucumbers, and blueberries. In regards to hypertension, food can truly be medicine.
Proper Sleep: Proper sleep is very important as disrupted circadian rhythms will lead to increased cortisol. I always refer my patients to one of my friends Dr. Craig Canapari, who is the Director of Pediatric Sleep Medicine at Yale. He has written extensively about the importance of teenage sleep. Refer to his site for further information, but just remember sleep is also medicine in regard to pediatric hypertension.
Model Good Behavior: Usually when I have a teenager with elevated blood pressure or pediatric hypertension, there is at least one adult with blood pressure problems. As adults, we are the ones that control the budget. We are the ones that buy the food, that order the pizza. I know I am responsible for my child’s health, and I own my part. I also know that as a family, we are all connected. I speak firmly but also collegially with everyone on my “team” that surrounds my son, his grandmother, his father, and even other mom friends, about my concerns. We make these changes as an entire family so that it will help improve his health and also our own. I have been trying to jog with our son in the evenings now, and it gives me extra motivation to increase my own aerobic exercise. Also knowing that I need to feed him more whole fruits and vegetables, encourages me to eat them too.