Blood-pressure-friendly meals while using GLP-1s

DASH, short for Dietary Approaches to Stop Hypertension, is a flexible eating plan from the National Heart, Lung, and Blood Institute (NHLBI). Its serving counts depend on your calorie needs, so it can scale down to a smaller appetite.

NHLBI-funded studies found that DASH lowers blood pressure, and that pairing it with less sodium works better than either change alone. The plan emphasizes vegetables, fruits and whole grains. It includes fat-free or low-fat dairy, fish, poultry, beans, nuts and vegetable oils. It limits fatty meats, full-fat dairy, tropical oils, sugar-sweetened drinks and sweets.

A DASH serving is small. NHLBI counts ½ cup of cooked rice or pasta, 1 cup of raw leafy greens, 1 medium fruit, 1 cup of milk or yogurt, and 1 ounce of cooked fish or chicken (or 1 egg) as one serving each. Ask your clinician or a registered dietitian how many servings fit you.

GLP-1 medicines reduce appetite and slow digestion, so you may feel full for longer. NHLBI's DASH tips include eating smaller portions more often through the day, which can suit a smaller appetite.

A low-appetite day can still include vegetables, fruit, whole grains, low-fat dairy and lean protein when you split food into small meals.

This sample day uses NHLBI serving sizes and lower-sodium choices. It shows the pattern, not a calorie or protein target, so eat what fits and stop when you are full. Keep the backup meal for days when cooking feels like too much.

If nausea makes meals hard, keep the same food groups and shrink the portions. If you cannot eat or drink enough to stay hydrated, call your clinician.

Most of the sodium Americans eat comes from packaged and prepared foods, not the salt shaker. FDA, citing CDC, says about 40% of the sodium Americans eat comes from deli meat sandwiches, pizza, burritos and tacos, soups, savory snacks, poultry, pasta mixed dishes, burgers and egg dishes.

On the Nutrition Facts label, the Daily Value for sodium is less than 2,300 mg a day. FDA's rule of thumb: 5% DV or less per serving is low, and 20% DV or more is high. Check the serving size, because the numbers usually apply to one serving.

The %DV does not shrink with your appetite. A soup at 20% DV still holds about 460 mg of sodium, even if it is most of what you eat that day.

Package claims help too. “Low sodium” means 140 mg or less per serving. “No-salt-added” means no salt was added during processing, but the food may still contain sodium.

Your limit is personal. NHLBI's DASH plan uses either 2,300 mg or 1,500 mg of sodium a day, and notes that 1,500 mg lowers blood pressure even further. Ask your clinician which target fits you, then build your next grocery list around the swaps below.

Ask before using a salt substitute. MedlinePlus lists them as a source of extra potassium, which can build up in the blood if your kidneys are not working well or you take certain blood-pressure medicines, such as ACE inhibitors or ARBs.

Call your clinician right away if you feel dizzy, lightheaded or faint, or have chest pain, shortness of breath or an irregular heartbeat. If you pass out, call 911 or your local emergency number.

GLP-1 medicines can cause nausea, vomiting, diarrhea and loss of appetite. Vomiting, diarrhea and drinking too little can lead to dehydration, and diuretics can add to fluid loss. MedlinePlus lists both dehydration and blood-pressure medicines as causes of low blood pressure. On days with vomiting or diarrhea, do not wait for signs of dehydration to call.

If you check your blood pressure at home and a reading is higher than 180/120, the American Heart Association says to wait at least 1 minute and measure again. If it is still that high and you have chest pain, shortness of breath, back pain, numbness, weakness, a change in vision or trouble speaking, call 911 and do not wait to see if it comes down. Without those symptoms, contact your clinician as soon as possible.

If you also take insulin or a sulfonylurea, dizziness together with trembling, extreme tiredness or a fast heart rate may be signs of low blood sugar. MedlinePlus lists these low blood sugar symptoms as a reason to call 911.