Written by Nabeel Keblawi
“But that’s impossible!”
Well, I just proved otherwise. And I’m going to tell you how. The thing is, you will not believe how ridiculously easy it was.
Disclaimer: This is not medical advice. Always talk to your doctor for qualified medical advice before undertaking a new diet or exercise plan. Also note that if you have chronic kidney disease or take prescription medications that raise blood pressure, the suggestions in this article will not likely work for you.
Background
I’ve always been healthy and active growing up as a kid and through my early adult years. I was a competitive swimmer and a cyclist. But because of that, I was lulled into a false sense of security about my health and what’s really going on under the hood.
As I entered my mid-late thirties, I started noticing that my body wasn’t as strong or powerful as it used to be. My endurance limits became lower and lower. Minor injuries took longer and longer to heal. Instead of sending me out of their offices with a clean bill of health, my doctors began lecturing me about elevated cholesterol levels, elevated blood glucose levels, and of course, elevated blood pressure.
Of course, I chalked it all up to aging. I still felt fine overall. There were no glaring symptoms that needed immediate medical attention. There was something that didn’t feel right, but I couldn’t quite put my finger on it. As a man, I was taught to be a tough guy and just “bull” my way through life and whatever it threw at me—ignoring the minor aches and pains, lack of sleep, and the occasional “mental fog”.
Uncontrolled High Blood Pressure
Looking back on all my doctor visits through the past decade, I could see a clear pattern that I did not see before. On almost every doctor visit, either the nurse or doctor would make a comment about my blood pressure. It started with offhand remarks that sounded harmless enough:
“Hmm, a bit elevated there, but nothing to be concerned about yet.”
“Blood pressure here… uh, I don’t know… perhaps you’re a bit stressed. Traffic is pretty bad out there today, eh?”
The whole time, I was in denial and dismissed it as a “white coat” phenomenon—where you get nervous at a doctor’s office and your blood pressure goes up as a result. However, as the years went on—and my blood pressure continued to creep up—the casual remarks turned into concerned comments.
“Your blood pressure is somewhat high. Maybe we should have you come in once a week and take a few repeat readings?”
“Do you have a blood pressure monitor at home? Your blood pressure is a tad elevated, so it may be a good idea to keep track of that, yes?”
Sometimes my blood pressure was so high that the nurses taking my reading would look at me in shock. Some nurses simply didn’t believe the numbers and re-did the measurement on my other arm. Still high every time. While the numbers varied, we were seeing readings between 151/89 and 162/100.
As soon as I was getting such alarming numbers, I started to keep a record of these readings. From eight readings in six appointments over two years, my average blood pressure was 157/94.
The Diagnosis
In late January 2020, I went in for a physical exam. Having just turned 40, I wanted to take my health more seriously. We did the vitals, ECG, blood draw, urine test—the works. Everything came back normal, except, of course, my blood pressure.
When the doctor went over the test results with me, he said he was worried about my blood pressure. He even thought that there was a potential problem with my kidneys causing my elevated BP. He referred me to a nephrologist right away. Now things were getting real.
I remembered all the media reports about how high blood pressure is a “silent killer” because hypertension has no obvious symptoms. What makes hypertension so serious and dangerous is that it is a ticking time bomb—except there’s no ticking sound to clue you in—with devastating consequences if left uncontrolled. Without warning, untreated hypertension can lead to sudden heart attacks, crippling strokes, debilitating kidney failure, and impotence. It was time to come out of denial and admit to myself that I had a serious health problem.
Side note: This was around the time when the COVID-19 pandemic was well underway in China, and just starting to spread worldwide. Interestingly, based on early epidemic data, people with hypertension had a mortality rate of 6% compared to 0.9% for people without any comorbidities or pre-existing conditions. (Source: World Health Organization via OurWorldInData.org)
Not long afterwards, I went back to the hospital to meet with the nephrologist. The nurse took my blood pressure again. Still high like always. The kidney specialist went over my test results from earlier and he delivered the good news:
“Your kidneys are fine. Nothing to worry about there!”
Imagine my relief. But it was very short-lived. Only a few seconds later, he said:
“Your blood pressure is too high, and you’ve had a history of this. You have stage 2 hypertension. I think it is best to start you on medications immediately. I’ll write you a prescription, and you’ll come back and see me in three months.”
Reeling from that kick in the gut, I was thinking of the horror stories involving side effects of blood pressure medications. But getting sidelined by a stroke terrified me as well. I decided that medications were a “last resort” option. I started thinking: is there nothing else I could do before going on medications? What about lifestyle changes like eating a better diet and exercising more?
So I asked the doctor if, before we go down the medication route, I could try to lower my blood pressure through diet and exercise. A crease of doubt flashed across his face as he considered it for a moment. I was expecting him to deny my request, but to my surprise he said:
“Okay, that’s fine. Just diet and exercise. But I’ll give you one month. Then you have to come back here and we’ll check this again.”
The doctor gave me the rundown on what to eat, what not to eat, how much to exercise, and how and when to measure my own blood pressure at home.
Lifestyle Changes Without Medications
Upon returning home, I was a man on a mission. I went shopping online for a home blood pressure monitor from a trusted brand. I ordered the Omron 7120-HEM monitor and it was delivered the next day.
I also ordered two books and they were on Kindle, so I could start reading them right away (these are not affiliate links):
- The High Blood Pressure Solution – Richard D. Moore, M.D., Ph.D.
- The Magnesium Solution for High Blood Pressure – Jay S. Cohen, M.D.
Both of these books changed the way I looked at hypertension. I had assumed the term “hypertension” meant excessive stress leading to consistently increased blood pressure over time. How misunderstood have I been?
Thanks to these books, I began to understand hypertension as a metabolic disorder—or more specifically, a mineral imbalance on the cellular level—rather than constriction of blood vessels due to excessive stress. Dr Moore’s explanation of this gets quite technical and complex, so I won’t get into the details here. But the biggest takeaway is that this mineral imbalance is caused by too much sodium and too little potassium in the body cells. Supposedly this cellular imbalance causes the smooth muscle cells lining our blood vessels to contract instead of relax, thus constricting these blood vessels and raising blood pressure.
A good analogy would be squeezing a water hose to make the water squirt out at higher speed—and when you really think about this, you can begin to see why high blood pressure is so harsh on the blood vessels.
Less Salt, More Potassium
To correct this imbalance and get the cells back into proper metabolism, there needed to be less sodium and more potassium. The smooth muscle cells would relax, allowing the blood vessels to dilate, thus lowering blood pressure. Unfortunately, today’s Western diets are rich in sodium and deficient in potassium, which is exactly the opposite of what we should be eating!
By far the biggest change I had to make was cut the table salt out completely. Table salt is primarily sodium chloride. Given my high blood pressure, the last thing my body needed was more sodium from table salt. Unfortunately, I loved table salt. Until two months ago, I had a habit of reaching for the salt-shaker and shaking it harder than a bottle of ketchup—even without tasting the food first! No wonder my blood pressure was in the stratosphere!
However, cutting sodium intake was only half of the picture. The other and just as important half was to drastically increase my potassium intake. Fruits like bananas and vegetables like potatoes are both rich in potassium.
According to Dr. Moore, the most important thing was to consume at least four times as much potassium as sodium. He calls this the dietary “K-factor”, where K is the chemical symbol for elementary potassium, and the K-factor is the ratio of potassium to sodium. To treat hypertension through dietary means, Dr. Moore advocates for a diet with a K-Factor of at least 4. This means if I consume 1,000 milligrams (mg) of sodium in one day, I should consume at least 4,000 mg of potassium to bring my blood pressure down. The American Heart Association recommends an ideal limit of no more than 1,500 mg of sodium per day for most adults. However, even that may be too much for hypertensive patients as it is difficult to obtain six grams of potassium a day through nutrition.
Personally, I was aiming to keep my sodium intake to under 1,000 mg per day while I ate whatever fruits, vegetables, nuts, and legumes I could to get at least 4,000 mg of potassium.
Don’t Forget Magnesium
According to Dr Cohen, I had to increase my magnesium intake as well. Magnesium is needed for more than 300 biochemical reactions in the body, including maintaining nerve function, muscle function, immune system function, stable blood glucose levels, adequate production of energy and protein, and the list goes on. (Source: MedlinePlus).
The bad news is that adequate dietary magnesium is tricky to obtain. Due to industrial farming practices, our soils have been partially depleted of magnesium and other essential micronutrients. To add insult to injury, it is particularly difficult for our body cells to absorb enough magnesium—which explains why magnesium supplementation is not always effective. Dr Cohen does recommend supplementation but only using certain types of magnesium compounds. Magnesium oxide is the least effective, while magnesium citrate or magnesium chelate is more bioavailable. I chose to supplement with 200 mg of magnesium citrate daily while getting the rest through the following:
- Bananas
- Dried apricots and prunes
- Avocados
- Nuts and seeds
- Legumes such as beans and peas
- Whole grains such as oatmeal
The good news here is that many foods high in magnesium are also high in potassium, so we’re killing two birds with one stone by eating lots of fruits, vegetables, and whole grains.
What My Daily Meals Are Like
I talked to my wife about my condition and asked for her support. She immediately sprang into action and went shopping for fresh fruits and vegetables. She also bought us a juicer. Over the past month, she made a variety of fresh fruit and vegetable juices every morning. My personal favourite is beetroot juice with ginger, and it seems to be quite effective at lowering blood pressure as well!
She also cooked nutritious meals while experimenting with different spices in lieu of table salt. I can feel my palate adjusting to the natural flavours of whole foods. Without getting saturated with heaps of salt, food now tastes the way they should. In fact, dishes with even a moderate amount of added salt now taste too salty. Even certain soups now taste like seawater to my new palate.
On a typical day, I eat the following for breakfast, lunch, and dinner along with an afternoon snack:
Breakfast
- Fresh fruit and vegetable juice made from beets, carrots, apple, and ginger
- Whole grain rolled oats with cinnamon, dried apricots, crushed walnuts, and a pinch of brown sugar
- A couple of tablespoons of yoghurt (no added sugar) with fresh berries and diced cantaloupe
- Hot cappuccino
Lunch
- Egg omelette with tomatoes, peppers, scallions, and seasoned with pepper
- Salad with leafy greens, sliced cucumbers, fresh tomatoes, diced apples, crushed walnuts, drizzled with extra virgin olive oil and Braggs apple cider vinegar
- Club soda OR black tea
Snack
- A few dried prunes
- A handful of seeds or nuts
Dinner
- Roasted chicken breast OR salmon steak seasoned with garlic, lemon, and pepper.
- Asparagus and diced potatoes, sautéed with garlic, Italian seasoning, and extra virgin coconut oil
- A bowl of legumes such as black beans or lentils mixed with various spices
- Club soda, no sugar, with a spritz of lemon
No added salt, no added sugars, and no processed food. We don’t even use butter or vegetable oils anymore. Plus, on most days, we don’t drink alcohol. Additionally, I have a strict rule against midnight snacking: no food after 8 pm, or at least three hours before I go to bed—whichever is earlier.
I’ll admit perhaps once a week I’ll cheat a little and have some pizza or even spring for a beer or two when out with some friends. But as long as I adhere to a high K-factor diet like the above at least 90-95% of the time, I have been getting noticeable results with my blood pressure among other subjective health indicators.
My Results
I had already been losing weight when I got my diagnosis, and I continued to lose weight since. Initially, I was hovering at around 185 pounds (84 kg) before I started losing weight. Today, I weigh at 170 pounds (77 kg). But I’m not on a restrictive diet. I don’t have to starve myself or white-knuckle through any fad diet.
The difference is that I changed what I ate. Before changing my diet and reducing my alcohol intake, I fed on processed foods such as pizza, burgers and fries, chips and crackers—all of which were loaded with salt. I knew it was unhealthy, so I helped myself to an occasional side of vegetables and went to the gym daily to make myself feel better. But as I found out, you cannot out-exercise a crappy diet.
Immediately after my diagnosis and began eating foods with a high K-factor while reducing table salt consumption, I obtained an Omron blood pressure monitor and took my blood pressure readings in the mornings, afternoons, and evenings—three times in each sitting, for a total of nine measurements per day. I made sure I followed the instructions that came with the Omron manual to ensure that I was measuring my blood pressure correctly.
In the first week of measuring my blood pressure at home, my readings were slightly lower than at the doctor’s office, but still quite high. Although there was a notable drop in blood pressure starting the second week, it plateaued for an additional three weeks. However, it was after the fourth week when I started to see real movement towards the normal range.
Figure 1: Daily blood pressure readings as an average of morning, afternoon, and evening readings. Each time-of-day reading is an average of three measurements in a single sitting.
Upon my diagnosis, my average clinical reading was 157/94 (with values ranging between 151/89 and 162/100). Today, my BP readings are now averaging around 117/78 for the last week—and still going down. Even if you corrected for the “white coat” effect in my clinic readings, they would still be firmly within the stage 2 hypertension range:
“A meta-analysis of 13 studies showed that clinic BP is higher than home BP by an average of 5.3 mm Hg for systolic BP and 3.1 mm Hg for diastolic BP.” (Source: HONEST Study, NIH, 2015).
If you subtracted my clinical average of 157/94 by 5.3 mm Hg for systolic BP and 3.1 mm Hg for diastolic BP, we would get 152/91. This is still well above 140/90, which is stage 2 hypertension according to the new American College of Cardiology and American Heart Association (AHA) guidelines.
It is abundantly clear that decreasing sodium intake while increasing consumption of both potassium and magnesium has been highly effective in lowering my blood pressure. This, coupled with exercise and limiting alcohol, reduced my systolic blood pressure by at least 30 points and diastolic by roughly 15 points in a span of merely six weeks.
Where Do I Go From Here?
If you asked me how I feel right now, and whether I feel different, my answer would be that my energy levels are much better. Both dietary improvements and limiting alcohol as well as exercise have helped this. I just turned 40, but I feel and look more like 30. I’m into boxing, and before these changes, I could barely last three rounds of 3 minutes each until I’m completely gassed. Now, I can last a full eight rounds before I need to take more than a minute of rest.
Another thing I noticed was that I have been getting more comments about my skin. My friends and even my wife have noticed that my skin looks better and “brighter”. Even I was amazed at the difference that others were seeing.
I do know that if I went back to my old eating habits, my blood pressure would pop right back up into the stage 2 hypertension range within a few days. Due to its dire consequences, I’m not going to allow that to happen. I intend to maintain my new dietary and lifestyle habits while continuing to monitor my blood pressure at home for the rest of my life.
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Note from Dr Emil: I didn’t work or advise Nabeel during this process but was so impressed with the changes he made when I read about them that I reached out to share his story. We don’t talk about lifestyle change enough in modern health care so I wanted to promote and share his story to show that it DOES work and it SHOULD be pursued. It won’t work as effectively as it did for Nabeel in all cases but it will ALWAYS beneficial