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Fasting with Medical Conditions

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As all of you who have read my posts on this forum will know, I have had an issue with high blood pressure for some time and despite the fact that I have now being following the 5:2 diet for almost three months, my blood pressure is still stubbornly refusing to respond to me keeping up with this WOE (if anything, my blood pressure is actually a little bit higher than where it was when I first started this WOE.

That has driven me to the point where I don't really feel like carrying on with this WOE for any longer. However, I know that when I feel like that, I am getting a message that there needs to be a change of direction because there are other benefits which I have had from this WOE (such as record low levels for my weight, waist size and body fat percentage) and it would be very sad if I ended up having to give all of that up, because my blood pressure just will not come down under any circumstances.

To begin with, I am not going to be recording any more blood pressure readings for now, because the results for that are just too depressing just now, and that is something which I am trying to minimise during what it really a depressing time of year anyway, with the darker nights (I know that it will be different for those of you in the Southern Hemisphere as you will now be going into your summer) and everything else which goes with that.

As my means of changing direction with this WOE, I have just bought a book about the DASH Diet which is said to reduce blood pressure, with some fairly good results after just a few weeks. The book itself seems to assume that you are going to be going through the traditional method of calorie restriction to lose weight (or maintain weight if that is the aim) and gives hints on how to calculate things like the BMR (Basal Metabolic Rate which is meant to be the minimum number of calories that the body needs to function every day, even though I'm deliberately eating far less than that for two days every week on the 5:2 diet).

However, that doesn't mean that everything about that book is a bad thing because what I could do is replace the stuff about calorie counting etc. with everything that I am doing on the 5:2 diet, and focus solely on the types of foods that the DASH Diet requires us to eat. That way, I would be taking all of the various relevant bits of each diet and joining them up into a new WOE which will hopefully be much better at reducing blood pressure whilst still providing the benefits that the 5:2 diet (combined with 16:8 in my case) has given me until now.

With that in mind, I am wondering if anyone on this forum has used the DASH Diet in this manner and if they have, it would also be interesting to gauge the various levels of experience with that, so that I know what I can look forward with that WOE.
I'm sorry but I've not heard about the DASH diet. I was just wondering about your blood pressure. Presumably you have cut out salt from your diet? And do you manage to exercise daily? Like a brisk walk or something similar? These two elements can have a big impact on your BP.

Bean :bugeyes:
Firstly, you can read more about the DASH Diet here.

In terms of my exercise, I'm doing that for five days every week by going to the gym on two of those days, and doing a fitness class (which currently consist of an RPM class (which is really just a spin class), an Aquafit class (which is just water aerobics) and a step class) on the other days. That gives me two rest days per week which are usually taken up with food shopping and housework.

When I first started exercising at the beginning of last year, I started off just by going for a walk every day. That eventually led to me doing all of the other things that I have just mentioned. Because of that, the amount of walking that I was doing got a lot less because that became a lot harder to fit in with all of my gym and fitness sessions.

In terms of my salt intake, I have experimented with both a high salt intake, and a low intake only to find that neither scenario made much of a difference. I am currently taking 20mg of lisinopril every day for my blood pressure and when I brought this matter to attention on this forum, it was suggested (by the forum's main expert in blood pressure issues) that reducing my salt intake might not even be the most appropriate action to take in this instance.

That is why I am now looking to see if something like the DASH diet might help.
Magnesium and potassium are minerals you might need to boost as there is some evidence for a deficiency in either of these being associated with higher blood pressure. Many of the foods in the DASH diet are high in potassium. Magnesium supplementation has been shown to have a modest impact on BP. Potassium supplementation is not such a good idea as it is possible to overdose easily, so best to stick to diet for increasing potassium I think.

The link between sodium and high blood pressure is not as straightforward as people think. Many people do not respond to cutting down on salt with a reduction in their BP. It can even cause an increase in BP. As the body handles salt differently in the context of a high carb diet than in the case of a low carb diet/fasting, cutting down on salt while you are also cutting down on carbs may not be ideal.

The DASH diet is probably too high in carbs as it was created back when the value of keeping carbs low was not generally accepted (as in fact it is still not in many parts of the world other than perhaps Sweden!).

I would aim to eat more of the high potassium foodstuffs from the DASH diet but not to increase carbs. As for use of salt, don't try to cut it out altogether, but go for moderation!

Good luck with it all.
I also noticed that the DASH Diet was also going for reduced levels of saturated levels and more unsaturated fats, although I expect that this is probably also tied in with the carbs issue because I now know that after reducing the carb intake, we actually need the intake of saturated fats to be a bit higher (hence the reason why for example, I switched from skimmed and semi-skimmed milk, back to full fat milk).

The main point of me starting this thread though was to see if there was anyone on this forum who has had any actual experience of incorporating some part of the DASH Diet into their normal 5:2 (or whatever, as that could be something different like 4:3 or 6:1) routine and if so, to find out where their experiences were of that.

If you have read any of my recent blog entries (I am now writing those every day because my previous weekly blog entries were getting a bit on the long side), you will see just what my recent blood pressure readings have been like and so, I would really welcome anything that might bring down those readings a bit.

That is particularly true since I had expected my cortisol levels to come down a bit as a result of this week's transition back to 5:2 from 4:3 and because of that, I had hoped that my blood pressure might have come down a bit this week as a result. The fact that this has not happened, is therefore a bit worrying for me.
Hi John. My diet is already DASH-like so can't really comment. Possibly not the answer you were looking for but I reduced my BP reducing alcohol intake. Couple of (slightly contradictory) studies here:
http://www.bmj.com/content/308/6939/1263
http://hyper.ahajournals.org/content/17 ... 7.full.pdf
Since I have just mentioned cortisol levels (and I know that increased cortisol levels are also linked with higher blood pressure), I was also wondering if the fact that I am doing 16:8 every day might be keeping my cortisol levels at a raised level, since that means that I am doing zero calorie 16 hour fasts on every single day of the week just now, even on my feeding days.

If that is correct, then those raised cortisol levels might be what is possibly keeping my blood pressure at a raised level. The alcohol issue is also an interesting one. However, I am not a heavy drinker and so, that shouldn't really be having too much of an effect. Whilst I did have one glass of wine last night, that was consumed well before 8pm to ensure that I wasn't consuming any calories outside of my eating window (which runs from 12 noon to 8pm).

Furthermore, my blood pressure readings are being taken at around 10:30pm, which is a whole two and a half hours after I have finished that glass of wine. The studies in the above links show that the effect of alcohol on blood pressure is only short lived and any effect that the glass of wine that I drunk last night, had on my blood pressure would have gone by the time that I took those readings.

In addition to that, I'm generally abstaining from alcohol on most days (especially my fasting days) and yet, my blood pressure still runs high on those days. To me, that would therefore seem to rule out the link between alcohol and blood pressure in my case.
Hi John,

My husband has stage 3 chronic kidney disease and he did the Dash diet to try and counteract the extremely debiliating effects of taking statins which had left almost unable to do anything without being in pain and breathless. Anyway, it made no difference at all to any if his symptoms so he just gave it up. Over the years we have tried everything to alleviate his symptoms to no avail. He has his blood tested for vitamin D deficiency and is still awaiting the results. In the meantime he has started a course if viramin D and for the first time in years he is sleeping through the night, his muscle cramps have decreased by about 90% and he is able to walk distances again. Vitamin D deficiency can be a cause of weight gain and the few weeks he has been on it has seen a small drop in his weight.

Sorry for the ramble, hope some of this may be helpful to you even if it was not the answer you wanted.

Good luck

Ballerina x
If my memory serves me correctly, I'm sure that vitamin D is the one which get mostly from sunlight rather than from what we eat (although it is present in a few foods). Here in Scotland, that is therefore something which we are likely to be able to get very little of especially during that period of the year centred around the winter solstice when the Sun barely rises above the horizon even at midday, and especially as you go further north.

That means that it is very difficult at this time of year in particular, to be able to get the required amount of vitamin D, other than by taking supplements for that. Because of that, I can see why this is likely to be a major issue amongst people who are prone to vitamin D deficiency.
Without wishing to be controversial - maybe given all you are doing with your exercise and weight loss etc you will have to accept that you're not able to control your bp adequately by those measures alone. How many medications do you take for your bp? I have been hypertensive since my early 30's and take 2 different types of medication to control it - most people treated for hypertension end up on more than one type of medication. I am losing weight quite steadily and I am hopeful that whilst I might be able to reduce my tablets when I get to a goal weight and be generally healthier, I am perfectly willing to accept that because of other factors I can't really do much about - I most likely will still need SOME medication for blood pressure. I just think one has to do what one can do to improve health, but also accept that maybe there are limits.
Just now, I'm taking 20mg of lisinopril per day (taken first thing in the morning) for my blood pressure, and 20mg of Simvastatin per day (taken last thing at night) for my cholesterol. When I recently presented my blood pressure readings to my doctor, she didn't seem that concerned with them about them being all that high, even though several of those readings were showing a systolic blood pressure above 140.

I would beg to disagree with that judgement a bit because although I might get the occasional set of readings that are in the 130s for my systolic blood pressure (even that is still in the prehypertension range), more and more of my readings are coming out at above 140 for that, which I would consider to be too high. It is because this appears to have been an increasing trend since I started the 5:2 diet, that I am a bit worried about.
What about asking to change to a different type of anti hypertensive to see if that makes your control any better - given all the stuff carorees mentioned in your other thread about ACE inhibitors and cortisol etc? Would your GP be amenable to that or not? (some are, some aren't). The British Hypertension Society reckons that a systolic below 140 (or 130 if you have renal problems) is desirable for good control so I can quite see what you mean about not feeling like your BP is particularly well controlled.
My doctor didn't seem to be that interested in changing my medication and since it was only recently that this appointment happened, I can't be bothered with the hassle of making another appointment so soon after the last one. This issue isn't one which requires any sort of urgent attention (it's not as though I'm in a situation where I would need to carted off to hospital or something like that after all) and so, I'll just have to put up with those readings for the meantime (I won't actually be taking any readings for a while as they just depress me too much and as Carorees has said on this forum, the additional anxiety that is generated by worrying about these readings might actually be contributing towards those high readings itself).

A number of years ago, my doctor had put me onto a diuretic for my blood pressure (I can't remember what they were because that was so long ago), but I had a bad side-effect from those which led to me experiencing a very painful bout of gout in one of my big toes. It was for that reason, that my doctor took me off those other tablets and onto the ones that I am now taking.

If you go back to around 2011 when I was 19 stone, my blood pressure was sky-high and at one point, that had led my systolic blood pressure to go consistently close to (or sometimes even above) 170 with a diastolic blood pressure well above 100. I then went on to lose a lot of weight just with the traditional methods of calorie counting and calorie restriction. With that, I was then able to get my systolic blood pressure all the way down to 116 at one point, without any change in medication with my diastolic blood pressure dropping into the 70s.

Since I started the 5:2 diet though, my systolic blood pressure has showed a gradual increase whilst my diastolic blood pressure has remained mostly in the 80s (which is in the prehypertension range), with some readings even being in the 70s (which is in the healthy range). Indeed, I get far more diastolic blood pressure readings now that are in the 70s on average, than the number of systolic blood pressure readings that are in the 130s or below.

I can also recall that my mother also has a history of hypertension, as did my uncle who died in 2006 with a heart-attack whilst he was only in his 50s (he was never as committed to looking after his health as what I am today, and I don't want to fall into that same trap as what he did). It would therefore appear as there is probably also a genetic link which makes me more prone to those types of problems, and that is why I have to be very careful and alert at all times when it comes to looking after my own health.
All the best John hope it is all not stressing you too much as it sounds like you have a lot going on there. My only contribution is to ask do you take your blood pressure first thing in the morning. That is what my GP suggested To take BP morning and as you do later at night but I noted you said you didn't want to be taking it too often.

I figure you can't go too wrong if you make most meals yourself from scratch. There are some lovely simple and nutritious meals to be had especially if you are doing 16:8 and 5:2. Any relaxed days for down time in there where you just instinctively eat what your body craves (within reason). :clover: :clover:
I was taking my blood pressure readings once a week when I was only weighing myself once again, and that is what I will probably go back to. I have felt that the recent situation with my blood pressure has been stressful, but so was the situation with my weight when that briefly jumped up to 75.5kg. That prompted me to immediately do 4:3 for a week, although that was more out of panic than anything else.

The introduction of 16:8 came after I started my daily weigh-ins, as I was noticing some massive increases in my weight of over 2kg when I was having days of giving myself a complete break from any sort of eating window. The reason why I introduced 16:8 was to prevent these large weight increases from happening again, and that has worked out really well because although my weight still goes up on most of my feeding days, I have now managed to limit those increases to not much more than 1kg at the most.

That in turn was to play a huge part in me finally getting below 74kg on my last Monday morning weigh-in. Now that I have gone back to 5:2 after that 4:3 week, I will now have three feeding days in a row once I have today's fasting day out of the way. At this morning's weigh-in, my weight was just 0.1kg less than what it was on Monday, and I am still concerned that my weight could shoot up once again over the weekend, if I don't keep my 16:8 routine in place during that period.

That is why I'm not yet feeling ready to let loose by having even one day without any eating window restrictions. It will be nice to be able to have that complete break but for me, that will only happen once I feel confident enough that my weight won't shoot up by quite a large amount in the process.
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