How did you quickly implement lifestyle changes?

October 16, 2015 5:39 PM

On doctor's orders, I need to fairly drastically change my diet and activity level on short notice. I've never had to watch or track what I ate. The specific goal is to maintain a healthy blood pressure and I am highly motivated; I've explained why inside. If you've done this, what tools did you use to plan and track your progress? What changes were most important in reducing your blood pressure?

I am transgender and I started testosterone last month under a doctor's supervision. Unfortunately, it had a very adverse effect on my (usually normal) blood pressure and sent me to the hospital. I've undergone a bunch of testing and no obvious underlying cause has been found. I have been off testosterone since the hospital trip and my BP is back to normal (generally 120/80).

Because I've never had high blood pressure in the past, and I've never been overweight, I've never had to watch what I ate. I'm also fairly sedentary (office worker) although I do try to do some walking. (I am barred from intense exercise until I have a coronary CT scan, just in case.) The working theory is that if I can change my lifestyle, I will be allowed to start taking testosterone again in a month. This is immensely important to me and I am willing to do whatever it takes. I want to walk into my endocrinologist's office in a month with evidence that convinces him I will do everything I can to manage my blood pressure without medication.

But I don't know where to start. There are tons of food apps and recipe websites and exercise trackers and I don't want to get overwhelmed. I just want a clear checklist of things to do.

Further notes:

- I have an iPhone 4s and a Windows 7 PC.
- I have a home blood pressure monitor (a fancy one with bluetooth and an app).
- I live alone so I don't have to account for anyone else's dietary preferences.
- I don't smoke or do any drugs. I do drink a bit but could easily stop if it furthered my cause.
- I don't drink much caffeine (1-2 servings/day) but would grudgingly stop if there was clear evidence it would help.
- I do not need to lose weight and in fact I would rather gain some.
- I have sleep apnea and use a CPAP.
- When I get the all clear, I want to start an exercise program that focuses on weightlifting (building the upper body).

posted by desjardins to Health & Fitness (23 answers total)

Do you have access to a dietician? I had an issue with my diet a few years ago, and my insurance picked up several months of consultations with someone who helped me look at my diet and make some changes.
posted by roomthreeseventeen at 5:47 PM on October 16, 2015

I find a basic notebook and pen works wonders. Keeping track of what I need to do and having a small notebook at my side that takes nothing but opening it and writing what I ate and how it tracks against my goals works for many different things.
posted by xingcat at 5:48 PM on October 16, 2015 [1 favorite]

This is just me as evidence, but my blood pressure normalized when I started running. Not like, a lot of running, just some very light jogging every other day, no weight loss was involved. So if you get cleared to do that, it might help.
posted by nanook at 5:51 PM on October 16, 2015 [6 favorites]

One simple thing would be to just focus on sodium. Our normal foods have a crazy amount of sodium, and if you can cut that way down, you'll probably make a big difference. Tips for a low sodium diet.
posted by LobsterMitten at 5:52 PM on October 16, 2015 [1 favorite]

Check out the DASH diet. It's specific to blood pressure.
posted by Aranquis at 6:00 PM on October 16, 2015

Until you're cleared for more-strenuous stuff, walking really is great exercise. I find that my fitbit is an easy way to keep track of it, plus a good kick in the ass to go do a little more walking on days I'm being lazy.
posted by Blue Jello Elf at 6:00 PM on October 16, 2015

Meditation... There are conflicting studies with some showing it helps blood pressure and others saying it doesn't, but it certainly can't hurt.
posted by cecic at 6:13 PM on October 16, 2015 [2 favorites]

Anecdotally, I think my BP tends to be better when I'm running/jogging (that being said, I am much more likely to run/jog when I'm feeling better, so there may be more going on there). However, you should obviously wait for the CT scan before starting. If you want to do some prep work for jogging now, you could start doing the 100 up to start building up your stabilizer muscles, balance, etc.

On the walking front, I found a Fitbit extremely motivating -- surprisingly so. I ended up losing mine and I haven't been able to bring myself to re-gamify, but if I had specific exercise goals, I would definitely go that route.

My father also swears by hibiscus tea and there have been studies to back it up -- he keeps a jug of it iced in the fridge and drinks at least a glass a day.
posted by pie ninja at 6:22 PM on October 16, 2015 [2 favorites]

I think watching sodium intake is big. I have high blood pressure, but I take some medication to help control it. I also watch my sodium intake, per doctor's orders. What is kind of cool about this is that when I watch sodium, it tends to regulate calories too, which is something I exclusively counted in the past to try and stay health. If you eat too many bad calories, the sodium starts adding up, so by virtue of watching sodium, it is a lot healthier overall in other ways, too.

Also, when watching sodium, it seems that the right amount for controlling high blood pressure is actually about half of the % daily value indicated on food labels.
posted by SpacemanStix at 6:23 PM on October 16, 2015

Sodium only affects some people. What brought my blood pressure down suddenly was going on a "clean" or anti-inflammatory diet: no refined carbs (including white rice) or sugar. Eat whole fruits (dried is OK, juice does not count because it throws away the fiber), vegetables, legumes, fish. Eat nuts every day. Eat pastured eggs and meat, and minimal dairy.

The only way I made it work was to just cut out refined flour and sugar for the first few weeks. I'm back to limited amounts of those but basically there were nutrients my body wanted and wasn't getting enough of, and *only* eating fruits and legumes and whole grains and vegetables really forced me to eat a lot more of them. I had not realized that "5/day" was a start rather than a target. (I can have 5 servings of fruit and veg before dinner, easily).

YMMV. The problem i had might not be the same as the problem you have, except that we both have blood pressure as a symptom.
posted by Lady Li at 6:26 PM on October 16, 2015 [3 favorites]

If it's been a while since you took your CPAP in (to review your data and adjust settings,) do that. Nearly every other intervention given above besides exercise is going to have a pretty small effect on your immediate BP. On my titration night, my BP dropped like twenty points by morning. The only other things that make it go up or down that fast for me are extreme emotional states, stimulants (especially my asthma inhaler,) and sedatives. Oh, and anaphylactic and vasovagal reactions, and drugs meant to mess with BP which manage not to be classified as sedatives.

Anyway, my dad's BP barely moved at all with treatment unless you looked at it using a five year retrospective chart and smoothed the line out by using a running average. The meds were fantastic when he finally started taking them, but everything else required superhuman patience. He'd have gone nuts if he had to drop it in a month.
posted by SMPA at 7:08 PM on October 16, 2015 [2 favorites]

I also have an iPhone 4s and a Windows 7 PC, and I use MyFitnessPal to track food. In addition to the website, there is an iPhone app.
posted by merejane at 9:09 PM on October 16, 2015

For the activity part of your question:

Two things had a big impact on my daily exercise: I bought an Omron pedometer (but really anything that counts your daily steps is fine) and set a goal of 10,000 steps per day. It is somewhat difficult but achievable - I would just wear it all day and take a morning and evening walk and usually I would make the goal.

Every day I did 10,000 steps, I put a star sticker on my calendar, one of those colorful foil ones kindergarten kids get. I very much liked seeing the week fill up with stars.

The other thing I did was learn to run; I used the Couch to 5k Robert Ullrey series of podcasts, a very good podcast series for absolute beginners.

I also had a running partner and that helped me stay motivated and on-track.

Good luck! Rooting for you.
posted by joseph conrad is fully awesome at 9:24 PM on October 16, 2015 [1 favorite]

There's a product called CholestOFF (you might find it cheaper at your local pharmacy) that is a completely natural way to lower your BP. My DH's GP recommended it to supplement his blood pressure medication and said it was completely safe.

I would agree with sodium but sugar also plays a big role too. You might want to look into the possibility of food allergies because anything that causes you inflammation is just bad news. It sounds extreme but I agree with the advice on going on an anti-inflammatory diet. I was on one (just to be healthy) and I never felt better.

Basic herbs and spices that lower BP: cinnamon, garlic, basil, celergy seed, cayenne, and tumeric.

A dietician would be great but if you can't get/afford one, there are some basic things you can do. Find your resting rate so you know how hard you have to work to get your heart rate up. You can google 'how many calories should i eat' to make sure that you are eating within the range that you're supposed to. I say this as someone who was surprised that I should be eating 1500-1700 calories to maintain my weight. I barely get up to the 1000s sometimes and I like to eat!! Just that I get very full easily and stop there.

If you are open to getting a diffuser (this one is my favorite) and go the aromatherapy route, you can use ylang ylang oil which is one of the best in lowering BP. Other good ones: lavendar, clary sage, and frankincense. I usually buy them for a great deal here and here.

Of course, if you can get on medication, that is great as well but if not, you've got options!

Good luck and I hope that you're able to get back on the testosterone!!
posted by thischarmingirl at 9:41 PM on October 16, 2015

The ONE time I radically and successfully changed my ENTIRE LIFESTYLE was thus....

- Start walking every morning

- Listened to Audio Books by Wayne Dyer and Deepak Chopra (not my thing, but the "positive only" input had an effect)

- Meditation w/ binaural beats after walk + podcast.

Similar, I once did 20 min Yoga + Meditation w/ Binaural Beats.

---

I applaud a notebook. That helps. Above were the two times I made it stick, FWIW.
posted by jbenben at 11:43 PM on October 16, 2015 [3 favorites]

Lose the caffeine. Consider getting a dog you have to walk twice a day. Won't necessarily help with the upper body, but your calves will be beautiful.
posted by trip and a half at 12:34 AM on October 17, 2015

The "Lose It" app is pretty great for tracking everything you eat. It's got a really intuitive and easy interface. The app can give quantitative breakdowns of all the things in your diet, across all meals, across any specified period of time. Should work on your iPhone.

Caveat: I don't do this for blood pressure.
posted by u2604ab at 6:55 AM on October 17, 2015

Just in case your doctor didn't cover it, be mindful of the OTC medications you're taking too (if any). Some will raise your BP.

Like Lady Li, cutting out refined carbs helped a lot, more than tracking sodium. Although cutting out a lot of premade stuff probably also reduced my sodium intake, it just wasn't what I was tracking. I generally do better on a very low carb diet with more fish/Chicken than red meat. But I think that is an individual thing (my sister does not do well at all on a similar diet) and it can be hard to keep it up if you ever have to deal with someone else's eating preferences in the future (or just like oodles of noodles), so I wouldn't hit that road too hard too fast in case you can't sustain it.

What is drinking a bit? A glass/cocktail is probably fine: iirc, 1 drink a day is usually considered OK for most people, so far as BP is concerned, but might be worth cutting out for a little bit to see if you have any improvement. Regular "binges", not so good. I think for the purposes of BP, binges are considered 3 or more in a sitting (so nothing extravagant, really). If you are a heavier drinker, you might need to gradually reduce your intake (I'd consult a medical professional if this is a concern).
posted by ghost phoneme at 6:56 AM on October 17, 2015

I've had great success (lost almost 50 lbs) tracking my diet with MyFitnessPal. I use the free version, because I just worry about calories, but the paid version allows more granular macro tracking. It was a bit irritating at first searching for all my food, but once my regular foods were loaded up, it's just a few taps and I've logged my breakfast and lunch. The recipe feature is also pretty good if you cook a lot at home. I load all of my recipes in as I cook them so the next time I make it (or when I have leftovers) it's all set.
posted by ThaBombShelterSmith at 9:10 AM on October 17, 2015 [1 favorite]

I got my blood pressure down following a mostly whole foods, vegan diet - so that's no meat, no dairy, no eggs, and very minimal oil, and processed food. No counting or tracking is necessary as long as you adhere to those guidelines. It's not for everybody, and there's a learning curve, but for me, that's much easier than trying to keep track of food and it's worth it to stay off of medication. There's a documentary called Forks Over Knives that's on Netflix. You can also find instructions in the following books: Prevent and Reverse Heart Disease by Caldwell Esselstyn, The Engine 2 Diet by Rip Esselstyn, The Starch Solution by John McDougall. There is also help at the following websites (just Google): PCRM, Forks Over Knives, Engine 2, John McDougall. The PCRM and McDougall sites have free forums where you can ask questions, though, just to warn you, some people on these forums can be a bit obnoxious. The only thing that is still hard for me is eating in restaurants, but I'm able to keep my blood pressure down with an occasional off-plan restaurant meal. Also, since everyone asks, it's pretty much impossible to be deficient in protein as long as you're getting enough calories and not eating junk. There are some really great athletes who follow this diet (Rich Roll, Brendan Brazier, Scott Jureck). Good luck!
posted by FencingGal at 9:50 AM on October 17, 2015

The other thing I did at the same time I changed my diet was to start supplementing vitamin B12 (I had been supplementing vitamin D for several months already). I mention this because of the vegan diet in FencingGal's comment - the only issue with a vegan or mostly-vegetarian diet is that it can make it hard to get enough B12, and although your liver stores a few years' worth you will eventually run low. (I have been eating meat only once a week or so for several years, and blood tests confirmed low levels.).

The point I really want to reinforce was how little idea I had of how many of my calories were coming from sugar and flour, until I cut them out and had to start buying 3x as many fruits and vegetables in order to not be hungry. I didn't eat a lot of pizza, or a lot of burgers, or a lot of sandwiches, or a lot of pasta, or a lot of white rice - but I didn't eat a lot of meals that *didn't* have one of those things, either.

I'm a bit of an evangelist for "sodium doesn't always matter", because good food is a major part of my enjoyment of life, and I've had people close to me suffer on a low-salt diet for years before their doctor casually mentioned that the diet wasn't necessary since their blood pressure didn't seem to be affected by it. Sodium's impact on high blood pressure appears to be genetically linked - so it may be worth a try especially if you're African-American - but it's not universal.
posted by Lady Li at 11:35 AM on October 17, 2015 [1 favorite]

As Lady Li says, if you go on a vegan diet, you do need to supplement with B12. Ground flaxseeds have also been shown to help with high BP. They have to be ground though or they go right through you. I put a tablespoon in my oatmeal every morning. And all dietary changes for high BP recommend increasing consumption of fruits and vegetables - Lady Li has clearly found a workable way to do that so that it's automatic and driven by hunger. Keeping track is very hard to stick with long term.
posted by FencingGal at 11:58 AM on October 17, 2015 [1 favorite]

I picked up the No-Salt, Lowest Sodium Cookbook to help my husband get his BP down, and found it to be helpful for drastically sodium-reduced recipes.
The other thing that helped his BP was getting rid of a major stressor - so add another vote for meditation or anything else that could help manage the stress you're under as you transition.
posted by dotparker at 7:49 PM on October 17, 2015