The most effective supplements and dietary changes for high blood pressure and cholesterol your GP may not tell you

Dr Andrew Fisher gives his insights on the most effective dietary changes and supplements for these common conditions

High blood pressure (hypertension) and ‘high’ cholesterol are common findings for which I am regularly asked what can I take instead of pharmaceuticals to help with this?

Although there can be large gains made by increasing activity levels with both aerobic and resistance exercise, as well as improving diet, there are supplements or specific dietary changes that may be particularly helpful.

Below I list my top five tips which are not regularly considered for blood pressure cholesterol management:

Tip #1 -add a (non-odourous!) Garlic capsule daily

Garlic supplementation appears to reduce blood pressure, and the magnitude is quite respectable in people with hypertension (around 10 points systolic or 8-10%) , whereas there is a smaller but significant reduction in people with normal blood pressure.

Consuming two cloves of garlic a day can be challenging and also off putting for those around you! Happily you can consume a garlic capsule to produce a similar effect.

Garlic also decreases LDL cholesterol and total cholesterol.

Tip #2 - Use Lo- Salt

Eating a high potassium diet and indeed supplementing with potassium chloride has been shown to lower blood pressure.

Lo-salt contains potassium chloride as well as the normal sodium chloride that we use as table salt. It can be purchased in various concentrations and when starting to use this substitute it is best to begin with one that contains 25% potassium chloride before they’re moving up to the 50% potassium chloride version as there is a slight difference in taste that your taste buds will quit people become used to and allow you to move up to the more effective version

Tip #3 - consider magnesium

Several large scale studies have shown that oral magnesium does reduce blood pressure in patients with hypertension.

Tip #4 - consider turmeric (Curcumin) or Berberine.

There is evidence that turmeric can both reduce blood pressure and decrease triglycerides.

Although barberine is often used to improve blood sugar control, it is less known that it has a positive effect on your cholesterol profile: reducing total cholesterol and triglycerides.

Tip #5 - add all the other important (and delicious!) things to your diet

For blood pressure: A heaped tablespoon of flaxseed daily, Spirulina added to your smoothie or glass of beetroot juice or hibiscus tea have all been shown to help lower BP.

For your lipid profile: some soy protein, a cup Yerba mate daily, or even going full hog on a vegan diet is shown to reduce your LDL cholesterol

Don’t Forget to make those behavioural changes too

There is increasing evidence that regular sauna use is associated with a drop in blood pressure, so don’t overlook those behaviours we could change in order to improve our blood pressure or cholesterol profile.

If you found these tips interesting and would like further advice why not book a meeting with the Longevity Docs for your own personalised meeting.

Frictionless Living?

Inflammation is a key medical concept that has been incorporated into a useful illustrative idea in Longevity Science and Wellbeing. The four facets of inflammation in medicine are captured by the Latin terms rubor, dolor, tumor, and calor: redness, pain, swelling, and heat. The analogy of a bodily system heating up describes the friction caused by less-than-optimal operation of cellular machinery, resulting in excess energy requirements and wear at the interface.

Some inflammation is a necessary part of life. Living involves interacting with our surroundings, which inevitably involves give and take. At a cellular level, where the cell membrane ends, the outside world begins. This fine line negotiates the exchange of useful materials in both directions. This interface between “you” and “non-you” causes friction across that differential.

Thus, we live along a spectrum of inflammation and expend energy to operate within that level of friction, much like any other object on our planet. However, our aspiration can still be to mitigate and minimize this friction, moving ourselves in an anti-inflammatory direction along the spectrum, away from pro-inflammatory influences.

Pro-inflammatory Influences vs. Anti-inflammatory Influences

	Pro-inflammatory Influences		Anti-inflammatory Influences
Daytime state	Stress Sedentary or inactive lifestyle		Peak of stress-performance curve & strategies to prevent over-reaching beyond it High levels of activity, mostly gentle movement (eg standing desk) with a mixture of aerobic and anaerobic exercise, outdoors where possible
Diet	High sugar, UPFs, refined carbs, alcohol, tar		Wholegrain foods, home-cooked from reliably sourced ingredients High protein, sourced from mostly vegetables/nuts & minimal meat Adequate hydration
Sleep	Interrupted, sedated (alcohol or medication), shortened duration, jet lag/shift work		Sufficient good quality
Physical state	Tiredness, limited exercise tolerance, obesity, diabetes, pain		Energy, flexibility eg through yoga, strength and endurance, able to sense the right pace for your body (interoception)
Emotional state	Anxious, agitated, angry, depressed, pessimistic/negative, fearful		Positivity, gratitude, awareness, good-humoured and able to laugh,  confidence, joy
Social state	Isolated, outsider feeling, weak or insecure connections/attachments		Adaptable, strong sense of connection and belonging, Love.

We are often told about the Anti-Inflammatory Diet, and it is an attractive idea to hold our diet accountable for the whole of our lifestyle. However, it cannot be as simple as focusing on just this one aspect, given the multi-faceted variables in our busy lives. Even when considering the gastrointestinal tract, what we ingest is only one part of what influences its health: stress hormones affect gut motility, sleep affects appetite hormones (ghrelin and leptin), and activity levels influence the absorption rate of sugar and even how quickly we ingest it—all of which go on to affect our gut microbiome. This, in turn, impacts our gut lining and communicates back to our bodies through neurotransmitter secretion.

We are far better off to address our lives as a whole, overwhelming as this might initially seem. But tackling each aspect gradually in a prioritised way, with the help of a coaching style conversation if you need, this becomes our life’s work: to maintain the foundation of our physical and mental wellbeing.

It is important to note that there are only a proportion of factors affecting our level of inflammation that are under our control, and many factors are beyond our influence. Bearing the responsibility of trying to change what we cannot control is a contributing factor to high stress levels, leading to distress, mediated by emotions such as regret, recrimination, anxiety, and shame. Paradoxically, these negative emotions and the hopelessness that arises from embarking on a futile task escalate our levels of inflammation and undermine our foundations.

So we have to be clear about those inflammatory factors we can change and those we have to accept. In doing so we conserve our energy to modulate our pace and rhythm, reducing the friction as we navigate as consistently as possible to keep to the slipstream of flow as we encounter the inevitable turbulence of life.

A guide to ‘Lingo’,is this the best continuous glucose monitor yet?

This blog is written by Dr Andrew Fisher and Dr Angus Tallini. At the Longevity Docs we are not sponsored or influenced by any company. We purchased Lingo devices with no reduction, payment or sponsorship from Abbott Pharmaceuticals.

Lingo is a continuous glucose monitor (CGM) using AI for analysis that has been created by the drug company Abbott. It monitors your glucose levels constantly for a 2 week period. A sensor attached to your upper arm communicates via Bluetooth to your phone and the Lingo app provides recommendations on behaviours (eg. Go for a walk or do some squats!) based on whether your blood sugar is spiking. The cost is an affordable £69 and it can be purchased directly from Abbott. Importantly, it does not require an ongoing subscription. We have previously trialled the freestyle libre 2, Abbott’s predecessor to Lingo, so this blog gives insights on some new features different to the previous version.

Lingo is well packaged in an attractive navy and silver box (see red arrow below). It is simple to set up.

I’m not diabetic, so why should I bother doing this ?

Well, the post-prandial (after eating) glycemic response in individuals without diabetes is consistently being shown to be of importance; It is likely to be involved in the development of the majority of age related diseases that limit our healthspan.

Repeated glucose spikes are associated with an increased risk of most of the leading causes of death:

• Cardiovascular Disease

• Cancer (particularly lung, colon, pancreatic, breast)

• Infection

(Including COVID-19)

• Alzheimer's

• Diabetes

• Liver Disease

And increase the risk of or severity of many non-lethal diseases....

• Obesity

• Metabolic Syndrome

• Neurological and

Psychological Diseases (Depression, Cognitive Decline, Migraine)

• Immune Disease

• visual problems

(Retinopathy, Cataracts)

• PCOS (polycystic ovarian symptom)

• Menopause Symptoms

• Infertility

• Amputation

• Periodontitis (gum disease)

• Acne

So what is it like to wear one?

Wearing a CGM feels like developing a seventh sense! A glimpse into what is really happening in your body rather than just your brain's interpretation of events. Lingo delivers this painlessly and accurately, and the clarity from a continually bluetoothed reading joins the data together to show you the landscape of your blood sugar in everyday reality. Two weeks ensures you won't just be on your best behaviour and can get to grips with all your day to day habits, even the ones you aren't proud of.

It also offers its own interpretation, through the Lingo score, a composite of the rate and duration of any glucose spikes (even if within the normal range) and the context of what you have logged (whether a meal, snack or exercise event.) The higher the score, the more you accelerate to your daily limit and, in our cases, often overshooting it!

Lingo has some advanced tools that were not present with the freestyle libre 2- such as an analysis of your glucose variability (see screenshot below)

Below we have compiled both insights and drawbacks from using a Lingo monitor:

Insight 1:

Dr Tallini found eating breakfast hurriedly after an overnight 12 hour fast spikes glucose higher than eating a meal not as quickly or hungrily or multi-tasking.

Insight 2:

Protein sources such as peanuts, walnuts or Chia seeds work to counteract the glucose spiking effects of carbohydrates from porridge/muesli.

Insight 3:

So does red wine (not with breakfast!) It flattens the spike from the same size of bowl of pasta when compared with or without wine.

Insight 4:

Even a gentle walk covering the period of time 1 hour after eating flattened any glucose spike, even after a high carb (eg large bowl of spaghetti) meal.

Insight 5:

Focusing on a single dimension biometric such as glucose creates blindspots and paradoxes: Dr Tallini found that snacks such as a cream tea with clotted cream and jam came out "ok" in terms of a low glucose spike, but only because he wasn't wearing a continuous blood lipid monitor!

Similarly, alcohol might prevent glucose from spiking, but due to its negative effects on sleep quality and brain/liver functioning in the long term, we cannot be relied on too heavily as a "solution".

Insight 6:

For Dr Tallini, even nights where he felt he had slept normally, the glucose trace was turbulent (albeit in the normal range between 4-7) in a wave form cycling from lower to higher throughout the night. Whether this represented more intense dreams, processing stressful events, or other sleep disturbance even if not to the extent of waking up, it is worth noting the importance of sleep hygiene on metabolism. This overshadows the following day by influencing your appetite control hormones ghrelin and leptin.

Dr Fisher however found that glucose overnight was stable, only arising in the event of waking up suiting the night. This highlights the individual response.

So what are the drawbacks?

Drawback 1:

While the Lingo score has been developed to provide you with a target, to some it can feel like a penalty, a negative telling-off for even quite minor offences. Dr Tallini found it to be distracting and disengaging, like a parent or teacher who nit picks all day long without balancing with one or two encouragements.

Drawback 2:

An early wake up can raise your cortisol levels and glucose , which can cause a spike beyond your control leading to some frustration! See the chart for Dr Fisher below after a 4.30am wake up before eating that morning.

If you worry over too much health data then a continuous glucose monitor may not be for you, so here are our top 2 takeaways any individual can use to help stabilise their glucose control if a lingo is not something they wish to pursue:

1. try and incorporate protein in each snack and main meal you have.

2. Exercising 30 minutes to 1 hour after a meal can have a profound effect on controlling any glucose rise. Even a 10 minute walk has a significant effect.

   
   

We hope you have enjoyed this summary of the use of a continuous glucose monitor and the insights one can gain. If you are interested in gaining a further opinion on your lingo data or any aspects of optimising your health then please do not hesitate to book in at thelongevitydocs.com

Dr Andrew Fisher and Dr Angus Tallini

November 2024