A nutrient-rich diet is important for everyone, but it’s especially helpful for people living with pulmonary arterial hypertension (PAH). Following a heart-healthy eating plan can help you better manage the condition. PAH is a specific type of pulmonary hypertension (PH) in which blood pressure is increased in the pulmonary arteries (the lungs’ large blood vessels).

Along with taking your medication as prescribed, making dietary and lifestyle changes can help you better manage PAH symptoms and reduce your risk of complications like sleep apnea, as well as comorbidities — other conditions that can occur alongside PAH — such as obesity.

Foods To Enjoy With PAH

Fueling your body with nutritious foods is a great way to manage PAH. Enjoying fruits, vegetables, and whole grains can help ensure you’re meeting your body’s nutritional needs while limiting complications from PAH.

Fruits and Vegetables

Fruits and vegetables are an excellent source of vitamins and minerals that your body needs to function. Research shows that people with PAH may not absorb nutrients as well as those without the condition. As a result, they may be deficient in key vitamins and minerals, including:

• Iron
• Selenium
• Vitamins B12, D, and K1

Unfortunately, vegetables and fruits aren’t a strong source of vitamin D, but the nutrient can be found in fortified cereals, milk, and juices, along with fatty fish like salmon and sardines.

Incorporating more fruits and vegetables into your diet also supports healthy gut bacteria and is associated with a better quality of life for people with PAH. There’s also some evidence linking low vitamin C levels to PAH. Getting plenty of vitamin C through fruits and vegetables supplies beneficial antioxidants to help support better health with a chronic disease.

If using canned or frozen options, check the nutrition label for low added sugar and reduced sodium. Choose canned vegetables labeled “low sodium” or “no salt added,” and rinse them with water before cooking to remove extra salt. For fruit, go for options packed in water rather than syrup or juice.

Whole Grains

Instead of choosing refined grains like white bread and white pasta, try adding more whole-grain options to your diet. Whole grains use the entire grain kernel, which means they contain more fiber, protein, and important nutrients like B vitamins and iron.

Some foods that typically come with whole-grain options include:

• Brown rice
• Whole-grain crackers
• Whole-wheat bread
• Hulled barley
• Oatmeal
• Quinoa
• Whole-wheat pasta
• Popcorn

Adding whole grains to your diet can also help you feel fuller for longer. The Dietary Guidelines for Americans recommend making at least half of the grains you eat whole grains.

Leafy Greens and Other High-Iron Foods

Leafy greens are an excellent source of fiber and essential nutrients, including iron. Many people with PAH have low iron levels, which can lead to more severe disease symptoms.

Without the proper amount of iron, you may develop anemia (low red blood cell levels), leading to shortness of breath or extreme fatigue, especially with PAH.

Iron is an important component of hemoglobin, the protein in red blood cells that carries oxygen around the body. Without enough iron, you may develop anemia (low levels of red blood cells), which can cause shortness of breath or extreme fatigue, especially with PAH.

You can add more iron into your pulmonary hypertension diet by eating leafy green vegetables, such as kale, spinach, or collard greens. Pair iron-rich foods with sources of vitamin C — like adding lemon juice to a salad or tossing bell peppers into a stir-fry — to help your body better absorb iron.

Other foods that are good sources of iron include:

• Peas and beans
• Fortified cereals, enriched rice, and whole-grain breads
• Red meats (such as beef or pork)
• Eggs
• Fish and shellfish
• Nuts and seeds (such as almonds, pumpkin seeds, and pine nuts)
• Dried fruits (such as dates, raisins, prunes, and figs)

The U.S. National Institutes of Health recommends an iron intake of 8 milligrams for adult males and 18 milligrams for adult females who aren’t pregnant. For all adults 51 years or older, the recommended amount is 8 milligrams. If needed, you may take an iron supplement to help boost your levels.

Before starting any supplements, it’s important to talk with your healthcare provider. They can help determine if a supplement is right for you, check for any risks — like interactions with your current medications — and guide you toward safe, trustworthy options.

What To Limit or Avoid With Pulmonary Arterial Hypertension

Limiting how much salt you consume and fluid you take in can help prevent unwanted PAH symptoms while keeping your heart healthy.

Salt and Processed Food

In PAH, the heart and lungs are already putting in extra work. When you eat salt, your body holds on to more fluid (known as fluid retention). This puts stress on the right side of the heart, leading to increased blood pressure in the lungs, shortness of breath, and a type of swelling called edema (caused by fluid buildup) in the legs or abdomen (belly area).

The American Heart Association recommends that people with high blood pressure limit their salt and sodium intake to less than 1,500 milligrams per day.

Although salt is a tasty addition to some meals, cutting back on your salt intake can help prevent harmful heart-related side effects. The American Heart Association recommends that people with high blood pressure limit their salt and sodium intake to less than 1,500 milligrams per day.

Pay attention to nutrition labels for added salt — you may be surprised by how much sodium is in some foods. These can include:

• Cheese
• Deli meats
• Canned vegetables with added salt
• Frozen dinners
• Pickled foods (such as sauerkraut or pickles)
• Canned soups
• Dressings, condiments, and sauces
• Cereals

Before eating at restaurants, look up the nutritional information for meals to find low-sodium options. Foods to avoid with pulmonary hypertension include processed or fast foods.

When cooking at home, substitute salt with other spices and herbs to add flavor to your dishes. Look for salt-free seasonings, like the brand Mrs. Dash or NoSalt, which can be found in most grocery stores.

Too Many Fluids

Staying hydrated is important, but drinking too many fluids can cause an uncomfortable — and potentially harmful — buildup in the body. For those with PAH, this can lead to edema, which can make breathing difficult.

Health experts often suggest a limit of 2 liters of fluid (about 8.5 cups) per day, but everyone with PAH is different and should follow their provider’s individualized guidance.

Fluid intake includes more than just what you drink. It also comes from foods like:

• Fruit
• Popsicles
• Soups
• Gelatin desserts like Jell-O

If your doctor has advised you to limit fluids, tracking your daily intake — both food and drink — can help you stay on target and feel your best.

Tips for Developing Healthy Eating Habits With PAH

Making diet changes can be difficult, but it’s important to remember that even the smallest of changes can have a big impact on your health. Building new habits takes time, so start by making one or two small changes at a time.

As you become more comfortable with the adjustments, incorporate a few more. Keeping a food and drink journal for a few days can help you spot patterns and keep track of how much sodium you’re eating.

Ask your healthcare provider or a registered dietitian for meal and snack ideas.

Ask your healthcare provider or a registered dietitian for meal and snack ideas. If you would like to, bring your food journal to the appointment to discuss with them. You may also search online for low-sodium recipes to try at home with family or friends. Bringing in your support system can give you accountability and support as you make these changes.

Diet Tips From myPHteam Members

On myPHteam, many members have shared their dieting tips and strategies to keep on track while living with PAH.

Some members share their difficulties with following a low-sodium diet. One said, “Is it hard to follow the low-sodium diet? I constantly catch myself slipping. Food is so good!”

Another member replied, “I’ve heard from at least two of our members that the Mrs. Dash seasonings are a really good alternative to salt.”

Other members have found that the internet is a great source for recipe ideas. “MrsDash.com has a meal-planning section for a no-salt diet that is intuitive and easy to use,” shared one member. “Lots of ideas and a variety of food choices to help us find our way along this new path.”

Eating out at restaurants can be challenging for someone on a PAH diet, especially since you may not know all of the ingredients used in a dish. One member said, “I do order in or I go out to eat a lot. But when I do, I only eat at places I know make their food from fresh ingredients rather than from Crisco oil.”

Other members prefer to cook at home to be able to control what ingredients are being used and consumed. One member of myPHteam shared, “I had a good day today, so I had an idea to take advantage of my good days and cook food to last several days. So when the bad days come, it will keep us from getting fast food.”

Talk With Others Who Understand

On myPHteam, the social network for people with pulmonary hypertension and their loved ones, more than 56,000 members come together to ask questions, give advice, and share their stories.

Have you made diet changes while living with PAH? What tips do you have for others? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.