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Diet and Pulmonary Arterial Hypertension: What To Eat and What To Avoid

Posted on July 01, 2022
Medically reviewed by
Steven C. Pugliese, M.D.
Article written by
Emily Wagner, M.S.

  • Following a healthy diet benefits everyone, but it can be especially important for managing the symptoms of pulmonary arterial hypertension (PAH).
  • Limiting salt and fluid intake helps prevent swelling and high blood pressure.
  • Enjoying fresh fruits, vegetables, lean meats, and whole grains ensures you are getting the nutrients you need while living with PAH.

A healthy diet is important for everyone, but for those with pulmonary arterial hypertension, following a heart-healthy eating plan can help manage their condition. PAH is a specific subset of pulmonary hypertension (PH) in which blood pressure is increased in the lung’s large blood vessels (known as the pulmonary arteries).

Along with taking your medication as prescribed, making dietary and lifestyle changes can help people with PAH better control their symptoms and prevent complications such as obesity and sleep apnea.

Dietary Tips for Pulmonary Arterial Hypertension

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

Limit Salt and Processed Food

In PAH, the heart and lungs are already putting in extra work. When you eat salt, your body will hold onto 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 abdominal and leg swelling.

Although salt is a tasty addition to most 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. Try to limit or avoid processed or fast foods when possible. When cooking at home, substitute salt with other spices and herbs to add flavor to your dishes. The brand Mrs. Dash offers salt-free seasoning blends that can be found in most grocery stores.

Avoid Too Many Fluids

Staying hydrated is important, but drinking too many fluids can cause a dangerous buildup in the body. For those with PAH, this can lead to swelling (known as edema), which can make breathing difficult. Health experts generally recommend people drink two liters of fluid per day, which is around eight-and-a-half cups of water. Fluid intake includes not only what you drink, but also those you consume through foods such as fruit, popsicles, soups, and gelatin desserts like Jell-O.

Tips for Developing Healthy Eating Habits

Making diet changes can be difficult, but it is important to remember that even the smallest of changes can have a big impact on your health. Building new habits is not an overnight process, so try to make one to two changes at a time. As you become more comfortable with the adjustments, incorporate a few more. Writing down what you eat and drink for a few days will also help you to track how much sodium you consume and help you identify your habits.

Ask your health care provider or a registered dietitian for meal and snack ideas to try. 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.

Foods To Enjoy With PAH

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

Fresh Fruits and Vegetables

Fresh fruits and vegetables are an excellent source of vitamins and minerals that your body needs to function. One study found that people with PAH do not absorb nutrients as well as those without the condition. As a result, they may be deficient in key vitamins — such as vitamins C and D — and also at risk of developing insulin resistance.

Vitamin C is found in berries and citrus fruits, tomatoes, white potatoes, and peppers. Vitamin D is found in fortified cereals, milk, and juices, along with fatty fish like salmon and sardines.

Try to limit or avoid canned fruits and vegetables, as these tend to have more salt and preservatives in them. If needed, there are typically low-sodium options in the grocery store to help cut back on salt intake.

Whole Grains

As an alternative to refined grains that are found in pasta and white bread, add more whole grain options to your diet. These are manufactured using the entire grain, which means they contain more beneficial vitamins, protein, and fiber. Some foods that typically come with whole-grain options include:

  • Brown rice
  • Crackers
  • Bread
  • Hulled barley
  • Oatmeal
  • Quinoa

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. Iron is an important component of hemoglobin, which carries oxygen in the blood. 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.

You can add more iron into your diet by eating leafy green vegetables, such as kale, spinach, or collard greens. Other foods that are high in iron include:

  • Peas and beans
  • Enriched rice, cereals, and bread
  • Red meats (such as beef or pork)
  • Eggs
  • Fish
  • 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 men and 18 milligrams for adult women. If you are 51 years or older, the recommended amount is 8 milligrams for both men and women. If needed, you may take an iron supplement to help boost your levels. Your health care provider can recommend what dose is best for you.

Learn more diet and nutrition tips for pulmonary hypertension.

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, 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 avoid unhealthy ingredients. One myPHteam member 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 45,000 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, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Steven C. Pugliese, M.D. is affiliated with the Hospital of the University of Pennsylvania in Philadelphia, serving as the director of the pulmonary embolism response team, co-director of the comprehensive pulmonary embolism program, and an assistant professor of clinical medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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