No-added-salt weekly meal plan for high blood pressure: 7 days with a shopping list

Who is this menu for, and who is it not for?

Who it is for. For an adult with high blood pressure who eats a varied diet and wants the week planned in advance. It is suitable whether your blood pressure is being monitored or you are already taking medication.

Who it is not for. This plan has not been designed for pregnancy or breastfeeding, or for anyone under 18. It is also not intended for people with diabetes treated with insulin or medicines that can lower blood sugar too much. It is not suitable for people with chronic kidney disease or anyone who has or has had an eating disorder. If you have had an eating disorder, your plan should be tailored to you and include psychological support. If you have coeliac disease, a diagnosed allergy, or heart or liver failure, follow your own plan. If you have kidney disease, your nephrologist or dietitian will tell you how much protein, potassium, phosphorus, and other ions and minerals are right for you at your stage of the disease.

There is no calorie count. Calories have not been calculated for each meal, and giving a round number for an unmeasured week would mean making one up. Adjust the amounts to your appetite. If you are still hungry, add vegetables and pulses before adding bread.

The full week, with breakfast, lunch and dinner

No dish has added salt. The bread is no-added-salt or low in salt, canned pulses are rinsed, and the stock is homemade. The fresh cheese is low in salt, and the tuna is packed in water and drained. If your blood pressure is not under control, talk to your doctor about coffee.

If lunch or dinner does not include fruit or yoghurt, add a piece of fruit for dessert. Aim for two or three servings of dairy a day, as recommended by the DASH plan [2].

The plan includes pulses on three days and fish on four, including oily fish on two days. Eggs appear six times and white meat three times. All fourteen lunches and dinners include vegetables, and there are potatoes, sweet potatoes or pulses almost every day. This increases potassium without needing to buy anything special.

The week’s shopping list

The quantities are for one person for seven days, grouped by supermarket aisle so you can shop in one trip. Freeze any leftovers.

Vegetables

• 1 kg potatoes, 2 sweet potatoes and half a pumpkin
• 6 onions, 3 leeks, 1 bunch celery, 2 bulbs garlic, 1 bunch parsley and 1 bunch basil
• 1.5 kg ripe tomatoes, 2 cucumbers, 2 green peppers and 1 red pepper
• 500 g carrots, 400 g green beans and 3 courgettes
• 300 g spinach, 1 bag lamb’s lettuce and 250 g mushrooms

Fruit

• 1 kg oranges, 4 bananas, 4 apples, 3 pears and 3 kiwis
• 1 small melon, half a pineapple, 250 g strawberries, 250 g grapes and 1 punnet blueberries
• 3 avocados

Pulses, grains and bread

• 250 g dried lentils or 2 jars cooked lentils
• 2 jars cooked chickpeas and 1 jar white beans
• 500 g brown rice, 250 g wholewheat pasta and 100 g noodles
• 500 g rolled oats and 1 packet muesli with no added sugar
• 2 loaves no-added-salt or low-salt bread, sliced and frozen

Fish, meat and eggs

• 2 hake fillets and 1 sea bream, fresh or frozen
• 4 fresh sardines and 1 can tuna in water
• 2 chicken breasts and 200 g turkey steaks
• 1 dozen eggs

Dairy

• 1.5 l milk or unsweetened soya drink (soya is an allergen)
• 12 plain unsweetened yoghurts
• 1 tub low-salt fresh cheese

Pantry

• Extra virgin olive oil and wine vinegar
• 150 g walnuts and 100 g hazelnuts, both unsalted
• Flaxseeds
• Paprika, cumin, oregano, thyme, bay leaf, cinnamon, saffron and black pepper
• 1 jar crushed tomatoes with no added salt

At the supermarket, the label is your best tool. In the European Union, a food may only be labelled low in sodium or salt if it contains no more than 0.12 g sodium per 100 g [3]. Use this threshold to compare two breads or two jars of tomatoes, as there can be large differences between brands.

What the week includes and what it leaves out

• Vegetables, fresh or frozen, at lunch and dinner every day.
• Whole fruit, four or five pieces a day, between breakfast and dessert [2].
• Pulses, three times a week, dried or canned and rinsed.
• Whole grains and starchy vegetables, such as oats, wholegrain rice and pasta, potatoes and sweet potatoes.
• Fish, both white and oily; choose fish canned in water rather than brine or marinade.
• Eggs and white meat, such as skinless chicken, turkey and rabbit.
• Dairy, low in fat and with no added salt, plus unsalted nuts and seeds.

Processed meats and cold cuts are left out, including turkey marketed as lean. Aged cheeses and sliced cheese, ready meals, stock cubes, packet soups and commercial sauces are also excluded. Salted canned foods, salty snacks, sugary drinks and packaged juices, including vegetable juices, are left out too.

Energy drinks are also excluded because they raise blood pressure [4]. Alcohol does not appear on any day either, because less is better [4].

How can you cook without salt and keep food tasty?

Flavour comes from four things, all of which are on the shopping list. Acidity from lemon and vinegar brings a bland dish to life with just a few drops. The sweetness of vegetables comes out when you slowly sweat onion, leek or carrot until golden.

Toasted flavours come from oven-baking, griddling and cooking en papillote; boiling does not bring them out. Then there are spices and herbs, such as paprika, cumin, oregano, thyme, bay leaf, garlic and parsley.

If you cook with a pinch of salt, use iodised salt: the iodised salt guide explains why and how much.

Why does this menu increase potassium as well as reduce salt?

Reducing sodium is half the work. The other half is potassium, which helps lower blood pressure and cardiovascular risk. The World Health Organization recommends getting more potassium from food and suggests at least 3,510 mg a day [5].

That potassium comes from vegetables, fruit, pulses, potatoes, unsalted nuts and low-fat dairy, which are the foods that fill the menu.

For people with hypertension who eat a lot of salt and do not have moderate or advanced kidney disease, increasing potassium by 0.5 to 1 g a day is considered [4]. This can be done by eating more fruit and vegetables. Potassium-enriched, reduced-sodium salt can also help lower blood pressure in adults [4].

The limit matters more than the recommendation. Some people need to monitor their blood potassium levels [4]. This includes people with kidney disease or those taking medicines that retain potassium, such as some diuretics, ACE inhibitors, ARBs or spironolactone. This menu increases potassium through food. Do not use potassium-enriched, reduced-sodium salt if you have kidney disease, are pregnant or take medicines that retain potassium. Ask your doctor first.

How is this menu similar to the DASH diet?

DASH stands for “Dietary Approaches to Stop Hypertension”. It is a plan from the US National Heart, Lung, and Blood Institute, with no special foods or branded products. It is based on servings from each food group [2].

For 2,000 kcal a day, it suggests 6 to 8 servings of grains, 4 to 5 of vegetables and 4 to 5 of fruit. It adds 2 to 3 servings of low-fat dairy, 6 or fewer of meat, poultry or fish, and 2 to 3 of fats and oils. It also recommends 4 to 5 servings a week of nuts, seeds and pulses [2].

This week follows that structure using the foods on this shopping list. Extra virgin olive oil provides the fat, and breakfast includes dairy, grains and fruit almost every day. Both the Mediterranean-style eating pattern and DASH are recommended to lower blood pressure [4].

If you also have high cholesterol, which often goes hand in hand with high blood pressure, here is the guide to lowering cholesterol, with its own weekly menu.

What mistakes do we see in consultations?

These four pitfalls come up almost every week when someone has high blood pressure.

• Putting away the salt shaker but leaving everything else the same. A large part of our salt intake is already in processed foods such as bread, cured meats and ready meals [4].
• Giving up in the first week because everything tastes bland. That is normal at first. Within two or three weeks, your sense of taste adjusts, and then the foods that used to taste salty may seem too salty.
• Changing your medication because your blood pressure has gone down. Reducing salt adds to the effect of your medication. Only your doctor decides the dose.
• Expecting a change in the numbers within a few days. How much and how quickly your blood pressure falls depends on your starting point. You can see this by measuring it at home.