Questions and Answers on the Dietary Guidelines for Adults with Hypertension (2023 Edition)

Recently, the National Health Commission issued the "Notice of the General Office of the National Health Commission on Printing and Distributing Four Dietary Guidelines Including the Dietary Guidelines for Adults with Hyperlipidemia (2023 Edition)". In order to implement the "Healthy China Action (2019-2030)" and the "National Nutrition Plan (2017-2030)", develop traditional dietary services, and prevent and control the occurrence and development of chronic diseases in the Chinese population, the "Dietary Guidelines for Adults with Hyperlipidemia (2023 Edition)", "Dietary Guidelines for Adults with Hypertension (2023 Edition)", "Dietary Guidelines for Children and Adolescents with Growth Retardation (2023 Edition)", and "Dietary Guidelines for Adults with Diabetes (2023 Edition)" were compiled. The four dietary guidelines aim to give full play to the advantages of modern nutrition and traditional Chinese and Western medicine, integrate food and drug substances and new food ingredients into a reasonable diet, provide recipe package examples and nutritional and health suggestions for different populations, regions and seasons, and improve the applicability and operability of dietary guidance.

Today, I will continue to share with you the "Dietary Guidelines for Adults with Hypertension (2023 Edition)", let's learn together~

1. What is the purpose and significance of the "Dietary Guidelines for Hypertension in Adults (2023 Edition)"?

The "Dietary Guidelines for Hypertension in Adults (2023 Edition)" (hereinafter referred to as the "Guidelines") were formulated based on meeting the health needs of the people, to provide scientific guidance for preventing and controlling the occurrence and development of hypertension in the Chinese population, improving the daily diet of hypertensive patients, improving the nutritional and health level of residents, and developing traditional dietary services.

The significance of the Guidelines is to:

• First, we should give full play to the advantages of modern nutrition and traditional Chinese and Western medicine in diet, integrate food and medicine substances into a reasonable diet, and assist in preventing and improving hypertension.
• The second is to compile recipe examples for people with different syndromes, different regions, and different seasons, and provide dietary guidance to improve the personalization and operability of dietary guidance.
• Third, based on modern nutritional theories and relevant evidence, as well as the concepts and conditioning plans of traditional Chinese medicine, we will promote the integration of Chinese and Western medicine, inherit traditional dietary culture, and effectively promote the high-quality development of dietary services.

2. What is the basis for the formulation of the Guidelines?

The Guidelines are based on the relevant requirements of the Healthy China Action (2019-2030) and the National Nutrition Plan (2017-2030). The Healthy China Action (2019-2030) points out that it is necessary to encourage the development of traditional dietary care services. The National Nutrition Plan (2017-2030) proposes that we should give full play to the advantages of traditional Chinese medicine, formulate dietary care guidelines for residents that are in line with my country's current situation, guide people to develop dietary care habits that are in line with the dietary characteristics of different regions in my country, carry out dietary care guidance for people with chronic diseases, and improve residents' dietary care literacy.

3. What are the principles for formulating the Guidelines?

The Guidelines were formulated based on the following four principles:

The first is the principle of scientificity. The Guidelines are based on literature research on nutrition science, TCM diet theory, and evidence of the relationship between food and health, and refer to relevant domestic and foreign guiding principles, guidelines, standards, and classics. In combination with China's actual situation and expert opinions, the Guidelines system framework is determined, and the content is repeatedly reviewed by experts to ensure scientificity.

The second is the principle of coordination and consistency. During the formulation of the Guidelines, China's current food-related laws, regulations, and management regulations were sorted out to ensure that they are consistent with various requirements.

The third is the principle of openness and transparency. The preparation of the Guidelines has widely solicited opinions from relevant departments, experts and scholars in related fields, universities, research institutes, medical institutions and social groups.

The fourth is the principle of combining guidance with practicality.

The formulation of the "Guidelines" fully considers the current situation, development trends and influencing factors of hypertension in my country, puts forward dietary principles and suggestions, and lists optional food recommendations, recipes and dietary examples based on the characteristics of different syndrome groups, different regions and different seasons, so that users can refer to and choose according to specific circumstances.

4. What is the status of relevant consensus, guidelines and standards at home and abroad?

The Guidelines refer to a number of dietary guidelines, specifications and standards for the prevention and treatment of hypertension issued at home and abroad, including the Dietary Guidelines for Chinese Residents (2022), Dietary Guidelines for Hypertension Patients (WS/T430 2013), Guidelines for the Prevention and Treatment of Hypertension in China (2018 Revised Edition), Guidelines for Diagnosis and Treatment of Hypertension in Traditional Chinese Medicine, Guidelines for Physical Activity for Chinese Population (2021), Statement on Hypertension Management by the Writing Group of the International Society of Hypertension (ISH) (WHO 2003), Guidelines for Prevention of Cardiovascular Disease, Cardiovascular Risk Assessment and Management (WHO 2007), and Guidelines for the Management of Arterial Hypertension 2007. Based on the above research results, and based on evidence-based medicine and expert consensus, recommendations for dietary regimens for adult hypertension, including lifestyle, are proposed.

5. What are the main contents of the Guidelines?

The Guidelines provide dietary principles and recommendations based on the characteristics and classification of hypertension. The appendix describes in detail the food choices for adult hypertensive patients, recommended dietary and medicinal substances and dietary prescriptions for different syndromes, as well as recipe examples and common food exchange tables for different regions and seasons. At least three days of recipes (including dietary and medicinal substances) are listed for each region and season.

6. How to use the Guidelines after they are released?

The Guidelines are mainly aimed at adult patients with hypertension and primary health workers (including nutrition counselors) to provide dietary guidance for auxiliary prevention and improvement of hypertension. Adult patients with hypertension are encouraged to refer to the recommendations of the Guidelines, combine their own conditions, reasonably match their daily diet, and develop good eating habits. Primary health workers (including nutrition counselors) are encouraged to refer to the Guidelines for auxiliary prevention and improvement of hypertension diseases in combination with work needs and the actual conditions of patients. This Guideline is not suitable for cases with complex conditions and multiple diseases. Relevant patients are requested to eat a reasonable diet under the guidance of professionals such as doctors and nutrition counselors. The Guidelines are dietary guidance for adult patients with hypertension and cannot replace drug treatment.

7. What should adult patients with hypertension pay attention to in their diet?

Adult patients with hypertension should choose comprehensive, balanced and diverse food. Pay attention to "reducing sodium and increasing potassium, and eating a light diet", reduce the intake of salt, sodium-containing condiments and various processed foods, and increase the intake of potassium-rich foods (such as fresh vegetables, fruits and beans, etc.). Increase the intake of whole grains and potatoes as staple foods, of which whole grains or miscellaneous beans account for 1/4-1/2 of cereals. Animal foods can be selected from fish, shrimp, poultry, lean meat, etc., and 300-500g of milk should be consumed every day. Limit foods rich in dietary fat and cholesterol, including fried foods and animal offal. Do not drink or limit alcohol. Do not drink or drink less sugary drinks. Choose vegetable oil containing unsaturated fatty acids as cooking oil, and it is recommended to use different types of vegetable oils alternately. At the same time, on the basis of a reasonable diet, food and medicine substances and dietary regimens can be selected for different syndromes.

8. What should adult patients with hypertension pay attention to when choosing food and medicine substances?

When choosing food and medicine, adult patients with hypertension should first accurately identify the syndrome and choose the appropriate food and medicine according to the principle of "depending on the person, the time and the place". At the same time, the energy and macronutrients provided by food and medicine should be taken into account in the total amount of food and medicine for the whole day. In addition, those who are known to be allergic to a certain food and medicine or are taking medicines that may have contraindications with food and medicine should consume the food under the guidance of professionals such as doctors, practicing pharmacists and nutrition counselors.

9. What should adult patients with hypertension pay attention to when referring to the recipe examples in the Guidelines?

Adult patients with hypertension should pay attention to the following six points when referring to the recipe examples in the Guidelines:

First, adjust the amount of food and tailor the diet to the patient's body. According to the region and season where the adult hypertensive patient lives, select the corresponding recipe examples and adjust the food amount accordingly based on the hypertension syndrome type, the patient's age, gender, physiological condition and other specific characteristics. If conditions permit, professional nutritional assessment and Chinese medicine dialectics can be carried out, and the recipe examples can be used as a reference to make precise quantitative adjustments.

Second, exchange the same type of food and enjoy the food. Exchange the same type of food according to the common food exchange table, especially according to local conditions, pay attention to the selection of local ingredients, take into account the local food culture and the taste characteristics of patients, so as to enrich the food variety. Encourage the diversification of cooking methods and presentation methods.

Third, eat less salt and less oil, step by step. Prepare food according to the recommended amount of salt and oil provided in the Guidelines, and gradually reduce the intake of salt and oil to cultivate a light taste.

Fourth, eat small meals frequently and encourage separate meals. Rationally distribute the energy of each meal to achieve personalization, eat small meals frequently, at regular times and quantitatively, and encourage separate meals.

Fifth, balance eating and exercise to maintain a healthy weight. Pay attention to both eating and exercise to maintain a healthy weight. While developing reasonable dietary habits, combine moderate exercise to balance energy intake and consumption.

Sixth, develop a habit, and persistence is the key. Pay attention to improving nutrition and health literacy on a daily basis, refer to the principles and examples in the Guidelines, persevere, and continue to develop healthy eating habits.

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