Dear HealthSmart,

Because I’m often bloated and constipated, I’m searching for a simple solution. I’ve heard there are many lifestyle and diet changes that could help. What really works and what doesn’t?

HealthSmart asked Dr. Arnold Wald, M.D., Professor of Gastroenterology and Hepatology at University of Wisconsin. Here’s his response:

Doctors frequently tell patients who suffer from constipation to eat more high fiber foods. Fiber is great and a natural way to promote regular bowel movements. There are many high-fiber cereals on the market and fiber is present naturally in a wide array of fruit and vegetables. But it’s important to note that a high-fiber diet can actually be counterproductive for people whose constipation is due to ‘pelvic floor dysfunction,’ which involves weak or out-of-condition pelvic muscles. For these patients, loading up on fiber makes their constipation worse rather than better.

Dear HealthSmart,

Both of my parents are in their late 70s, suffer from hypertension, and were recently told they should start intensive treatment with medication. I worry about risks associated with taking more than one blood pressure medication. What are the benefits of intensive treatment versus standard treatment?

HealthSmart asked Dr. Jeff Williamson, M.D., Professor of Gerontology and Geriatric Medicine at Wake Forest Baptist Medical Center, in Winston-Salem, N.C. Here’s his response:

Intensive treatment of high blood pressure reduces older adults’ risk of heart disease without increasing their risk of falls or other complications. Our SPRINT Study included more than 2,600 patients, aged 75 and older. They were randomly assigned to one of two groups: one targeting systolic blood pressure at a maximum of 120 (mm Hg) using intensive therapies, the other aiming for the standard target of 140 (mm Hg.). Compared to those in the standard target group, patients targeted for intensive therapies were nearly one-third less likely to have a heart attack, heart failure or stroke, and nearly one-quarter less likely to die, the study authors said. Our findings have substantial implications for the future of high blood pressure therapy in older adults because of the devastating consequences high blood pressure complications can have on the independent function of older people.

Dear HealthSmart,

What are natural ways to treat hypertension? Can these compete with medical treatment options?

HealthSmart asked Dr. Glenn Gaesser, Ph.D., Arizona State University. Here’s his response:

It has been argued that lifestyle intervention may actually be more effective in treating hypertension than medication. Many people don’t end of taking their medications because of their side effects. Even small changes in exercise and diet can yield big results. Physical activity, even light to moderate intensity, will help lower your blood pressure. If possible, spread your exercise throughout as opposed to sectioning off a part of the day to keep your circulation moving and blood pressure somewhat steady. Losing weight is also very important in naturally combating hypertension, but it’s important to keep weight off because weight cycling is a risk factor of high blood pressure. Chronic fluctuation of weight can be more harmful than maintaining a current weight – and the bigger the weight loss the more potentially hazardous. The DASH diet, which is available online, is a useful resource if you’re attempting to lower blood pressure through changes in diet. It’s important to adapt a realistic diet that you can maintain and not fluctuate between weights with crash dieting. In terms of all the natural approaches recommended to reduce high blood pressure, the only method with proven, clear positive effects is exercise.

Do you have questions on health or wellness you’d like answered by the nation’s leading medical researchers? If so, you can send to Editor@WashNews.com. HealthSmart is a national newspaper column from the Washington News Service in DC. Due to demand, we are unable to reply to all inquiries. Responses through the column are no substitute for care from physicians or other medical professionals.

Copyright Ellen James Martin 2021