Managing Three Highs: Nutritionist Advises on 3 Effective Methods

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What are the Big Three Highs and Their Standards?

The Big Three Highs include hypertension (high blood pressure), hyperlipidemia (high cholesterol), and hyperglycemia (high blood sugar). While these chronic conditions may not cause immediate discomfort, their severity lies in the potential for serious cardiovascular complications if not well-controlled. Let’s understand the diagnostic standards for the Big Three Highs:

Hypertension⁽¹⁾⁽²⁾

Blood Pressure Type	Systolic Pressure (mmHg)		Diastolic Pressure (mmHg)
Normal Blood Pressure	< 120	and	< 80
Prehypertension	120-129	and	< 80
Stage 1 Hypertension	130-139	or	80-89
Stage 2 Hypertension	≥ 140	or	≥ 90

 

Hyperlipidemia

Hyperlipidemia includes elevated levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), or high triglycerides. According to the American Heart Association guidelines, the recommended concentrations for adults are total cholesterol below 150 mg/dL and LDL-C below 100 mg/dL for lower risk of atherosclerotic cardiovascular disease⁽³⁾. For those with additional cardiovascular diseases or diabetes, the LDL-C target is advised to be less than 70 mg/dL⁽⁴⁾. Additionally, triglyceride concentrations between 175 to 499 mg/dL indicate moderate hypertriglyceridemia, while ≥ 500 mg/dL suggests severe hypertriglyceridemia⁽³⁾.

Further Reading: What is Hyperlipidemia? What are the Symptoms, and How to Lower Lipid Levels?

 

Hyperglycemia⁽⁵⁾

Meeting any of the following criteria indicates diabetes:

• Fasting blood sugar ≥ 126 mg/dL
• Two-hour blood sugar after oral glucose tolerance test (OGTT) ≥ 200 mg/dL
• Hemoglobin A1c (HbA1c) ≥ 6.5%
• Classic symptoms of diabetes (excessive eating, drinking, urination, and weight loss) with random blood sugar ≥ 200 mg/dL

Further Reading: What are the Big Three Highs? What are the Symptoms and Diseases? 5 Tips to Prevent the Big Three Highs!

 

How to Adjust the Big Three Highs?

If diagnosed with the Big Three Highs, besides taking prescribed medications, lifestyle adjustments such as weight management, exercise, and dietary changes are crucial for improvement.

Weight Management

Weight management is the primary task in preventing the Big Three Highs. It is recommended to use body mass index (BMI) and waist circumference measurements as health standards. According to the American Heart Association, reducing initial body weight by 5% is beneficial for controlling blood pressure, blood lipids, and blood sugar⁽¹⁾.

Exercise⁽⁶⁾⁽⁷⁾

• Intensity: Choose moderate to low-intensity exercises; avoid overly strenuous activities. Diabetic patients should monitor blood glucose levels before and after exercise, record the impact on blood glucose, and ensure proper food intake to prevent hypoglycemia after exercise.
• Duration: Aim for at least 30 minutes each time. For those not accustomed to regular exercise, start with 15 minutes and gradually increase to 30 minutes.
• Frequency: Exercise at least three times a week, gradually building up to a daily routine.

 

Dietary Pattern

Mediterranean Diet

Many studies suggest that the Mediterranean diet is associated with a lower risk of cardiovascular diseases and cancer^(1)(8)(9). This dietary pattern is based on the traditional eating habits of countries around the Mediterranean, with key dietary recommendations as follows^(9)(10):

Per Meal	Per Day	Per Week
Olive oil Vegetables ≥ 2 servings Fruits 1-2 servings Grains/Bread 1-2 servings	Nuts 1-2 servings Dairy 2 servings	Legumes ≥ 2 servings Fish/Seafood ≥ 2 servings Eggs 2-4 servings Poultry 2 servings Red Meat < 2 servings Desserts < 2 servings
Drink plenty of water and consume moderate amounts of red wine.

Note: Each serving is defined, for example: 25 grams of bread, 100 grams of potatoes, 100 grams of vegetables, 1 cup of milk, 1 egg, 60 grams of meat.

 

DASH Diet (Dietary Approaches to Stop Hypertension)

The DASH diet involves consuming a diet rich in fruits, whole grains, low-fat dairy, while limiting red meat, processed meats, salt, sugar, and saturated fat⁽¹¹⁾. Studies show that adopting the DASH diet can lead to an 11mmHg reduction in blood pressure for hypertensive patients and a 3mmHg reduction for normotensive individuals^(12)(13).

 

Smoking Cessation and Moderate Alcohol Consumption

Smoking has been proven to cause cardiovascular diseases, so both hypertensive patients and the general population are advised to quit smoking and reduce exposure to secondhand smoke⁽¹⁾. Additionally, individuals with hypertension are advised to consume alcohol in moderation, with a recommended daily alcohol intake of no more than 28 grams for men (approximately two cans of 5% beer) and 14 grams for women (approximately one can of 5% beer)^(1)(14).

 

What Nutrients Can Be Supplemented for the Three Highs?

In addition to lifestyle adjustments and medication, current research suggests that some nutritional supplements may be beneficial:

High-Concentration Fish Oil

Omega-3 fatty acids play an anti-inflammatory role in the body, including EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These essential fatty acids cannot be synthesized by the body and need to be obtained through diet or supplementation, with fish oil being an excellent source.⁽¹⁵⁾ Many studies suggest that proper supplementation of fish oil can be beneficial for obesity, the three highs, and cardiovascular diseases.⁽¹⁶⁾ It’s recommended to take fish oil with a higher concentration, such as fish oil with 84% or higher concentration. Taking just 2 capsules a day can meet the recommended dosage and reduce the burden of swallowing.

Blood Pressure:
A meta-analysis of 70 clinical trials found that supplementing with fish oil rich in EPA and DHA can reduce systolic blood pressure by 1.52 mmHg and diastolic blood pressure by 0.99 mmHg. The average intake of EPA+DHA in the studies was 3.8 grams per day. Results also showed that a daily intake of more than 2 grams of EPA+DHA had a significant impact on reducing diastolic blood pressure.⁽¹⁷⁾

Blood Lipids:
Early studies indicate that fish oil can reduce triglycerides by 25-30%. Another meta-analysis confirmed that fish oil supplementation significantly lowers triglycerides. While it increases the concentrations of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), it does not affect overall total cholesterol.⁽¹⁹⁾ Research also suggests a linear relationship between the dose of fish oil and the reduction in triglyceride levels. Providing 3 to 4 grams of EPA+DHA per day is more effective than less than 1 gram per day.⁽²⁰⁾ The American Heart Association (AHA) recommends fish oil supplementation for patients with severe hypertriglyceridemia (≥ 500 mg/dL).⁽³⁾

Blood Sugar:
Current research on the effects of fish oil on blood sugar is not conclusive, but some meta-analyses suggest that supplementing fish oil in diabetic patients can reduce glycated hemoglobin (HbA1c) by 0.27.⁽²¹⁾

Red Yeast Rice

Blood Lipids:
Red yeast rice contains monacolin K, which is the main active ingredient in the cholesterol-lowering drug lovastatin. Numerous studies show that red yeast rice is effective in improving low-density lipoprotein cholesterol (LDL-C) and total cholesterol.^(22)(23)

Blood Pressure:
Current evidence suggests that red yeast rice may help lower blood pressure. Some studies indicate that supplementation with red yeast rice and coenzyme Q10 can simultaneously reduce blood pressure, blood lipids, and blood sugar, and these regulations are interrelated.⁽²⁵⁾

 

Black Garlic

Blood Pressure:
Garlic has been shown to lower blood pressure in hypertensive patients, and aged garlic extract (black garlic) containing a stable active ingredient called S-allylcysteine is particularly effective. Studies suggest that supplementing with 480 mg or more of black garlic per day can significantly reduce blood pressure by 11.8±5.4 mmHg.⁽²⁷⁾

 

Magnesium

Blood Pressure:
Magnesium is a crucial element in the body, playing a key role in regulating blood pressure by reducing vascular tension, regulating the endothelial system, and providing antioxidant effects. Studies indicate that daily supplementation of approximately 400 mg of magnesium can have beneficial effects on lowering blood pressure.^(28)(29)

 

Natto

Blood Lipids:
Natto contains a potent fibrinolytic enzyme called nattokinase, which has beneficial effects on the cardiovascular system. Research shows that administering nattokinase at 6500 FU for 26 weeks can simultaneously reduce total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides.⁽³⁰⁾

 

Bitter Melon Extract

Blood Sugar:
Limited evidence suggests that supplementing with bitter melon extract can, on average, decrease fasting blood glucose by 0.72 mmol/L, postprandial blood glucose by 1.43 mmol/L, and glycated hemoglobin by 0.26%. Researchers are actively seeking more robust evidence to support its clinical application.⁽³²⁾

 

Cinnamon Extract

Blood Sugar:
Cinnamon extract can activate insulin receptors in the body, increase hepatic glycogen synthesis, enhance insulin sensitivity, and further promote the control of blood glucose and blood lipids.^(33)(34) Ongoing research continues to explore cinnamon’s role in assisting with blood sugar control. Some studies suggest that in addition to diabetes medications, adding cinnamon supplementation may help lower fasting blood glucose and improve glycated hemoglobin.⁽³⁵⁾

 

Chromium

Blood Sugar:
Chromium is a trace element that assists in blood sugar homeostasis and is often recommended for diabetic patients.⁽³⁶⁾ A meta-analysis found that using chromium supplements can help lower fasting blood glucose and improve the control of glycated hemoglobin.⁽³⁷⁾

 

If the three high conditions are not well controlled, they may lead to various cardiovascular complications. Therefore, it’s essential to cultivate exercise habits and maintain a healthy diet to keep the body healthy and embrace a bright future!