Key TakeawaysEating flavanol-rich foods like tea, berries, and apples can help manage hypertension, according to a new study.Relying on biomarkers in urine instead of food diaries gives a more accurate glimpse into whether there is a true relationship between the intake of these foods and health outcomes.

Key Takeaways

Eating flavanol-rich foods like tea, berries, and apples can help manage hypertension, according to a new study.Relying on biomarkers in urine instead of food diaries gives a more accurate glimpse into whether there is a true relationship between the intake of these foods and health outcomes.

A diet rich in flavanol-containing foods and drinks, including tea, apples, and berries, could help lower blood pressure, according to a recent study.

The October study, published inScientific Reports, evaluated the intake of over 25,000 subjects in the U.K. and determined whether there was a link between their blood pressure and what they ate. But instead of using self-reported diet as a way to gather data, the researchers used nutritional biomarkers found in blood. This is because the variability of flavanol content in food makes it challenging to rely solely on dietary reporting to assess intake.

Between processing, natural breakdown, and other factors, one food may contain more flavonols than a seemingly identical option. For example, black tea flavanol content ranges from 3-64 mg/100 mL. In other words, five cups of tea can contain between 23 and 480 mg of flavanols depending on the tea—quite a range.

Researchers found that higher levels of flavanol, a naturally-occurring compound, were associated with a significantly lower systolic blood pressure in both men and women.The levels were comparable to adherence to aMediterranean dietor moderate salt reduction.

Subjects considered to be hypertensive had a stronger inverse association between flavanol levels and systolic blood pressure when compared to those who were not considered to be hypertensive, suggesting the effects are stronger in those with this diagnosis.

According to the American Heart Association, someone should be diagnosed with hypertension when their systolic blood pressure is greater than or equal to 140 mm Hg and/or their diastolic blood pressure is greater than or equal to 90 mm Hg following repeated examination.

However, the researchers did not observe consistent or statistically significant association between flavanol intake and heart attack or death.

What This Means For YouIf you are managing hypertension, including foods like cocoa, tea, berries, and apples may help you lower your blood pressure in a natural way.

What This Means For You

If you are managing hypertension, including foods like cocoa, tea, berries, and apples may help you lower your blood pressure in a natural way.

What Are Nutritional Biomarkers?

According to the researchers, it’s almost impossible to estimate flavanol intake without analyzing the actual food consumed.But self-reported dietary data like a dietary recall or a food frequency questionnaire can be unreliable in certain situations,Melissa Azzaro, RDN, LD, a registered dietitian in New Hampshire and author of A Balanced Approach To PCOS, tells Verywell.

This is where biomarkers can help.

A nutritional biomarker is something that can be objectively measured in different biological samples and can be used as an indicator of nutritional status—with respect to the dietary intake or metabolism of nutrients.By taking a sample of blood or urine, levels of certain biomarkers—like flavanols—can be measured. No more relying on self-reported data.

In the case of this study, flavonol levels were measured through urine samples.

Using biomarkers tells the researchers how much flavonol is in the body in a more accurate and objective way than relying on traditional subjective methods.

Flavonols and Hypertension

Common recommendations to manage high blood pressure include limiting salt, getting regular physical activity, and managing stress.But guidelines do not specifically include taking in a consistent amount of flavanols per day. However, the new data highlights a single compound’s potential positive role in the health of people with hypertension.

“We know from the DASH DIET (Dietary Approaches to Stop Hypertension) that what we eat is critical to managing blood pressure,” Lauren Harris-Pincus, MS, RDN, a New Jersey-based registered dietitian and author of The Protein-Packed Breakfast Club, tells Verywell.

What Are the Best Foods for High Blood Pressure?

The standard DASH diet guidelines include:

Harris-Pincus adds that the new data reinforces that consuming foods rich in flavanols such as tea, cocoa, apples, and berries can positively impact hypertension and the risk of cardiovascular disease.

“The addition of one or more servings of fruit per week, like apples and berries, has additional benefits—vitamins, minerals, phytochemicals, and soluble fiber, which has been shown to support a healthy heart,” Compston says.

“Currently, only 1 in 10 Americans consume the recommended servings of fruits and vegetables per day,” she says. “Fruits, vegetables, and teas also contain potassium, which has been shown to support the sodium-potassium ratio on blood pressure.”

Chocolate Allergy Signs and Treatments

To help manage hypertension, you can enjoy a cup of tea, indulge in some blueberries dipped in dark chocolate for a decadent treat, or snack on a crunchy apple. Along with other healthy lifestyle changes like managing stress, avoiding cigarette smoking, and maintaining a healthy weight, incorporating flavanol-rich foods into your diet on a consistent basis could be the missing link in your overall health.

6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ottaviani J, Britten A, Lucarelli D, et al.Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk.Sci Rep. 2020 Oct 21;10(1):17964. doi:10.1038/s41598-020-74863-7Rothwell J, Perez-Jimenez J, Never V. et al.Phenol-Explorer 3.0: a major update of the Phenol-Explorer database to incorporate data on the effects of food processing on polyphenol content.Database (Oxford). 2013 Oct 7;2013:bat070. doi:10.1093/database/bat070Unger T, Borghi C, Charchar F, et al.2020 international society of hypertension global hypertension practice guidelines.Hypertension. 2020;75(6):1334-1357. doi: 10.1161/HYPERTENSIONAHA.120.15026Pico C, Serra F, Rodriguez A, Keijer J, Palou A.Biomarkers of nutrition and health: new tools for new approaches.Nutrients. 2019 May 16;11(5):1092. doi:10.3390/nu11051092American Heart Association.Changes you can make to manage high blood pressure.Nissensohn M, Roman-Vinas B, Sanchez-Villegas A, Piscopo S, Serra-Majem L.The effect of the Mediterranean diet on hypertension: a systematic review and meta-analysis.J Nutr Educ Behav. 2016 Jan;48(1):42-53.e1. doi:10.1016/j.jneb.2015.08.023

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ottaviani J, Britten A, Lucarelli D, et al.Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk.Sci Rep. 2020 Oct 21;10(1):17964. doi:10.1038/s41598-020-74863-7Rothwell J, Perez-Jimenez J, Never V. et al.Phenol-Explorer 3.0: a major update of the Phenol-Explorer database to incorporate data on the effects of food processing on polyphenol content.Database (Oxford). 2013 Oct 7;2013:bat070. doi:10.1093/database/bat070Unger T, Borghi C, Charchar F, et al.2020 international society of hypertension global hypertension practice guidelines.Hypertension. 2020;75(6):1334-1357. doi: 10.1161/HYPERTENSIONAHA.120.15026Pico C, Serra F, Rodriguez A, Keijer J, Palou A.Biomarkers of nutrition and health: new tools for new approaches.Nutrients. 2019 May 16;11(5):1092. doi:10.3390/nu11051092American Heart Association.Changes you can make to manage high blood pressure.Nissensohn M, Roman-Vinas B, Sanchez-Villegas A, Piscopo S, Serra-Majem L.The effect of the Mediterranean diet on hypertension: a systematic review and meta-analysis.J Nutr Educ Behav. 2016 Jan;48(1):42-53.e1. doi:10.1016/j.jneb.2015.08.023

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Ottaviani J, Britten A, Lucarelli D, et al.Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk.Sci Rep. 2020 Oct 21;10(1):17964. doi:10.1038/s41598-020-74863-7Rothwell J, Perez-Jimenez J, Never V. et al.Phenol-Explorer 3.0: a major update of the Phenol-Explorer database to incorporate data on the effects of food processing on polyphenol content.Database (Oxford). 2013 Oct 7;2013:bat070. doi:10.1093/database/bat070Unger T, Borghi C, Charchar F, et al.2020 international society of hypertension global hypertension practice guidelines.Hypertension. 2020;75(6):1334-1357. doi: 10.1161/HYPERTENSIONAHA.120.15026Pico C, Serra F, Rodriguez A, Keijer J, Palou A.Biomarkers of nutrition and health: new tools for new approaches.Nutrients. 2019 May 16;11(5):1092. doi:10.3390/nu11051092American Heart Association.Changes you can make to manage high blood pressure.Nissensohn M, Roman-Vinas B, Sanchez-Villegas A, Piscopo S, Serra-Majem L.The effect of the Mediterranean diet on hypertension: a systematic review and meta-analysis.J Nutr Educ Behav. 2016 Jan;48(1):42-53.e1. doi:10.1016/j.jneb.2015.08.023

Ottaviani J, Britten A, Lucarelli D, et al.Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk.Sci Rep. 2020 Oct 21;10(1):17964. doi:10.1038/s41598-020-74863-7

Rothwell J, Perez-Jimenez J, Never V. et al.Phenol-Explorer 3.0: a major update of the Phenol-Explorer database to incorporate data on the effects of food processing on polyphenol content.Database (Oxford). 2013 Oct 7;2013:bat070. doi:10.1093/database/bat070

Unger T, Borghi C, Charchar F, et al.2020 international society of hypertension global hypertension practice guidelines.Hypertension. 2020;75(6):1334-1357. doi: 10.1161/HYPERTENSIONAHA.120.15026

Pico C, Serra F, Rodriguez A, Keijer J, Palou A.Biomarkers of nutrition and health: new tools for new approaches.Nutrients. 2019 May 16;11(5):1092. doi:10.3390/nu11051092

American Heart Association.Changes you can make to manage high blood pressure.

Nissensohn M, Roman-Vinas B, Sanchez-Villegas A, Piscopo S, Serra-Majem L.The effect of the Mediterranean diet on hypertension: a systematic review and meta-analysis.J Nutr Educ Behav. 2016 Jan;48(1):42-53.e1. doi:10.1016/j.jneb.2015.08.023

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