When the Body Accumulates Waste, Hypertension Easily Follows

Dr. Lee Everyone, do you happen to know what disease most Koreans suffer from?

Susan Could it be stomach disease? Around menopause, a lot of digestive problems develop.

Zoe These days cancer is rising rapidly — could it be cancer?

Emily Children today have so many cases of atopic dermatitis. I'll guess atopy.

Grace I think I can answer this one. As people enter old age, hypertension becomes very common.

Dr. Lee Grace, you're correct. According to the Hypertension Fact Sheet 2024 published by the Korean Society of Hypertension, an estimated 13 million Koreans aged 20 and over — about 30% of that age group — have hypertension. Of these, 7.2 million are men and 5.8 million are women. Out of a total population of about 50 million, 13 million represents roughly 26% of all citizens. Government reports indicate that 11.5 million people receive medical services for hypertension treatment, and 10.9 million are prescribed antihypertensive medication. There are also 890,000 sufferers in their 20s and 30s.

Zoe Dr. Lee, what causes hypertension in the first place?

Dr. Lee The causes of hypertension include aging, obesity, a high-salt diet, stress, lack of exercise, and genetics.

Susan I've seen many people suffering from hypertension. Older adults with high blood pressure often worry about having a stroke.

Dr. Lee Yes, that's true. Untreated hypertension can lead to cerebrovascular diseases such as cerebral hemorrhage, stroke, and cerebral infarction. It also increases the risk of heart conditions like angina, myocardial infarction, valvular heart disease, and heart failure. In addition, it raises the risk of kidney diseases such as renal failure, nephrosclerosis, and chronic kidney disease, as well as hypertensive retinopathy, which can even lead to blindness.

Zoe Are there many hypertension patients in other countries besides Korea?

Dr. Lee According to research reports, as of 2023 about 1.3 billion people worldwide suffer from hypertension. This is double the figure from 30 years ago.

Zoe Why is the number of hypertension patients increasing like this? Is it because of meat-centered eating habits, like other chronic diseases?

Dr. Lee Yes, that's right. Hypertension mostly arises from lifestyle — particularly improper eating habits. Therefore, the most important first step in a hypertension-improving diet is reducing excess body weight. The next is removing waste from the blood. One of the main reasons the heart raises pressure is to clear waste from inside the body.

Susan Because of waste? I'm curious how waste can affect blood pressure.

Dr. Lee The cell membrane surrounding each cell is a kind of semi-permeable membrane. Water can move across it. So it's best when the concentration outside the cell matches the concentration inside. If the concentration outside becomes higher, water inside the cell flows out. When that happens, the cell shrinks and its survival becomes endangered.

Zoe Ah, so when the blood becomes loaded with waste, its concentration rises higher than that of the cells. Then water leaves the cells, putting them at risk.

Dr. Lee Yes, exactly. So when there is too much waste — or even too many nutrients — in the blood, the body retains water to balance the concentration. This raises the pressure of the blood. And the heart raises blood pressure to help remove the waste.

Emily Why does the heart raise pressure to remove waste?

Dr. Lee The main organ responsible for removing waste from the body is the kidney. The kidney has a semi-permeable structure called the glomerulus. So the heart raises blood pressure so that waste can pass through this semi-permeable membrane more quickly.

Emily Ah — so when hypertension develops, pressure on the kidney also rises, and that's why kidney damage often follows.

Fiber Helps Remove Body Waste and Lower Blood Pressure

Dr. Lee That's correct. Now, body waste can be divided broadly into two types: water-soluble waste and fat-soluble waste. Water-soluble waste is removed through the kidneys, and fat-soluble waste through bile. From this perspective, a plant-based ketogenic diet using a variety of plant foods such as legumes, nuts, seeds, vegetables, and fruits is highly effective for improving hypertension.

Susan Why are plant foods so good at removing bile and fat-soluble waste?

Dr. Lee Excellent question. First, plant foods are rich in fiber, right? This fiber efficiently binds and removes waste from the body. One of the major components of bile released into the digestive tract is cholesterol. When fiber is deficient, more than 95% of this cholesterol is reabsorbed back into the bloodstream — a process called enterohepatic circulation.

Susan If cholesterol re-enters the bloodstream, then blood cholesterol levels rise.

Dr. Lee Yes. Animal foods contain no fiber at all. So animal foods are doubly problematic for blood cholesterol. The animal food itself contains cholesterol, and at the same time it allows the cholesterol secreted as bile to be reabsorbed — raising blood cholesterol through both pathways.

A Ketogenic Diet Including Soybeans Helps Lower Blood Pressure

Zoe I understand how the abundant fiber in plant-based ketogenic diets removes waste. But does the ketogenic part itself also play a role in waste removal?

Dr. Lee Yes. The ketogenic diet raises blood ketone levels and sends autophagy signals to all 50 trillion cells in the body. As I explained earlier, autophagy is the process by which cells break down accumulated cellular debris and reuse it as nutrients. The ketogenic diet also stimulates the hypothalamus to produce satiety, naturally reducing food intake. In addition, ketones improve blood circulation, helping waste excretion. For these reasons, even a ketogenic diet using animal foods has been shown to lower blood pressure. But a plant-based ketogenic diet should normalize blood pressure even more effectively, in a shorter time.

Emily Listening to your explanation is fascinating. I have many friends with hypertension. One friend is in her mid-40s with three young children, and her blood pressure is usually over 200, sometimes climbing to 300. After learning today, I think I can share this with her so she can improve her hypertension.

Dr. Lee Yes — even simply eating black-bean (seoritae) rice often helps improve hypertension. Eat as little white rice as possible and increase soybean intake. Soybeans are rich in high-quality lipids, and they cause the liver to produce smaller-particle albumin in the blood, which the body can use more efficiently. Many studies show that eating soybeans helps improve diabetes and blood pressure through this small albumin produced in the liver. In addition, soybeans are rich in plant-based phytoestrogens such as isoflavones, which help stabilize the body's endocrine system. Of course, the soybeans must be non-GMO.

Why You Should Eat Organic and Eco-Friendly Plants: Avoid Glyphosate-Resistant GMOs

Dr. Lee Most genetically modified GMO soybeans and GMO corn currently grown today carry a gene that makes them resistant to a herbicide called glyphosate. The World Health Organization has designated glyphosate as a carcinogen. According to a report by the researcher Swanson, glyphosate accounts for 90% of the cause of most cancers (Swanson et al., 2014).

Susan Why is glyphosate a carcinogen?

Dr. Lee Glyphosate is a word combining 'glycine' and 'phosphate.' Glycine is one of the 20 amino acids, and phosphate is a phosphate group carrying a negative charge. The basic structure of an amino acid has an amino group (positively charged) on one end and a carboxyl group (negatively charged) on the other. But in glyphosate, a negatively charged phosphate group has been attached to the amino end. So glyphosate carries negative charges on both ends. That's why it can damage DNA. It causes a wide range of side effects — for example, reports show it damages P450, an enzyme important for energy production in mitochondria, thereby reducing energy generation (Samsel & Seneff, 2013).

According to Swanson's analysis, as shown in Figure 9-1, glyphosate-treated crops (corn, soybean) explain 99% of thyroid cancer incidence (Swanson et al., 2014). R-square, also called 'explanatory power,' refers to the percentage by which an independent variable explains a dependent variable. In Table 9-1, you can see that glyphosate-resistant GMO corn and soybean explain 87.9% of thyroid cancer prevalence, 82.9% of liver cancer, and 89.3% of bladder cancer mortality.

Susan Seeing the actual data is horrifying. I knew about GMOs, but I had no idea they were modified to be resistant to glyphosate — a herbicide designated by the WHO as a carcinogen.

Dr. Lee People who are not in good health should be especially cautious. For those currently suffering from disease, it's wise to adopt the principle: 'When in doubt, don't eat it.' Glyphosate has a molecular structure similar to amino acids, so it can become incorporated during protein extraction. Glyphosate's strong negative charge also binds positively charged minerals, causing mineral deficiency in the body. According to scientific publications, it binds with manganese, creating manganese deficiency, which one hypothesis suggests can disrupt thyroid hormone production and contribute to autism symptoms (Samsel & Seneff, 2015a, 2015b).

Emily Dr. Lee, I have long bought organic and eco-friendly ingredients. They cost a little more, but I spend without hesitation, thinking that treating illness costs even more. And when I plan meals around organic foods, I find I only buy what's truly necessary, and avoid unnecessary purchases.

Dr. Lee Yes — eating good things is important, but these days it may be even more important to avoid what could harm you, and avoid anything suspicious. So we need to set criteria for choosing plant-based, organic or pesticide-free, domestically grown, minimally processed natural foods whenever possible.

Research Review: "The Ketogenic Diet and Cardiovascular Diseases" (Dyńka et al., 2023)

Dr. Lee Now today let's look at several research papers showing that blood pressure was normalized through a ketogenic diet. The first paper we'll examine is The Ketogenic Diet and Cardiovascular Diseases (Dyńka et al., 2023). This study presents and summarizes the results of various previous studies on the beneficial effects of the ketogenic diet on cardiovascular disease. The authors stated that the ketogenic diet provides cardioprotective function through four effects: first, the anti-inflammatory effect of ketones themselves; second, the anti-inflammatory effect of reduced sugar; third, the anti-inflammatory effect of carbohydrate restriction; and fourth, the anti-inflammatory effect from abundant omega-3 fatty acid intake.

The authors then listed nine reasons why the ketogenic diet benefits endothelial cell health. Blood vessels are essentially hollow tubes, and these tubes are made up of layers of various cell types. Among these layers, the vascular endothelial cells form the inner lining of the vessel and are in direct contact with the blood. They are elastic and can stretch or contract depending on the situation. In other words, the endothelial layer regulates blood flow, fluidity, and vascular tone, thereby influencing blood pressure. If endothelial cells lack omega-3 fatty acids, they become rigid and lose their ability to expand and contract, so even small changes in pressure may cause vessels to rupture. But the ketogenic diet provides smooth energy supply to endothelial cells, improves their function, and helps them function properly. Ketones also have anti-inflammatory effects and increase the activity of nitric oxide synthase, thereby enhancing vascular elasticity. When inflammation occurs in vessels, plaques form, leading to blockage and rigidity. Ketones prevent this. Furthermore, ketones prevent premature aging of endothelial cells, suppress inflammatory activity, and inhibit the expression of inflammation-related genes. They also lower blood glucose and reduce glycated hemoglobin (HbA1c), thereby protecting endothelial cells.

Susan I understand glycated hemoglobin as glucose attached to red blood cells. But does a high level of HbA1c raise blood pressure?

Dr. Lee Excellent question. The body has 50 trillion cells, and roughly half are red blood cells. Red blood cells live for 90 to 120 days. Each red blood cell contains about 100,000 hemoglobin molecules. In the lungs, one hemoglobin molecule binds with four oxygen molecules and delivers them to peripheral cells. But when blood glucose is high, the hemoglobin protein, which is supposed to bind with oxygen, binds with sugar instead. This is called glycated hemoglobin or HbA1c. Once formed, the red blood cell carries this glycated hemoglobin until the end of its 90–120 day lifespan. That is why HbA1c reflects average blood glucose over the past 3 months, regardless of recent meals.

Glycated hemoglobin increases red blood cell viscosity and causes red cells to stick to each other, making it easier to form blood clots. It also makes osmotic regulation difficult, shortening red cell lifespan. So the more HbA1c, the more red blood cell structure and function are damaged, and the worse blood flow becomes. Eventually blood pressure has no choice but to rise.

When blood flow slows, less oxygen reaches cells, causing hypoxia, and nutrient delivery efficiency drops. This leads to metabolic abnormalities. Reactive oxygen species generated by cells aren't properly cleared, raising oxidative stress. Toxins aren't smoothly removed, causing cellular toxicity issues. The overall homeostasis of the blood is disrupted. In conclusion, when blood flow slows, the health and life of the organism are endangered. To prevent this, the heart applies even greater pressure — and this leads to hypertension.

Susan So hypertension can be seen as a process the body produces unavoidably for survival.

Dr. Lee Yes. That's why we must address the cause of hypertension. Just lowering blood pressure without addressing the cause is not desirable in the long run.

Zoe I understand. The principle of solving root causes rather than just hiding symptoms applies not only to physical illness but to how we live our lives. By the way, what is eNOS in the figure? And how does it affect blood pressure reduction?

Dr. Lee Good question. eNOS stands for endothelial nitric oxide synthase. This enzyme uses the amino acid arginine to produce nitric oxide. Nitric oxide relaxes the smooth muscle of blood vessels, preventing sudden spikes in blood pressure and helping maintain stable pressure. It also inhibits platelet aggregation to prevent blood clots, and inhibits cell proliferation to prevent atherosclerosis. According to research reports, decreased nitric oxide is also one cause of various heart diseases. That is, when eNOS in cardiac vessels produces less nitric oxide and reactive oxygen species increase, cardiovascular sclerosis occurs.