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Turkey tends to take center stage during Thanksgiving dinner. But if we’re being honest, the bird is really an appetizer for dessert, especially pie. If you have high blood pressure, you may imagine your healthcare team growling at you like your stomach for thinking about your favorite holiday treat. Indeed, consuming seconds, thirds and fourths of desserts daily isn’t the best idea for your heart. However, one preventative cardiology dietitian says she doesn’t tell patients to swear off Thanksgiving desserts. Instead, she shares information to help them make the best decisions—on holidays, but mostly throughout the year. “Understanding how your favorite dessert affects your body can help you make more informed choices, enjoy indulgences safely and avoid unexpected spikes in blood pressure and other cardiovascular stress,” shares Michelle Routhenstein, MS, RD, a preventive cardiology dietitian at EntirelyNourished.com. One particular Thanksgiving dessert can cause a sudden and fast spike in blood pressure. Routhenstein and a doctor share what it is, why you don’t have to avoid it and how to build a Thanksgiving plate your heart feels great about. 🩺SIGN UP for Parade’s health newsletter with expert-approved tips, healthy eats, exercises, news & more to help you stay healthy & feel your best self💊 The Thanksgiving Dessert That Spikes Blood Pressure the Fastest “A dessert like pecan pie can cause a quick rise in blood pressure for several reasons,” reveals Dr. Florence Comite, MD, an endocrinologist, author and founder of Comite Center for Precision Medicine & Healthy Longevity. “Some ingredients act directly on the cardiovascular system, while others set off chain reactions in your metabolism.” The news may not be all that sweet, but take heart: “One slice won’t hurt most people, but repeated indulgence in processed foods can lead to weight gain, insulin resistance and chronic hypertension,” she clarifies. Dr. Comite and Routhenstein dug into what happens to your blood pressure when you eat pecan pie. Remember, knowledge is power. 1. It raises blood glucose No surprise here—the added sugar in pecan pie causes a surge in blood glucose. Yet, you may be surprised to learn that blood glucose spikes aren’t just an issue if you have or are trying to prevent Type 2 diabetes. “When you consume a concentrated amount of sugar, blood glucose spikes, triggering the release of insulin,” Routhenstein says. “Insulin increases sodium retention and fluid volume in the body, both of which raise blood pressure.” 2. It contains sodium Pecan pie has a sneakily high amount of sodium, which the American Heart Association suggests limiting to 2,300 mg, or about a teaspoon, daily (ideally 1,500 mg) “While sodium is vital, too much causes the body to retain fluid, increasing blood volume and the pressure inside your arteries,” Dr. Comite says. 3. It’s a source of saturated fat The crust is arguably the most delicious part of pecan pie. But at the risk of being a killjoy, “The buttery filling and crust contribute saturated fat, which can stiffen arteries over time, making it harder for blood pressure to stay stable,” Dr. Comite notes. Keyword: Over time. A slice of pie at Thanksgiving is probably just fine (but your doctor or a registered dietitian can help you make the best decisions based on any health concerns you have). Related: Cardiologists Are Begging People With Hypertension To Stop Doing This One Thing ASAP Wait—Aren’t Pecans Heart-Healthy? Nuts contain vital nutrients and fats that can improve your heart health, including blood pressure. However, the data on whether pecans can help regulate blood pressure is mixed. A 2025 study suggested that eating pecans for 12 weeks can improve cholesterol but not blood pressure. However, a 2023 study suggested that consuming pecans may help improve the responsiveness of blood vessels to bodily changes. As a result, blood can flow more smoothly. Better blood flow usually means healthier blood pressure. Routhenstein reports that pecans can be a blood pressure-friendly nut. She says that the tiny nuts have a lot going for them, including: Monosaturated fats Antioxidants and nutrients, such as potassium, calcium and magnesium, that regulate fluid balance, and relax blood vessels Flavonoids and polyphenols, which reduce inflammation and protect the blood vessels “To reap these blood pressure benefits, aim for about 1 ounce of pecans, about 15 halves, either raw, dry roasted and unsalted or lightly salted,” she explains. Indeed, what else is on the pecan can affect how heart-friendly the meal, snack or dessert (sorry again, pecan pie lovers) is. “The challenge comes when pecans are candied, caramelized, or baked in sugar and butter, as in traditional pecan pie,” Dr. Comite says. “That combination of sugar, saturated fat, and refined carbs can reverse their benefits, especially if eaten often.” Related: ‘I’m a Cardiologist and This Is the Nut I Eat Almost Every Single Day for Heart Health’ Yes, You Can Have Pecan Pie—Even With Hypertension Pecan pie isn’t off the table, even if you’re one of the nearly 120 million U.S. adults living with high blood pressure. “If you love pecan pie, go ahead and enjoy a slice this Thanksgiving,” Dr. Comite emphasizes. “I don’t believe in demonizing any food. Life is meant to be lived—and food is one of its great joys. The key is moderation, not deprivation.” If you’re stressing about pecan pie and blood pressure, these tips are designed to help. 1. Mind your overall diet that week Thanksgiving is likely circled on your calendar. Don’t treat the days leading up to it as an exercise in deprivation, but rather as one in nourishment. “Focus on lower-sodium, nutrient-dense meals for the rest of the [week],” Routhenstein notes. “This helps balance the temporary indulgence and supports stable blood pressure.” 2. Start with fiber Load up on fiber-rich foods, such as vegetables, with dinner. “Fiber slows digestion, promotes fullness and reduces cravings for sugar later in the meal,” Dr. Comite says. 3. Put protein on your plate This one isn’t applicable if you’re loading up on turkey, but even vegetarians and vegans are in luck. Nuts also contain protein, and that’s key when you’re trying to consume dessert like pecan pie in moderation. “Protein helps slow carbohydrate absorption and blunt the insulin surge that follows a sweet treat,” Dr. Comite says. “It also curbs hunger, so you’re less likely to overdo it when dessert arrives.” 4. Peep your portion Let’s define “in moderation” as it relates to pecan pie. “A small sliver—about the size of your palm—is enough to satisfy your craving,” Dr. Comite clarifies. “When you’re not ravenous, a taste often feels indulgent enough.” 5. Fill your plate (seriously) If that sliver makes your plate feel mighty empty, Dr. Comite notes you can actually benefit from adding more to it. Fill half your dessert plate with fresh berries or lower-glycemic fruits [like berries and citrus] and the other half with a small piece of pie,” she says. “Add a few nuts or a spoonful of Greek yogurt for extra protein to stabilize blood sugar further.” When your plate is empty, your belly and heart will feel full. Up Next: Sources:
