Dash diet reviews 2016

DASH Diet For Dummies Cheat Sheet

DASH Diet Nutrition Basics

The DASH (Dietary Approaches to Stop Hypertension) eating plan isn’t hard to follow. Following are the types of food the diet recommends you eat, along with the number of servings per day.

These servings are based on a 2,000-calorie diet, but you may need to consume more or less than 2,000 calories a day depending on your age, gender, and activity level. Check with your doctor or use a calorie calculator for an estimate of your daily calorie needs.

  • Grains (6–8 daily servings), preferably whole: Examples of 1 serving of grains include 1 slice of bread, 1 cup of dry cereal, or 1/2 cup cooked cereal, pasta, rice, barley, or other grain. Look for the word whole — don’t assume that any brown-colored “wheat” bread is a great choice. Read further and check the Nutrition Facts label, the list of ingredients, and the fiber content. Look for whole-wheat flour or another whole-grain flour as the first ingredient. Also, seek out grain products with 2 or more grams of fiber per serving. Venture out of your comfort zone and try brown and wild rice, barley, bulgur, quinoa, or whole-wheat couscous.

  • Fruits (4–5 daily servings): A serving of fruit may be a small to medium piece of fruit, 10 grapes, 1/2 grapefruit, 1/2 banana, or 2 tablespoons of raisins or other dried fruit. Find new ways to add more fruit to your meals: Top salads with sliced strawberries or apples and add raisins or blueberries to oatmeal. Make fruit your daily go-to choice for snacking, too.

  • Vegetables (4–5 daily servings): A serving of vegetables comprises 1 cup of raw veggies or 1/2 cup cooked. If you think eating 4 to 5 servings of vegetables every day is difficult, try adding more vegetables to sandwiches: Spinach leaves, green peppers, sliced tomatoes, and sprouts are all excellent sandwich toppers. If you’re tired of the bland taste of boiled vegetables, give grilling a chance. Grill zucchini, portobello mushrooms, eggplant, peppers, and Vidalia onions to really turn up the volume on vegetable flavor.

  • Low-fat or nonfat dairy (2–3 daily servings): Limit your milk to skim or 1%, and primarily eat low-fat yogurt and cheese. To meet your 2 to 3 servings goal, drink two 1-cup servings of skim or 1% milk daily. Or, as 1 serving, have a snack of 8 ounces of low-fat Greek yogurt. Eating 1 ounce of low-fat or nonfat cheese also counts as a serving. To cut the fat even more, use low-fat yogurt in place of sour cream in your recipes.

  • Lean meats, fish, and poultry (2 or fewer daily servings): Limit the total amount of lean protein to no more than 6 to 8 ounces. Examples of the recommended foods in this category include fresh chicken breast or legs, fresh turkey breast, loin cuts of beef, sirloin, round steak, extra-lean ground beef, pork loin roast, pork tenderloin, fresh fish, and low-sodium canned tuna.

  • Nuts and seeds (4–5 weekly servings): Even though nuts and seeds provide good fats, they’re calorically dense. So try adding small amounts of nuts to your salads or stir-fries to meet your goal of getting 4 to 5 servings of nuts and seeds per week. A serving of nuts is about 1/3 cup (make sure they’re unsalted) or 2 tablespoons of nut butter (like peanut or almond). A healthy serving size of unsalted seeds, such as sunflower seeds, is 2 tablespoons.

  • Healthy fats (2-3 daily servings): Oils with healthy monounsaturated fats include olive, peanut, and canola oils. Soybean oil and corn oil are higher in polyunsaturated fats, which are good for you, too. Some foods that feature healthy fats are avocados, nuts, olives, seeds, vinaigrette salad dressings, spread margarines, natural nut butters, quick breads made with vegetable oil, and recipes that include the healthy oils listed here. Generally, a teaspoon of oil or a tablespoon of salad dressing or spread is a 1-serving equivalent. Check the Nutrition Facts label to determine the serving size for food products under this umbrella.

  • Fats and sweets (2 or fewer daily servings — according to the actual serving size): You don’t actually need these foods, so you shouldn’t consume them daily — this allotment is solely for pleasure. Make sure you actually read the label of whatever goodie you’re indulging in so that you consciously eat just 1 serving (instead of eating 5 servings by accident). Examples of servings of fats and sweets include a 2-inch square brownie, a small donut, a miniature candy bar, 2 small cookies, 1 small muffin, 1 small piece of pie or cake, and 8 ounces of soda or another sugary beverage.

4 Ways to Eat If You Want to Lower Your Blood Pressure

For the sixth year running, the DASH diet was named the best overall eating plan of 2016 in U.S. News & World Report’s annual diet ranking released earlier this year. It’s also the best diet for lowering blood pressure, according to a new meta-analysis of 24 randomized trials published last week in the journal Hypertension. That’s not the least bit surprising given that DASH — which stands for Dietary Approaches to Stop Hypertension — was born out of a large, government-funded study testing the effects of different food combinations on blood pressure control.

Yet, despite all of the accolades and a solid, scientific foundation, many people have never even heard of, let alone followed, the DASH program. It hasn’t made waves the same way that low-carb, Paleo, gluten-free, and other trendy diets have, in large part because it’s a commonsense, no-frills approach without much sizzle or marketing potential. The DASH eating plan, which is available free of charge on the National Institutes of Health website, emphasizes vegetables, fruits, low-fat dairy, whole grains, and other whole foods, so companies aren’t profiting off of snack bars, supplements, and other specialty products sold as complements to the diet. There are no promises of losing 15 pounds in two weeks. There are no celebrity endorsers, gimmicky hooks, or provocative lists of toxic foods to avoid, either.

With DASH, you get what you don’t pay for — a smart, sensible eating plan that can help reduce your risk for heart disease and other chronic conditions. The diet is squarely in line with healthy eating recommendations outlined in the U.S. Dietary Guidelines. In fact, the guidelines refer to it by name as an exemplary diet pattern for Americans to follow.

Though the formal DASH plan dictates a specific number of servings to eat daily from each major food group, you can take a more flexible approach by following the basic parameters below.

1. Make half your plate vegetables and/or fruits at meals.

The DASH plan recommends 4 to 5 servings each of fruits and vegetables daily for the standard 2,000 calorie menu, but you don’t need to keep a tally if you follow the simple advice to fill half your plate with produce. Get started with a side of fruit at breakfast every day, and add an extra dose by using veggies in egg dishes or serving mashed avocado on toast. At lunch and dinner, double up on portions of steamed, roasted, or sautéed veggies. Scale up on the vegetables when making soups, stews, and other mixed dishes — there’s always room for more, and you’ll squeeze a few extra servings out of your recipe as a bonus. Adding a simple side salad is another easy way to tack on more greens.

2. Incorporate a few servings of low-fat dairy products each day.

Low-fat dairy products are a key element of the DASH program. Researchers hypothesize that the calcium, potassium, and milk proteins found in dairy products may all help manage blood pressure. Low-fat yogurt with fresh fruit makes a great breakfast or snack option. You can also add yogurt and milk to homemade fruit smoothies, or snack on an ounce of cheese with some nuts or whole-grain crackers. If you don’t eat dairy products, non-dairy alternatives with minimal added sugar are good options.

3. Swap sugary and starchy snacks for whole foods.

The DASH eating plan doesn’t leave much room in your calorie budget for chips, cookies, and other traditional junk food snacks. To meet the daily food group targets, you’ll need to choose snacks that incorporate whole foods like vegetables, fruits, nuts, low-fat dairy, and whole grains the majority of the time. Here are some DASH-friendly picks:

  • Apple, banana, or celery sticks with 1 tablespoon nut butter
  • Whole grain crackers with 1 ounce cheese
  • Plain, low-fat yogurt topped with fresh fruit
  • 1/4 cup unsalted nuts
  • 3 to 4 cups air-popped popcorn
  • Veggies with hummus or bean dip
  • 1 cup edamame in the pod

4. Limit red meat — choose beans, fish, and poultry instead.

DASH menus call for about 6 ounces of lean protein per day, and fish, chicken, and beans are among the top choices. Americans eat plenty of poultry, but many people struggle with incorporating more seafood and beans into their weekly menus. If you shy away from cooking fish at home because it seems too difficult, try this foolproof low-and-slow baking method. Load up on legumes by subbing canned, low-sodium beans for animal proteins in hearty soups, entrée salads, tacos, chili, and pasta dishes.

Finding yourself confused by the seemingly endless promotion of weight-loss strategies and diet plans? In this series, we take a look at some popular diets—and review the research behind them.

What Is It?

The DASH (Dietary Approaches to Stop Hypertension) diet is sometimes prescribed by doctors to help treat high blood pressure. Blood pressure is the amount of pressure that blood places against the walls of arteries. It will normally vary throughout the day but if it remains too high, this is called high blood pressure or hypertension. Untreated high blood pressure can lead to heart disease, stroke, congestive heart failure, kidney disease, and blindness.

DASH was first introduced at a meeting of the American Heart Association in 1996 and later published in the New England Journal of Medicine in 1997. The DASH trial randomly assigned 456 people to different diets to test the effects of dietary patterns on lowering blood pressure. The authors surmised that eating a diet with many different foods with blood pressure-lowering nutrients would show a greater effect on blood pressure than eating single nutrients, such as found in supplements or in a limited diet. Three diets were tested: 1) a control diet, or a standard American diet, 2) a fruits and vegetables diet, similar to the control diet but providing more fruits and vegetables and less snacks and sweets, and 3) a combination diet rich in fruits, vegetables, nuts, and low-fat dairy foods with reduced amounts of saturated fat, total fat, and cholesterol. The last two diets were richer in nutrients associated with lower blood pressure, such as potassium, magnesium, calcium, fiber, and protein. All three diets provided about 3000 mg sodium, which is more than the recommended amount from the Dietary Guidelines for Americans but less than the average sodium intake for Americans.

Despite no weight changes, the combination diet reduced blood pressure more than the other two diets. Those with hypertension showed greater decreases in blood pressure than those without hypertension. The reduction of blood pressure in the DASH combination diet was comparable to that of people on medication for stage 1 hypertension.

The results of this landmark study contributed much of the scientific basis for the Dietary Guidelines for Americans 2010 and later editions.

How It Works

DASH is based on the following foods: fruits, vegetables, low fat milk, whole grains, fish, poultry, beans, and nuts. It recommends reducing sodium, foods and beverages with added sugars, and red meat. The diet is heart-friendly as it limits saturated and trans fat, while increasing the intake of potassium, magnesium, calcium, protein, and fiber, nutrients believed to help control blood pressure.

The diet suggests a specific number of servings of the recommended foods listed above. The sample plans provided by the National Heart Lung and Blood Institute (NHLBI) are based on 1600, 2000, or 2600 calories daily. For 2000 calories a day, this translates to about 6-8 servings of grains or grain products (whole grains recommended), 4-5 servings vegetables, 4-5 fruits, 2-3 low fat dairy foods, 2 or fewer 3-ounce servings of meat, poultry, or fish, 2-3 servings of fats and oils, and 4-5 servings of nuts, seeds, or dry beans per week. It advises limiting sweets and added sugars to 5 servings or less per week. The plan defines the serving sizes of each these food groups.

To follow the plan, one must decide their calorie level and then divide the suggested servings of each food group throughout the day. This requires meal planning ahead of time. The NHLBI guide provides many tips on how to incorporate DASH foods and to lower sodium intake; a one-day sample menu following a 2300 mg sodium restriction and a 1500 mg sodium restriction; and one week’s worth of recipes. The NHLBI also publishes an online database of “heart healthy” recipes.

The Research So Far

Numerous studies show wide-ranging health benefits of the DASH diet. A consistent body of research has found that DASH lowers blood pressure in people with high blood pressure but also normal blood pressure even without lowering sodium intake. It can produce greater reductions in blood pressure if sodium is restricted to less than 2300 mg a day, and even more so with a 1500 mg sodium restriction. When compared with a standard American diet (e.g., high intake of red and processed meats, beverages sweetened with sugar, sweets, refined grains) DASH has also been found to lower serum uric acid levels in people with hyperuricemia, which places them at risk for a painful inflammatory condition called gout. Because people with gout often also have high blood pressure and other cardiovascular diseases, DASH is optimal in improving all of these conditions.

Adherence to the DASH-style pattern may also help prevent the development of diabetes, as analyzed in a recent meta-analysis, and kidney disease as found in the Atherosclerosis Risk in Communities (ARIC) cohort that followed more than 3700 people who developed kidney disease. Dietary components of DASH that were protective in the ARIC cohort included a high intake of nuts, legumes, and low-fat dairy products. A high intake of red meat and processed meats increased kidney disease risk.

Potential Pitfalls

  • DASH requires each person to plan their own daily menus based on the allowed servings. People who are not used to meal planning or cooking may need more specific guidance.
  • The types of foods listed are not comprehensive. For example, avocados are not included so it is not clear if they would be categorized as a fruit or a fat serving. Certain foods are placed into questionable categories: pretzels are placed in the grain group even though they have fairly low nutrient content and no fiber; frozen yogurt is placed in the dairy group even though most brands contain little calcium and vitamin D and are high in added sugar. The general term “cereals” are placed in the grain group but different types of cereals can be highly variable in nutrient and sugar content.
  • Those with lactose intolerance or food allergies (e.g., nuts) may need to modify the diet to include lactose-free alternatives to dairy and seeds instead of nuts.
  • Some people may experience gas and bloating when starting the diet due to the high fiber content of plant foods like fruits, vegetables, and whole grains. This can be minimized by adding one or two new high fiber foods a week instead of all at once.

Bottom Line

Research supports the use of the DASH diet as a healthy eating pattern that may help to lower blood pressure, and prevent or reduce the risk of cardiovascular diseases, diabetes, kidney disease, and gout.

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  1. US Department of Health and Human Services. Your guide to lowering your blood pressure with DASH. Bethesda, MD: National Heart, Lung, and Blood Institute. (NIH Publication No. 06-4082). 2006.
  2. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH. A clinical trial of the effects of dietary patterns on blood pressure. NEJM. 1997 Apr 17;336(16):1117-24.
  3. US Department of Health and Human Services. Dietary guidelines for Americans 2015-2020. 2017 Sep 5.
  4. Steinberg D, Bennett GG, Svetkey L. The DASH Diet, 20 Years Later. JAMA. 2017 Apr 18;317(15):1529-1530.
  5. Sacks FM, et al.; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. NEJM. 2001 Jan 4;344(1):3-10.
  6. Saneei P, Salehi-Abargouei A, Esmaillzadeh A, Azadbakht L. Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: a systematic review and meta-analysis on randomized controlled trials. Nutr Metab Cardiovasc Dis. 2014 Dec 31;24(12):1253-61.
  7. Rai SK, Fung TT, Lu N, Keller SF, Curhan GC, Choi HK. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. BMJ. 2017 May 9;357:j1794.
  8. Jannasch F, Kröger J, Schulze MB. Dietary Patterns and Type 2 Diabetes: A Systematic Literature Review and Meta-Analysis of Prospective Studies. J Nutr. 2017 Jun;147(6):1174-1182
  9. Rebholz CM, Crews DC, Grams ME, Steffen LM, Levey AS, Miller ER, Appel LJ, Coresh J. DASH (Dietary Approaches to Stop Hypertension) diet and risk of subsequent kidney disease. Am J Kidney Dis. 2016 Dec 31;68(6):853-61.

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July 25, 2016 Twitter Facebook Devin Mann, a former MED associate professor of medicine, hopes the app he was developing will help people control their weight using the DASH diet, leading to lower blood pressure in people with hypertension. Photo courtesy School of Medicine

You might think that a cell phone could only drive blood pressure up, not down, but a team from the BU School of Medicine is studying a smartphone app they hope will lower high blood pressure by helping people control their weight.

“We got the idea of rebuilding the DASH diet using mobile technology,” says Devin Mann, until recently a MED associate professor of medicine and associate chief medical information officer for innovation and population health at Boston Medical Center.

The DASH (Dietary Approaches to Stopping Hypertension) diet, developed in 1992 by Thomas Moore, a MED professor of medicine and a Medical Campus associate provost, and a team of researchers from five academic institutions is designed to offer a healthy diet for the general public, and can offer an alternative to low doses of blood pressure medication. Supported by the National Heart, Lung, and Blood Institute, part of the National Institutes for Health, the DASH diet was judged the best diet plan six years in a row by U.S. News & World Report. Designed to lower blood pressure, it is also effective for weight reduction, lowering cholesterol, and managing or preventing diabetes.

In 2010, the University offered employees the free online DASH for Health Nutrition Program. In 2012, after attending a conference on mobile technology and health, Mann realized it was ripe for reinvention as a mobile app.

“Blood pressure is obviously a highly prevalent condition, and we thought lent itself well to enhanced implementation with mobile health tools,” Mann says. “It’s truly evidence-based; it’s very clear cut what you need to do for it.” Participants in Mann’s study have their Android or iPhone equipped with the app, which asks users to record what they eat by tapping tiles that correspond to the eight components of a healthy diet. Bluetooth connects to a blood pressure machine, a scale, and a pedometer, all provided for the study.

Mann has departed his job for a position at New York University this month. He will still contribute, but the project will now be overseen by Lisa Quintiliani, a MED assistant professor of internal medicine and registered dietitian with expertise in behavioral science and medical informatics.

The simple food-recording interface “was a big piece of it, because diet tracking is one of the hardest things,” Mann says. Other apps “ask you to look up this food and the calories and all that stuff. We made a very conscious decision to say, listen, we will sacrifice accuracy for usability.”

Screen shots of one version of the DASH diet app being developed by a team at the BU School of Medicine. Photos courtesy Devin Mann

The other key element of the smartphone approach is counseling. Some apps provide automated prompts based on data input. “We still feel human coaching is important, but setting up appointments is not easy to do,” Mann says. So the researchers enabled the app to connect study subjects with a dietician for twice-monthly 20-minute phone calls, during which counselors use motivational interviewing techniques originally developed for smoking cessation.

It’s important “having a counselor contact the participant to see where they are in terms of their readiness to change,” says Quintiliani. The counselors can then help the subject with goal setting and focus on areas where the subject is most ready.

“We’re using the app for all the things a computer is good for, and using a human for all the things a human is good for, which is listening and responding and building rapport,” she says.

Mann and others built an original version of the project a couple of years ago, after a seminar at Qualcomm got them “really excited about doing something with mobile applications,” Mann says. Last year, after a first attempt using undergraduate programmers fell by the wayside, they brought in BU Medical Center information technology staff and the Software & Application Innovation Lab (SAIL) at the Hariri Institute for Computing. An outside company, iHealth Labs, based in Mountain View, Calif., provides the Bluetooth-connected devices.

The MED team has recruited 24 participants for the study, which they hope to finish at the end of July, with analysis to follow. What happens next if the data supports the app’s effectiveness? A typical next step—quick commercialization—is not in the cards.

“I’m not sure that’s the right venue,” says Mann. The team’s vision is to use the app as a behavior modification module in a program overseen by a doctor. The doctor might say, for example, “You have pre-diabetes, here are six things I want you to do,” one of which is to sign up for the app and its coaching. Mann says he and his team want to figure out the most effective clinical approach to using the app before deciding how best to disseminate it.

“What we want to be able to say is that we’re confident in the approach, and then find the best way to scale that,” Mann says.

In the long run, they hope to develop a system that could be applied to change behavior for people with other health challenges. “It’s not really about blood pressure, it’s about the approach,” says Mann.

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The Dietary Approaches to Stop Hypertension (DASH) diet is an eating plan based on eating plenty of fresh fruits and vegetables, and choosing lean proteins, low-fat dairy, beans, nuts, and vegetable oils, while limiting sweets and foods high in saturated fats.

A recent study published the American Journal of Preventive Medicine found that men and women younger than 75 who most closely followed the DASH diet had a significantly lower risk of heart failure compared to study participants who did not follow the DASH diet. Currently, about 5.7 million adults in the United States have heart failure, and about half of those who develop heart failure die within five years of diagnosis.

The DASH diet and heart health

This latest study adds to established research linking the DASH diet with heart health. For example, the original DASH trial, published in the New England Journal of Medicine in 1997, found that the DASH diet reduced blood pressure in adults with borderline high blood pressure (hypertension). Importantly, the DASH trial represented a broad spectrum of men and women, including racial and ethnic minorities from a variety of socioeconomic levels.

In a second study, researchers added a low-sodium modification to the DASH diet. In this trial, participants following a DASH diet were randomized to receive 3,000, 2,300, or 1,500 milligrams (mg) of sodium per day. The study found that the low-sodium (1,500 mg/day) DASH diet was as effective for lowering blood pressure as a first-line blood pressure-lowering medication. This is significant because, according to the American Heart Association, an estimated 103 million adults in the United States have high blood pressure, defined as a reading of 130/80 mm Hg or greater.

Why does the DASH diet work?

The DASH diet

  • is low in saturated fat and dietary cholesterol
  • is low in sodium (if following the low-sodium version)
  • is rich in potassium, magnesium, calcium, protein, and fiber
  • emphasizes fruits, vegetables, and low-fat dairy
  • includes whole grains, fish, poultry, and nuts
  • limits red meat, sweets, and sugary beverages.

These components seem to work synergistically to reduce risk factors for heart disease.

Getting started on the DASH diet

If you’d like to try the DASH diet, follow these guidelines, which are based on a 2,000 calorie per day diet.

Food group Daily servings Examples of one serving
Whole grains 6–8 1 slice bread; 1/2 cup cooked rice; pasta; 1 ounce dry cereal
Vegetables 4–5 1 cup raw, leafy vegetables; 1/2 cup cooked vegetable
Fruit 4–5 1 medium apple; 1 cup melon
Low-fat/fat-free dairy 2–3 1 cup milk or yogurt; 1 1/2 ounces cheese
Lean meat, poultry, fish 6 or less 1 ounce cooked lean meat, fish, poultry; 1 egg
Nuts, legumes, seeds 4–5 per week 1/3 cup nuts; 2 tablespoons peanut butter; 1/2 cup cooked legumes
Fats and oils 2–3 1 teaspoon healthy oil (olive); 2 tablespoons salad dressing
Sweets 5 or less per week 1 tablespoon sugar; 1 cup soda; 1/2 cup sorbet
Adapted from the National Heart, Lung, and Blood Institute, National Institutes of Health

Here are some tips for incorporating the DASH diet throughout your day.

Fruits and vegetables

  • Start loading up on fruits and vegetables with your first meal of the day. Try an egg white omelet, cooked in olive oil. Add spinach, mushrooms, and yellow and orange peppers. Or make a quick smoothie using strawberries, blueberries, greens, and low-fat yogurt or low-fat milk.
  • Assemble a marvelous salad for lunch with fresh salad greens, your favorite fruits and veggies, a healthy protein like beans, tuna, chicken, or tofu, a sprinkling of nuts or seeds, some whole grains like farro or quinoa, and a drizzle of olive oil and lemon.
  • Make a stir-fry for dinner. Start with a healthy oil (olive or peanut), add some garlic, and load up with onions, peppers, baby bok choy, broccoli, mushrooms, asparagus, and any other vegetables you may have. Frozen vegetables are fine too. Make a little space in the wok to cook some chicken, shrimp, or tofu. Don’t forget to add some spices for flavor!

Dairy and whole grains

  • Try a whole-grain cold cereal with low-fat milk or old-fashioned oats prepared using milk.
  • Use low-fat cottage cheese and add some fresh chives. Serve on a few whole-grain crackers.
  • Make a whole-wheat pasta and add some low-fat feta or goat cheese. Include a few peas and cherry tomatoes. Top with some extra virgin olive oil or a little pesto.

Healthy fats

  • For a healthy dressing, mix 2/3 cup extra virgin olive oil to 1/3 cup vinegar, add a teaspoon of Dijon mustard, a dash of salt, and some ground pepper.
  • Use olive oil when preparing roasted, stir-fried, or grilled vegetables.
  • Try avocado toast — a slice of whole-grain bread with 1/2 an avocado sliced thin. Squeeze some fresh lemon over, and top with a teaspoon of sesame seeds.

Nuts, legumes, and seeds

  • Add some nuts to your oatmeal or plain yogurt.
  • Add pumpkin or sunflower seeds to salads.
  • Have a small package of nuts or seeds on hand as a late afternoon snack.
  • Make a vegetarian chili with black or red beans, chopped onions, canned tomatoes, minced garlic, cumin, and chili powder. If you use canned beans, rinse and drain them or buy the low-sodium version.

Fish, poultry, or lean meat

  • Use lean protein as a part of the meal, not as the focus or the only food on your plate.
  • Add chicken, fish, and occasionally lean meat to soups and salads where vegetables, whole grains, herbs, and nuts can take center stage.
  • Try fish or chicken kabobs on the grill with chunks of red onion, portobello mushrooms, and yellow, red, and green peppers.

The DASH Diet: Healthy Eating to Control Your Blood Pressure

Wellness starts with a healthy diet. In fact, eating healthier foods improves many health problems. This includes high blood pressure (hypertension). The right foods can lower your blood pressure. Your doctor may recommend the DASH (Dietary Approaches to Stop Hypertension) diet to lower your blood pressure and your LDL (bad cholesterol).

The DASH diet promotes a balanced diet and portion control. It encourages introducing more fruits and vegetables, whole-grain foods, fish, poultry, nuts, and fat-free or low-fat milk products into your daily diet. It recommends reducing foods high in saturated fat, cholesterol, trans fats, sweets, sugary drinks, sodium (salt), and red meats.

Some people have high blood pressure because of a family history. For others, poor diet, lack of exercise, or another medical condition may be to blame. People who have high blood pressure often take medicine. However, diet and exercise can help lower high blood pressure, even if it’s part of your family history.

Path to improved well being

Following the DASH diet is simple. It doesn’t require any special or prepackaged meals. It relies on many standard foods you already have in your home. When following the DASH diet, you eat about 2,000 calories each day. These calories will come from a variety of foods.

The DASH diet recommendation includes:

  • Whole grains (6 to 8 servings a day).
  • Vegetables (4 to 5 servings a day).
  • Fruits (4 to 5 servings a day).
  • Low-fat or fat-free milk and milk products (2 to 3 servings a day).
  • Lean meat, poultry, and fish (6 or fewer servings a day).
  • Nuts, seeds, and beans (4 to 5 servings a week).
  • Healthy fats and oils (2 to 3 servings a day).
  • Sweets, preferably low-fat or fat-free (5 or fewer a week).
  • Sodium (no more than 2,300 mg a day).
  • If you drink alcohol, limit yourself to 2 drinks or less per day for men and 1 drink or less per day for women.
  • To reduce your blood pressure even more, replace some DASH diet carbohydrates with low-fat protein and unsaturated fats.
  • For weight loss, reduce your daily calories to 1,600 per day.
  • Lower your sodium to no more than 1,500 mg per day if you are age 40 or older, are African American, or if you have been diagnosed with high blood pressure.

Adapt the DASH diet to meet your needs. For example, eating plenty of fruits, vegetables, and whole grains can provide some protection against cancer, osteoporosis, stroke, and diabetes. Immediate results are possible with the DASH diet. Blood pressure could go down a few points in as little as 2 weeks. However, continue to take your blood pressure medicine and see your doctor.

Things to consider

Don’t be discouraged if following the DASH diet is difficult at first. Start with small, achievable goals. The following ideas can help you make healthy changes.

  • It’s easier to track your food if you keep a journal of what you eat each day. Write down the sodium content, when possible.
  • Don’t throw in the towel if the DASH diet seems overwhelming at first. Try making one or two changes at a time until you can do it all.
  • Learn to read labels. By knowing serving size, you know how much sodium you are getting per serving.
  • Slow down when you eat.
  • Exercise.
  • Use spices and herbs to flavor your food instead of salt.
  • Choose fewer processed foods (frozen meals, canned soups, packaged mixes, etc.). These contain more sodium.
  • Look for foods that say, “no salt added,” “sodium-free,” and “low sodium.”
  • Avoid fried foods. Grill, steam, roast, or poach your food instead.
  • Apply your new knowledge to restaurant food, as well. Avoid ordering food with ketchup, mustard, pickles, or sauces. Don’t add salt. And if you have time, ask your server how the food is prepared.
  • Reduce your alcohol intake to DASH-acceptable servings.

Most popular foods are full of salt. Here’s how many milligrams (mg) of salt you’re getting with:

Food Serving Sodium Content
¼ teaspoon table salt 575 mg
½ teaspoon table salt 1,150 mg
1 teaspoon table salt 2,300 mg
1 hot dog 460 mg
1 regular fast-food hamburger 600 mg
2 ounces processed cheese 600 mg
1 tablespoon soy sauce 900 mg
1 serving frozen pizza with meat and vegetables 982 mg
8 ounces regular potato chips 1,192 mg

Questions to ask your doctor

  • Can caffeine increase your blood pressure?
  • Can stress increase your blood pressure?
  • What are the side effects to most blood pressure medicines?
  • Are certain frozen foods, such as unsweetened fruit, acceptable?

Resources

National Institutes of Health, National Heart, Lung and Blood Institute, Description of the DASH Eating Plan

U.S. National Library of Medicine, MedlinePlus, DASH Diet to Lower High Blood Pressure

Studies have found that the DASH diet can lower blood pressure, and dietitians say it’s one of the healthiest ways to eat

  • The DASH diet has been found to help lower blood pressure and prevent heart disease.
  • It emphasizes foods that are low in sodium and high in potassium, calcium, magnesium, protein, and fiber — such as leafy greens, fruits, whole grains, nuts, fat-free or low-fat dairy, and lean meats.
  • The eating plan recommends limiting foods high in saturated fat, such as red meat and whole-milk dairy, as well as sugary foods and sweetened beverages.
  • The DASH diet can help with weight loss, and dietitians say it is one of the healthiest ways to eat.
  • This article was reviewed by Samantha Cassetty, MS, RD, a nutrition and wellness expert with a private practice based in New York City.
  • Visit Insider’s homepage for more stories.

DASH stands for dietary approaches to stop hypertension and was developed in the early 1990s when the National Institutes of Health was researching ways to lower blood pressure.

Since then, studies have found that the DASH diet can help lower blood pressure and prevent heart disease in people over time.

Here’s what you need to know about the DASH diet.

How to follow the DASH diet

The DASH diet focuses on nutrient-rich foods that are low in sodium, like many fruits and vegetables.

“For too long we focused just on cutting down on sodium,” said Lisa Sasson, a registered dietitian and clinical professor of nutrition and food studies at New York University. “We now know that including more of the other minerals that are in plant-based foods is very helpful and beneficial.”

The NIH offers a helpful guide for following the DASH eating plan, with recommended serving sizes based on your daily calories and examples of the best foods to eat. It mainly recommends:

  • Fruits
  • Vegetables
  • Whole grains
  • Fat-free or low-fat dairy
  • Lean meats
  • Nuts, seeds, and legumes
  • Limited sweets, fats, and oils

So if you’re following a diet of 2,000 daily calories, a day on DASH might look like this:

  • Breakfast: Three-quarters of a cup of bran-flakes cereal, with one medium banana and one cup of low-fat milk, paired with a slice of whole-wheat bread and, if you like, one teaspoon of margarine. Wash it all down with a cup of orange juice.
  • Snack: One-third of a cup of unsalted almonds.
  • Lunch: Three-quarters of a cup of chicken salad, with two slices of whole-wheat bread and a tablespoon of Dijon mustard.
  • Snack: A quarter cup of raisins.
  • Dinner: Three ounces of roast beef topped with two tablespoons of fat-free gravy with a side of one cup of sauteed green beans and a small baked potato topped with a teaspoon of margarine. If you’re not satisfied, add a small apple and one cup of low-fat milk.
  • Snack: Half a cup of fat-free fruit yogurt.
  • For more meal ideas, the NIH has a week’s worth of daily meal plans.

Specifically, you’ll want to eat foods that are high in potassium, magnesium, calcium, and fiber. Some examples of DASH-approved foods are oatmeal, leafy greens, potatoes, apples, bananas, oranges, fish, and mixed nuts.

Research on the DASH diet’s effect on blood pressure

A 2017 study published in the Journal of the American College of Cardiology examined 412 participants with pre-hypertension or stage-one hypertension. The study found that the participants who followed the DASH diet and reduced their sodium intake to 1,150 milligrams per day for 30 days straight saw a greater reduction in their systolic blood pressure than participants who ate a standard American diet.

Moreover, the higher a person’s systolic blood pressure was at the start of the study, the greater the improvement they saw from following a low-sodium DASH diet. For example, people whose original systolic blood pressure was greater than 150 mm Hg saw a decrease of as much as 15.54 mm Hg, whereas people whose original systolic blood pressure was less than 130 mm Hg saw a drop of as much as 2.07 mm Hg.

A 2014 review in the journal Nutrition, Metabolism & Cardiovascular Disease found that the DASH diet was also associated with lower diastolic blood pressure as well as systolic blood pressure.

And while these two studies didn’t examine the diet’s effect on blood pressure in the long term, a 2014 study published in the American Journal of Hypertension found that a 16-week structured DASH diet was associated with lower systolic blood pressure for the next eight months.

Moreover, a 2018 study published in the British Journal of Nutrition of 1,409 participants over 24 to 28 years found that living by a DASH diet might also improve a person’s cardiovascular health, as it was associated with higher levels of HDL cholesterol and lower pulse wave velocity, a measure of a person’s arterial health. Cardiovascular health was even better for people who paired the DASH diet with regular exercise, the study found.

However, the benefits of this diet may extend beyond hypertension and heart health.

“Although the original research was about the benefits of the DASH diet on hypertension, it would be a diet I recommend for everyone,” Sasson said.

She said it’s a diet that’s easy to follow, since it isn’t very specific and there aren’t many restrictions, aside from cutting out excessive sweets — the NIH recommends five servings of sweets a week at most.

“The diet is very safe and sustainable for anybody who’s looking to eat healthier,” Sasson said. “It’s exactly how we would advise all people to eat.”

While the main focus of this diet is not weight loss, Sasson said many people do end up losing some weight on the diet, since many of them are eating healthier, less processed foods, and cutting back on snacking. A 2016 study found that the DASH diet was more effective for weight loss than other low-energy diets, especially for participants who were overweight or obese.

According to Sasson, the DASH diet is also a good way to educate people on what healthy meals look like, especially when so many of us eat on the go and opt for processed foods.

“We should look at it as one of the healthiest ways to eat,” she said.

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