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High blood pressure is a risk factor for developing heart disease, the leading cause of death among U.S. adults. Medications are very effective at improving blood pressure, but you may not realize that diet can also play a role. Read on to learn more about how the DASH diet can help you lower your blood pressure and its other benefits.
What is the DASH diet?
Dietary Approaches to Stop Hypertension (DASH) is an eating plan created to manage high blood pressure, also known as hypertension, a risk factor for heart disease (cardiovascular disease). The National Institutes of Health (NIH) first developed the diet in 1992 when they funded several research projects to identify interventions to manage hypertension (Challa, 2021).
In a world full of strict diets and regimented food lists, DASH is a relatively straightforward method for healthy eating. It’s a flexible eating plan that allows people to make manageable changes to their diets to help lower blood pressure.
What does the DASH diet entail?
In a nutshell, DASH is a healthy diet rich in fruits, vegetables, and whole grains. It also promotes fat-free or low-fat dairy products, lean proteins like fish, poultry, beans, and dietary fats like nuts and vegetable oils. The idea is that these nutrient-dense foods are high in fiber, protein, potassium, magnesium, and calcium—which are all linked to lowering blood pressure and improving heart health. Conversely, DASH limits foods that are high in saturated fat, such as red meat and full-fat dairy products, as well as sugar-sweetened beverages and treats (Challa, 2021).
Importantly, DASH encourages people to consume less sodium. Too much sodium in the bloodstream pulls water into the blood vessels, which increases the vessels’ volume of blood. The extra fluid and increased pressure on the blood vessel walls lead to high blood pressure. This is why the DASH plan emphasizes a low-sodium diet (Filippou, 2020).
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According to the FDA, the DASH sodium guidelines are much lower than the average American’s daily sodium consumption—most of us eat around 3,400 mg of sodium per day (FDA, 2021). Depending on your specific health needs, different versions of the diet limit your sodium to the following (based on 2,000 calories per day):
- The standard DASH diet limits sodium consumption to 2,300 mg per day.
- The lower-sodium DASH diet limits sodium consumption to 1,500 mg per day.
Most of the sodium you eat comes from packaged or processed foods and going out to restaurants. A pre-made or restaurant bowl of soup may have over 1000 mg, while that side of french fries may set you back over 200 mg of sodium.
The DASH eating plan focuses mainly on whole grains, fruits, and veggies and calls for a specific number of servings from each approved food group. According to the National Heart, Lung, and Blood Institute, the number of servings will vary depending on how many calories you eat each day. For a 2,000-calorie daily diet, this translates to (NHLBI, n.d):
- 6–8 servings of grains or grain products (whole grains recommended)
- 4–5 servings of vegetables
- 4–5 servings of fresh fruits
- 2–3 servings of low-fat dairy
- 2–3 servings of fats and oils
- 2 or fewer 3-ounce servings of lean meats, poultry, or fish
- 4–5 servings of nuts, seeds, or dry beans per week
- Less than 5 servings of sweets and added sugars per week
Foods to eat on the DASH diet
DASH meal plans encourage you to eat more fruits, veggies, whole grains, lean meats, etc. Examples of foods to eat on the DASH diet include (Challa, 2021):
- Vegetables: leafy greens like spinach, kale, broccoli
- Carbohydrates: whole grains like oats, cracked wheat, whole wheat bread, brown rice
- Protein: legumes, beans, lean meats, fish
- Dairy: eggs and low-fat dairy products
- Fruits: bananas, oranges, avocados
- Fats: nuts, seeds, olive oil, foods rich in omega-3 fatty acids
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Foods to avoid on the DASH diet
One of the main goals of the DASH diet is to reduce your sodium intake, as well as how much saturated fat and sugars you eat each day.
Examples of foods to avoid while following a DASH diet plan include (Challa, 2021):
- Saturated fats and hydrogenated oils like margarine, vegetable shortenings, coconut oil, palm oil
- Fatty meats
- Full-fat dairy products
- Sugary foods like soft drinks, candy, cookies, cakes
Benefits of the DASH diet
Since the advent of the DASH diet 30 years ago, countless studies report its ability to reduce blood pressure and improve heart health. The diet was originally designed to help people living with high blood pressure (hypertension) and an increased risk of type 2 diabetes and heart disease—it has been instrumental in allowing them to lead a heart-healthy lifestyle.
Recent research demonstrates its health benefits in other conditions as well. One study found that following the DASH diet might improve a person’s cardiovascular health. It showed that the diet was linked to higher levels of HDL cholesterol (“good” cholesterol) and lower pulse wave velocity (a measure of arterial health) (Maddock, 2018).
Other studies show that the DASH diet may lower blood glucose and cholesterol levels, further reducing your risk of heart disease. It may also play a role in the management of chronic heart failure. There’s also evidence that the DASH diet can lower the incidence of colorectal cancer (Challa, 2021).
Although the DASH diet’s primary focus is to manage high blood pressure, its emphasis on whole foods and portion control can lead to unexpected weight loss. Clinical trials show that not only does the DASH diet improve blood pressure, but it also promotes weight loss, especially when combined with exercise (Appel, 2003).
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Risks of the DASH diet
One of the hardest parts of the DASH diet is limiting your sodium intake. According to the FDA, more than 70% of your daily sodium intake comes from processed and prepackaged foods—foods that are generally easier and more convenient than homemade meals (FDA, 2021).
Furthermore, salt adds flavor to food—if you are used to eating more sodium, you may find your food tastes bland on the DASH diet, especially in the beginning.
While DASH is an overall healthy diet plan, people with certain medical conditions like kidney disease, uncontrolled diabetes, heart failure, etc., may need to modify their DASH diet plan with guidance from their healthcare provider (Tyson, 2012).
Is the DASH diet recommended?
Although the original goal of the DASH diet was to help reduce hypertension, it’s now recommended as a viable option for anyone interested in adopting a healthier diet. The American Heart Association (AHA) promotes DASH, and it’s highly regarded among doctors, dietitians, and other healthcare providers (AHA, 2016).
As always, it’s important to discuss your plans with your healthcare provider. DASH is meant to complement your medication management for high blood pressure or cholesterol, not to replace it.
- Appel, L. J., Champagne, C. M., Harsha, D. W., Cooper, L. S., Obarzanek, E., et al. (2003). Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA, 289(16), 2083–2093. doi: 10.1001/jama.289.16.2083. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12709466/
- Challa, H.J. Ameer, M.A. Uppaluri, K.R. (2020) DASH Diet (Dietary Approaches to Stop Hypertension). StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482514/
- Maddock, J., Ziauddeen, N., Ambrosini, G. L., Wong, A., Hardy, R., & Ray, S. (2018). Adherence to a Dietary Approaches to Stop Hypertension (DASH)-type diet over the life course and associated vascular function: a study based on the MRC 1946 British birth cohort. The British Journal of Nutrition, 119(5), 581–589. doi: 10.1017/S0007114517003877. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29508688/
- National Heart, Lung, and Blood Institute (NHLBI). (n.d.). DASH eating plan. Retrieved on July 19, 2021 from https://www.nhlbi.nih.gov/education/dash-eating-plan
- Tyson, C.C., Nwankwo, C., Lin, PH. et al. The dietary approaches to stop hypertension (DASH) eating pattern in special populations. Current Hypertension Reports 14, 388–396 (2012). doi: 10.1007/s11906-012-0296-1. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22846984/
- U.S. Food and Drug Administration (FDA). (2021, Jun). Sodium in your diet. Retrieved on July 19, 2021 from https://www.fda.gov/food/nutrition-education-resources-materials/sodium-your-diet
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.