The DASH (Dietary Approaches to Stop Hypertension) diet is often recommended for its health benefits, particularly in managing blood pressure. However, like any dietary plan, it's essential to consider its potential drawbacks and limitations to make informed decisions about one's health. While the DASH diet is considered one of the best dietary approaches because it is well-studied and backed by large amounts of strong research, a deeper look reveals potential cons that individuals should be aware of.
What is the DASH Diet?
The DASH diet was created approximately 20 years ago with support from the National Institute of Health (NIH)’s National Heart, Lung, and Blood Institute (NHLBI). DASH is an acronym for “Dietary Approaches to Stop Hypertension.” The intention for the diet is to 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.
The DASH diet focuses on vegetables, fruits, and whole grains. The diet limits foods that are high in salt, also called sodium. The standard DASH diet limits salt to 2,300 milligrams (mg) a day. A lower sodium version of DASH restricts sodium to 1,500 mg a day. You can choose the version of the diet that meets your health needs.
The DASH diet is a balanced eating plan that gives choices of what to eat. The diet helps create a heart-healthy eating style for life. There's no need for special foods or drinks.
Potential Downsides and Limitations
Risk of Eating Disorders
While effective in treating what it was created to treat, it cannot be denied that the DASH diet presents risks for development of eating disorder beliefs and behaviors. This is true not only of the DASH diet but truly any diet that encourages restriction, which the DASH diet does. Restriction is considered any degree of control or rules being placed around what type of food and what amount an individual should put in their bodies. Restrictive eating behaviors is present in almost all eating disorder diagnoses and is one of the largest risk factors for eating disorder development. One study learned that “teenage girls who even moderately dieted had a five times higher risk of developing an eating disorder than those who did not diet; those who dieted at ‘a severe leve’” were 18 times more likely to develop an eating disorder.
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Many professionals do report that, of all the diets, the DASH diet is one of the more well-balanced in allowing all foods groups. Even so, the question becomes “why is the individual engaging in the diet?” If they are approaching the diet from a disordered place with the intention of altering their bodies, it is dangerous. This is particularly true if the individual has a history of disordered eating. If you or someone you love is considering exploring the DASH diet, it is best that they do so with consistent support of a medical professional. If this individual has a history of disordered eating, it is recommended they also engage in the DASH diet with the support of a therapeutic and dietary professional. This multidisciplinary support will keep the individual accountable to making the best choices for their medical health without falling into harmful restrictive beliefs and behaviors that could lead to eating disorder development.
Not Designed for Weight Loss
For those engaging in the DASH diet with the intention of weight loss, it does not “work.” According to a review completed by the Harvard School of Public Health, while the DASH diet reduced blood pressure effectively, it did not result in any weight changes. The key in distinguishing these findings is the recognition that this diet does what it is intended to do yet should not be misused for body alteration purposes. It is when individuals engage in diets purely to lose weight or alter their natural bodies that they become dangerous.
Requires Diligent Meal Planning
DASH requires each person to plan their own daily menus based on the allowed servings. 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.
Categorization Ambiguities
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.
Potential Gastrointestinal Discomfort
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.
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Barriers to Implementation
Despite having numerous known health benefits, the diet of the majority of individuals doesn’t confirm the incorporation of all these natural food ingredients in their food due to various barriers. The reasons behind the non-adherence to DASH diet include cultural preferences of people, limited availability, lack of time for preparing DASH meals and higher cost of DASH food ingredients, which cannot be afforded by under-resourced population.
DASH Diet & Eating Disorders
While effective in treating what it was created to treat, it cannot be denied that the DASH diet presents risks for development of eating disorder beliefs and behaviors. This is true not only of the DASH diet but truly any diet that encourages restriction, which the DASH diet does. Restriction is considered any degree of control or rules being placed around what type of food and what amount an individual should put in their bodies. Restrictive eating behaviors is present in almost all eating disorder diagnoses and is one of the largest risk factors for eating disorder development. One study learned that “teenage girls who even moderately dieted had a five times higher risk of developing an eating disorder than those who did not diet; those who dieted at ‘a severe leve’” were 18 times more likely to develop an eating disorder.
Many professionals do report that, of all the diets, the DASH diet is one of the more well-balanced in allowing all foods groups. Even so, the question becomes “why is the individual engaging in the diet?” If they are approaching the diet from a disordered place with the intention of altering their bodies, it is dangerous. This is particularly true if the individual has a history of disordered eating. If you or someone you love is considering exploring the DASH diet, it is best that they do so with consistent support of a medical professional. If this individual has a history of disordered eating, it is recommended they also engage in the DASH diet with the support of a therapeutic and dietary professional. This multidisciplinary support will keep the individual accountable to making the best choices for their medical health without falling into harmful restrictive beliefs and behaviors that could lead to eating disorder development.
Read also: Is Vegetarianism Healthy?