Interested in following the DASH diet? The DASH (Dietary Approaches to Stop Hypertension) diet is a recognized treatment for hypertension, heart disease, and kidney disease and can slow the progression of heart and kidney disease. Today’s leading health organizations are heartily endorsing the DASH Diet for the informed health-conscious diner.
What is the DASH Diet?
DASH stands for Dietary Approaches to Stop Hypertension (high blood pressure). The DASH diet helps people lower salt, which contains sodium, in diets. The diet is also rich in nutrients that help lower blood pressure. The DASH diet is not a strict diet, but more of a lifestyle. It’s fairly easy to follow and doesn’t restrict any type of food. While following this diet, kids can still have favorite treats on occasion as long as they get most of their calories from whole, unprocessed foods. The DASH (Dietary Approaches to Stop Hypertension) Diet has been recommended by the National Kidney Foundation and approved by The National Heart, Lung and Blood Institute, The American Heart Association, the Dietary Guidelines for Americans, and also forms the basis for the USDA MyPyramid.
The DASH Diet is rich in fruits, vegetables, low-fat dairy products, whole grains, fish, poultry, beans, seeds, and nuts. It is low in salt and sodium, added sugars and sweets, fat and red meats.
The Science Behind DASH
Nearly half of adults in the United States have high blood pressure, also known as hypertension, according Centers for Disease Control and Prevention. "I think most people know salt is a problem for blood pressure, but most people do not know about the DASH diet plan,” says Dr. The DASH Eating Plan is short for Dietary Approaches to Stop Hypertension. “Early stages of hypertension are still associated with negative outcomes, including for the heart and kidneys, and raises stroke and dementia risk,” says Dr. Mendez, who is also an assistant professor clinical medicine at Weill Cornell Medicine. “Even a little elevation in blood pressure is something that people need to be aware of and do something to address. Dr. “By that time, we had kind of known salt is the enemy of anybody with high blood pressure,” says Dr. Mendez. “And so most diets and interventions focused on lowering salt.
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. They were then randomly assigned to two different diets: a control diet rich in fruits and vegetables, or a “combination” diet rich in fruits and vegetables with the addition of low-fat dairy products and with reduced saturated and total fat. 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.
Read also: Delicious DASH Diet Treats
“They found that even without counting salt, people had lower blood pressure following that DASH-style diet plan,” says Dr. What makes the DASH Diet unique is its focus on nutrient-rich foods that naturally support healthy blood pressure. “Potassium plays an important role in the regulation of vascular tone, or how tight your blood vessels are,” says Dr. Mendez. “The fruits and vegetables are rich in nutrients associated with lowering blood pressure, and the calcium in dairy seems to add that extra difference,” says Dr. It also helps that these foods are low in salt, which can cause the body to retain fluid and has long been known to raise blood pressure. “Overall, these foods are much lower in salt than the average American diet,” says Dr.
Key Components of the DASH Diet
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.
Who Should Follow the DASH Diet?
Anyone who wants to prevent or lower high blood pressure would benefit from following the DASH diet. Though the DASH diet specifically benefits patients with high blood pressure who are looking to lower it, a lot of its principles - more fruits and vegetables, less processed foods - can be good for everyone. Kids don’t have to be diagnosed with high blood pressure to follow this diet. Many kids (and adults) at risk of developing high blood pressure can benefit from it. “But especially once you have hypertension, it’s time to make those changes for the long-term benefits,” says Dr. Mendez. Doctors may recommend the DASH diet for kids who have ever had a blood pressure reading that was higher than normal. The DASH diet is a recognized treatment for hypertension, heart disease, and kidney disease and can slow the progression of heart and kidney disease. If you already have chronic kidney disease, you should speak with your doctor and dietitian before starting any new diets as you may have special restrictions to consider. The DASH diet should not be used by people on dialysis. Individuals on dialysis have special dietary needs that should be discussed with a registered dietitian.
Implementing the DASH Diet: Practical Tips
To help you get started with the DASH diet eating plan, here are some guidelines.
Making Gradual Changes
If you’re looking to change your diet, Dr. Mendez recommends starting small. “I find that it’s making smaller changes first rather than all of the sudden go from eating fast food every day to five servings of fruits and vegetables each day,” he says.
Read also: Which Diet is Right for You?
Keeping a Food Diary
Dr. Mendez suggests keeping a food and exercise diary to help keep track of your habits.
Smart Grocery Shopping
Shop the Perimeter of the Grocery Store: Stick to the outer edges of the store when food shopping, which helps encourage more whole foods, since processed foods are mostly found in the aisles.
Focus on Nutrient-Rich Foods
Vegetables, fruits and whole grains are the basis of the DASH diet. Foods that Dr. Mendez enjoys that follow the DASH diet plan include oatmeal with banana, berries, apples, and carrots.
Portion Control and Serving Sizes
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.
Sample DASH Diet for a 2,000 Calorie Diet
| Food Group | Daily Servings | Serving Size |
|---|---|---|
| Grains | 6-8 | 1 Slice bread, 1 oz dry cereal, ½ cup cooked rice, pasta, or cereal |
| Vegetables | 4-5 | 1 cup raw leafy vegetable, ½ cup cut-up raw or cooked vegetable, ½ cup vegetable juice |
| Fruits | 4-5 | 1 medium fruit, ¼ cup dried fruit, ½ cup fresh, frozen, or canned fruit, ½ cup fruit juice |
| Fat-free or low-fat milk | 2-3 | 1 oz milk or yogurt, 1 ½ oz cheese |
| Lean meats, poultry, and fish | 6 or less | 1 oz cooked meats, poultry, or fish, 1 egg |
| Nuts, seeds, and legumes | 4-5 per week | 1/3 cup or 1 ½ oz nuts, 2 Tbsp peanut butter, 2 Tbsp or ½ oz seeds, ½ cup cooked legumes (dry beans and peas) |
| Fats and oils | 2-3 | 1 tsp soft margarine, 1 tsp vegetable oil, 1 Tbsp mayonnaise, 2 Tbsp salad dressing |
| Sweets and added sugars | 5 or less/week | 1 Tbsp sugar, 1 Tbsp jelly or jam, ½ cup sorbet, gelatin, 1 cup lemonade |
*Whole grains are recommended for most grain servings as a good source of fiber and nutrients.*Serving sizes vary between ½ cup and 1 ¼ cups, depending on cereal type. Check the product's Nutrition Facts label.
Read also: The DASH Diet and Blood Sugar
Adapting the DASH Diet for Children
The DASH diet is a healthy eating plan that focuses on nutritious foods while limiting processed and unhealthy foods. This diet separates foods into three broad categories: Foods to fill up on every day, foods you can have in moderation, and foods to eat rarely (or avoid). You’ll also want to limit added salt and oil in your child’s diet. If you must use these when cooking, use just a few teaspoons of oil or add just a sprinkle of salt. Keep in mind you can add flavor in other ways. Try using different spices and herbs to see which ones your child likes. Kids’ taste buds will adjust to low-salt food relatively quickly, and they may even start to find restaurant food too salty. There are many ways to follow this diet, so you can do so based on your child’s likes and dislikes.
Sample Meals for Kids on the DASH Diet
Here are some sample breakfasts, lunches, and dinners. These are just suggestions, and you can adjust them however you’d like, as long as you don’t add too much salt or oil.
Eating Out and Special Occasions
It’s better to avoid eating at restaurants or buying processed foods while on the DASH diet, but this might not be realistic for many families. It’s fine for your child to enjoy a treat once in a while. At restaurants, check with your server to see if any options are low-sodium, and ask for any sauces or dressings to be served on the side. When shopping for groceries, always check the food labels on any processed foods, and choose low-sodium versions if possible. At parties, let your child try a small portion of any desired treats so they won't feel deprived. It’s also a good idea to serve a healthy and filling meal before the party so kids are less likely to fill up on junk food and sweets.
Making it a Family Affair
One of the best ways to help your child stick to the DASH diet is to follow the diet yourself. Kids typically want to eat what the adults around them are eating, so making this a family goal can be fun for them. Show kids that healthy food can be tasty and enjoyable, and bring them into the kitchen to get them involved in how their food is prepared.
Additional Strategies for Managing Blood Pressure
In addition to the DASH diet plan, there is a lot you can do to keep your blood pressure under control, says Dr. Mendez, including losing weight, watching alcohol consumption, increasing physical activity and reducing salt intake. “For blood pressure especially, it’s something that patients can take control of, for example by monitoring blood pressure at home in a relaxed setting, rather than just at the doctor after you’ve sprinted from the subway,” he says. It’s also important to remember that sometimes blood pressure can be hereditary, and the DASH diet will help even if a patient also needs medication to manage it. “Some people feel that it’s a failure on their part if they have to take medication,” says Dr. Mendez. “But some things are hereditary and beyond our control.
Proven Health Benefits of the DASH Diet
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. The DASH diet was found to lower cardiovascular risk in a controlled 8-week trial looking at participants randomized to consume either a DASH diet (low in total/saturated fat with whole grains, poultry, fish, nuts, fruits and vegetables), a fruit and vegetable-rich diet (more fruits/vegetables than control diet but same amount of fat), or control diet (standard American diet high in fat and cholesterol). The researchers estimated a 10-year reduction in risk for cardiovascular disease based on the participants’ blood pressure and cholesterol levels before and after the diet intervention.
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.
Potential Drawbacks
DASH requires each person to plan their own daily menus based on the allowed servings. 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. 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.