High blood pressure, or hypertension, affects nearly half the world's population and increases the risk of heart disease, kidney failure, and stroke. As diet plays a major role in the development of high blood pressure, specific dietary strategies have been engineered to help reduce it. This article explores various red line diet plans, including the DASH diet, Bright Line Eating (BLE), the Vertical Diet, and calorie density principles, to help you make informed decisions about your health.
The DASH Diet: Dietary Approaches to Stop Hypertension
The DASH (Dietary Approaches to Stop Hypertension) diet was created after researchers noticed that high blood pressure was much less common in people who followed a plant-based diet, such as vegans and vegetarians. The DASH diet emphasizes fruits and vegetables while containing lean protein sources like chicken, fish, and beans. The diet is low in red meat, salt, added sugars, and fat.
How DASH Works
Scientists believe that one of the main reasons people with high blood pressure can benefit from this diet is because it reduces salt intake to no more than 3/4 teaspoon (tsp) or 1,500 milligrams (mg) of sodium per day.
Benefits of the DASH Diet
Beyond reducing blood pressure, the DASH diet offers a number of potential benefits:
- Blood pressure: Numerous studies have found the DASH diet to be effective at reducing blood pressure.
- Weight loss: A 2020 study found that following DASH containing at least 126 grams (g) of lean protein helped older adults over 65 with obesity reduce body fat. A 2023 study also suggests DASH can be helpful in lowering belly fat.
- Cancer risk: A 2019 review found that people following the DASH diet had a lower risk of cancer, specifically breast, hepatic, endometrial, and lung cancer. Similar results were found in a study looking at colorectal cancer and DASH.
- Metabolic syndrome risk: Research suggests that the DASH diet reduces your risk of metabolic syndrome by nearly 50%. Other research confirms there may be an inverse relationship between following DASH and the chance of developing metabolic syndrome.
- Diabetes: The diet has been linked to a lower chance of diabetes. Research also demonstrates that it may improve insulin resistance as well.
- Heart disease: A 2019 review found that following DASH may be linked to a lower chance of developing heart disease. Specifically, research suggests this diet may help lower various risk factors for heart disease, such as blood cholesterol, sugar, and fats.
Many of these protective effects are attributed to the diet’s high fruit and vegetable content. In general, eating more fruits and vegetables can help reduce the chance of developing disease.
Read also: The Hoxsey Diet
Adapting Your Diet to DASH Guidelines
You can adapt your current diet to the DASH guidelines by doing the following:
- Eat more vegetables and fruits.
- Swap refined grains for whole grains.
- Choose fat-free or low fat dairy products.
- Choose lean protein sources like fish, poultry, and beans.
- Cook with vegetable oils.
- Limit your intake of foods high in added sugars, like soda and candy.
- Limit your intake of foods high in saturated fats like fatty meats, full-fat dairy, and oils like coconut and palm oil.
DASH Diet Food Portions
The number of servings you can eat depends on how many calories you consume. Below is an example of food portions based on a 2,000-calorie diet.
Whole grains: 6-8 servings per day
Examples of a serving include:
- 1 slice of whole-grain bread
- 1 ounce (oz) or 28 g of dry, whole-grain cereal
- 1/2 cup (95 g) of cooked rice, pasta or cereal
Vegetables: 4-5 servings per day
Read also: Walnut Keto Guide
All vegetables are allowed on the DASH diet. Examples of a serving include:
- 1 cup (about 30 g) of raw, leafy green vegetables like spinach or kale
- 1/2 cup (about 45 g) of sliced vegetables - raw or cooked - like broccoli, carrots, squash or tomatoes
Fruits: 4-5 servings per day
If you’re following the DASH approach, you’ll be eating a lot of fruit. Examples of fruits you can eat include apples, pears, peaches, berries, and tropical fruits like pineapple and mango.
Examples of a serving include:
- 1 medium apple
- 1/4 cup (50 g) of dried apricots
- 1/2 cup (30 g) of fresh, frozen or canned peaches
Dairy products: 2-3 servings per day
Read also: Weight Loss with Low-FODMAP
Dairy products on the DASH diet should be low in fat. Examples include skim milk, low-fat cheese, and yogurt.
Examples of a serving include:
- 1 cup (240 ml) of low fat milk
- 1 cup (285 g) of low fat yogurt
- 1.5 oz (45 g) of low fat cheese
Lean chicken, meat, and fish: 6 or fewer servings per day
Choose lean cuts of meat and try to eat a serving of red meat only occasionally - no more than once or twice a week.
Examples of a serving include:
- 1 oz (28 g) of cooked meat, chicken or fish
- 1 egg
Nuts, Seeds, and Legumes: 4-5 Servings per Week
Examples of a serving include:
- 1/3 cup (50 g) of nuts
- 2 tbsp (40 g) of nut butter
- 2 tbsp (16 g) of seeds
- 1/2 cup (40 g) of cooked legumes
Fats and Oils: 2-3 Servings per Day
The DASH diet recommends vegetable oils over other oils. These include margarine and oils like canola, corn, olive, or safflower. It also recommends low fat mayonnaise and light salad dressing.
Examples of a serving include:
- 1 tsp (4.5 g) of soft margarine
- 1 tsp (5 milliliters (ml)) of vegetable oil
- 1 tsp (15 g) of mayonnaise
- 2 tsp (30 ml) of salad dressing
Candy and Added Sugars: 5 or Fewer Servings per Week
Added sugars are kept to a minimum on the DASH diet, so limit your intake of candy, soda, and table sugar. The DASH diet also restricts unrefined sugars and alternative sugar sources, like agave nectar.
Examples of a serving include:
- 1 tablespoon (tbsp) (12.5 g) of sugar
- 1 tbsp (20 g) of jelly or jam
- 1 cup (240 ml) of lemonade
Considerations for the DASH Diet
While studies on the DASH diet determined that the greatest reductions in blood pressure occurred in those with the lowest salt intake, the benefits of salt restriction on health and lifespan are not clear-cut. The theory that some people are more salt sensitive - meaning that salt exerts a greater influence on their blood pressure - could partly explain this.
One 2020 study suggests that it’s unclear whether there are any benefits to reducing salt intake this low, and that the chance of heart disease begins to rise only after consuming more than 5,000 mg of sodium daily. That said, this target can be achieved easily by reducing the amount of highly processed food in your diet and eating mostly whole foods.
Common Questions About the DASH Diet
Are eggs ok to eat on a DASH diet?
Yes, eggs are ok to eat on a DASH diet. Here is an example of a meal you might eat for breakfast that includes eggs: 2 boiled eggs, 2 slices of turkey bacon with 1/2 cup (38 g) of cherry tomatoes, 1/2 cup (80 g) of baked beans, and 2 slices of whole-wheat toast, plus 1/2 cup (120 ml) of fresh orange juice.
Are potatoes ok to eat on a DASH diet?
Yes, you can include potatoes in a DASH diet. For example, you might plan to eat one of the following: 3 oz (85 g) of salmon cooked in 1 tsp (5 ml) of vegetable oil with 1 cup (300 g) of boiled potatoes and 1.5 cups (225 g) of boiled vegetables. 6 oz (170 g) of cod fillet, 1 cup (200 g) of mashed potatoes, 1/2 cup (75 g) of green peas and 1/2 cup (75 g) of broccoli.
Is peanut butter ok to eat on the DASH diet?
For example, for breakfast, you might make 2 slices of whole-wheat toast with 2 tbsp (40 g) of peanut butter, 1 medium banana, 2 tbsp (16 g) of mixed seeds, and 1/2 cup (120 ml) of fresh orange juice.
Conclusion on DASH Diet
The DASH diet may be an easy and effective way to reduce blood pressure. However, keep in mind that cutting daily salt intake to 3/4 tsp (1,500 mg) or less has not been linked to any hard health benefits - such as a reduced risk of heart disease - despite the fact that it can lower blood pressure. For this reason, healthy individuals may have little reason to follow this diet.
Bright Line Eating (BLE): A Structured Approach to Weight Loss
Bright Line Eating, or BLE, is a diet movement presented by Susan Peirce Thompson in her 2017 book, "Bright Line Eating: The Science of Living Happy, Thin and Free.” It's based on the idea that “the brain blocks weight loss,” and her solution is to remove that obstruction. The "bright lines" are intended to work together to produce lasting weight loss results.
The Four Tenets of Bright Line Eating
- No added sugar: Thompson writes that sugar works on the brain the same way that drugs such as cocaine and heroin do. She points to research highlighting the addictiveness of sweetness to support that notion. The no-sugar rule is the brightest line of the bunch, and by removing it, you can cure your dependency on food, Thompson argues.
- No flour: Thompson says that for some people, flour is an insidiously addictive food. While the “science of flour addiction” isn’t fully understood, she writes that it’s known to elevate blood sugar levels. Though some people avoid wheat flour to remove gluten from their diets, Thompson recommends avoiding all kinds of flour, no matter what plant they come from.
- Eating 3 meals per day with no snacking in between: Teaching your body that there are certain times of day, and those times only, when it’s OK to eat is part of the conditions BLE uses to keep folks from overindulging throughout the day. Thompson also writes that designating a special place to eat, such as the dining room table, rather than mindlessly eating in your car or on the couch in front of the television, can also help you keep your weight loss efforts on track.
- Controlling portion size: The final pillar of the Bright Line Eating plan is to carefully control portion sizes. Thompson writes that “the quantities of Bright Line meals are generous, but they are finite.” She encourages dieters to weigh or measure every meal to carefully quantify the portion size.
The Science Behind BLE
Thompson liberally cites research on social science and brain research studies, as well as her own academic background in cognitive science, to support her theories. She says that many people struggle with the cycle of yo-yo dieting because their brains block their efforts in three key ways:
- The willpower gap: Willpower, according to Thompson, is housed in the anterior cingulate cortex; like other portions of the brain, this section runs on glucose, or blood sugar, and is highly sensitive to fluctuations in the levels of sugar in the body that it can draw on for energy. As you make decision after decision all day long, which uses up brain power and thus the body's energy, your blood sugar levels get depleted. In terms of dieting, this is when you might say "forget it" and give in to temptation. Learning to overcome that gap between waning willpower and the constant temptations of modern society creates the Thompson-termed willpower gap.
- Leptin resistance: Insatiable hunger, or the drive to eat even when you’re already full, is linked to leptin resistance, Thompson notes. Leptin is a hormone that signals when you’re full, and when that signal isn’t transmitted properly, it can lead to overeating.
- Overpowering cravings: Thompson writes that overpowering food cravings occur when the bingeing mechanism in the brain is triggered. This particular challenge originates in the nucleus accumbens, a section of the brain where pleasure resides. Over time, overindulging causes the nucleus accumbens to downregulate.
Exercise and Other Activities on the BLE Plan
The BLE plan includes no specific requirements for exercise. In fact, Thompson writes that she discourages people from adopting a new exercise program within the first four or five months of being on the BLE program because it can drain your willpower levels. The BLE program also encourages detailed journaling of your daily food journey, both in planning for what to eat the next day and in recording what you did today.
Sample BLE Meal Plan
- Breakfast: A protein, a grain, and a fruit.
- Lunch: A protein, vegetables, fruit and fat.
- Dinner: A protein, vegetables, salad and fat.
Whole grains such as oats or brown rice are allowed. Potatoes and sweet potatoes are also counted as a grain. Grains should be limited to one ounce when measured dry. Proteins can include plant-based proteins such as tofu and tempeh, Greek yogurt, seeds, cheese, eggs, beef, chicken and any other animal protein, except bacon. Fruit should be measured at about 6 ounces for a serving. Vegetables can include virtually any kind of vegetable, whether cooked or raw. When making an 8-ounce salad, start with about 2 to 3 ounces of lettuce and add another 5 to 6 ounces of various vegetables on top.
Health Risks and Drawbacks of the Bright Line Eating Plan
Before getting started on the BLE program, Thompson recommends visiting your doctor to make sure this approach won’t exacerbate an existing medical condition or interfere with any medications you might be taking. It’s also worth noting that while Thompson posits this diet can be a good approach for people who’ve struggled with food addiction and eating disorders in the past, generally speaking, people with a history of eating disorders should avoid restrictive diets.
Some dietitians note that imposing strict rules such as prohibiting snacks and added sugars isn’t sustainable or enjoyable. Labeling certain foods as prohibited will make us want them more, which simply defeats the purpose of a diet that is designed to address food addiction.
The Vertical Diet: Performance-Based Nutrition
The Vertical Diet was created by powerlifter Stan Efferding to enhance athletic performance and improve recovery. It promotes a limited number of high quality, nutrient-rich foods that are easy to digest. The Vertical Diet is a performance-based nutrition plan developed by a professional bodybuilder and powerlifter. It claims to optimize gut health, correct nutritional deficiencies, and balance hormones. It also promises to improve energy, endurance, and recovery in athletes.
How the Vertical Diet Works
Unlike traditional “horizontal” diets emphasizing dietary variety across numerous food groups, the Vertical Diet focuses on a limited number of high quality, nutrient-rich foods. According to Efferding, limiting variety makes your body more efficient at digesting and absorbing nutrients, improving muscle growth, recovery, gut health, and metabolism.
Primary Foods in the Vertical Diet
Red meat and white rice comprise the bulk of the Vertical Diet. According to the diet’s advocates, white rice is the primary carb source because it’s easy to digest, especially in large quantities. This is particularly important for serious athletes with very high calorie needs. Red meat is preferred over poultry or fish due to its nutrient density and concentration of iron, B vitamins, zinc, and cholesterol, which the diet claims are important for muscle growth and testosterone production.
Restrictions in the Vertical Diet
All foods that aren’t easily digestible are discouraged. These include vegetables that may cause bloating and gas, such as broccoli and cauliflower, which are high in FODMAPs, as well as onion and garlic. Legumes, brown rice, and other grains are also curbed because they contain lectins and phytic acid, which may limit your absorption of certain nutrients.
Steps to Start the Vertical Diet
When starting out, you calculate your basal metabolic rate (BMR), or the number of calories your body needs to function while at rest. You then add calories based on your training regimen. Bodybuilders should aim for a calorie surplus to gain muscle weight. As your body adjusts to the diet and starts to feel hungry between meals, you’re supposed to “go vertical” by adding more calories.
Potential Benefits of the Vertical Diet
Bodybuilders, powerlifters, and other athletes looking to gain muscle mass may find that the Vertical Diet fits their needs. It may also benefit those who want to lose weight or have difficulty digesting FODMAPs.
Downsides of the Vertical Diet
The Vertical Diet has numerous downsides, including being:
- Low in fiber: Adequate fiber intake aids fullness, heart health, and digestive health.
- Low in prebiotics: Despite claims that it boosts gut health, the Vertical Diet excludes many important sources of prebiotics.
- Limited in variety: The diet is restrictive and repetitive, making long-term adherence difficult.
- Inappropriate for vegetarians or vegans: As the Vertical Diet emphasizes red meat intake while limiting vegetable, grain, and legume intake, it’s unsuitable for people who are vegetarian or vegan.
- Expensive to follow: While white rice is usually cheap, the other components of the Vertical Diet can be costly.
Foods Allowed and Discouraged on the Vertical Diet
The Vertical Diet emphasizes red meat and white rice while offering limited amounts of other items.