High blood pressure (hypertension) is a serious health concern linked to a higher chance of conditions such as heart disease, kidney failure, and stroke. It affects nearly half of the world’s population, and the older you are, the higher your chance of developing it. In fact, it develops in more than 60% of people over age 60. Recognizing the significant role diet plays in managing hypertension, scientists and policymakers have developed specific dietary strategies to help reduce it, most notably, the DASH diet.
This article examines the DASH diet, which was designed to combat high blood pressure and reduce people’s chance of heart disease.
What is the DASH Diet?
The DASH (Dietary Approaches to Stop Hypertension) diet is a healthy-eating plan designed to help prevent or treat high blood pressure, also called hypertension. 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.
First introduced in 1997, it is a diet promoted by the National Institute of Health’s National Heart, Lung, and Blood Institute (NHBLI) for reducing blood pressure. Since its introduction, it has shown promise in multiple studies. Ultimately, eating according to the DASH Diet means eating a variety of foods and food groups that research has shown can be beneficial to heart health, while avoiding others, that have been found to be harmful.
The DASH diet focuses on vegetables, fruits and whole grains. Foods in the DASH diet are rich in the minerals potassium, calcium and magnesium.
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How DASH Diet Works
The DASH 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. That’s why 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.
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. The standard DASH diet limits salt to 2,300 milligrams (mg) a day. That amount agrees with the Dietary Guidelines for Americans. 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.
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.
Benefits of the DASH Diet
Numerous studies have found the DASH diet to be effective at reducing blood pressure. Beyond reducing blood pressure, the DASH diet offers a number of potential benefits:
- 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.
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Implementing the DASH Diet
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. The DASH diet provides daily and weekly nutritional goals.
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.
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.
Food Group Servings on the DASH Diet (2,000-Calorie Diet)
Grains: 6 to 8 servings a day. Whole grains are recommended for most grain servings as a good source of fiber and nutrients. 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 to 5 servings a day. All vegetables are allowed on the DASH diet. Examples of a serving include:
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- 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 to 5 servings a 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
Fat-free or low-fat dairy products: 2 to 3 servings a day. 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 meats, poultry and fish: six 1-ounce servings or fewer a 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, or dry beans and peas: 4 to 5 servings a 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 to 3 servings a 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
Sweets and added sugars: 5 servings or fewer a 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
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, or 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? Yes. 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.
Tips for Sticking to the DASH Diet
- Eat less restaurant food. The foods at the center of the DASH diet are low in salt.
- Be mindful of sodium. As you cut back on processed, salty foods, you might notice that food tastes different. It can take time for your taste buds to adjust. But once they do, you might prefer the DASH way of eating.
- Increase fiber intake gradually: On the DASH diet eating plan you will likely be eating a lot more of fruits, vegetables, and whole grains. These foods are high in fiber and increasing your intake of fiber too quickly may cause GI discomfort. Slowly increase how much fiber you eat each day and be sure to drink plenty of fluids.
- Consult with a healthcare provider: If you have a health condition, it is a good idea to talk with your provider before starting this or any diet plan to lose weight. Before you increase the potassium in your diet or use salt substitutes (which often contain potassium), check with your provider. People who have kidney problems or who take certain medicines must be careful about how much potassium they consume.
Considerations and Potential Downsides
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.