The DASH diet emphasizes portion size, eating a variety of foods and getting the right amount of nutrients. Discover how DASH can improve your health and lower your blood pressure.
By Mayo Clinic staff
DASH
stands for Dietary Approaches to Stop Hypertension. The DASH diet is a lifelong
approach to healthy eating that's designed to help treat or prevent high blood
pressure (hypertension). The DASH diet encourages you to reduce the sodium in
your diet and eat a variety of foods rich in nutrients that help lower blood
pressure, such as potassium, calcium and magnesium.
By
following the DASH diet, you may be able to reduce your blood pressure by a few
points in just two weeks. Over time, your blood pressure could drop by eight to
14 points, which can make a significant difference in your health risks.
Because
the DASH diet is a healthy way of eating, it offers health benefits besides
just lowering blood pressure. The DASH diet may offer protection against
osteoporosis, cancer, heart disease, stroke and diabetes. And while the DASH
diet is not a weight-loss program, you may indeed lose unwanted pounds because
it can help guide you toward healthier meals and snacks.
DASH diet: Sodium levels
A key goal of the DASH diet is reducing how
much sodium you eat, since sodium can dramatically increase blood pressure in
people who are sensitive to its effects. In addition to the standard DASH diet,
there is also a lower sodium version of the diet. You can choose the version of
the diet that meets your health needs:
Standard DASH diet. You can consume up to 2,300 milligrams
(mg) of sodium a day.
Lower sodium DASH diet. You can consume up to 1,500 mg of
sodium a day.
Both versions of the DASH diet aim to reduce
the amount of sodium in your diet compared with what you might get in a more
traditional diet, which can amount to a whopping 3,500 mg of sodium a day or
more. That level is far beyond the recommendation of the 2005 Dietary
Guidelines for Americans of a maximum of 2,300 mg of sodium a day.
Studies show that the lower sodium version of
the DASH diet is especially helpful in lowering blood pressure for adults who
are middle-aged or older, for African-Americans and for those who already have
high blood pressure. If you aren't sure which version of the DASH diet is best
for you, talk to your doctor.
DASH diet: What to eat
Both sodium versions of the DASH diet include
lots of whole grains, fruits, vegetables and low-fat dairy products. The DASH
diet also includes some fish, poultry and legumes. You can eat red meat, sweets
and fats in small amounts. The DASH diet is low in saturated fat, cholesterol
and total fat.
Here's a look at the recommended servings
from each food group for the 2,000-calorie-a-day DASH diet.
Grains
(6 to 8 servings a day)
Grains
include bread, cereal, rice and pasta. Examples of one serving of grains
include 1 slice whole-wheat bread, 1 ounce (oz.) dry cereal, or 1/2 cup cooked
cereal, rice or pasta.
Focus on whole grains because they
have more fiber and nutrients than do refined grains. For instance, use brown
rice instead of white rice, whole-wheat pasta instead of regular pasta and
whole-grain bread instead of white bread. Look for products labeled "100
percent whole grain" or "100 percent whole wheat."
Grains are naturally low in fat, so
avoid spreading on butter or adding cream and cheese sauces.
Vegetables
(4 to 5 servings a day)
Tomatoes,
carrots, broccoli, sweet potatoes, greens and other vegetables are full of
fiber, vitamins, and such minerals as potassium and magnesium. Examples of one
serving include 1 cup raw leafy green vegetables or 1/2 cup cut-up raw or cooked
vegetables.
Don't think of vegetables only as side
dishes — a hearty blend of vegetables served over brown rice or whole-wheat
noodles can serve as the main dish for a meal.
Fresh or frozen vegetables are both
good choices. When buying frozen and canned vegetables, choose those labeled as
low sodium or without added salt.
To increase the number of servings you
fit in daily, be creative. In a stir-fry, for instance, cut the amount of meat
in half and double up on the vegetables.
Fruits
(4 to 5 servings a day)
Many
fruits need little preparation to become a healthy part of a meal or snack.
Like vegetables, they're packed with fiber, potassium and magnesium and are
typically low in fat — exceptions include avocados and coconuts. Examples of
one serving include 1 medium fruit or 1/2 cup fresh, frozen or canned fruit.
Have a piece of fruit with meals and
one as a snack, then round out your day with a dessert of fresh fruits topped
with a splash of low-fat yogurt.
Leave on edible peels whenever
possible. The peels of apples, pears and most fruits with pits add interesting
texture to recipes and contain healthy nutrients and fiber.
Remember that citrus fruits and juice,
such as grapefruit, can interact with certain medications, so check with your
doctor or pharmacist to see if they're OK for you.
Dairy
(2 to 3 servings a day)
Milk,
yogurt, cheese and other dairy products are major sources of calcium, vitamin D
and protein. But the key is to make sure that you choose dairy products that
are low-fat or fat-free because otherwise they can be a major source of fat.
Examples of one serving include 1 cup skim or 1% milk, 1 cup yogurt or 1 1/2
oz. cheese.
Low-fat or fat-free frozen yogurt can
help you boost the amount of dairy products you eat while offering a sweet
treat. Add fruit for a healthy twist.
If you have trouble digesting dairy
products, choose lactose-free products or consider taking an over-the-counter
product that contains the enzyme lactase, which can reduce or prevent the
symptoms of lactose intolerance.
Go easy on regular and even fat-free
cheeses because they are typically high in sodium.
Lean
meat, poultry and fish (6 or fewer servings a day)
Meat
can be a rich source of protein, B vitamins, iron and zinc. But because even
lean varieties contain fat and cholesterol, don't make them a mainstay of your
diet — cut back typical meat portions by one-third or one-half and pile on the
vegetables instead. Examples of one serving include 1 oz. cooked skinless
poultry, seafood or lean meat, 1 egg, or 1 oz. water-packed, no-salt-added
canned tuna.
Trim away skin and fat from meat and
then broil, grill, roast or poach instead of frying.
Eat heart-healthy fish, such as
salmon, herring and tuna. These types of fish are high in omega-3 fatty acids,
which can help lower your total cholesterol.
Nuts,
seeds and legumes (4 to 5 servings a week)
Almonds,
sunflower seeds, kidney beans, peas, lentils and other foods in this family are
good sources of magnesium, potassium and protein. They're also full of fiber
and phytochemicals, which are plant compounds that may protect against some
cancers and cardiovascular disease. Serving sizes are small and are intended to
be consumed weekly because these foods are high in calories. Examples of one
serving include 1/3 cup (1 1/2 oz.) nuts, 2 tablespoons seeds or 1/2 cup cooked
beans or peas.
Nuts sometimes get a bad rap because
of their fat content, but they contain healthy types of fat — monounsaturated
fat and omega-3 fatty acids. They're high in calories, however, so eat them in
moderation. Try adding them to stir-fries, salads or cereals.
Soybean-based products, such as tofu
and tempeh, can be a good alternative to meat because they contain all of the
amino acids your body needs to make a complete protein, just like meat. They
also contain isoflavones, a type of natural plant compound (phytochemical) that
has been shown to have some health benefits.
Fats
and oils (2 to 3 servings a day)
Fat
helps your body absorb essential vitamins and helps your body's immune system.
But too much fat increases your risk of heart disease, diabetes and obesity.
The DASH diet strives for a healthy balance by providing 30 percent or less of
daily calories from fat, with a focus on the healthier unsaturated fats.
Examples of one serving include 1 teaspoon soft margarine, 1 tablespoon low-fat
mayonnaise or 2 tablespoons light salad dressing.
Saturated fat and trans fat are the
main dietary culprits in raising your blood cholesterol and increasing your
risk of coronary artery disease. DASH helps keep your daily saturated fat to
less than 10 percent of your total calories by limiting use of meat, butter,
cheese, whole milk, cream and eggs in your diet, along with foods made from
lard, solid shortenings, and palm and coconut oils.
Avoid trans fat, commonly found in
such processed foods as crackers, baked goods and fried items.
Read food labels on margarine and
salad dressing so that you can choose those that are lowest in saturated fat
and free of trans fat.
Sweets
(5 or fewer a week)
You
don't have to banish sweets entirely while following the DASH diet — just go
easy on them. Examples of one serving include 1 tablespoon sugar, jelly or jam,
1/2 cup sorbet or 1 cup (8 oz.) lemonade.
When you eat sweets, choose those that
are fat-free or low-fat, such as sorbets, fruit ices, jelly beans, hard candy,
graham crackers or low-fat cookies.
Artificial sweeteners such as
aspartame (NutraSweet, Equal) and sucralose (Splenda) may help satisfy your
sweet tooth while sparing the sugar. But remember that you still must use them
sensibly. It's OK to swap a diet cola for a regular cola, but not in place of a
more nutritious beverage such as low-fat milk or even plain water.
Cut back on added sugar, which has no
nutritional value but can pack on calories.
DASH diet: Alcohol and caffeine
Drinking too much alcohol can increase blood
pressure. The DASH diet recommends that men limit alcohol to two or fewer
drinks a day and women one or less.
The
DASH diet doesn't address caffeine consumption. The influence of caffeine on
blood pressure remains unclear. But caffeine can cause your blood pressure to
rise at least temporarily. If you already have high blood pressure or if you
think caffeine is affecting your blood pressure, talk to your doctor about your
caffeine consumption.
DASH diet and weight loss
The DASH diet is not designed to promote weight
loss, but it can be used as part of an overall weight-loss strategy. The DASH
diet is based on a diet of about 2,000 calories a day. If you're trying to lose
weight, though, you may want to eat around 1,600 a day. You may need to adjust
your serving goals based on your health or individual circumstances — something
your health care team can help you decide.
Tips to cut back on sodium
The foods at the core of the DASH diet are
naturally low in sodium. So just by following the DASH diet, you're likely to
reduce your sodium intake. You also can cut back on sodium in your diet by:
Using sodium-free spices or flavorings
with your food instead of salt
Not adding salt when cooking rice,
pasta or hot cereal
Rinsing canned foods to remove some of
the sodium
Buying foods labeled "no salt
added," "sodium-free," "low sodium" or "very low
sodium"
One
teaspoon of table salt has about 2,300 mg of sodium, and 2/3 teaspoon of table
salt has about 1,500 mg of sodium. When you read food labels, you may be
surprised at just how much sodium some processed foods contain. Even low-fat
soups, canned vegetables, ready-to-eat cereals and sliced turkey from the local
deli — all foods you may have considered healthy — often have lots of sodium.
You
may not notice a difference in taste when you choose low-sodium food and
beverages. If things seem too bland, gradually introduce low-sodium foods and
cut back on table salt until you reach your sodium goal. That'll give your
palate time to adjust. It can take several weeks for your taste buds to get
used to less salty foods.
Putting the pieces of the DASH diet together
Try these strategies to get started on the
DASH diet:
Change gradually. To boost your success, avoid dramatic
changes in your eating approach. Instead, change one or two things at a time.
If you now eat only one or two servings of fruits or vegetables a day, try to
add a serving at lunch and one at dinner. Rather than switching to all whole
grains, start by making one or two of your grain servings whole grains.
Increasing fruits, vegetables and whole grains gradually can also help prevent
bloating or diarrhea that may occur if you aren't used to eating a diet with
lots of fiber. You can also try over-the-counter products to help reduce gas
from beans and vegetables.
Forgive yourself if you backslide. Everyone slips, especially when
learning something new. Remember that changing your lifestyle is a long-term process.
Find out what triggered your setback and then just pick up where you left off
with the DASH diet.
Reward successes. Reward yourself with a nonfood treat
for your accomplishments.
Add physical activity. To boost your blood pressure lowering
efforts even more, consider increasing your physical activity in addition to
following the DASH diet. Combining both the DASH diet and physical activity
makes it more likely that you'll reduce your blood pressure.
Get support if you need it. If you're having trouble sticking to
your diet, talk to your doctor or dietitian about it. You might get some tips
that will help you stick to the DASH diet.
Remember, healthy eating isn't an
all-or-nothing proposition. What's most important is that, on average, you eat
healthier foods with plenty of variety — both to keep your diet nutritious and
to avoid boredom or extremes. And with the DASH diet, you can have both.