LOWER BLOOD PRESSURE WITH THE DASH EATING PLAN

Recently, the Dietary Approaches to Stop Hypertension or DASH diet was named the the best overall diet by U.S. News & World Report for the fifth year in a row.  Why does the DASH plan deserve top ratings? The DASH diet, developed by the National Heart, Lung, and Blood Institute (NHLBI), is a lifelong approach to healthy eating that is designed to help treat or prevent high blood pressure. 

Benefits of the DASH Plan

Research has demonstrated those who follow the plan can see reductions in their systolic pressure (the pressure in the arteries when the heart beats) by as much as 7-12 mmHg and diastolic pressure (the pressure in the arteries when the heart is at rest) by 3-6 mmHg.  These changes significantly improve heart and cardiovascular health outcomes. Research also indicates that following the DASH diet reduces risk of osteoporosis, some cancers, kidney disease, obesity, and diabetes. 

Components of the DASH Plan

DASH emphasizes intake of vegetables, fruits, and fat-free/low-fat dairy products and includes healthy amounts of whole grains, fish, poultry, beans, seeds, nuts, and vegetable oils while limiting salt, sweets, sugary beverages, and red meats.  Nutritionally, this means DASH is low in sodium and unhealthy saturated fats while being rich in fiber, protein, and the blood pressure-friendly minerals potassium, calcium, and magnesium.

Below is a table detailing the contents of the DASH diet at 1200 calories, 1600 calories, and 2000 calories.  Everyone has different calorie needs but if you are looking to lose weight the 1200 calorie menu is a good starting place for women and the 1600 calorie level for men.  It may look complicated but going DASH is easy.  Include generous portions of veggies at 2 meals daily, fruit for a snack and dessert, and include a lowfat dairy source at every meal and your basically there.  Detailed information on the DASH plan is available online at: http://www.nhlbi.nih.gov/files/docs/public/heart/new_dash.pdf.  There you will find menu plans at different calorie levels and for different cuisines including Hispanic, Asian, and Southern. 

The DASH diet was developed when guidelines recommended limiting sodium to 2300 mg, roughly equivalent to 1 teaspoon of salt.  Currently, the average American consumes 2-3 times this amount. It is now recognized that there are additional blood pressure benefits to lowering sodium intake to less than 1500 mg (~2/3 of a teaspoon of salt). Even if you do not add salt at home, you are probably eating too much sodium.  Approximately 75% of our sodium intake is derived from salt added by manufacturers to food products long before they appear on our tables.  Preparing foods from home and avoiding pre-made products is the most effective way to reduce your sodium intake.

DASH Eating Plan Overview
Food Group	Daily Servings				Notes	Significance of Each Food Group to the DASH Eating Pattern
	2000 calorie	1600 calorie		1200 calorie
Grains	8 oz	6 oz		3 oz	-Opt for whole grain or whole wheat options. -Examples include whole wheat bread and rolls, whole wheat pasta, whole grain cereals, oatmeal, brown rice, barley, quinoa, & buckwheat.	-Major sources of energy & fiber -Brans are great sources of magnesium
	1 oz = 1 slice bread, 1/2 cup cooked grains or cereal, or 1/3 cup pasta
Veget-ables	2-3 cups	2 cups		2 cups	-Potassium is lost in cooking water so when cooking opt for steaming instead of boiling or consider drinking the cooking water. -Some vegetables especially rich in potassium include dark leafy greens, potatoes, tomato, beets, squash, broccoli, romaine, & Brussels sprouts.	-Rich sources of fiber, potassium, magnesium -Dark leafy greens rich in calcium & potassium
Fruits	2-2.5 cups	2 cups		1.5-2 cups	-Dark purple fruits such as cranberry, blueberry, pomegranate, cherries, and acai appear especially helpful. -Choose fresh or frozen over canned or dried which often have added sugar. -Standouts for potassium include kiwi, banana, orange, guava, and melons.	-Important sources of potassium, magnesium, & fiber
Fat-free/ low-fat milk and dairy	3 serving	2-3  serving		2-3  serving	-Dairy is naturally high in unhealthy saturated fat so opt for the low or nonfat options.  Use cheese sparingly as it is high in sodium as well as saturated fat. -Consider some of the less common options such as lowfat/nonfat cottage cheese, nonfat ricotta, and lowfat/nonfat plain kefir. -Lactose intolerant persons can take lactase pills, choose lactose-free products (e.g. Lactaid), opt for products naturally low in lactose (e.g. hard cheeses, yogurt), or use fortified substitutes such as unsweetened soy milk.	-Major sources of calcium, potassium, and protein
	Ex: -1 cup milk or yogurt -1.5 oz cheese
Poultry, fish, & other lean protein	7 oz	5 oz		5 oz	-Select only lean cuts of meat; trim away visible fats; remove skin from poultry. -Choose fish and chicken most of the time. -Mostly avoid processed meats as they appear to be especially bad for heart health and are high in sodium. -1 oz of tofu or 1/2 cup of beans can substitute for 1 oz of animal protein.	-Rich sources of protein & magnesium -Many fish are also high in potassium -Fatty fish such as salmon & tuna are good sources of essential omega-3 fatty acids
Nuts, seeds, & beans	4-5  serving  per  week	3-4   serving  per  week		3-4 serving per week	-All types of raw, unsalted nuts are excellent options. -While it is important to be mindful of portions do not shy away from nuts as there is strong evidence of  their heart health benefits. -Try Beano or similar products if you find beans uncomfortably gassy.  Slowly increasing your intake of beans helps to minimize gas symptoms. -Use beans on salads, as spreads and dips, and in soups as well as many other ways.	-Rich sources of energy, magnesium, potassium, protein, & fiber
	Ex: -1/3 cup nuts/seeds -2 Tbsp peanut butter -1/2 cup beans
Oil	3-4 tsp		2-3 tsp	2 tsp	-Choose healthy plant-based oil such as olive as well as fat-rich fish.  -Avoid unhealthy saturated fats (as well as salt) in butter and margarine.	-The DASH study had 27% of calories as fat
Sweets and added sugars	4 or less per week		2 or less per week	1 or less per week	-Note that the allowed portions and serving sizes of sweets here are very limited compared to the average American diet which includes 19 teaspoons of sugar daily. -Try to use the blood pressure-friendly fruits and lowfat dairy products as sources of sweets.	-Studies reveal that high sugar diets increase blood pressure independently of their impact on bodyweight.