What is the DASH diet?

“DASH” stands for “dietary approaches to stop hypertension.” Hypertension, or high blood pressure, is affected by what you eat. The DASH diet is low in saturated and trans fat, cholesterol, and total fat. It is rich in fruits, vegetables, and low-fat dairy foods. It helps you choose fewer servings of red meat, sweets, and drinks that contain sugar. It also shows you ways to cut back on the amount of salt in your diet.

Following the DASH diet and reducing the amount of salt or sodium in your diet may help lower your blood pressure. It may also help prevent high blood pressure. Some people also need to take medicine to control their blood pressure.

What is hypertension?

Blood pressure is the force of blood against artery walls as the heart pumps blood through the body. Blood pressure can be unhealthy if it is over 120/80. The higher your blood pressure, the greater the health risks. High blood pressure is a problem in many ways.

• Your heart has to work harder to pump blood through your body. The added workload on the heart causes thickening of the heart muscle. Over time, the thickening damages the heart muscle so that it can no longer pump normally. This can lead to a disease called heart failure.
• The higher pressure in your arteries may cause them to weaken and bleed, resulting in a stroke.
• As you get older, blood vessels may get hard and stiff. Fatty deposits called plaque build up in blood vessels and make them more narrow. The narrowing decreases the amount of blood flow to the body. Small pieces of plaque may break off from the wall of a blood vessel and completely block a smaller blood vessel. This can cause a stroke or a heart attack. Your kidneys and eyes may also be damaged. High blood pressure speeds up this process.

How do I get started?

Your healthcare provider or a dietitian can tell you how many calories a day you need. Most adults need somewhere between 1600 and 2800 calories a day. Check product nutrition labels for serving sizes and the number of calories per serving.

You don’t need to buy special foods and there are no hard-to-follow recipes. Start by seeing how DASH compares with what you eat now.

Make changes gradually. Here are some suggestions that might help:

• If you now eat 1 or 2 servings of vegetables a day, add a serving at lunch and another at dinner.
• Add vegetables into soups, stews, and sauces.
• If you have not been eating fruit regularly, or only drink fruit juice, add a serving of fruit to your meals or have it as a snack. Use fruits canned in their own juice or eat more fresh fruits such as apples and bananas.
• Drink milk or water with lunch or dinner instead of soda, sugar-sweetened tea, or alcohol. Choose low-fat (1%) or fat-free dairy products so that you eat fewer calories and less fat and cholesterol.
• Read food labels on margarines and salad dressings to choose products lowest in fat and sodium.
• If you eat a lot of meat, slowly cut back at each meal. Limit meat to 2 servings per day, with each serving being about 3 to 4 ounces, which is the size of a deck of cards or the palm of your hand.
• Have 2 or more meals each week that do not include meat. Increase servings of vegetables, rice, pasta, and beans in all meals. Try casseroles, pasta, and stir-fry dishes that have less meat and more vegetables, grains, and beans.
• Try these snacks ideas: unsalted pretzels or nuts mixed with raisins or cranberries, graham crackers, low-fat and fat-free yogurt or frozen yogurt, popcorn with no added salt or butter, or raw vegetables.
• Choose whole-grain foods to get more minerals and fiber. For example, choose whole-wheat bread, whole-grain cereals, or brown rice. Although whole grains are a healthy choice, large portions can lead to weight gain. A portion of grain is 1/2 to 1 cup. A cup of food is about the same size as your fist.

The DASH diet can also help you reduce the salt and sodium in your diet. Try to have no more than 2300 milligrams (mg) of sodium per day. An even lower level of sodium, 1,500 mg, can further reduce blood pressure. Three ways to reduce sodium are:

• Eat food products with reduced-sodium or no salt added. Use fresh, frozen, or no-salt-added canned vegetables.
• Use less salt when you cook and do not add salt to your food at the table. Use spices and seasonings such as pepper, garlic, onion, sage, or rosemary to replace salt.
• Read food labels. Look for foods that contain less than 5% of the daily value of sodium.

If you need to lose weight as well as lower your blood pressure, replace high-calorie foods with more fruits and vegetables. The DASH eating plan contains many lower-calorie foods, such as fruits and vegetables. Here are some ways to cut calories:

• Eat a medium apple instead of 4 cookies. You’ll save 80 calories.
• Eat 1/4 cup of dried apricots instead of a 2-ounce bag of pork rinds. You’ll save 230 calories.
• Have a hamburger that weighs 3 ounces instead of a quarter pound. Add a 1/2 cup serving of carrots and a 1/2 cup serving of spinach. You’ll save more than 200 calories.
• Instead of 5 ounces of chicken, have a stir fry with 2 ounces of chicken and 1 and 1/2 cups of raw vegetables. Use just a small amount of vegetable oil. You’ll save 50 calories.
• Have a 1/2 cup serving of low-fat frozen yogurt instead of a 1-and-1/2-ounce chocolate bar. You’ll save about 110 calories.
• Use low-fat or fat-free salad dressings.
• Eat smaller portions. Cut back slowly.
• Use food labels to compare fat and calorie content in packaged foods. Items marked low-fat or fat-free may be lower in fat but not lower in calories than their regular versions.
• Limit foods with lots of added sugar, such as pies, flavored yogurts, candy bars, ice cream, sherbet, regular soft drinks, and fruit drinks.
• Drink water or club soda instead of cola or other soda drinks.

For more information, see the Guide to lowering your Blood Pressure with DASH at: http://www.nhlbi.nih.gov/files/docs/public/heart/dash_brief.pdf