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Blood Pressure > High blood pressure: Using the DASH diet

High blood pressure: Using the DASH diet
========================================

Healthwise By Robin Parks, MS

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Introduction

The DASH diet is an eating plan that is low in fat but rich in low-fat
dairy foods, fruits, and vegetables. DASH stands for Dietary
Approaches to Stop Hypertension. Hypertension is high blood pressure.
Following the DASH diet may lower blood pressure. The DASH diet may
also help you prevent high blood pressure if you have prehypertension
(your blood pressure is between 120–139 over 80–89).1

DASH also recommends eating whole grains, fish, poultry, nuts, seeds,
and dried beans (legumes) as part of a balanced diet.

DASH is one of several lifestyle changes your doctor may recommend to
lower your high blood pressure. Your doctor may also want you to
decrease the amount of sodium and sodium-rich prepared foods in your
diet. Lowering sodium while following DASH has been proven to lower
blood pressure even further than just DASH alone.2 You can cut down on
your salt (sodium) intake by using a salt substitute. Talk to your
doctor before trying a salt substitute.

Key points:

Eating fewer processed foods, such as snack items, luncheon meats,
 and canned soups, will reduce the amount of sodium in your diet
 and help you lower your blood pressure.

A diet high in calcium, potassium, and magnesium may lower your
 blood pressure.

A diet high in sodium may cause high blood pressure.

To increase the potassium in your diet, fruits and vegetables are
 excellent sources of this nutrient. Dairy products are high in
 calcium and magnesium. DASH recommends that you eat 8 to 10
 servings of fruits and vegetables and 3 servings of low-fat dairy
 products each day.

Eating a diet low in both saturated fat and total fat will also
 help lower your blood pressure. Only 30% of your total calories
 should be from fat, with only 7% to 10% of your fat calories from
 saturated fat. Saturated fat is found in meats, cheeses, butter,
 poultry, snack foods, and other processed foods.

In general, vegetarian diets reduce blood pressure. The DASH diet
could easily be a vegetarian diet if legumes were substituted for
meat. Vegetarian diets tend to be higher in potassium, magnesium,
and calcium, as is the DASH diet. Vegetarian diets also are higher
in fiber and unsaturated fat than other diets.

Controlling your weight, increasing your physical activity, and
 reducing sodium in your diet will help reduce your blood pressure
 even more when combined with the DASH diet.

What can I do to incorporate DASH into my lifestyle?
Why does adding more fruits and vegetables and low-fat dairy products
to my diet help me lower my high blood pressure?
How can I make sure I stay with the DASH eating plan?
Where to go from here

More information about high blood pressure can be found in the topic:

High Blood Pressure (Hypertension).

Return to topic:

Cardiac Rehabilitation.

Chronic Kidney Disease.

Coronary Artery Disease.

Diabetic Nephropathy.

Healthy Eating.

Heart Attack and Unstable Angina.

High Blood Pressure (Hypertension).

High Triglycerides.

Stroke.

What can I do to incorporate DASH into my lifestyle?

You can make small changes to incorporate the DASH diet into your
lifestyle. Slowly change your eating habits to fulfill the following
recommendations.

Eat 8 to 10 servings of fruits and vegetables each day. If you are
 not eating this many yet, keep track of the fruits and vegetables
 you eat. Slowly add more to your diet. Check what counts as a
 serving in the food guide pyramid.

Eat 3 servings of low-fat or nonfat dairy foods such as milk,
 yogurt, and cheese.

Limit the amount of saturated fat you eat. Substitute
 monounsaturated and polyunsaturated oils instead.

Limit the amount of sodium in your diet by cutting down on the
 amount of processed foods you eat, such as snack items, luncheon
 meats, and canned soups.

See a sample DASH menu.

Here are some ideas for eating with DASH:

Think about including fruits and/or vegetables in every meal.
Take fruit to work or school, for a snack.

Drink nonfat milk. A glass of skim milk has only 80 calories and
 no fat and is packed with blood pressure–lowering nutrients. Have
 a "skinny" latte (caffe latte made with skim milk) as a way to add
 milk to your diet. If you don't drink coffee, try a skinny almond
 milk.

Make a baked potato bar. Serve baked potatoes with a variety of
 vegetables, such as broccoli, and use other toppings, such as
 low-fat shredded cheese, chili, salsa, and refried beans. If you
 use canned or jar toppings, be sure to choose low-sodium
 varieties, or even better, make them yourself from fresh
 ingredients. Be creative. You could end up with 4 or 5 servings of
 vegetables at one meal.

Use a variety of cut-up vegetables with a low-fat dip as an
 appetizer such as hummus, instead of high-fat chips and dips. Try
 some new vegetables. Make a stir-fry containing lots of different
 vegetables.

Try some vegetarian meals featuring legumes (cooked dried beans
and peas). Add garbanzo beans to a salad, use fat-free refried
beans, and/or make split pea or black bean soup. Buy a vegetarian
cookbook and try one recipe each month or each week.

Combine a ready-made pizza crust with low-fat mozzarella cheese
 and lots of vegetable toppings. Use tomatoes, zucchini, spinach,
 carrots, cauliflower, and onions.

For breakfast, have whole-grain cereal, fruit, and low-fat milk.

For a snack, have a smoothie made with low-fat milk and frozen
 fruit chunks.

Make a dip for fruit from low-fat vanilla yogurt and cinnamon.

Test Your Knowledge

1. To start incorporating the DASH diet into my lifestyle, I should
  slowly add more fruits and vegetables to my diet. My goal is 8 to
  10 servings each day.

1. Trueclose

The answer is correct

To start with, think about changing only your fruit and
vegetable intake. Keep track of the fruits and vegetables you
eat, and slowly add more to your diet. Your goal is 8 to 10
servings a day.

close

2. Falseclose

The answer is incorrect

To start with, think about changing only your fruit and
vegetable intake. Keep track of the fruits and vegetables you
eat, and slowly add more to your diet. Your goal is 8 to 10
servings a day.

close

2. Nonfat milk is an important part of the DASH diet.

1. Trueclose

The answer is correct

A glass of skim milk has only 80 calories and no fat and is
packed with blood pressure–lowering nutrients.

close

2. Falseclose

The answer is incorrect

A glass of skim milk has only 80 calories and no fat and is
packed with blood pressure–lowering nutrients.

close

Continue to Why does adding more fruits and vegetables and low-fat
dairy products to my diet help me lower my high blood pressure?
Return to High blood pressure: Using the DASH diet

Why does adding more fruits and vegetables and low-fat dairy products
to my diet help me lower my high blood pressure?

People who eat mainly processed foods usually get too much sodium and
not enough potassium, calcium, and magnesium in their diets. Not
getting enough of these nutrients, which come from fruits, vegetables,
and dairy products, may contribute to high blood pressure.

Researchers believe that it is the combination of 8 to 10 servings a
day of fruits and vegetables and 3 servings of low-fat dairy products
that causes the DASH diet to lower blood pressure. Simply adding
calcium, potassium, and magnesium supplements to the diet does not
lower blood pressure.

Good sources of potassium

All fresh fruits and vegetables and meats are good sources of
potassium. Fruit and vegetable examples include:

Bananas, cantaloupe, oranges, and orange juice.

Raw or cooked spinach, lima beans, zucchini, broccoli, carrots,
cauliflower, and artichokes.

Potatoes.

Legumes (cooked dried beans and peas) such as pinto beans,
 chickpeas, and lentils.

A serving size of fruits and vegetables includes:

¾ cup fruit or vegetable juice.

½ cup raw, canned, or cooked fruits or vegetables.

1. medium apple or ½ a banana.

1. cup raw, leafy vegetables.

Good sources of calcium

Low-fat dairy products (yogurt, skim milk, cheese)

A serving size is:

1. cup milk or yogurt.

1.5 oz (42.5 g) to 2 oz (56.7 g) low-fat cheese.

Good sources of magnesium

Legumes (cooked dried beans and peas), seeds, and nuts

Halibut

Milk and yogurt

Brown rice and potatoes

Tomatoes

Bananas and watermelon

Leafy green vegetables

A serving size includes:

¾ cup cooked dry beans.

½ cup brown rice.

Test Your Knowledge

1. A balanced, low-fat diet that contains 8 to 10 servings each day
  of fresh fruits and vegetables and 3 servings each day of low-fat
  dairy foods will help me lower my high blood pressure.

1. Trueclose

The answer is correct

People who mainly eat a diet of processed foods may not get
enough potassium, calcium, and magnesium that come from eating a
balanced diet with 8 to 10 servings each day of fresh fruits and
vegetables and 3 servings each day of low-fat dairy products.

close

2. Falseclose

The answer is incorrect

People who mainly eat a diet of processed foods may not get
enough potassium, calcium, and magnesium that come from eating a
balanced diet with 8 to 10 servings each day of fresh fruits and
vegetables and 3 servings each day of low-fat dairy products.

close

Continue to How can I make sure I stay with the DASH eating plan?
Return to High blood pressure: Using the DASH diet

How can I make sure I stay with the DASH eating plan?

Ask your doctor to recommend a registered dietitian who can work with
you to change your eating habits and help you plan menus that follow
the DASH eating style. See a sample DASH menu.

Use a form to track your eating habits. Record everything you eat
before you start DASH, charting the number of servings you eat in the
following food groups: grains; vegetables; fruits; dairy; meats
(including poultry and fish); nuts, seeds, and beans; fats and oils;
and sweets. As well as you can, record the amount of sodium in
everything you eat. After you begin the DASH eating plan, keep the
same charts, and compare your lists.

Use the following as a guide for the DASH eating plan:

Milk and dairy

1. servings a day. One serving equals: 8 ounces of nonfat or low-fat milk; 1 cup of low-fat yogurt; or 1½ ounces of low-fat cheese.

Fruits and vegetables

1. to 10 servings a day. One fruit serving equals: 1 medium fruit; ¼ cup dried fruit; ½ cup frozen or canned fruit; or 6 ounces of fruit juice. One vegetable serving equals: 1 cup raw, leafy vegetables; ½ cup cooked vegetables; or 6 ounces vegetable juice.

Grains

1. to 8 servings a day. One serving equals: 1 slice whole wheat bread; ½ cup dry or hot cereal; or ½ cup cooked brown rice, pasta, or other cooked grain.

Meat, fish, poultry

1. to 6 ounces a day. One serving equals: 3 ounces cooked meat, poultry, or fish (about the size of a deck of cards).

Nuts, seeds, dried beans

1. to 5 servings a week. One serving equals: 1/3 cup nuts; 2 tablespoons seeds; or 3/4 cup cooked dried beans. Use nuts, seeds, or dried beans to replace meat in some of your meals.

Test Your Knowledge

1. With the DASH eating plan, I don't have to worry about the number
  of servings I eat as long as I get a lot of fruits and vegetables
  in my diet.

1. Trueclose

The answer is incorrect

DASH is a proven scientific method for lowering blood pressure.
If you don't follow the recommended number of servings in the
important food groups, you may not be able to lower your blood
pressure.

close

2. Falseclose

The answer is correct

DASH is a proven scientific method for lowering blood pressure.
If you don't follow the recommended number of servings in the
important food groups, you may not be able to lower your blood
pressure.

close

Continue to Where to go from here
Return to High blood pressure: Using the DASH diet

Where to go from here

Now that you have read these tips on following the DASH diet, you are
ready to change your eating habits to lower your high blood pressure.

For more sample menus and recipes for the DASH eating plan, go to
www.nhlbi.nih.gov (under Health Information and Publications, click on
High Blood Pressure) or write to the NHLBI Health Information Center,
P.O. Box 30105, Bethesda, MD, 20824-0105, and request information on
the DASH diet.

Return to High blood pressure: Using the DASH diet

References

Citations

1. 

Elmer PJ, et al. (2006). Effects of comprehensive lifestyle
modification on diet, weight, physical fitness, and blood
pressure control: 18-month results of a randomized trial.
Annals of Internal Medicine, 144(7): 485–495.

2. 

Sacks F, et al. (2001). Effects on blood pressure of reduced
dietary sodium and the Dietary Approaches to Stop Hypertension
(DASH) diet. New England Journal of Medicine, 344(1): 3–10.

Credits

Author

Robin Parks, MS

Editor

Kathleen M. Ariss, MS

Associate Editor

Pat Truman, MATC

Primary Medical Reviewer

Caroline S. Rhoads, MD - Internal Medicine

Specialist Medical Reviewer

Robert A. Kloner, MD, PhD - Cardiology

Specialist Medical Reviewer

Ruth Schneider, MPH, RD - Diet and Nutrition

Last Updated

April 24, 2007

Author:Robin Parks, MS Medical Review:Caroline S. Rhoads, MD -
Internal MedicineRobert A. Kloner, MD, PhD - CardiologyRuth Schneider,
MPH, RD - Diet and Nutrition Last Updated: 04/24/2007 Email this
Article Print this Article IM this Article Syndication:

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