DASH Diet

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The basics

The DASH—Dietary Approaches to Stop Hypertension—diet was developed for a US government–sponsored, controlled study that investigated the effect of a healthy diet on blood pressure. High blood pressure, or hypertension, is anything over 120/80 mmHg.

Focus on what you can eat:

  • 6 to 8 servings of grains per day (choose whole grains when you can)
  • 4 to 5 servings of fruits and 4 to 5 servings of vegetables per day
  • 2 to 3 servings of low-fat or non-fat dairy per day
  • 6 ounces of meat, poultry, or fish per day
  • Limit your sodium intake to less than 2,300 mg per day

Best bets: Limit animal fats, and eat more fruits, vegetables, nuts, and non- or low-fat dairy products. Talk to a registered dietitian or other trained healthcare professional for more information about following this diet.

Why do people follow this diet?

The DASH diet lowers blood pressure and blood cholesterol levels, and improves insulin sensitivity. For these reasons, many doctors recommend it to people at risk for heart disease or diabetes. Because it is a well-balanced diet low in animal fats and high in nutrient-rich foods and fibre, it has also been recommended as an eating guide for all people. Since most people will eat fewer calories when following the DASH diet, could also be used as a weight-loss and weight-maintenance diet.

What do the advocates say?

The DASH diet is a heart-healthy diet designed to increase intake of nutrients (such as potassium, calcium, and magnesium) that should help lower blood pressure. Controlled studies have found that decreases in high blood pressure may begin within two weeks of starting the diet. In addition, blood levels of LDL (“bad”) cholesterol may begin to lower within two months.

Consuming less salt when following the DASH diet is even more effective for lowering blood pressure, and a salt-controlled DASH diet further improves heart disease and diabetes risk factors such as unstable blood sugar, high triglycerides, and low HDL cholesterol levels in people who have the insulin-resistance (metabolic) syndrome. This diet has also been shown to improve indicators of osteoporosis risk.

What do the critics say?

There is no known criticism of the DASH diet. In some people, the DASH diet may lower HDL (“good”) as well as LDL (“bad”) and cholesterol, but the overall effect remains a heart-healthy one.

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Best bets

Here are some examples of the types of food choices recommended by the DASH diet.

  • Grains (choose whole grain products whenever possible)

    Whole wheat bread and rolls, whole wheat pasta, English muffin, pita bread, bagel, cereals, grits, porridge, brown rice, and unsalted pretzels

  • Vegetables

    Broccoli, carrots, collards, green beans, green peas, kale, lima beans, potatoes, spinach, squash, sweet potatoes, tomatoes

  • Fruits

    Apples, apricots, bananas, dates, grapes, oranges, grapefruit, grapefruit juice, mangoes, melons, peaches, pineapples, raisins, strawberries, tangerines

  • Low- or non-fat milk products

    Fat-free (skim) or low-fat (1%) milk or buttermilk; fat-free, low-fat, or reduced-fat cheese; fat-free or low-fat regular or frozen yoghurt

  • Meats, fish, and poultry (prepared without additional fat)

    Lean red meats; skinless poultry; broiled, roasted, or poached fish; egg whites (limit egg yolks to four or fewer per week)

  • Nuts, seeds, and pulses

    Almonds, hazelnuts, mixed nuts, peanuts, walnuts, sunflower seeds, peanut butter, kidney beans, lentils, split peas

  • Fats and oils

    Soft margarine, non-hydrogenated vegetable oil (such as canola, olive, or safflower), low-fat mayonnaise, light salad dressing

  • Sweets and added sugars (limit to five or fewer servings per week)

    Fruit-flavoured gelatine, fruit punch, hard candy, jelly, maple syrup, sorbet and ices, honey

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Are there any groups or books associated with this diet?

The DASH Diet Action Plan by Marla Heller. Deerfield, Illinois: Amidon Press, 2005.

The DASH Diet for Hypertension by Thomas Moore. New York: Simon & Schuster, 2001.

DASH for Health Web site: www.dashforhealth.com

Your Guide To Lowering Your Blood Pressure With DASH from the National Heart, Lung and Blood Institute Web site: www.nhlbi.nih.gov/health/public/heart/hbp/dash

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Bibliography

Azadbakht L, Mirmiran P, Esmaillzadeh A, et al. Beneficial effects of a Dietary Approaches to Stop Hypertension eating plan on features of the metabolic syndrome. Diabetes Care 2005;28:2823–31.

Lin PH, Ginty F, Appel LJ, et al. The DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults. J Nutr 2003;133:3130–6.

Obarzanek E, Sacks FM, Vollmer WM, et al. Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial. Am J Clin Nutr 2001;74:80–9.

Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001;344:3–10.

Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997;336:1117–24.

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