DASH diet.

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What is the DASH diet?

DASH stands for Dietary Approaches to Stop Hypertension, and the diet was developed for a research study in the early 1990s.1 The purpose of the study was to identify a food-based strategy to lower blood pressure. Even though the original research was quite a long time ago, scientists recently conducted a meta-analysis for a DASH diet review to summarize how much blood pressure can be reduced by the DASH diet. The study found, on average, people reduce their blood pressure by 6.7 mmHg systolic and 3.5 mmHg diastolic in just two weeks. The more sodium is restricted, the lower blood pressure goes.
Or more simply stated, the DASH diet plan includes eating more
  • fruits and vegetables,
  • low-fat or nonfat dairy,
  • beans, and
  • nuts.
And eating less
  • fatty meats,
  • full-fat dairy products,
  • sugar-sweetened beverages,
  • sweets, and
  • sodium (salt).
Since the original research, scientists also have found that they could apply the DASH diet plan for weight loss.2 When people follow the Dash diet in addition to increasing exercise, they lose weight and improve metabolic measures such as insulin sensitivity. However, in comparison to low-carbohydrate diets, the DASH diet alone was not as effective a strategy for weight loss. When the DASH diet is followed along with exercise and caloric reduction, people improved their blood pressure even more; lowering it by 16 mmHg systolic and 9mmHg diastolic; plus, they lost some weight.2 As people adopt the DASH diet and lower their blood pressure, they may have a reduced need for medication. Discuss the diet-based changes you are making with your health-care professional, and if your blood pressure is at or below goal (<140/80), you can discuss reducing your medications and maintaining your blood pressure with diet alone.

What is the recommended daily allowance of sodium?

The National Institutes of Health's 2015-2020 Dietary Guidelines for Americans recommend consuming less than 2,300 mg of salt each day as part of a healthy diet.

What foods are allowed in the DASH diet eating plan?

People often ask what foods are on the DASH diet eating plan. The good news is that it includes a wide variety of foods, and many options. The DASH diet is simple. Eat more fruit, and especially vegetables, and eat fewer foods high in salt (sodium). For example:
  • Eat a salad with protein for lunch instead of a burger and fries.
  • Choose low-fat dairy products such as Greek yogurt instead of fruity, sweetened yogurt.
  • Choose snacks such as fruit, raw veggie sticks, bean-based spreads like hummus or black bean dip, and raw unsalted nuts.
Whole grains are encouraged, such as brown rice or quinoa along with lean proteins such as chicken, lean pork, and fish.

How does the DASH diet lower blood pressure and promote weight loss?

The DASH diet is rich in potassium, magnesium, calcium, and fiber; and has a low content of sodium (salt) and saturated fat. Adding more of these nutrients improve the electrolyte balance in the body, allowing it to excrete excess fluid that contributes to high blood pressure. These nutrients also promote relaxation of the blood vessels, reducing blood pressure. These nutrients are often deficient in overweight and obese people, so the DASH diet can help correct those deficiencies and help people feel better. By itself, some people may lose weight with the DASH diet, but most will need to add exercise or further reduce carbohydrates to see big weight losses. The good news for people with diabetesprediabetes, or insulin resistance is that the DASH diet does improve insulin sensitivity.
The DASH diet guidelines from the original research study specified two levels of sodium reduction.
  • The DASH diet phase 1 limited sodium to 2300mg, or about 1 teaspoon per day.
  • The DASH diet phase 2 further reduced sodium to 1500mg.
To reach the goal of phase 2, the person should avoid all table salt and avoid adding any salt to cooking. We tend to get more than the recommended amount of sodium when we eat packaged or processed foods or when eating or dining out. Salt is the major source of sodium in the diet, and we can usually refer to the two words interchangeably unless we are discussing specific biochemical processes.

What foods and drinks should be avoided while following a DASH diet?

Foods and drinks to avoid when following the DASH diet include high sugar, high fat snacks, and foods high in salt such as:
  • Candy
  • Cookies
  • Chips
  • Salted nuts
  • Sodas
  • Sugary beverages
  • Pastries
  • Snacks
  • Meat dishes
  • Prepackaged pasta and rice dishes (excluding macaroni and cheese because it is a separate category)
  • Pizza
  • Soups
  • Salad dressings
  • Cheese
  • Cold cuts and cured meats
  • Breads and rolls
  • Sandwiches
  • Sauces and gravies
  • Soups
Using a salt substitute made with potassium not only works as a substitute in cooking and on the table, but the additional potassium can help lower blood pressure. People who are on blood pressure medications that increase potassium should ask their doctors to help them monitor the blood level of potassium (K) while they are making changes.

What about red meat and heart disease?
While not specifically recommended, grass-fed beef and buffalo would fit within these parameters. Grass-fed beef has a very different composition than conventional grain-fed beef. Grass-fed beef is high in omega-3s and is more similar to fish, nutritionally. Grain-fed red meat is high in omega 6s and saturated fat, both of which are promote inflammation and contribute to heart disease, high blood pressure, and obesity. Red meat that is not grass-fed is not allowed.

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