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DASH Diet: Healthy Eating For Lower Blood Pressure

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High blood pressure is a global health issue affecting more than a billion people worldwide and unfortunately that number continues to increase.

Over the past 40 years, the number of people with high blood pressure has doubled, raising serious concerns as it is closely linked to a higher risk of conditions such as heart disease, kidney failure, and stroke. Study 1, Study 2

Given the significant role of diet in the development of high blood pressure, researchers and policymakers have developed targeted dietary strategies to help combat this condition. Study 1, Study 2

This article provides an in-depth overview of the DASH diet, which is a carefully designed eating plan that aims to combat high blood pressure and to reduce the risk of heart disease.

What is the DASH diet?

Dietary Approaches to Stop Hypertension, commonly known as the DASH diet, is specifically recommended for people seeking to prevent or manage hypertension (high blood pressure) and reduce the risk of heart disease.

The foundation of the DASH diet consists of including fruits, vegetables, whole grains, and lean meats. This dietary approach was created by researchers, who noticed that people who followed a plant-based diet, such as vegans and vegetarians, had lower blood pressure. Study 1, Study 2

This is the reason that the DASH diet focuses on the consumption of fruits and vegetables, while also adding lean protein sources like chicken, fish, and beans. The DASH diet is low in added sugars, red meat, salt, and fat.

One of the main reasons why the DASH diet is believed to be beneficial for people with high blood pressure is the fact that it reduces salt intake. The standard DASH diet program recommends a daily sodium intake of no more than 1 teaspoon (2,300 mg), aligning with most national guidelines.

There is a lower-salt version of this diet, which recommends limiting sodium intake to no more than 3/4 teaspoon (1,500 mg) per day.

Potential benefits

In addition to its blood pressure-lowering effects, the DASH diet offers several potential benefits, such as weight loss and a decreased risk of cancer.

Nevertheless, it is important to note that the main purpose of the DASH diet is to address high blood pressure. Weight loss may be an additional benefit rather than its main focus.

The diet influences different aspects of your body in different ways.

Lowers blood pressure

Blood pressure is a measurement of the force put on your blood vessels and organs as blood flows through them. It is recorded using two numbers:

  • Systolic pressure: The pressure in your blood vessels when your heart beats.
  • Diastolic pressure: The pressure in your blood vessels between heartbeats, when your heart is at rest.

Normal blood pressure for adults is typically below 120 mmHg systolic and below 80 mmHg diastolic, often expressed as 120/80.

Individuals with a blood pressure reading of 140/90 are considered to have high blood pressure.

Interestingly, the DASH diet has been shown to effectively lower blood pressure in both healthy individuals and those with high blood pressure.

Different studies have found that even without weight loss or reduced salt intake, people following the DASH diet experienced lower blood pressure. Study 1, Study 2

However, when sodium intake was limited, while following the DASH diet, blood pressure was further decreased. Notably, the most significant reductions in blood pressure were observed in individuals with the lowest salt consumption. Study 1

For people with high blood pressure, the low-salt DASH diet showed impressive results, reducing systolic blood pressure by an average of 12 mmHg and diastolic blood pressure by 5 mmHg. Study 1

In people with normal blood pressure, the DASH diet led to a reduction of 4 mmHg in systolic blood pressure and 2 mmHg in diastolic blood pressure. Study 1

These findings align with other studies that clear show that restricting salt intake can effectively lower blood pressure, particularly in people with high blood pressure. Study 1

It is important to note, however, that while a decrease in blood pressure is beneficial, it does not automatically guarantee a decreased risk of heart disease. Study 1

May aid weight loss

Even if you don’t lose weight, adopting the DASH diet is likely to help you to lower blood pressure.

However, if you already have high blood pressure, healthcare professionals often recommend weight loss as an additional measure. This is because the more you weight the higher your blood pressure is. Study 1, Study 2, Study 3

Moreover, studies have shown that losing weight can effectively lower blood pressure as well. Study 1, Study 2

While some studies show that weight loss can happen while following the DASH diet, it’s important to note that weight loss in these cases was achieved through controlled calorie deficit which means that people were instructed to consume fewer calories than they expended. Study 1, Study 2, Study 3

Since the DASH diet focuses the consumption of nutrient-dense foods and restricts high-fat and sugary options, people may naturally reduce their calorie intake and experience weight loss. Others may need to consciously restrict their calorie intake. Study 1

If your goal is to lose weight while following the DASH diet, it is still recommended to follow a reduced-calorie eating plan.

Other potential health benefits

The DASH diet is not only beneficial for lowering blood pressure but also has a positive impact on many different areas of health. Some of the many notable effects of the DASH diet include:

  • Reduction in cancer risk: According to a recent review, people following the DASH diet had a lower risk of certain cancers, including colorectal and breast cancer (21Trusted Source).
  • Lowered risk of metabolic syndrome: Several studies have shown that the DASH diet can significantly reduce the risk of metabolic syndrome by up to 81%. Study 1, Study 2
  • Decreased risk of diabetes: The DASH diet has been linked with a lower risk of type 2 diabetes, with some studies suggesting improvements in insulin resistance as well. Study 1, Study 2
  • Reduced risk of heart disease: In a recent review focusing on women, following a DASH-like diet was linked to a 20% lower risk of heart disease and a 29% lower risk of stroke. Study 1

Many of these protective effects are attributed to the diet’s high content of fruits and vegetables in the DASH diet. In general, increasing the consumption of fruits and vegetables is known to reduce the risk of different diseases. Study 1, Study 2, Study 3, Study 4

Does it work for everyone?

Even though, research on the DASH diet has shown that people with the lowest salt intake experience the most significant reductions in blood pressure, the overall impact of salt restriction on health and lifespan remains uncertain.

Reducing salt intake has a substantial effect on blood pressure in people with high blood pressure. However, the effects of salt reduction in people with normal blood pressure are comparatively smaller. Study 1, Study 2

One possible explanation for this theory is the concept of salt sensitivity, where certain people are more responsive to the influence of salt on their blood pressure. Study 1

Restricting salt too much is not good for you

Consuming very low amounts of salt has been linked with certain health issues, including an increased risk of heart disease, insulin resistance, and fluid retention.

The low-salt version of the DASH diet advises people to limit their sodium intake to no more than 3/4 teaspoon (1,500 mg) per day.

However, it remains uncertain whether reducing salt intake to such low levels, has any benefits, even for people with high blood pressure. Study 1

Interestingly, a recent review revealed that there is no link between salt intake and the risk of death from heart disease, despite a small reduction in blood pressure resulting from lower salt intake.

However, considering that many people consume excessive amounts of salt, reducing salt intake from very high levels of 2–2.5 teaspoons 10–12g (grams) per day to 1–1.25 teaspoons 5–6g (grams) per day may be beneficial. Study 1

This target can be easily achieved by reducing the consumption of highly processed foods and prioritizing whole foods in your diet.

What to eat on the diet

The DASH diet does not provide a detailed list of specific foods to eat. Instead, it offers recommendations regarding the recommended servings of different food groups.

The number of servings you should eat depends on your calorie intake. Here is an example of food portions based on a 2,000-calorie daily diet:

Whole grains: 6–8 servings per day

Whole grains consist of a variety of options such as whole-wheat or whole-grain breads, whole-grain breakfast cereals, brown rice, bulgur, quinoa, and oatmeal.

Examples of appropriate serving sizes, include:

  • 1 slice of whole-grain bread
  • 1 ounce or 28g (grams) of dry, whole-grain cereal
  • 1/2 cup or 95g (grams) of cooked rice, pasta, or cereal.

Vegetables: 4–5 servings per day

The DASH diet allows all types of vegetables.

Examples of appropriate serving sizes, include:

  • 1 cup or 30g (grams) of raw, leafy green vegetables, such as spinach or kale.
  • 1/2 a cup or 45g (grams) of sliced vegetables, whether raw or cooked, such as broccoli, carrots, squash, or tomatoes.

Fruits: 4–5 servings per day

When following the DASH diet, you will be eating lots of fruits. There is a large variety of fruits to choose from, including apples, pears, peaches, berries, as well as tropical fruits like pineapple and mango.

Examples of appropriate serving sizes, include:

  • 1 medium-sized apple
  • 1/4 cup or 50g (grams) of dried apricots
  • 1/2 cup 30g (grams) of fresh, frozen, or canned peaches

Dairy products: 2–3 servings per day

Dairy products while following the DASH diet should be low in fat. Examples of suitable options include skim milk, low-fat cheese, and low-fat yogurt.

Examples of appropriate serving sizes, include:

  • 1 cup or 240ml (milliliter) of low-fat milk
  • 1 cup or 285g (grams) of low-fat yogurt
  • 1.5 ounces or 45g (grams) of low-fat cheese

Lean chicken, meat and fish: 6 or fewer servings per day

When it comes to meat consumption on the DASH diet, it is recommended to choose lean cuts of meat and limit the consumption of red meat to no more than once or twice a week.

Examples of appropriate serving sizes, include:

  • 1 ounce 28g (grams) of cooked meat, chicken, or fish
  • 1 egg

Nuts, seeds and legumes: 4–5 servings per week

The DASH diet promotes the consumption of various nuts and legumes, such as almonds, peanuts, hazelnuts, walnuts, sunflower seeds, flax seeds, kidney beans, lentils, and split peas.

Examples of appropriate serving sizes, include:

  • 1/3 cup or 50g (grams) (50 grams) of nuts
  • 2 tablespoons or 40g (grams) of nut butter
  • 2 tablespoons or 16g (grams) of seeds
  • 1/2 cup or 40g (grams) of cooked legumes

Fats and oils: 2–3 servings per day

As part of the DASH diet, vegetable oils are preferred over other types of oils. This includes options such as canola oil, corn oil, olive oil, and safflower oil. Additionally, the diet recommends the use of low-fat mayonnaise and light salad dressing.

Examples of appropriate serving sizes, include:

  • 1 teaspoon or 4.5g (grams) of soft margarine
  • 1 teaspoon or 5ml (milliliter) of vegetable oil
  • 1 tablespoon or 15g (grams) of mayonnaise
  • 2 tablespoons or 30ml (milliliter) of salad dressing

Candy and added sugars: 5 or fewer servings per week

To properly follow the DASH diet, it is important to minimize the consumption of added sugars. This means limiting your intake of sugary items such as candy, soda, and table sugar. The diet also restricts the use of unrefined sugars and alternative sweeteners, including agave nectar.

Examples of appropriate serving sizes, include:

  • 1 tablespoon or 12.5g (grams) of sugar
  • 1 tablespoon or 20g (grams) of jelly or jam
  • 1 cup or 240ml (milliliter) of lemonade

Sample menu for one week

Below is a sample one-week meal plan for the regular DASH diet, designed for a daily calorie intake of 2,000 calories:

Monday

  • Breakfast: 1 cup or 90g (grams) of oatmeal with 1 cup or 240ml (milliliter) of skim milk, 1/2 cup or 75g (grams) of blueberries, and 1/2 cup or 120ml (milliliter) of fresh orange juice.
  • Snack: 1 medium apple and 1 cup or 285g (grams) of low-fat yogurt.
  • Lunch: Tuna and mayonnaise sandwich made with 2 slices of whole-grain bread, 1 tablespoon or 15g (grams) of mayonnaise, 1.5 cups or 113g (grams) of green salad, and 3 ounces or 80g (grams) of canned tuna.
  • Snack: 1 medium banana.
  • Dinner: 3 ounces or 85g (grams) of lean chicken breast cooked in 1 teaspoon or 5ml (milliliter) of vegetable oil with 1/2 cup or 75g (grams) each of broccoli and carrots. Served with 1 cup or 190g (grams) of brown rice.

Tuesday

  • Breakfast: 2 slices of whole-wheat toast with 1 teaspoon or 4.5g (grams) of margarine, 1 tablespoon or 20g (grams) of jelly or jam, 1/2 cup or 120ml (milliliter) of fresh orange juice, and 1 medium apple.
  • Snack: 1 medium banana.
  • Lunch: 3 ounces or 85g (grams) of lean chicken breast with 2 cups or 150g (grams) of green salad, 1.5 ounces or 45g (grams) of low-fat cheese, and 1 cup or 190g (grams) of brown rice.
  • Snack: 1/2 cup or 30g (grams) of canned peaches and 1 cup or 285g (grams) of low-fat yogurt.
  • Dinner: 3 ounces or 8g (grams) of salmon cooked in 1 teaspoon or 5ml (milliliter) of vegetable oil with 1 cup or 300g (grams) of boiled potatoes and 1.5 cups or 225g (grams) of boiled vegetables.

Wednesday

  • Breakfast: 1 cup or 90g (grams) of oatmeal with 1 cup or 240ml (milliliter) of skim milk, 1/2 cup or 7g (grams) of blueberries, and 1/2 cup or 120ml (milliliter) of fresh orange juice.
  • Snack: 1 medium orange.
  • Lunch: 2 slices of whole-wheat bread, 3 ounces or 85g (grams) of lean turkey, 1.5 ounces or 45g (grams) of low-fat cheese, 1/2 cup or 38g (grams) of green salad, and 1/2 cup or 38g (grams) of cherry tomatoes.
  • Snack: 4 whole-grain crackers with 1.5 ounces or 45g (grams) of cottage cheese and 1/2 cup or 75g (grams) of canned pineapple.
  • Dinner: 6 ounces or 170g (grams) of cod fillet, 1 cup or 200g (grams) of mashed potatoes, 1/2 cup or 75g (grams) of green peas, and 1/2 cup or 75g (grams) of broccoli.

Thursday

  • Breakfast: 1 cup or 90g (grams) of oatmeal with 1 cup or 240ml (milliliter) of skim milk, 1/2 cup or 75g (grams) of raspberries, and 1/2 cup or 120ml (milliliter) of fresh orange juice.
  • Snack: 1 medium banana.
  • Lunch: Salad made with 4.5 ounces or 130g (grams) of grilled tuna, 1 boiled egg, 2 cups or 152g (grams) of green salad, 1/2 cup or 38g (grams) of cherry tomatoes, and 2 tablespoons or 30ml (milliliter) of low-fat dressing.
  • Snack: 1/2 cup or 30g (grams) of canned pears and 1 cup or 285g (grams) of low-fat yogurt.
  • Dinner: 3 ounces or 85g (grams) of pork fillet with 1 cup or 150g (grams) of mixed vegetables and 1 cup or 190g (grams) of brown rice.

Friday

  • Breakfast: 2 boiled eggs, 2 slices of turkey bacon, 1/2 cup or 38g (grams) of cherry tomatoes, 1/2 cup or 80g (grams) of baked beans, 2 slices of whole-wheat toast, and 1/2 cup or 120ml (milliliter) of fresh orange juice.
  • Snack: 1 medium apple.
  • Lunch: 2 slices of whole-wheat toast, 1 tablespoon of low-fat mayonnaise, 1.5 ounces or 45g (grams) of low-fat cheese, 1/2 cup or 38g (grams) of salad greens, and 1/2 cup or 38g (grams) of cherry tomatoes.
  • Snack: 1 cup of fruit salad.
  • Dinner: Spaghetti and meatballs made with 1 cup or 190g (grams) of spaghetti and 4 ounces or 115g (grams) of minced turkey, served with 1/2 cup or 75g (grams) of green peas.

Saturday

  • Breakfast: 2 slices of whole-wheat toast with 2 tablespoons or 40g (grams) of peanut butter, 1 medium banana, 2 tablespoons or 16g (grams) of mixed seeds, and 1/2 cup or 120ml (milliliter) of fresh orange juice.
  • Snack: 1 medium apple.
  • Lunch: 3 ounces or 85g (grams) of grilled chicken, 1 cup or 150g (grams) of roasted vegetables, and 1 cup or 190g (grams) of couscous.
  • Snack: 1/2 cup or 30g (grams) of mixed berries and 1 cup or 285g (grams) of low-fat yogurt.
  • Dinner: 3 ounces or 85g (grams) of pork steak with 1 cup or 150g (grams) of ratatouille, 1 cup or 190g (grams) of brown rice, 1/2 cup or 40g (grams) of lentils, and 1.5 ounces or 45g (grams) of low-fat cheese. Plus, a serving of low-fat chocolate pudding for dessert.

Sunday

  • Breakfast: 1 cup or 90g (grams) of oatmeal with 1 cup or 240ml (milliliter) of skim milk, 1/2 cup or 75g (grams) of blueberries, and 1/2 cup or 120ml (milliliter) of fresh orange juice.
  • Snack: 1 medium pear.
  • Lunch: Chicken salad made with 3 ounces or 85g (grams) of lean chicken breast, 1 tablespoon of mayonnaise, 2 cups or 150g (grams) of green salad, 1/2 cup or 75g (grams) of cherry tomatoes, 1/2 tablespoon or 4g (grams) of seeds, and 4 whole-grain crackers.
  • Snack: 1 banana and 1/2 cup or 7g (grams) of almonds.
  • Dinner: 3 ounces or 85g (grams) of roast beef with 1 cup or 150g (grams) of boiled potatoes, 1/2 cup or 75g (grams) of broccoli, and 1/2 cup or 75g (grams) of green peas.

It is important to note that portion sizes and specific food choices may be adjusted to fit individual preferences and dietary needs.

How to make your diet more DASH-like

To align your current diet with the DASH guidelines, you can make the following adjustments:

  • Eat more vegetables and fruits.
  • Replace refined grains with whole grains.
  • Choose for fat-free or low-fat dairy products.
  • Choose lean sources of protein such as fish, poultry, and beans.
  • Cook using vegetable oils.
  • Reduce your consumption of foods high in added sugars, such as soda and candy.
  • Limit your consumption of foods rich in saturated fats, such as fatty meats, full-fat dairy, and oils like coconut and palm oil.

Apart from measured portions of fresh fruit juice, make sure to prioritize low-calorie beverages like water, tea, and coffee.
By implementing these modifications, you can adapt your current diet to adhere to the DASH guidelines.

Frequently Asked Questions

We have provided answers to some of the frequently asked questions regarding aspects of your lifestyle when considering the DASH diet to lower blood pressure.

Can I drink coffee on the DASH diet?

The DASH diet does not provide specific guidelines for the consumption of coffee. However, some people may be concerned about the potential effects of caffeinated beverages like coffee on their blood pressure.

It is widely known that caffeine can lead to a temporary increase in blood pressure, especially in individuals with high blood pressure. This short-term rise in blood pressure typically lasts for a few hours. Study 1, Study 2, Study 3

However, a recent review found that although coffee does cause a temporary increase in blood pressure, it does not contribute to a long-term risk of high blood pressure or heart disease.

For most healthy individuals with normal blood pressure, it is generally considered safe to consume 3-4 regular cups of coffee per day. Study 1

It is important to note that individuals with pre-existing high blood pressure may need to be more careful and be mindful of their coffee consumption due to the slight elevation in blood pressure caused by caffeine (5-10 mm Hg).

Do I need to exercise on the DASH diet?

When combined with regular physical activity, the effectiveness of the DASH diet in reducing blood pressure is boosted. Study 1

This correlation is not surprising considering the individual benefits exercise provides for overall health.

It is recommended to do 30 minutes of moderate activity most days of the week. It is also important to choose an activity that you enjoy, as this increases the likelihood of not quitting.

Examples of moderate activities include:

  • Brisk walking at a pace of 15 minutes per mile or 9 minutes per kilometer.
  • Running at a pace of 10 minutes per mile or 6 minutes per kilometer.
  • Cycling at a pace of 6 minutes per mile or 4 minutes per kilometer.
  • Swimming laps for 20 minutes.
  • Housework for 60 minutes.

Adding physical activity into your routine alongside the DASH diet can contribute to even greater blood pressure-lowering benefits.

Can I drink alcohol on the DASH diet?

Excessive alcohol consumption has been associated with elevated blood pressure levels. Consistently consuming more than three drinks per day has been linked to an increased risk of high blood pressure and heart disease. Study 1, Study 2

When following the DASH diet, it is recommended to consume alcohol in moderation and follow the official guidelines. Men should limit their alcohol consumption to 2 or less drinks per day, while women should consume 1 or less drinks per day. By following these recommendations, you can maintain a balanced approach to alcohol consumption while supporting your blood pressure management efforts.

Conclusion

The DASH diet offers an easy and effective way to lowering blood pressure. However, it is important to note that reducing daily salt intake to 3/4 teaspoon (1,500 mg) or less has not been conclusively associated with specific health benefits, such as a reduced risk of heart disease, despite its ability to lower blood pressure.

Furthermore, the DASH diet shares many similarities with the standard low-fat diet, which, according to large controlled trials, has not been proven to reduce the risk of death from heart disease. Study 1, Study 2

For generally healthy people, there may be limited motivation to strictly follow the DASH diet. However, if you have high blood pressure or suspect that you are sensitive to salt, the DASH diet may be a great choice for you.

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