Dietary Approaches to Stop Hypertension (The DASH Diet)

What is hypertension?

Hypertension is blood pressure that keeps being higher than normal. 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 above 120/80. The higher your blood pressure, the greater the health risk.

High blood pressure can be controlled if you take these steps:

• Maintain a healthy weight.
• Are physically active.
• Follow a healthy eating plan, which includes foods that do not have a lot of salt and sodium.
• Do not drink a lot of alcohol.

Diet affects high blood pressure. Following the DASH diet and reducing the amount of sodium in your diet will help lower your blood pressure. It will also help prevent high blood pressure.

What is the DASH diet?

Dietary Approaches to Stop Hypertension (DASH) is a diet that is low in saturated fat, cholesterol, and total fat. It emphasizes fruits, vegetables, and low-fat dairy foods. The DASH diet also includes whole-grain products, fish, poultry, and nuts. It encourages fewer servings of red meat, sweets, and sugar-containing beverages. It is rich in magnesium, potassium, and calcium, as well as protein and fiber.

How do I get started on the DASH diet?

The DASH diet requires no special foods and has no hard-to-follow recipes. Start by seeing how DASH compares with your current eating habits.

The DASH eating plan illustrated below is based on a diet of 2,000 calories a day. Your healthcare provider or a dietitian can help you determine how many calories a day you need. Most adults need somewhere between 1600 and 2800 calories a day. Serving sizes for different foods vary from 1/2 cup to 1 and 1/4 cups. Check product nutrition labels for serving sizes and the number of calories per serving.

 
                Number of        Examples of
Food Group      servings         serving size
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Grains and      7 to 8 per day   1 slice of bread
grain products                   1 cup ready-to-eat cold cereal
                                 1/2 cup cooked rice, pasta,
                                 or cereal

Vegetables      4 to 5 per day   1 cup raw leafy vegetable
                                 1/2 cup cooked vegetable
                                 6 ounces (oz) vegetable juice


Fruits          4 to 5 per day   1 medium fruit
                                 1/4 cup dried fruit
                                 1/2 cup fresh, frozen, or
                                 canned fruit
                                 6 oz fruit juice


Low-fat or      2 to 3 per day   8 oz milk
fat-free                         1 cup yogurt
dairy foods                      1 and 1/2 oz cheese

Lean meats,
poultry,        2 or fewer per   3 oz cooked lean meat,
or fish         day              skinless poultry, or fish

Nuts, seeds,    4 to 5 per week  1/3 cup or 1 and 1/2 oz nuts
and dry beans                    1 tablespoon or 1/2 oz seeds
                                 1/2 cup cooked dry beans

Fats and oils   2 to 3 per day   1 teaspoon soft margarine
                                 1 tablespoon low-fat mayonnaise
                                 2 tablespoons light salad
                                 dressing
                                 1 teaspoon vegetable oil

Sweets          5 per week       1 tablespoon sugar
                                 1 tablespoon jelly or jam
                                 1/2 oz jelly beans
                                 8 oz lemonade
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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.
• If you have not been eating fruit regularly, or have only juice at breakfast, add a serving to your meals or have it as a snack.
• Drink milk or water with lunch or dinner instead of soda, sugar-sweetened tea, or alcohol. Choose low-fat (1%) or fat-free (nonfat) dairy products so that you are eating fewer calories and less saturated fat, total fat, and cholesterol.
• Read food labels on margarines and salad dressings to choose products lowest in fat.
• If you now eat large portions of meat, slowly cut back--by a half or a third at each meal. Limit meat to 6 ounces a day (two 3-ounce servings). Three to 4 ounces is about the size of a deck of cards.
• Have 2 or more meatless meals each week. Increase servings of vegetables, rice, pasta, and beans in all meals. Try casseroles, pasta, and stir-fry dishes, which have less meat and more vegetables, grains, and beans.
• Use fruits canned in their own juice. Fresh fruits require little or no preparation. Dried fruits are a good choice to carry with you or to have ready in the car.
• Try these snacks ideas: unsalted pretzels or nuts mixed with raisins, graham crackers, low-fat and fat-free yogurt or frozen yogurt, popcorn with no salt or butter added, and raw vegetables.
• Choose whole-grain foods to get more nutrients, including minerals and fiber. For example, choose whole-wheat bread, whole-grain cereals, or brown rice.
• Use fresh, frozen, or no-salt-added canned vegetables.

Remember to also reduce the salt and sodium in your diet. Try to have no more than 2000 milligrams (mg) of sodium per day, with a goal of further reducing the sodium to 1500 mg per day. Three important ways to reduce sodium are:

• Eat food products with reduced-sodium or no salt added.
• Use less salt when you prepare foods and do not add salt to your food at the table.
• Read food labels. Aim for foods that contain less than 5% of the daily value of sodium.

The DASH eating plan is not designed for weight loss. But it contains many lower-calorie foods, such as fruits and vegetables. You can make it lower in calories by replacing high-calorie foods with more fruits and vegetables. Some ideas to increase fruits and vegetables and decrease calories include:

• Eat a medium apple instead of 4 shortbread 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's 3 ounces instead of 6 ounces. 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 condiments, such as fat-free salad dressings.
• Eat smaller portions. Cut back gradually.
• 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 National Heart, Lung, and Blood Institute Web site at: http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/.