The DASH diet: How does it work?

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DASH diet’s key aim is to reduce high blood pressure. A person will consume fruit, vegetables, whole grain, low-fat dairy products, poultry, fish, nuts, and beans, but their consumption of red meat, fat, sugar, and salt will be reduced.

DASH dietary full name is Nutritional Strategies to Combat Hypertension. The diet was developed by doctors at the National Institutes of Health (NIH) to help people control blood pressure.

This is, however, an overall balanced eating program, which can help people lose weight.

Check out what the DASH diet is in this post, what it entails and how it can support a person’s health.

High blood pressure in the United States is a significant health problem. Read more here.

What is the DASH diet?

The key target of the DASH diet is not weight loss but blood pressure reduction. This can also help those who want weight loss, lower cholesterol, and control or avoid diabetes, however.

Important aspects include:

• portion size
• consuming a wide variety of healthful foods
• obtaining the proper balance of nutrients

DASH encourages a person to:

• eat less sodium (the key ingredient in salt)
• increase their intake of magnesium, calcium, and potassium

These strategies help lower blood pressure.

DASH is not a vegetarian diet as it includes more fruits and vegetables, low-fat or non-fat dairy foods, beans, nuts and other nutritious items.

It provides ideas for safe “junk food” alternatives and urges people to avoid processed foods.

Your guide to lowering your blood pressure with DASH, published by the NIH, provides useful information on how to switch to the DASH diet. This also offers meal plan samples and their nutritional qualities.

Health benefits

Low blood pressure, or excessive blood pressure, can increase the risk of heart attack, heart failure, stroke, and kidney disease.

Experts who reviewed the DASH diet in 2017, 20 years after its introduction, described it as an intervention which could significantly improve public health.

According to the study, if people with high blood pressure followed specifically the DASH diet, this could prevent about 400,000 cardiovascular disease deaths over 10 years.

Who can benefit?

According to an article published in 2019, people following the DASH diet will reduce the rates of:

• blood pressure
• blood sugar
• triglycerides, or fat, in the blood
• low-density lipoprotein (LDL), or “bad” cholesterol
• insulin resistance

These are all metabolic syndrome characteristics, a disorder that also includes obesity, type 2 diabetes and an elevated risk of cardiovascular disease.

A 2013 research investigated the effect of DASH on people with and without metabolic syndrome who adopted the eight weeks of diet.

On average the results showed that:

In people with metabolic syndrome, the systolic pressure fell by 4.9 millimeters of mercury (mm Hg), and the diastolic fell by 1.9 mm HG.

In people without metabolic syndrome, the systolic pressure fell by 5.2 mm Hg, and the diastolic fell by 2.9 mm Hg.

In other words, in people with or without metabolic syndrome, DASH may be effective in reducing blood pressure There is also evidence that colorectal cancer risk can be reduced and the overall life expectancy increased.

DASH is recommended for people with kidney disease by the National Kidney Foundation.

Understanding blood pressure

Systolic pressure is the blood pressure when the heart pumps blood and diastolic pressure is the pressure between beats while the heart is resting. A person with 120 mm Hg of systolic pressure and 80 mm Hg of diastolic pressure will have 120/80 mm Hg of reading.

Current American College of Cardiology guidelines define the following for blood pressure:

Normal: Below 120/80 mm Hg.

Elevated: Systolic is 120–129, and diastolic is below 80.

Stage 1 hypertension: Systolic is 130–139, and diastolic is 80–89.

Stage 2 hypertension: Systolic is 140 or above; diastolic is 90 or above.

Hypertensive crisis: Systolic is over 180; diastolic is over 120.

Will I lose weight?

Individuals on the DASH diet can lose weight but they don’t have to. When a person wants to lose weight, the National Heart Lung and Blood Institute (NHLBI) is suggesting a gradual reduction of calories.

Other tips for losing weight on DASH include:

• having small portions often during the day
• eating less meat and more fruits, vegetables, and whole grains
• choosing fruits or vegetables as a snack instead of candies or chips
• using the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)’s body weight planner
• using the calorie chart in the NHLBI’s DASH eating plan

Nutrition

The DASH diet is aimed at supplying nutrients which can help to reduce blood pressure.

Here are some of the features:

• It focuses on dietary patterns, rather than single nutrients.
• It emphasizes foods that are rich in antioxidants.

A person should aim to balance their nutrient intake as follows:

Total fat	27% of calories
Saturated fat	6% of calories
Protein	18% of calories
Carbohydrate	55% of calories
Cholesterol	150 mg per day
Sodium	1,500 mg or 2,300 mg, depending on the diet
Potassium	4,700 mg
Calcium	1,250 mg
Magnesium	500 mg
Fiber	30 g

Foods should be:

• low in saturated and trans fats
• rich in fiber, protein, magnesium, calcium, and potassium
• low in sodium

Fatty meat, full-fat dairy products, coconut oil, palm oil, and palm kernel oil are mainly saturated fats.

The DASH diet primarily focuses on plant-based ingredients, many of which are rich in antioxidants. Scientists claim that antioxidants, like heart disease, stroke, type 2 diabetes, and cancer, play a role in avoiding various health issues.

Sodium

The DASH diet calls for people to eat less sodium. Sodium is the main ingredient in table salt, which naturally appears in a variety of foods. The human body requires salt so it can cause sodium levels too high by adding salt to the diet. In some cases, this can increase blood pressure.

Two types of DASH diet

There are two versions of the DASH diet:

The Standard DASH diet: People consume up to 2,300 milligrams (mg) of sodium each day.

The Low Sodium DASH diet: The maximum sodium intake is 1,500 mg each day.

Most people in the US consume 3,600 mg or more of sodium per day, and all variations of the DASH diet seek to reduce sodium intake.

In a clinical trial to determine the effect of the diet, experts found that combining the DASH diet with a low intake of sodium has more impact on blood pressure than simply doing either of these acts.

As people reduce their salt consumption, more foods containing potassium should also be consumed. Potassium helps relax the blood vessels, so this can reduce blood pressure. People will be looking to eat 4,700 mg of potassium every day.

Foods that contain potassium include:

• dried fruit, such as apricots, prunes, and raisins
• lentils and kidney beans
• squash
• potato
• orange juice
• banana

A half-cup of dried apricots should provide around 30 percent of a person’s daily potassium requirement. A cup of cooked lentils accounts for 21%.

What you can eat

The DASH diet emphasizes:

• fresh fruits and vegetables
• low-fat dairy products
• whole grains
• some legumes, poultry, and fish
• small amounts of red meat, fats, and sweets

It is low in saturated fat, total fat, and cholesterol.

On a typical day on a 2,000 calorie-per-day DASH diet, a person might eat:

Grains: Portions 6–8. Sources include pasta, wheat, beans, and toast. One serving may be a slice of whole wheat bread, a half-cup of cooked pasta, rice or cereal, or one ounce (oz) of dry cereal.

Vegetables, particularly vegetables with a high fiber and vitamin content: 4–5 servings. Examples include sweet potatoes, broccoli, spinach, carrots or tomatoes. One serving may be a raw or cooked half-cup of vegetables, or a cup of fresh, green, leafy vegetables.

Fruit: 4–5 plates. They are high in minerals such as carbon, magnesium, potassium, vitamins and others. One serving can include a half-cup of fresh, canned, or frozen fruit, or a medium-fresh.

Low-fat or fat-free dairy food: 2–3 portions: Calcium, protein and vitamin D are given. One serving may include 1 cup of skim milk or milk which is 1% fat, 1.5 oz cheese, or 1 cup yogurt.

Meat, poultry, or lean meat: Up to six portions of 1 oz. Meats are rich in protein, B vitamins, zinc and other nutrients, but people adopting the DASH diet can reduce their meat intake and instead consume fruits and vegetables. One serving can include 1 oz of cooked, skinless poultry, lean meat or seafood, 1 egg, 1 oz of tuna, packed with water, with no added salt.

Nuts, legumes, seeds: 4–5 servings. Protein, potassium, magnesium, fibre, phytochemicals, and other essential nutrients are given here. Sunflower seeds, beans, peas, lentils, almonds, peanuts, and pistachios are only some examples.

Oils and good fats: 2–3 servings. Fat helps the body consume vital vitamins and other nutrients, and, among other functions, to strengthen the immune system. One serving can include 1 tbsp of margarine, 1 tbsp of low-fat mayonnaise, or 2 tbsp of light salad dressing.

Sweets: Up to 5 servings a week. The DASH diet does not exclude sweets but advises restricting their consumption. One serving could include 1 cup of lemonade, a half-cup of sorbet, 1 tbs of sugar, jam, or jelly.

The DASH diet recommends no more than two alcoholic drinks per day for males and one for females.

The amount of food will also depend on the energy needs of the person, and this will depend on their age, sex and levels of activity.

For example:

• A 51-year-old female who is not very active will need only 1,600 calories a day.
• A highly active 25-year-old male will need 3,000 calories.

Getting started

One benefit of DASH diet is that it allows for variety.

Dietitians have prepared special diet-friendly recipes like garden splendor chicken, delicious frittata, and spaghetti meaty sauce.

A variety of DASH diet cookbooks are available for online purchase.

Here are a few general hints:

• Make sure there is plenty of color on the plate.
• Include fruits, vegetables, and nonfat or low-fat dairy foods.
• Have at least two side dishes of vegetables.
• Prepare fruit-based desserts, rather than pastries.
• Focus on an overall eating plan, rather than specific dishes, to get a variety of nutrients.

The NHLBI suggests transitioning for a few days or weeks to the DASH diet, slowly adding more vegetables and cutting back on fatty foods until it becomes a part of the everyday routine.

Q:

I want to follow this diet, but the rest of my family don’t need to lower their blood pressure. Is DASH a good choice us all to follow?

A:

Yes! DASH diet is not only good for patients with high blood pressure, but it’s also good for prevention and health maintenance. Miho Hatanaka, RDN, L.D.

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.