This information is not intended to diagnose, treat, or replace the advice provided by your primary care physician. Seek medical care before beginning a new treatment regimen.
What Is the DASH Diet?
Scientists supported by the National Heart, Lung, and Blood Institute (NHLBI) tested nutrients as they occur together in food. The results were dramatic. The study found that elevated blood pressures can be reduced with an eating plan low in saturated fat, total fat, and cholesterol, and rich in fruits, vegetables, and lowfat dairy foods. The plan is rich in magnesium, potassium, and calcium, as well as protein and fiber.
DASH compared three eating plans:
1) A plan similar in nutrients to what many Americans consume
2) A plan similar to what Americans consume but higher in fruits and vegetables
3) A "combination" plan--the DASH diet--lower in saturated fat, total fat, and cholesterol, and rich in fruits, vegetables, and lowfat dairy foods
All three plans used about 3,000 milligrams of sodium daily--about 20 percent below the U.S. average for adults. None of the plans was vegetarian or used specialty foods. Results showed that both the fruit/vegetable and combination plans reduced blood pressure, but the combination plan had the greatest effect. The DASH eating plan reduced blood pressure by an average of about 6 mm Hg for systolic and 3 mm Hg for diastolic. It worked even better for those with high blood pressure--the systolic dropped on average about 11 mm Hg and the diastolic about 6 mm Hg. Further, the reductions came fast--within 2 weeks of starting the eating plan.
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How Do I Make the DASH?
Following the DASH Diet gives the servings and food groups for the DASH eating plan. The number of servings you need may vary, depending on your caloric need.
You should be aware that the DASH plan has more daily servings of fruits, vegetables, and grains than you may be used to eating. This makes it high in fiber, which can cause bloating and diarrhea. To get used to the new eating plan, gradually increase your servings of fruits, vegetables, and grains.
The DASH eating plan is rich in various nutrients believed to benefit blood pressure and in other factors involved in good health. The amounts of the nutrients vary by how much you eat. If you eat about 2,000 calories a day on the plan, the nutrients you get will include:
4,700 milligrams of potassium
500 milligrams of magnesium
1,240 milligrams of calcium
Those totals are about two to three times the amounts most Americans get.
The DASH eating plan makes it easier to consume less salt and sodium, because it is rich in fruits and vegetables, which are lower in sodium than many other foods. You can also keep salt and sodium down by using fewer already prepared foods and less salt at the table and in cooking. The next phase of the study--called DASH2--is examining the relationship between blood pressure, eating patterns, and a reduced sodium intake. It should yield important findings about how much sodium and salt is advisable to prevent or control high blood pressure when using the DASH eating plan.
The DASH plan requires no special foods and has no hard-to-follow recipes. One way to begin is by seeing how DASH compares with your current food habits.Remember that some days you may eat more than what's recommended from one food group and less of another. But don't worry. Just be sure that the average of several days or a week comes close to what's recommended.
One note: It's important that, if you have high blood pressure and take a medication, you should not stop your therapy. Use the DASH diet and talk about your drug treatment with your doctor.
The DASH eating plan shown below is based on 2,000 calories a day. The number of daily servings in a food group may vary from those listed depending on your caloric needs.
Use this chart to help you plan your menus or take it with you when you go to the store.
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Tips on Eating the DASH Diet Way
1) Make it easier to increase your servings of fruits and vegetables to eight a day by trying to have two servings of fruits and/or vegetables at each meal. For instance, for lunch have one fruit and one vegetable. Then add one fruit and one vegetable as snacks.
2) To increase your dairy servings to three a day, try to have one lowfat or fat free dairy serving at each meal. If you have trouble digesting dairy products, try taking lactase enzyme pills or drops (available at drugstores and groceries) with the dairy foods. Or, buy lactose free milk or milk with lactase enzyme added to it.
3) Choose whole grain foods to get added nutrients, especially the B vitamins. For example, choose whole wheat bread or whole grain cereals.
4) Use the percent Daily Value on food labels to compare products and choose those lowest in saturated fat, total fat, cholesterol, and sodium.
5) Feed your craving for sweets with fresh or dried fruit or fruit-flavored gelatin.
6) Use fresh, frozen, canned, or dried fruits.
7) Use fresh, frozen, or no-salt-added canned vegetables.
8) Change gradually. If you now eat one or two vegetables a day, add a serving at lunch and another at dinner.
If you don't eat fruit now or have only juice at breakfast, add a serving to your meals or have it as a snack.
Use only half the butter, margarine, or salad dressing you do now. Try lowfat or fat free condiments, such as fat free salad dressings. Gradually increase dairy products to three servings per day. For example, drink milk with lunch or dinner, instead of soda, alcohol, or sugar-sweetened tea. Choose lowfat (1 percent) or fat free (skim) dairy products to reduce total fat intake. Treat meat as one part of the whole meal, instead of the focus.
Buy less meat. If it's not there, you won't eat it. Limit meat to 6 ounces a day (two servings)--all that's needed. Three to four ounces is about the size of a deck of cards. If you now eat large portions of meat, cut them back gradually--by a half or a third at each meal. Include two or more vegetarian-style (meatless) meals each week.
Increase servings of vegetables, rice, pasta, and dry beans in meals. Try casseroles and pasta, and stir-fry dishes, having less meat and more vegetables, grains, and dry beans. Use fruits or lowfat foods as desserts and snacks.
Fruits and lowfat foods offer great taste and variety. Use fruits canned in their own juice. Fresh fruits require little or no preparation. Dried fruits are easy to carry with you.
Try these snack ideas: unsalted pretzels or nuts mixed with raisins; graham crackers; lowfat and fat free yogurt and frozen yogurt; plain popcorn with no salt or butter added; and raw vegetables.
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Making the DASH to Good Health
The DASH plan is a new way of eating--for a lifetime. If you slip from the eating plan for a few days, don't let it keep you from reaching your health goals. Get back on track. Here's how:
Ask yourself why you got off-track. Was it at a party? Were you feeling stress at home or work? Find out what triggered your sidetrack--and start again with DASH.
Don't worry about a slip. Everyone slips--especially when learning something new. Remember that changing your lifestyle is a long-term process.
See if you tried to do too much at once. Often, those starting a new lifestyle try to change too much at once. Instead, change one or two things at a time. Slowly but surely is the best way to succeed.
Break the process down into small steps. This not only keeps you from trying to do too much at once but also keeps the changes simpler. Break complex goals into smaller, simpler steps, each of which is attainable.
Write it down. Keep track of what you eat. This can help you find the problem. Besides noting what you eat, also record: where you are, what you're doing, and how you feel. Keep track for several days. You may find, for instance, that you eat high fat foods while watching television. If so, you could start keeping a substitute snack on hand to eat instead of the high fat foods. This record also helps you be sure you're getting enough of each food group.
Celebrate success. Treat yourself to a non-food treat for your accomplishments.
Want to Learn More?
"National Heart, Lung, and Blood Institute. NIH Publication No. 98-4082. Facts About the DASH Diet, September 1998. (Online) http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/."
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