High blood pressure affects nearly half of American adults and can lead to heart disease, stroke, and other health complications. While medication is often necessary to control hypertension, lifestyle changes like diet can also make a significant impact.
The DASH (Dietary Approaches to Stop Hypertension) diet has been scientifically proven to lower blood pressure levels and provide additional health benefits. Read on to learn what exactly the DASH diet is, how it works to reduce hypertension, tips for following it, and how it stacks up against other healthy eating plans.
What is the DASH Diet?
The DASH diet is a nutritional approach focused on reducing sodium intake and eating more fruits, vegetables, whole grains, lean protein, nuts, and low-fat dairy.
Originally developed by the National Heart, Lung, and Blood Institute (NHLBI), this eating pattern has been ranked #1 for best overall diet by U.S. News and World Report for 11 years straight.
The DASH diet is not a formal diet plan you need to purchase. Instead, it provides evidence-based guidelines to follow for long-term health. The goal is to change overall dietary habits rather than follow a short-term fix.
A Brief History
Research on the DASH diet began in the early 1990s in an effort to find non-pharmacological ways to treat high blood pressure. Previous studies had already shown that reducing sodium intake could lower blood pressure, but only to a small degree.
Scientists wanted to test whether dietary changes beyond just sodium reduction could lower hypertension more substantially. The first DASH trial was published in 1997 and found that the DASH diet lowered blood pressure significantly compared to a typical American diet.
Since then, numerous studies have confirmed the benefits of the DASH approach for heart health. Modifications like limiting sodium have made the diet even more effective. Today, the DASH diet is recommended by leading health organizations like the American Heart Association for managing blood pressure.
Key Principles
The DASH diet is focused on eating real, whole foods while limiting processed items, sugar, and unhealthy fats.
The core principles include:
- Emphasizing fruits, vegetables, whole grains, lean protein, nuts, and low-fat dairy
- Minimizing saturated fat, added sugars, and sodium
- Focusing on nutrient-dense foods high in potassium, calcium, protein, fiber, and magnesium
- Avoiding highly processed snack foods and beverages
- Paying attention to portion sizes and calorie needs
The DASH diet is flexible and balanced. No food groups are completely off limits, but the focus is on healthy whole foods consumed in moderation.
DASH Diet Guidelines: Foods to Eat and Limit
The DASH diet recommends optimal serving ranges across various food groups. Here’s a closer look at the dietary guidelines:
Fruits and Vegetables
Fruits and vegetables take center stage in the DASH diet, with a recommendation of 4-5 servings of each per day. This adds up to roughly 9-12 total servings of produce.
One serving is equivalent to:
- 1 cup raw leafy greens
- 1/2 cup cooked vegetables
- 1/2 cup fresh, frozen, or canned fruits
- 1 medium whole fruit like an apple or orange
Fruits and vegetables are emphasized because they provide vitamins, minerals, fiber, and phytochemicals that support good health. Potassium found in produce helps counterbalance sodium to lower blood pressure.
Focus on eating a rainbow of colors and choose options low in added sugar, like fresh or frozen fruit instead of fruit canned in syrup.
Whole Grains
Whole grains provide important nutrients like fiber, B vitamins, iron, and magnesium. At least half of your grain intake should come from whole grain sources, ideally 6-8 servings daily.
One serving is equal to:
- 1 slice of 100% whole grain bread
- 1 ounce uncooked whole grain pasta or brown rice
- 1⁄2 cup cooked whole grains like oatmeal, quinoa, or barley
- 5-6 whole grain crackers
Read labels carefully and choose products marked “100% whole grain” or “100% whole wheat.” Beware of imposters like “wheat bread” that is often not fully whole grain. Limit refined grains like white bread, white rice, and baked goods.
Lean Protein
Protein foods are important for building muscles and supporting healthy aging. The DASH diet recommends 2 or fewer 3-4 ounce servings of lean protein daily.
Good sources include:
- Skinless chicken or turkey
- Lean cuts of beef or pork
- Fish and seafood
- Tofu, tempeh, edamame
- Eggs
- Beans and lentils
Nuts, seeds, and soy products also contain protein. Choose lower fat options like grilling, roasting, or baking instead of frying meats. Limit processed meats like deli slices, sausages, and hot dogs which are high in sodium.
Low-Fat Dairy
Dairy provides protein, calcium, vitamin D, and potassium. The DASH diet advises 2-3 servings of low-fat dairy per day.
One serving equals:
- 1 cup milk or yogurt
- 1.5 ounces cheese (~ size of 3 dice)
Opt for skim (non-fat) or 1% milk and low-fat cheeses and yogurt. Higher fat versions are allowed sparingly for flavor. Limit sour cream, cream, and other full-fat dairy.
Nuts, Seeds, and Legumes
Nuts, seeds, and legumes (like beans and lentils) are great sources of protein, fiber, vitamins, and minerals. Aim for 4-5 servings per week, roughly 1/3 cup per serving.
Some healthy options include:
- Almonds, walnuts, pecans, peanuts
- Sunflower or pumpkin seeds
- Kidney beans, chickpeas, black beans
- Lentils, split peas, edamame
Choose unsalted nuts and seeds to help reduce sodium intake. Rinse canned beans to lower sodium as well.
Fats and Added Sugars
While no foods are strictly off limits, the DASH diet advises limiting added fats and sugars. Solid fats provide empty calories without nutritional benefits. Common sources to reduce include:
- Butter, lard, bacon fat
- Cream, hydrogenated oils
- Coconut or palm oil
- Fatty cuts of meat
- Full-fat cheese and ice cream
Swap healthy fats like olive oil, avocado, nuts, and seeds instead. Added sugars in processed foods, syrups, and sweetened beverages should also be minimized.
Sodium Reduction
Perhaps the most important guideline is slashing sodium intake. The standard DASH target is no more than 2,300 mg of sodium per day. However, lowering to 1,500 mg daily provides maximum blood pressure reduction.
The average American consumes a whopping 3,400 mg sodium per day. Processed foods and restaurant meals are major contributors. To reduce sodium:
- Limit processed snack foods, canned goods, frozen meals, fast food
- Choose fresh, unsalted nuts and seeds
- Remove salt shaker from the table
- Use herbs, spices, vinegar, citrus instead of salt for flavor
- Rinse canned items like beans to remove sodium
- Check labels and opt for low-sodium versions
- Request no added salt when dining out
Other Nutrients
In addition to the food group targets, the DASH diet emphasizes getting adequate potassium, calcium, and magnesium which help regulate blood pressure:
- Potassium: Shoot for 4,700mg daily, found in fruits, vegetables, dairy, fish, and beans.
- Calcium: 1,000-1,200mg per day from low-fat dairy, leafy greens, or supplements.
- Magnesium: 350-500mg a day from whole grains, nuts, seeds, beans, and green leafy vegetables.
The Science Behind DASH: Why It Lowers Blood Pressure
Study after study has proven the DASH approach successfully reduces hypertension. But why? Here are the key mechanisms:
Slashes Sodium, Boosts Potassium
Sodium causes blood pressure to rise by increasing fluid retention and vessel constriction. Potassium counters sodium, allowing blood vessels to relax. The DASH diet’s dramatic reduction in sodium coupled with higher potassium intake from fruits and veggies strikes the right balance to reduce hypertension.
Provides Vasodilating Nutrients
The DASH diet provides plentiful sources of calcium, magnesium, and antioxidants. These nutrients relax blood vessels and improve blood flow, lowering blood pressure.
Reduces Arterial Stiffness
Fiber and antioxidants from fruits and vegetables improve arterial function and make vessels more flexible and elastic. This reduces stiffness allowing blood to flow more freely.
Fights Inflammation and Oxidative Stress
Inflammation and oxidative damage are underlying factors in hypertension. The natural antioxidants and phytochemicals found abundantly in the DASH diet fight these processes and support healthy blood pressure.
Promotes Weight Loss
Excess weight strains the cardiovascular system, increasing blood pressure. By focusing on low calorie, high fiber foods, the DASH diet helps manage weight, which takes pressure off the circulatory system.
Benefits Beyond Lowering Blood Pressure
The DASH diet targets high blood pressure, but benefits many other aspects of health by focusing on nutritious whole foods.
Supports Heart Health
In addition to lowering hypertension, the DASH diet has been shown to:
- Decrease LDL (bad) cholesterol and triglycerides
- Reduce atherosclerosis and blood clotting
- Lower risk of heart failure, heart attack, and stroke
This adds up to phenomenal heart protective effects. The DASH diet can be an important part of cardiac rehabilitation and secondary prevention after a cardiac event.
Aids Weight Loss and Maintenance
Despite not strictly being a weight loss diet, the DASH approach is ranked one of the best diets for weight management.
By emphasizing fruits, veggies, whole grains, and lean proteins, it helps reduce calorie intake. The high fiber content also promotes satiety and prevents overeating.
One study found women following the DASH diet lost weight and reduced waist circumference comparable to being on a formal weight loss diet. The DASH diet provides a healthy lifelong approach to maintaining an ideal weight.
Fights Diabetes
Multiple studies demonstrate the DASH diet lowers the risk of developing type 2 diabetes by 20-30%. It also improves blood glucose control and insulin sensitivity in those already diagnosed. This makes it an optimal diet for diabetes management.
Protects Brain Health
The DASH diet reduces risk of cognitive decline, dementia, and Alzheimer’s disease. Participants score consistently higher on assessments of memory and mental performance. The brain protective effects are attributed to improved cardiovascular health from the DASH diet.
May Help Fight Cancer
Emerging research indicates following the DASH diet may lower the risk of certain cancers including colorectal, breast, lung, and prostate cancers. It’s believed that the high antioxidant content and nutrients like calcium provide anti-cancer effects. More studies are underway.
Reduces Metabolic Syndrome
Metabolic syndrome refers to a cluster of conditions including hypertension, high blood sugar, unhealthy cholesterol levels, and excess body fat around the waist. By improving all of these factors, the DASH diet successfully reduces metabolic syndrome.
As you can see, the benefits of this diet go far beyond just lowering high blood pressure!
How to Follow the DASH Diet: Tips and Meal Plan Examples
Implementing the DASH diet may seem daunting initially. But the guidelines translate into simple, everyday actions you can easily build into your routine.
Meal Planning Tips
- Plan weekly menus incorporating the recommended servings of each food group. This helps ensure you stay on track.
- Cook extra grains, beans, vegetables so you have healthy leftovers for lunches.
- Do meal prep like washing and chopping veggies in advance.
- Keep fresh fruit visible on the counter and vegetables prepped in the fridge for easy grabbing.
- Make your own salad dressings and dips using healthy oils, herbs and spices to avoid excess sodium.
- Choose one night a week to cook a big batch of whole grains or beans to use throughout the week in various dishes.
- Eat snacks like fresh fruit, nuts, seeds, and yogurt to fill hunger between meals rather than less healthy options.
- When eating out, ask for sauces and dressings on the side and request less sodium.
Sample Daily Meal Plan
Here is an example day following DASH diet guidelines:
Breakfast:
- 1 cup oatmeal cooked with 1 cup nonfat milk and 1⁄2 cup blueberries
- 1 slice 100% whole wheat toast with 2 tsp natural peanut butter
- 1 cup coffee
Lunch:
- Turkey and avocado sandwich on 2 slices whole grain bread with lettuce, tomato, onion and mustard
- Sweet potato hash browns baked with a dash of paprika
- 1 cup green salad with balsamic vinaigrette
- 1 orange
Dinner:
- 3 ounces baked salmon
- 1 cup quinoa
- 1 cup steamed broccoli and carrots
- Garden salad with oil and vinegar
Snacks:
- 1⁄4 cup mixed nuts
- 6 ounces nonfat Greek yogurt with cinnamon
- Baby carrots and hummus
Lifestyle Modifications
Compliment the DASH diet with these lifestyle adjustments:
- Exercise regularly: Aim for at least 30 minutes per day of moderate activity like brisk walking to improve cardiovascular health.
- Lose weight if overweight/obese: Gradually work to get to a healthy BMI through the DASH diet and exercise. Even small amounts of weight loss create benefits.
- Quit smoking: Smoking raises blood pressure. Kicking the habit improves the effectiveness of the DASH diet.
- Limit alcohol: Moderate alcohol consumption does not need to be avoided completely. But heavy drinking can contribute to hypertension, so drink only light-moderately if you indulge.
- Manage stress: Chronic stress takes a toll on the body and hormones which influence blood pressure. Make time to relax and practice activities like yoga, meditation, or deep breathing.
- Monitor progress: Check your blood pressure regularly to assess if adjustments to medications or lifestyle are needed for better control.
How Does the DASH Diet Compare to Other Heart-Healthy Plans?
The DASH diet shares similarities with other proven healthy eating patterns, like the Mediterranean diet. But there are some key differences in their approaches.
DASH Diet vs. Mediterranean Diet
The Mediterranean diet emphasizes fruits, vegetables, whole grains, beans, nuts, healthy fats like olive oil, seafood, herbs and spices. It limits red meat, sweets, and processed foods.
Similarities:
- Both diets focus on produce, lean proteins, whole grains.
- They limit processed foods, added sugar, unhealthy fats.
- Emphasis on heart-healthy fats like olive oil and avocados.
Differences:
- DASH has specific daily nutrient targets. Mediterranean is more general healthy eating.
- DASH restricts sodium substantially more.
- DASH includes low-fat dairy. Mediterranean uses more full-fat cheese and yogurt.
- Mediterranean incorporates more fish, seafood and legumes.
Both provide immense heart benefits, but the DASH diet may have an added advantage for lowering high blood pressure.
The DASH-Sodium Diet
The DASH-Sodium diet is a variation specifically limiting sodium to 1,500mg per day. Compared to standard DASH:
- Lowers sodium further for maximum blood pressure reduction
- Typically avoids adding any salt in cooking or at the table
- Focuses even more on fresh, unprocessed foods
- Requires close label reading and preparation from scratch
- Difficult to maintain long-term for most people
For those with resistant hypertension, starting with standard DASH and shifting to the lower sodium DASH plan can provide extra improvement under medical supervision. But for most, standard DASH with 2,300mg sodium cap is more sustainable.
Reap the Rewards of the DASH Diet
The DASH diet provides a proven solution to reduce high blood pressure and promote overall health through lifelong dietary changes. With its flexibility and balance, it is more achievable to stick to than restrictive fad diets.
Focus on making gradual shifts like including more fruits and vegetables, prioritizing whole grains, and choosing fresh foods over processed convenience items. Be sure to restrict sodium intake to really get hypertension lowering benefits.
Pair the DASH diet with regular activity, weight management, stress relief and other positive lifestyle adjustments for a multi-pronged approach to combat high blood pressure.
With some meal planning creativity and commitment to new habits, the DASH diet can get your blood pressure under control and provide far-reaching health advantages for years to come.
Frequently Asked Questions about the DASH Diet
What are the guidelines for sodium intake on the DASH diet?
The recommended sodium limit on the standard DASH diet is 2,300 mg per day, which is the upper tolerable intake level recommended by health organizations. An even lower sodium intake of 1,500 mg per day provides maximum blood pressure reduction, but is less realistic for most people long-term. Focus on choosing fresh, unprocessed foods and avoiding adding extra salt whenever possible.
Is the DASH diet appropriate for weight loss?
The DASH diet was not designed specifically for weight loss, but it does encourage eating lower calorie foods that can aid weight management. By focusing on produce, whole grains, lean proteins and low-fat dairy, the DASH diet helps reduce overall caloric intake. The high fiber foods also promote satiety. Those looking to lose weight should pay attention to portion sizes and calorie targets in addition to following DASH guidelines.
What if I don't like or can't eat certain recommended DASH foods?
The great thing about the DASH diet is that no food groups are completely eliminated. There is flexibility to make substitutions based on your personal tastes and health needs. Don't like fish? Choose another lean protein like chicken or beans instead. Can't tolerate dairy? Try plant-based milk alternatives enriched with calcium and vitamin D. Work with your healthcare provider to adapt the diet as needed.
How does the DASH diet affect cholesterol levels?
Studies show the DASH diet lowers LDL (bad) cholesterol by an average of 10% while maintaining healthy HDL (good) cholesterol. The reduction in saturated fat and emphasis on healthy fats like olive oil, avocados and nuts contributes to improved cholesterol levels. Less sodium intake and more potassium also play a role. The DASH diet is very heart protective beyond just reducing hypertension.
What if I am already on blood pressure medication?
The DASH diet can complement medication treatment for high blood pressure. Lifestyle modifications boost the effectiveness of antihypertensive drugs. In some cases, the DASH diet combined with weight loss, exercise and other healthy habits can allow for lower medication dosages over time if blood pressure improves under medical guidance. But do not stop taking prescribed blood pressure medications unless advised by your healthcare provider.
How long does it take to see blood pressure changes on the DASH diet?
Research shows blood pressure starts to lower within 2 weeks of starting the DASH diet, with the maximum reduction occurring after 4-8 weeks. The benefits continue as long as the diet is maintained. Keep in mind that blood pressure fluctuates daily, so monitor long-term changes rather than expect an immediate dramatic drop. Patience and consistency are key.
What are good low-sodium flavor boosters to use on the DASH diet?
Herbs, spices, citrus juices, vinegars, mustard, and hot sauces are great ways to add flavor without salt. Build up your spice cabinet with basil, oregano, rosemary, cumin, turmeric, cinnamon, paprika, ginger, garlic, and chili powder. Lemon, lime, orange, rice vinegar, balsamic vinegar, apple cider vinegar and wine vinegars provide tangy brightness. Mustard, hot sauce, and a dash of oil also enhance flavor. Get creative with blend
How can I make the DASH diet more affordable?
choosing fruits and vegetables that are in-season to save money. Buying store brand or generic labels is cheaper than name brands. Opt for frozen or canned produce and beans to reduce costs while still getting nutritional benefits. Cook a big batch of whole grains or beans to use throughout the week in various meals. Meal planning helps reduce food waste and impulse purchases too. Finally, making coffee or tea at home rather than purchasing them daily helps trim expenses.
What are good snacks on the DASH diet?
The DASH diet includes room for healthy snacks between meals. Good options include fresh fruit, raw veggies with hummus, nuts, seeds, Greek yogurt, cottage cheese, hard boiled eggs, whole grain toast with natural peanut butter, and air-popped or light popcorn. Prepare snacks ahead of time so you aren't tempted by less healthy convenience items. Portion snacks into baggies or containers for grab-and-go ease.
Are alcoholic beverages allowed on the DASH diet?
Alcohol should be consumed in moderation, if at all, when following the DASH diet. While moderate drinking does not need to be avoided completely, heavy alcohol intake can negatively impact blood pressure. Women should limit to 1 drink or less per day and men 1-2 drinks maximum. Also, be mindful of calories from mixers and sugars in cocktails which should be minimized. Going easy on alcohol supports getting the best blood pressure reduction.