The DASH Diet

This eating plan is meant for those with elevated blood pressure.  It also is a heart-healthy plan.

High blood pressure can be controlled by the following steps: lose weight, if overweight; become physically active; eat healthy, including choosing foods lower in salt and sodium; limit alcohol intake; and, if prescribed, take high blood pressure pills.

"DASH" for Dietary Approaches to Stop Hypertension, 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 low-fat dairy foods.

The DASH plan has more daily servings of fruits, vegetables and grains than you may be used to eating.

You can also keep salt and sodium down by using fewer already prepared foods and less salt at the table and in cooking.

The latest study conducted at five hospitals throughout the United States with 412 people found that both a lower salt intake and the DASH diet lowered blood pressure, but combining them was more effective than either alone.  The DASH diet combined with a lower than average salt intake can substantially reduce blood pressure in people with or without hypertension.  Blood pressure dropped dramatically when they followed a 1,500 mg sodium level with the DASH diet.  Systolic (top number) dropped an average of 8.9 mm Hg and diastolic (low number) fell by 4.5 mm Hg.

Get Those Nutrients:

If you eat about 2,000 calories a day on the plan, the nutrients you receive will include: 4,700 milligrams of potassium, 500 milligrams of magnesium and 1,240 milligrams of calcium.  Those totals are about two to three times the amounts most Americans receive.

Tips on Eating the DASH Diet Way

• 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.
• To increase your dairy servings to three a day, try to have one low-fat 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 grocery stores) with the dairy foods.  Or, buy lactose-free milk or milk with lactase enzyme added to it.
• Choose whole-grain foods to get added nutrients, especially the B vitamins.  For example, choose whole-wheat bread or whole-grain cereals.
• Use the percent Daily Value on food labels to compare products and choose those lowest in saturated fat, total fat, cholesterol and sodium.
• Feed your craving for sweets with fresh or dried fruit or fruit-flavored gelatin.
• Use fresh, frozen, canned or dried fruits.
• Use fresh, frozen or no-salt-added canned vegetables.

Getting Started

It's easy to adopt the DASH eating diet.  Here are some ways to get started.

1. 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 low-fat 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 low-fat (1 percent) or fat-free (skim) dairy products to reduce total fat intake.
2. 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.
3. Use fruits or low-fat foods as desserts and snacks.
   • Fruits and low-fat 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; low-fat and fat-free yogurt and frozen yogurt; plain popcorn with no salt or butter added and raw vegetables.  

Following the DASH Diet

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.

*Serving sizes vary between ½ - 1 ¼ cups.  Check the product's nutrition label.

**Fat content changes serving counts for fats and oils:  For example, 1 Tbs. of regular salad dressing equals 1 serving; 1 Tbs. of a low-fat dressing equals ½ serving; 1 Tbs. of a fat-free dressing equals 0 servings.

Tips for Reducing Sodium Intake

• If you would like to cut back on the amount of sodium you and your family consume, keep in mind that a sudden switch from salt-laden foods to foods prepared with no salt will probably win few converts.  Plan to cut back on sodium over the course of a few weeks or even months.  Make the changes where they'll be noticed the least, such as using less salt in baked goods and buying salt-free canned tomatoes and legumes.  However, low-sodium canned soups are not very tasty and tend to be high in fat.  Choose a soup that is "less sodium" or make your own.  After awhile, your taste buds will adjust to less salt, and you'll find that you can enjoy many lower-sodium and salt-free foods.
• Remember that your goal is not to reduce your sodium intake to zero.  Sodium occurs naturally in many foods, especially root vegetables and leafy greens.  Keeping your daily sodium intake within the suggested guidelines can be accomplished in a number of ways, depending upon your eating habits.
• Seventy-five percent of the sodium in your diet comes from processed, canned or restaurant foods.  If many of your meals come from restaurants or deli counters, you will need to be especially diligent when you cook at home, using no-salt-added products and adding very little, if any, salt during cooking.
• If you eat most of your food at home, but rely heavily on processed foods such as canned soups and frozen items, try to balance your meals with simple foods that are naturally low in sodium, such as fresh salads (easy on the dressing), fresh fruit and steamed vegetables sprinkled with lemon juice.
• If most of your meals are made in your own kitchen, you have the most control over your sodium intake and can probably add reasonable amounts of salt during cooking or salt your foods lightly at the table and easily stay within the recommended sodium amounts.  When cooking and baking, use the following table to estimate how much sodium (in mg) per serving will be added from salt (for example, a recipe that serves 4 and calls for 1 teaspoon of salt will equal 575 mg of sodium per serving from salt).

• The key to a diet low in sodium is balance.  If one item of your menu is high in sodium, complement it with other low-sodium dishes.  For example, if you are fixing a vegetable stir-fry with tamari or soy sauce, serve it atop rice prepared without salt.
• Buy salt-free canned tomato products, canned beans and other canned goods.  Larger grocery stores and supermarkets may carry salt-free brands, either in the regular canned goods aisle or in special diet sections.  Natural food stores often have a wide variety of no-salt-added canned legumes.  Because these products have a long shelf life, it is a good idea to stock up on low-sodium varieties when you see them.
• If you do not use salt-free canned tomato products, do not automatically add salt to tomato-based recipes.  For example, if you prepare tomato sauce with regular canned crushed tomatoes, each cup of finished sauce will provide 591 mg of sodium without any salt added to the recipe.  If you add a teaspoon of salt, the amount of sodium jumps to 879 mg.  If you use salt-free crushed tomatoes, however, and add one teaspoon of salt, each cup of sauce would contain only 319 mg of sodium.
• Dried herbs and spices lose their effectiveness after a few months, so periodically check your spice rack for stale herbs and spices.  Natural food stores often sell dried herbs and spices in bulk quantities, allowing you to buy only as much as you will use within a few weeks.
• Try a variety of salt-free herb and seasoning mixes until you find ones you like.  The quality and tastes of different brands vary considerably, so do not give up if you do not like the first one you try.  Salt-Free Spike and Vegit by Modern Products, Inc. of Milwaukee, WI by McCormick offers an extensive line of salt-free seasonings.  Try Salt-Free Garlic and Herb, Salt-Free Onion and Herb or Herbes de Provence.  Penzeys Spices (800) 741-7787 or www.penzeys.com also carries many salt-free seasonings.
• Salting foods at the table is not necessarily a bad thing to do, provided you do not add much salt during cooking.  If you do use a salt shaker at the table, try this experiment: salt an empty plate as you usually would if it were full of food, then pour the salt into a measuring spoon.  One-sixteenth of a teaspoon of salt will add only 144 mg of sodium to your meal, while one-eighth of a teaspoon will add 288 mg of sodium.  If the amount is larger than one-eighth teaspoon, use less muscle with the salt shaker.
• Light salt or one-third less sodium salt has a filler.  It sill contains sodium, so if you salt to taste, you can get the sodium back to the same amount as using regular salt.
• Salt substitutes may not be a good idea, since they do not help you to diminish your taste for salt.  They also have a somewhat bitter taste.  Because of their high potassium content, they should be avoided by people who take certain medications, such as ACE inhibitors, which are used to lower blood pressure.
• Finally, unless you are on a salt-restricted diet for medical reasons, do not make sodium restriction an "issue" for your family.  Instead, try to establish healthy low-sodium habits that will in time become second nature.  You and your family may even come to enjoy lower-sodium foods as the norm rather than the exception.
• Sodium is an acquired taste.  When you start using less salt, foods will taste bland.  After about six weeks, your palate will be re-adjusted so that foods will taste better.  Your taste buds will become aware of the more subtle flavors that excessive amounts of salt cover up.