Reena Jasani, National Center for Health Research
The Dietary Approaches to Stop Hypertension (DASH) diet encourages a diet high in fruits and vegetables, moderate in low-fat dairy products, and low in fats.1 It is described as “an example of a healthy eating pattern” by the U.S. 2015-2020 Dietary Guidelines for Americans.2 The National Heart, Lung, and Blood Institute (part of NIH) encourages the DASH eating plan because of its flexibility and heart-healthy benefits.3
What does this diet do?
The goal of the DASH diet is to decrease blood pressure, especially for those with high blood pressure. Research shows the diet can decrease systolic blood pressure (the first of the 2 numbers representing your blood pressure) and diastolic blood pressure (the second number).4 Both those numbers are relevant to preventing heart disease.
An 8-week study by researchers from Kaiser Permanente Center for Health Research, Johns Hopkins, Harvard, and many other research centers fed participants all of their meals to accurately measure the impact of the DASH diet. They found that individuals with high blood pressure who were on the DASH diet reduced their systolic blood pressure by 11.4 mmHg on average without losing weight. Sodium intake was limited to 3000 mg/day, which is similar to what an average American consumes.4
It is important to note that sodium and salt are not the same. Sodium is a component of salt but can also be found in baking soda and other ingredients. Therefore, 3,000 mg of sodium is not the same as 3,000 mg of salt.
Another study by the same researchers examined how the DASH diet affected blood pressure when sodium in the diet was also decreased. Participants that ate the DASH diet and consumed less sodium had the lowest blood pressures.4 Because of the better results when the DASH diet was accompanied by reduced sodium intake, a lower sodium DASH diet is now encouraged. The standard DASH diet recommends no more than 2,300 milligrams (mg) of sodium daily, while the lower sodium DASH diet recommends no more than 1,500 mg of sodium daily.5
What should I eat to follow the DASH diet?
The DASH diet recommends the following servings of each food group:
1. Vegetables: 4-5 servings daily
- 1 serving looks like 1 cup of raw leafy green vegetables (spinach, kale, broccoli) or ½ cup of cut-up raw or cooked vegetables.
- Both fresh and frozen vegetables can be healthy, as long as the frozen vegetables are low in sodium or without added salt.
2. Fruits: 4-5 servings daily
- 1 serving looks like 1 medium fruit, ½ cup of fruit, or 4 ounces of juice.
- Remember to stick with juice that does not have any added sugars.
3. Carbohydrates: 6-8 servings daily
- 1 serving looks like 1 slice of whole-wheat bread or ½ cup cooked cereal, rice, or pasta. Focus on eating carbohydrates made of whole grains, including brown rice, whole-wheat pasta, oats, and whole-wheat bread. These items have more fiber and nutrients than refined grains like white rice and white pasta.
4. Low-fat or fat-free dairy products: 2-3 servings daily
- 1 serving looks like 1 cup fat-free milk or 1% milk or 1 cup low-fat or nonfat yogurt.
- Limit cheese intake because usually cheese is high in sodium.
5. Lean meat (or fish) products: 6 ounces or fewer daily
- 1 serving looks like 1 egg or 1 ounce of cooked meat, poultry, or fish.
- A healthy choice for animal protein is fish high in omega-3 fatty acids, like salmon, herring, and tuna.
6. Nuts, seeds, and legumes: 4-5 times weekly
- 1 serving looks like ⅓ cup nuts, 2 tablespoons of seeds or nut butter, or ½ cup cooked beans or peas.
- Nuts contain healthy fats, but are still high in calories, so be mindful of how much you eat.
7. Fats and oils: 2-3 servings daily
- 1 serving looks like 1 teaspoon soft margarine, 1 tablespoon mayonnaise, or 2 tablespoons salad dressing.5
- Focus on consuming good fats (usually unsaturated fats) that prevent inflammation. These include olive oil, avocados, nuts, hempseeds, flax seeds, and fish rich in omega 3 fatty acids.
- Avoid bad fats (usually saturated fats), including butter, lard, margarine, vegetable shortenings, and partially hydrogenated vegetable oils.6, 7
8. Sweets: 5 servings or fewer weekly
- 1 serving looks like 1 tablespoon sugar (about 12.5 grams), jelly, or jam, ½ cup sorbet, 1 cup soda, or 1 cup lemonade.5, 8
- Stick to sweets that are low in fat or fat-free. Limit consumption of added sugars.5
How is this diet different from the Mediterranean diet?
It can be easy to confuse the DASH diet with the Mediterranean diet. The Mediterranean diet emphasizes vegetables, fruits, nuts, whole grains, and healthy oils. While the two diets are similar, the DASH diet has more precise guidelines and was originally designed to treat hypertension (high blood pressure).
How will the DASH diet affect my health?
Although DASH stands for Dietary Approaches to Stop Hypertension, it has benefits beyond lowering blood pressure. The recommendations in the DASH diet are similar to the dietary guidelines that lower the risk for developing other chronic diseases, including diabetes, osteoporosis, heart disease, and probably cancer.1, 5
Research clearly shows that the DASH diet has many benefits on health, from decreasing blood pressure to decreasing your risk of osteoporosis. While this remains a good choice for individuals with high blood pressure, it may not be for everyone. If you’d like to learn more about how to live a healthy lifestyle, check out our articles on eating habits, developing an exercise routine, and maximizing good health.
All NCHR articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.
References:
- Craddick SR, Elmer PJ, Obarzanek E, Vollmer WM, Svetkey LP, & Swain MC. The DASH diet and blood pressure. Current atherosclerosis reports. 2003;5(6): 484-491. https://link.springer.com/article/10.1007/s11883-003-0039-5
- U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. http://health.gov/dietaryguidelines/2015/guidelines/.
- National Heart, Lung, and Blood Institute. DASH Eating Plan. NHLBI.NIH.gov. https://www.nhlbi.nih.gov/health-topics/dash-eating-plan.
- Vollmer WM, Sacks FM, & Svetkey LP. New insights into the effects on blood pressure of diets low in salt and high in fruits and vegetables and low-fat dairy products. Trials. 2001;2(2):71. https://trialsjournal.biomedcentral.com/articles/10.1186/cvm-2-2-071
- Mayo Clinic. DASH diet: Healthy eating to lower your blood pressure. MayoClinic.com. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456. May 8, 2019.
- Challa HJ & Uppaluri KR. DASH Diet (Dietary Approaches to Stop Hypertension). In StatPearls [Internet]. StatPearls Publishing. 2018. https://www.ncbi.nlm.nih.gov/books/NBK482514/
- Harvard University. Know the facts about fats. Harvard Health Publishing. https://www.health.harvard.edu/staying-healthy/know-the-facts-about-fats. October 2018.
- McManus KD. The DASH diet: A great way to eat foods that are healthy AND delicious. Harvard Health Publishing. https://www.health.harvard.edu/blog/the-dash-diet-a-great-way-to-eat-foods-that-are-healthy-and-delicious-2019072517326. July 25, 2019.