• The DASH Diet

    IMAGE DASH stands for Dietary Approaches to Stop Hypertension, which is the name of the research study that looked at the effects of eating patterns on blood pressure. From this study came the DASH diet—a diet rich in fruits, vegetables, and low-fat dairy foods, and low in saturated fat, total fat, and cholesterol. This diet was shown to significantly reduce blood pressure. The DASH diet combined with a low sodium intake can reduce blood pressure even further.
    Researchers believe that it is the combination of nutrients from this eating pattern that helps to lower blood pressure. Specifically, magnesium, potassium, and calcium, as well as protein and fiber may act together to achieve this goal.
    In addition to helping you manage your blood pressure, the DASH eating plan is a healthy one that will help you manage your weight and possibly reduce your risk of other chronic diseases. For example, research suggests that women who follow the DASH diet can reduce their risk of heart failure.
    A registered dietitian can help design a DASH meal plan that will work for you. Check out the one-day sample menu at the end of this page for an idea of what is in a DASH meal plan!

    How Many Servings Do You Need?

    Depending on your calorie needs, these are the number of servings of each food group you should strive for each day under the DASH eating plan:

    Grains and Grain Products

    Grains are rich in carbohydrates, which provide quick energy for exercise. If you choose whole grains, you will also get a good dose of fiber and several vitamins and minerals. (Be aware though that many bread products are quite high in sodium. It may be better to make your own salt-free bread or buy baked goods with minimum added salt or baking powder.)
    One serving equals:
    • 1 slice of bread
    • 1 ounce of dry cereal (½ to 1-¼ cup; check the Nutrition Facts label on the cereal box)
    • ½ cup of cooked rice, pasta, or cereal
    Good choices include:

    Vegetables

    Vegetables are low in calories and have almost no fat. They are also excellent sources of fiber, phytochemicals, vitamins, and minerals, such as potassium and magnesium.
    One serving equals:
    • 1 cup of raw leafy vegetables
    • ½ cup of cooked vegetables
    • 6 ounces of vegetable juice
    Good choices include:
    • Tomatoes
    • Carrots
    • Squash
    • Broccoli
    • Turnips
    • Greens, like collards, kale, and spinach
    • Artichokes
    • Beans, including green beans and lima beans
    • Sweet potatoes
    • Potatoes

    Fruits

    Not only are they low in fat and calories, but fruits are good sources of potassium, magnesium, and fiber.
    One serving equals:
    • 6 ounces of fruit juice
    • 1 medium piece of fruit
    • ¼ cup of dried fruit
    • ½ cup of fresh (cut up), frozen, or canned fruit
    Good choices include:
    • Apricots
    • Bananas
    • Dates
    • Grapes
    • Citrus, such as oranges and orange juice, and grapefruit and grapefruit juice
    • Mangoes
    • Melons
    • Peaches
    • Pineapples
    • Prunes
    • Raisins
    • Strawberries
    • Tangerines

    Low-fat or Fat-free Dairy Foods

    Dairy foods are excellent sources of calcium and protein.
    One serving equals:
    • 1 cup of milk
    • 1 cup of yogurt
    • 1-½ ounces of cheese
    Good choices include:
    • Fat-free (skim) or low-fat (1%) milk
    • Fat-free or low-fat buttermilk
    • Fat-free or low-fat regular or frozen yogurt
    • Fat-free or low-fat cheese (Remember, though that most cheeses—including cottage cheese—can be quite high in salt.)

    Meats, Poultry, and Fish

    Meats, poultry, and fish are packed with protein and magnesium. Be sure to buy lean cuts of meat and poultry.
    One serving equals 2 1/2 to 3 1/2 ounces of cooked meats, poultry, or fish. One egg is also equivalent.
    Here are some tips for eating the healthiest meats:
    • Select lean meats
    • Trim away visible fat
    • Use lowfat cooking methods, such as broiling, roasting, or boiling
    • Remove skin from poultry before eating
    • Try not to eat more than 4 egg yolks per week since they are high in cholesterol

    Nuts, Seeds, and Dry Beans

    These foods are great sources of magnesium, potassium, protein, and fiber.
    One serving equals:
    • 1/3 cup or 1-½ ounces of nuts
    • 2 tablespoons or ½ ounce of seeds
    • ½ cup of cooked dry beans
    Good choices include (in most cases you will want to choose unsalted varieties):
    • Nuts: almonds, filberts, mixed nuts, peanuts, and walnuts
    • Sunflower seeds
    • Dry beans: kidney beans, black beans, lentils, peas

    Fats and Oils

    Fats and oils should be used sparingly. When choosing fats, select those lowest in saturated fat, such as oils.
    One serving equals:
    • 1 teaspoon of soft margarine
    • 1 tablespoon of lowfat mayonnaise
    • 2 tablespoons of light salad dressing
    • 1 teaspoon of vegetable oil
    Good choices include:
    • Soft margarine (The softer the margarine, the less trans fatty acids it has; trans fats are as dangerous to your heart as saturated fats found in butter.)
    • Low-fat mayonnaise
    • Light salad dressing
    • Vegetable oils: olive, corn, canola, safflower

    Sweets

    Sweets rarely provide any nutrients. Select those that are low in fat and limit your overall intake of them.
    One serving equals:
    • 1 tablespoon of sugar
    • 1 tablespoon of jelly or jam
    • ½ ounce of jelly beans
    • 8 ounces of lemonade or fruit punch
    Good choices include:
    • Maple syrup
    • Jellies and jams
    • Fruit-flavored gelatin
    • Candy: jelly beans and hard candy
    • Fruit punch
    • Sorbet

    Reducing Your Sodium Intake

    It may take a little time for your taste buds to adjust to eating less sodium. Here are some tips to help you reduce your intake:
    • Choose low- or reduced-sodium versions of foods and condiments when available.
    • Buy fruits and vegetables fresh, frozen plain, or canned in water, with no salt added.
    • Use fresh meats, poultry, and fish rather than canned, smoked, or processed versions.
    • Check the Nutrition Facts label on breakfast cereals and snacks, choose those lowest in sodium.
    • Limit cured foods, such as bacon and ham.
    • Limit foods packed in brine, such as pickles, pickled vegetables, olives, and sauerkraut.
    • Limit condiments, such as MSG, mustard, horseradish, ketchup, and barbecue sauce.
    • Add half the amount of salt than you normally would to your foods; gradually decrease this amount.
    • Instead of seasoning with salt, use other sources of flavor—herbs, spices, lemon, lime, vinegar, or salt-free seasoning blends.
    • Do not add salt when you are cooking rice, pasta, and hot cereal. Cut back on instant mixes of these foods; they are usually high in salt.
    • Rinse canned foods, such as tuna, to remove some sodium
    • Cut back on convenience foods, such as frozen dinners, packaged mixes, and canned soups or broths.

    Putting It All Together

    This sample menu for one day provides 1,944 calories and 31 grams of total fat (14% of total calories from fat).

    Breakfast

    • 1 lowfat granola bar (½ grain)
    • 1 medium banana (1 fruit)
    • 1 cup of fruit yogurt, fat-free, no sugar added (1 dairy)
    • 1 cup of orange juice (1-½ fruit)
    • 1 cup of fat-free milk (1 dairy)

    Lunch

    • Turkey breast sandwich: 3 ounces of turkey breast (1 meat), 2 slices of whole wheat bread (2 grains), 2 slices (1-½ ounces) of natural cheddar cheese, reduced fat (1 dairy), 1 large leaf of romaine lettuce (¼ vegetable), 2 slices of tomato (½ vegetable), 2 teaspoons of mayonnaise, lowfat (2/3 fat), 1 tablespoon of dijon mustard
    • 1 cup of broccoli, steamed from frozen (2 vegetables)
    • 1 medium orange (1 fruit)

    Dinner

    • 3 ounces of spicy baked fish (1 fish)—see recipe below
    • 1 cup of scallion rice (2 grains)—see recipe below
    • ½ cup of spinach, cooked from frozen (1 vegetable)
    • 1 cup of carrots, cooked from frozen (2 vegetables)
    • 1 small whole wheat roll (1 grain)
    • 1 teaspoon of soft margarine (1 fat)
    • 1 cup of fat-free (skim) milk (1 dairy)

    Snack

    • 2 large rectangle graham crackers (1 grain)
    • 1 cup of fat-free (skim) milk (1 dairy)
    • ¼ cup of dried apricots (1 fruit)

    Spicy Baked Fish

    makes 4 servings, serving size is 3 ounces
    • 1 pound of cod (or other fish) fillet
    • 1 tablespoon of olive oil
    • 1 teaspoon of spicy seasoning, salt-free
    1. Preheat oven to 350 degrees F. Spray a casserole dish with cooking oil spray.
    2. Wash and pat dry fish. Place in dish. Mix oil and seasoning in separate bowl and drizzle over fish.
    3. Bake uncovered for 15 minutes or until fish flakes with a fork.
    4. Cut into 4 pieces and serve with rice.

    Scallion Rice

    makes 5 servings; serving size is 1 cup
    • 4-½ cups of cooked rice (in unsalted water)
    • 1-½ teaspoons of bouillon granules, unsalted
    • ¼ cup of scallions (green onions) chopped
    1. Cook rice according to directions on the package.
    2. Combine the cooked rice, scallions, and bouillon granules, and mix well.
    3. Measure 1 cup portions and serve.

    RESOURCES

    The DASH DietNational Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/

    ChooseMyPlate.gov http://www.choosemyplate.gov

    CANADIAN RESOURCES

    Canada's Food Guide http://www.hc-sc.gc.ca/

    Dietitians of Canada http://www.dietitians.ca/

    References

    7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Levitan EB, Wolk A, Mittleman MA. Consistency with the DASH diet and incidence of heart failure. Arch Intern Med. 2009;169:851-857.

    DASH diet. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated August 26, 2011. Accessed June 13, 2012.

    Dash diet serving sizes. The Dash Diet Eating Plan website. Available at: http://dashdiet.org/servingsizes.asp. Accessed June 22, 2012.

    Following the DASH eating plan. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/dash/followdash.html. Updated November 1, 2010. Accessed June 13, 2012.

    Your guide to lowering your blood pressure with DASH. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/how%5Fmake%5Fdash.html. Accessed June 13, 2012.

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