The DASH diet stands for Dietary Approaches to Stop Hypertension. It is a type of diet that is clinically proven to prevent and control hypertension or high blood pressure. "Clinically proven" means that they did very high quality experimental studies over the years and researchers always found consistent results. The National Institute of Health funded the experimental studies and the National Heart, Lung and Blood Institute (NHLBI) conducted them.
The NHLBI put together educational materials about the DASH Diet to educate the public. A copy of the brochure "Your Guide to Lowering Your Blood Pressure with DASH" is presented here. You may also go directly to the original source by clicking here.
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Your Guide to Lowering Your Blood Pressure with DASH
Get with the plan that is clinically proven to significantly reduce blood pressure! This updated booklet contains a week’s worth of sample menus and recipes recalculated using 2005 nutrient content data. The "Dietary Approaches to Stop Hypertension" eating plan features plenty of fruits, vegetables, whole grains, and other foods that are heart healthy and lower in salt/sodium. Also contains additional information on weight loss and physical activity.
For those interested in a more condensed version on this topic, see In Brief: Your Guide to Lowering Your Blood Pressure with DASH.
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Item No.: 06-4082
Availability:Web/HTML | PDF (976 kb) | Print (Information about file types)
Format: Recipe Collections : Full Color
Page Count: 56 pages
Subject: Your Guide High Blood Pressure Booklets
Audience: General Public/Patients
Size: 6 in. X 9 in.
Date of Publication: 2006
What you choose to eat affects your chances of developing high blood pressure, or hypertension (the medical term). Recent studies show that blood pressure can be lowered by following the Dietary Approaches to Stop Hypertension (DASH) eating plan—and by eating less salt, also called sodium.
While each step alone lowers blood pressure, the combination of the eating plan and a reduced sodium intake gives the biggest benefit and may help prevent the development of high blood pressure.
This booklet, based on the DASH research findings, tells how to follow the DASH eating plan and reduce the amount of sodium you consume. It offers tips on how to start and stay on the eating plan, as well as a week of menus and some recipes. The menus and recipes are given for two levels of daily sodium consumption— 2,300 and 1,500 milligrams per day. Twenty-three hundred milligrams is the highest level considered acceptable by the National High Blood Pressure Education Program. It is also the highest amount recommended for healthy Americans by the 2005 "U.S. Dietary Guidelines for Americans." The 1,500 milligram level can lower blood pressure further and more recently is the amount recommended by the Institute of Medicine as an adequate intake level and one that most people should try to achieve.
The lower your salt intake is, the lower your blood pressure. Studies have found that the DASH menus containing 2,300 milligrams of sodium can lower blood pressure and that an even lower level of sodium, 1,500 milligrams, can further reduce blood pressure. All the menus are lower in sodium than what adults in the United States currently eat—about 4,200 milligrams per day in men and 3,300 milligrams per day in women.
Those with high blood pressure and prehypertension may benefit especially from following the DASH eating plan and reducing their sodium intake.
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
National Heart, Lung, and Blood Institute
NIH Publication No. 06-4082
Originally Printed 1998
Revised April 2006
Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mmHg) and recorded as two numbers—systolic pressure (when the heart beats) over diastolic pressure (when the heart relaxes between beats). Both numbers are important. (See box 1)
Blood pressure rises and falls during the day. But when it stays elevated over time, then it's called high blood pressure. High blood pressure is dangerous because it makes the heart work too hard, and the high force of the blood flow can harm arteries and organs such as the heart, kidneys, brain, and eyes. High blood pressure often has no warning signs or symptoms. Once it occurs, it usually lasts a lifetime. If uncontrolled, it can lead to heart and kidney disease, stroke, and blindness.
High blood pressure affects more than 65 million—or 1 in 3— American adults. About 28 percent of American adults ages 18 and older, or about 59 million people, have prehypertension, a condition that also increases the chance of heart disease and stroke. High blood pressure is especially common among African Americans, who tend to develop it at an earlier age and more often than Whites. It is also common among older Americans—individuals with normal blood pressure at age 55 have a 90 percent lifetime risk for developing high blood pressure.
High blood pressure can be controlled if you take these steps:
All steps but the last also help to prevent high blood pressure.
|Category||Systolic** (mmHg)***||Diastolic** (mmHg)***||Result|
|Normal||Less than 120 and||Less than 80||Good for you!|
|Prehypertension||120-139 or||80-89||Your blood pressure could be a problem. Make changes in what you eat and drink, be physically active, and lose extra weight. If you also have diabetes, see your doctor.|
|Hypertension||140 or higher or||90 or higher||You have high blood pressure. Ask your doctor or nurse how to control it.|
* For adults ages 18 and older who are not on medicine for high blood pressure and do not have a short-term serious illness. Source: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; NIH Publication No. 03-5230, National High Blood Pressure Education Program, May 2003.
** If systolic and diastolic pressures fall into different categories, overall status is the higher category.
*** Millimeters of mercury.
Blood pressure can be unhealthy even if it stays only slightly above the normal level of less than 120/80 mmHg. The more your blood pressure rises above normal, the greater the health risk.
Scientists supported by the National Heart, Lung, and Blood Institute (NHLBI) conducted two key studies. Their findings showed that blood pressures were reduced with an eating plan that is low in saturated fat, cholesterol, and total fat and that emphasizes fruits, vegetables, and fat-free or low-fat milk and milk products. This eating plan—known as the DASH eating plan—also includes whole grain products, fish, poultry, and nuts. It is reduced in lean red meat, sweets, added sugars, and sugar-containing beverages compared to the typical American diet. It is rich in potassium, magnesium, and calcium, as well as protein and fiber. (See box 2for the DASH studies' daily nutrient goals.)
Total fat: 27% of calories
Saturated fat: 6% of calories
Protein: 18% of calories
Carbohydrate: 55% of calories
Cholesterol: 150 mg
Sodium: 2,300 mg*
Potassium: 4,700 mg
Calcium: 1,250 mg
Magnesium: 500 mg
Fiber: 30 g
* 1,500 mg sodium was a lower goal tested and found to be even better for lowering blood pressure. It was particularly effective for middle-aged and older individuals, African Americans, and those who already had high blood pressure. g = grams; mg = milligrams
The DASH eating plan follows heart healthy guidelines to limit saturated fat and cholesterol. It focuses on increasing intake of foods rich in nutrients that are expected to lower blood pressure, mainly minerals (like potassium, calcium, and magnesium), protein, and fiber. It includes nutrient-rich foods so that it meets other nutrient requirements as recommended by the Institute of Medicine.
The first DASH study involved 459 adults with systolic blood pressures of less than 160 mmHg and diastolic pressures of 80-95 mmHg. About 27 percent of the participants had high blood pressure. About 50 percent were women and 60 percent were African Americans. It compared three eating plans: a plan that includes foods similar to what many Americans regularly eat; a plan that includes foods similar to what many Americans regularly eat plus more fruits and vegetables; and the DASH eating plan. All three plans included about 3,000 milligrams of sodium daily. None of the plans was vegetarian or used specialty foods.
Results were dramatic. Participants who followed both the plan that included more fruits and vegetables and the DASH eating plan had reduced blood pressure. But the DASH eating plan had the greatest effect, especially for those with high blood pressure. Furthermore, the blood pressure reductions came fast—within 2 weeks of starting the plan.
The second DASH study looked at the effect on blood pressure of a reduced dietary sodium intake as participants followed either the DASH eating plan or an eating plan typical of what many Americans consume. This second study involved 412 participants. Participants were randomly assigned to one of the two eating plans and then followed for a month at each of the three sodium levels. The three sodium levels were a higher intake of about 3,300 milligrams per day (the level consumed by many Americans), an intermediate intake of about 2,300 milligrams per day, and a lower intake of about 1,500 milligrams per day.
Results showed that reducing dietary sodium lowered blood pressure for both eating plans. At each sodium level, blood pressure was lower on the DASH eating plan than on the other eating plan. The greatest blood pressure reductions were for the DASH eating plan at the sodium intake of 1,500 milligrams per day. Those with high blood pressure saw the greatest reductions, but those with prehypertension also had large decreases.
Together these studies show the importance of lowering sodium intake—whatever your eating plan. For a true winning combination, follow the DASH eating plan and lower your intake of salt and sodium.
The DASH studies were sponsored by the NHLBI and conducted at four medical centers. There was also a central coordinating center at Kaiser Permanente Center for Health Research in Portland, OR. The four medical centers were: Brigham and Women's Hospital, Boston, MA; Duke Hypertension Center and the Sarah W. Stedman Nutrition and Metabolism Center, Durham, NC; Johns Hopkins Medical Institutions, Baltimore, MD; and Pennington Biomedical Research Center, Baton Rouge, LA.
The DASH eating plan used in the studies calls for a certain number of daily servings from various food groups. These are given in box 3 for 2,000 calories per day. The number of servings you require may vary, depending on your caloric need. Box 4 gives the number of servings for 1,600, 2,600, and 3,100 calories.
The DASH eating plan used along with other lifestyle changes can help you prevent and control blood pressure. If your blood pressure is not too high, you may be able to control it entirely by changing your eating habits, losing weight if you are overweight, getting regular physical activity, and cutting down on alcohol. The DASH eating plan also has other benefits, such as lowering LDL ("bad") cholesterol, which, along with lowering blood pressure, can reduce your risk for getting heart disease.
It's easy. Reading the "Getting Started" suggestions in box 13 should help you along the way. The DASH eating 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. Use the "What's On Your Plate?" form. (See box 14.) Fill it in for 1-2 days and see how it compares with the DASH plan. This will help you see what changes you need to make in your food choices.
Remember that on some days the foods you eat may add up to more than the recommended servings from one food group and less from another. Similarly, you may have too much sodium on a particular day. But don't worry. Try your best to keep the average of several days close to the DASH eating plan and the sodium level recommended for you.
Use the menus if you want to follow the menus similar to those used in the DASH trial—or make up your own using your favorite foods. In fact, your entire family can eat meals using the DASH eating plan. Use box 3 to choose your favorite foods from each food group based on your calorie needs as described in the 2005 "U.S. Dietary Guidelines for Americans."
The Dietary Guidelines determined that the DASH eating plan is an example of a healthy eating plan and recommends it as a plan that not only meets your nutritional needs but can accommodate varied types of cuisines and special needs.
Remember that the DASH eating plan used along with other lifestyle changes can help you prevent and control your blood pressure. Important lifestyle recommendations for you include: achieve and maintain a healthy weight, participate in your favorite regular physical activity, and, if you drink, use moderation in alcohol consumption (defined as up to one drink per day for women and up to two drinks per day for men).
One important note: If you take medication to control high blood pressure, you should not stop using it. Follow the DASH eating plan and talk with your doctor about your medication treatment. The tips in box 15 can help you continue to follow the DASH eating plan and make other healthy lifestyle changes for a lifetime.
It's easy to adopt the DASH eating plan. Here are some ways to get started:
Treat meats as one part of the whole meal, instead of the focus
Use fruits or other foods low in saturated fat, trans fat, cholesterol, sodium, sugar, and calories as desserts and snacks
Try these other tips
Use the form in box 14 to track your food and physical activities habits before you start on the DASH eating plan or to see how you're doing after a few weeks. To record more than 1 day, just copy the form. Total each day's food groups and compare what you ate with the DASH eating plan. To see how the form looks completed, check the menus that start on page 30.
|Food||Amount (serving size)||Sodium (mg)||Number of Servings by DASH Food Group|
|Grains||Vegetables||Fruits||Milk Products||Meats, fish, and poultry||Nuts, seeds, and legumes||Fish oils and oils||Sweets and added sugars|
|Example: whole wheat bread, with soft (tub) margarine||2 slices|
|Compare yours with the DASH eating plan at 2,000 calories.||2,300 or 1,500 mg per day||6-8 per day||4-5 per day||4-5 per day||2-3 per day||6 or less per day||4-5 per week||2-3 per day||5 or less per week|
Record your minutes per day for each activity. Aim for at least 30 minutes of moderate-intensity physical activity on most days of the week.
The DASH plan is a new way of eatingÑfor 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 the DASH plan.
Don't worry about a slip.
Everyone slipsÑespecially 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.
Use the table in box 14 to keep track of what you eat and what you're doing. This can help you find the problem. 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 and physical activity each day.
Treat yourself to a nonfood treat for your accomplishments.
Most people eat much more sodium (salt) than they need. This can lead to health problems like high blood pressure. When you go food shopping, keep these tips in mind for reducing the sodium in your diet:
Take the list below with you the next time you go food shopping.
Vegetables and Fruits
Choose fresh or frozen vegetables and fruits when possible.
Breads, Cereals, and Grains
Compare labels to find products with less sodium. When you cook rice or pasta, don’t add salt.
Meats, Nuts, and Beans
Choose fresh meats when possible. Some fresh meat has added sodium, so always check the label.
Milk and Milk Products
Choose fat-free or low-fat milk and yogurt more often than cheese, which can be high in sodium. Milk and yogurt are also good sources of potassium, which can help lower blood pressure.
Dressings, Oils, and Condiments
When preparing food, choose ingredients that are low in sodium or have no sodium at all.
Try these seasonings instead of salt to flavor food.