The DASH Diet

Patients often ask what changes in life style can contribute to improving their blood pressure. In response, we doctors often recommend that reducing body weight, decreasing intake of dietary salt, and limiting consumption of alcohol can be beneficial. However, we need to now also consider the increasingly publicized DASH diet. This diet can bring about a reduction in blood pressure in people with normal blood pressure or high blood pressure (hypertension). Furthermore, when combined with a restricted dietary intake of salt, DASH actually has an additive effect in reducing the blood pressure.

Medical Author: Dwight Makoff, M.D.

This eating plan is from the "Dietary Approaches to Stop Hypertension" (DASH) clinical study. The research was funded by the National Heart, Lung, and Blood Institute (NHLBI), with additional support by the National Center for Research Resources and the Office of Research on Minority Health, all units of the National Institutes of Health. (DASH's final results appeared in the April 17, 1997, issue of The New England Journal of Medicine.) The results show that the DASH "combination diet" lowered blood pressure and, so, may help prevent and control high blood pressure. The "combination diet" is rich in fruits, vegetables, and low fat dairy foods, and low in saturated and total fat. It also is low in cholesterol, high in dietary fiber, potassium, calcium, and magnesium, and moderately high in protein.

The DASH eating plan shown below is based on 2,000 calories a day. Depending on your caloric needs, your number of daily servings in a food group may vary from those listed.

Food Group	Daily Servings	Serving Sizes	Examples and Notes	Significance of each food group to the DASH Diet Pattern
Grains & grain products	7-8	1 slice bread 1/2 cup dry cereal 1/2 cup cooked rice, pasta, or cereal	whole wheat bread, English muffin, pita bread, bagel, cereals, grits, oatmeal	Major sources of energy and fiber.
Vegetables	4-5	1 cup raw leafy vegetable 1/2 cup cooked vegetable 6 oz. vegetable juice	tomatoes, potatoes, carrots, peas, squash, broccoli, turnip greens, collards, kale, spinach, artichokes, sweet potatoes, beans	Rich sources of potassium, magnesium, and fiber
Fruits	4-5	6 oz. fruit juice 1 medium fruit 1/4 cup dried fruit 1/2 cup fresh, frozen or canned fruit	apricots, bananas, dates, oranges, orange juice, grapefruit juice, mangoes, melons, peaches, pineapples, prunes, raisins, strawberries, tangerines.	Important sources of potassium, magnesium, and fiber
Low fat or nonfat dairy foods	2-3	8 oz. milk 1 cup yogurt 1.5 oz. cheese	skim or 1% milk, skim or low fat buttermilk, nonfat or lowfat yogurt, part skim mozzarella cheese, nonfat cheese	Major sources of calcium and protein
Meats, poultry, and fish	2 or less	3 oz. cooked meats, poultry or fish	select only lean; trim away visible fats; broil, roast or boil, instead of frying; remove skin from poultry	Rich sources of protein and magnesium
Nuts, seeds, and legumes	4-5 per week	1.5 oz. or 1/3 cup nuts 1/2 oz. or 2 Tbsp seeds 1/2 cup cooked legumes	almonds, filberts, mixed nuts, peanuts, walnuts, sunflower seeds, kidney beans, lentils	Rich sources of energy, magnesium, potassium, protein, and fiber

The DASH Sample Menu
(based on 2,000 calories per day)

Food	Servings Provided
Breakfast
6 oz. orange juice 8 oz. (1 cup) 1% low fat milk 1 cup corn flakes (with 1 tsp sugar) 1 medium banana 1 slice whole wheat bread (with 1 Tbsp jelly) 1 tsp soft margarine	1 fruit 1 dairy 2 grains
Lunch
3/4 cup chicken salad 1/2, large pita bread 3-4 sticks raw vegetable medley; carrot & celery sticks (each) 2 radishes 2 leaves loose-leaf lettuce 1.5 slice (1.5 oz.) part skim mozzarella cheese 8 oz. (1 cup) 1% low fat milk 1/2 cup fruit cocktail in light syrup	1 poultry 1 grain 1 vegetable 2 dairy 1 fruit
Dinner
3 oz. herbed baked cod 1 cup scallion rice 1/2 cup steamed broccoli 1/2 cup stewed tomatoes spinach salad: 1/2 cup raw spinach, 2 cherry tomatoes, 2 slices cucumber 1 Tbsp light Italian salad dressing 1 small whole wheat dinner roll 1 tsp soft margarine 1/2 cup melon balls	1 fish 3 grains 3 vegetables 1/2 fat 1 fruit
Snacks
1 oz. (1/4 cup) dried apricots 1 oz. (3/4 cup) mini-pretzels 1/5 oz. (1/3 cup) mixed nuts 12 oz. diet ginger ale	1 fruit 1 grain 1 nuts

Total number of servings in 2,000 calories/day menu

Food Group	Servings
Grains	8
Vegetables	4
Fruits	5
Diary Foods	3
Meats, Poultry, and Fish	2
Nuts, Seeds, and Legumes	1
Fats & Oils	2.5

Tips on Eating the DASH Way:

• Start small. Make gradual changes in your eating habits.
  
  
• Center your meal around carbohydrates, such as pasta, rice, beans, or vegetables.
  
  
• Treat meat as one part of the whole meal, instead of the focus.
  
  
• Use fruits or low fat, low-calorie foods such as sugar free gelatin for desserts and snacks.

REMEMBER! If you use the DASH diet to help prevent or control high blood pressure, make it part of a lifestyle that includes choosing foods lower in salt and sodium, keeping a healthy weight, being physically active, and, if you drink alcohol, doing so in moderation.

For more, please visit the following areas:

• Salt, DASH, and Blood Pressure
• High Blood Pressure (Main article)
• High Blood Pressure Center

Source: National Institutes of Health (www.nih.gov)

Last Editorial Review: 11/18/2005

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