May 2001

 

Lower Blood Pressure With DASH
Lynda Zimmerman, zimmermanl@missouri.edu

If you want to lower your blood pressure, it’s best to eat:

a. fruits and vegetables;

b. whole grains;

c. low-fat dairy foods;

d. meals that are low in saturated fat, total fat and  cholesterol;

e. all the above.

If you answered “e”, you are correct. A new way of eating called DASH has been shown to substantially lower blood pressure -- without weight loss or a low sodium diet.

Research on DASH

In the past, researchers tested various single nutrients, such as calcium and magnesium, to find clues about what affects blood pressure. These studies were done mostly with dietary supplements and their findings were not conclusive.

Then, scientists supported by the National Heart, Lung, and Blood Institute (NHLBI) tested the effects of eating nutrients as they occurred together in food. The researchers found that blood pressures were reduced with DASH – an acronym for "Dietary Approaches to Stop Hypertension."

In the DASH study, three eating plans were compared:

1. A plan similar to what many Americans consume;

2. A plan similar to what Americans consume but higher in fruits and vegetables;

3. A "combination" plan -- the DASH plan -- lower in saturated fat, total fat, and cholesterol, and rich in fruits, vegetables, and lowfat dairy foods.

All three plans included about 3,000 milligrams of sodium daily. Although this level is not considered “low sodium,” it is about 20 percent lower than the U.S. average for adults.

The results showed that both plans #2 (higher in fruits and vegetables) and #3 (combination) reduced blood pressure, but the combination plan had the greatest effect. Further, the reductions came fast -- within two weeks of starting the eating plan.

Foods to Eat

The DASH plan requires no special foods and has no hard-to-follow recipes. The daily eating plan includes 7-8 servings of whole grain foods, 8-10 servings of fruits and vegetables, 2-3 servings of lowfat dairy foods, and 2 or less servings of lean meat, fish or poultry. The number of servings from each food group may vary, depending on the calories you need.

One way to begin is by writing down all the foods you eat for a day or two and comparing that to the DASH guidelines. This will help you see where you might want to make changes.

You may find that some days you may eat more than what's recommended from one food group and less of another. But don't worry.  Try to come close to the goal most of the time.

One note: If you have high blood pressure and take a medication, it’s important to not stop taking it. Always consult with your doctor before discontinuing a medication.

Getting Started

The DASH eating plan may be different than how you’re used to eating. Here are some suggestions as you begin:

• Make changes 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 each meal or have it as a snack.
• Eat fruit for a snack or dessert.
• Use only half the butter, margarine, or salad dressing that you are using now.
• Gradually increase your servings of dairy products to two or three per day. For example, drink lowfat milk with lunch or dinner, instead of soda, alcohol, or sugar-sweetened tea.
• If you have trouble digesting dairy products, try taking lactase enzyme pills or drops with the dairy foods.
• If you now eat large portions of meat, cut them back gradually. Three ounces is about the size of a deck of cards.
• 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.

Remember that changing your lifestyle is a long-term process. Often, individuals 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.

Want To Learn More?

A good source for more information is the publication, Facts About the DASH Diet, available from the National Institutes of Health (NIH). It includes a form to track food habits before starting the DASH plan, a chart to help with meal planning and shopping guide, easy-to-make recipes, and a week's worth of menus. The publication is available on NIH’s website:

http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/.

If you prefer to have the publication mailed to you, single copies may be ordered free of charge. Orders can be placed online at:

http://emall.nhlbihin.net/product2.asp?source=&sku=4082.

Orders also may be placed by sending a letter to: NHLBI Information Center, P.O. Box 30105, Bethesda, MD 20824-0105. Request NIH Publication No. 98-4082.

Additional information about DASH is available at the websites: http://dash.bwh.harvard.edu and http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/dashbody.htm.