Everything You Ever Wanted to Know About the DASH Diet
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Everything You Ever Wanted to Know About the DASH Diet

Drop pounds, cut cholesterol and lower your blood pressure with DASH.

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By Rose Hayes 

In 2017, the DASH Diet was ranked #1 in the diabetes-friendly, heart-healthy and overall best diet categories by US News and World Report. DASH is designed to help control high blood pressure, but—when followed closely—it may offer additional benefits, such as:

  • Weight loss
  • Higher “good” cholesterol (HDL)
  • Lower “bad” cholesterol (LDL)
  • Improved blood sugar control over time (A1C level)

Madhi Challapalli, MD, a cardiologist and internist from Methodist Hospital in San Antonio, Texas, explains how the DASH Diet works and offers simple tips to help you stick with it.

What is the DASH Diet?

2 / 15 What is the DASH Diet?

DASH stands for Dietary Approaches to Stop Hypertension, the medical term for high blood pressure. It encourages you to eat specific food groups that contain blood pressure-lowering nutrients like potassium, magnesium and fiber, which can be found in whole grains, lean protein, fruits and veggies. At the same time, you should reduce your intake of foods that can hurt your heart like salt, alcohol, sweets and red meat.

Foods to include

3 / 15 Foods to include

Before starting on DASH, check how many calories your diet should include based on your age, gender, activity level and weight loss goals. That’s not because the DASH Diet requires a strict daily calorie count, but because it’ll help you determine exactly how many servings you should get from each food group. For a typical, 2000 calorie a day diet, aim for:

  • Whole grains: Three servings daily
  • Beans, seeds and nuts: Four to five servings weekly
  • Lean meat, including fish: Two servings or less daily
  • Vegetables: Four to five servings daily
  • Fruits: Four to five servings daily
  • Good oils like olive oil: Two to three servings daily—avoid butter and margarine
Foods to avoid

4 / 15 Foods to avoid

Limit your sodium, or salt intake to less than 2,300 mg daily. Your healthcare provider (HCP) may recommend cutting salt even more, depending on your personal or family health history.

Also reduce your red meat intake, keep sweets to less than five servings weekly and avoid fried and fast foods. In general, it’s easier to follow the DASH Diet when cooking at home because you can control exactly how much salt, sugar and oil you put in your food.

Who should go on the DASH Diet?

5 / 15 Who should go on the DASH Diet?

“Theoretically, anybody could go on the DASH Diet,” says Dr. Challapalli. It’s not just about lowering blood pressure, but also about prevention.

“If you're doing the diet for disease prevention, then you might see a three to four millimeter drop in your systolic [top number] blood pressure,” he continues. “We see a much bigger reduction in people who already have hypertension. They tend to experience a drop of around eight to fourteen millimeters.”

Consider this diet if you have:

  • A family history of high blood pressure, high cholesterol or heart disease
  • A personal history of any of these conditions
  • Diabetes or chronic kidney disease

Older adults, black people and those who are overweight or lack physical activity are also at higher risk for hypertension and may benefit from the DASH Diet.

Know your numbers

6 / 15 Know your numbers

Get a blood pressure screening when you start the DASH Diet to learn your baseline, or starting numbers.

You can get a free blood pressure screening at some pharmacy chains like participating Walmart locations. But consider booking an appointment with your general practitioner. He or she can help you make a whole-lifestyle plan to reduce your disease risk, including exercise, tobacco cessation, stress reduction and more. They can also measure your starting weight and cholesterol.

Invest in an automatic blood pressure monitor for home, too. They cost around 15 to 45 dollars or more, depending on the brand. That way, you can check your numbers regularly, track your progress and get if your numbers are high. 

What’s normal?

7 / 15 What’s normal?

Normal blood pressure is less than 120/80 mm Hg. High blood pressure is anything over 140/90 mm Hg.

If you get a reading above 180/110, wait five minutes and then take it again. Still above 180/110? Call 9-1-1 or have someone take you to the emergency room immediately.

Also call 9-1-1 immediately if you experience shortness of breath, chest pain, numbness or weakness in your limbs or face, changes in vision or difficulty speaking—with or without high blood pressure. 

5 ways to love the low-sodium life

8 / 15 5 ways to love the low-sodium life

“There are actually two versions of the DASH Diet,” says Challapalli. “One is the standard DASH Diet, which recommends a limit of 2300 milligrams of sodium daily. Then there's a lower-sodium version, which is stricter. That version recommends up to 1500 milligrams daily.” (Ask your HCP which version is appropriate for you based on your blood pressure and disease risk.) 

But less salt doesn’t have to mean less flavor. Enjoy tasty, low-salt meals with these simple tricks:

  • Sautee onions or heat garlic for a savory base, instead of using broth or consommé.
  • Add lemon, lime, vinegar or vegetables pickled in vinegar (not sodium or brine).
  • Choose fresh veggies over canned. Frozen vegetables are often okay, but check the nutrition facts to make sure they’re low sodium.
  • Move spices to the stovetop or a counter rack. It’s easy to forget about all of your flavor potential when it’s hiding in the back of the pantry. (Get 11 other kitchen make over tips for weight loss.)

Roasted red peppers, sundried tomatoes and olives are potentially safe toppings, but choose ones jarred in olive oil or vinegar, instead of salt or brine, and check the sodium content. 

Beware of bouillon (and other sneaky sodium bombs)

9 / 15 Beware of bouillon (and other sneaky sodium bombs)

Sodium can hide in some truly surprising places. Always check labels, even on foods you wouldn’t normally consider salty. Here are some potentially high-sodium foods you might not expect:

  • Sliced breads, biscuits and crackers
  • Instant oatmeal and cereals
  • Nut butters
  • Rice and potato mixes
  • Some vegetable juices
  • Specialty coffee beverages
  • Canned and instant soups

“Stay away from fast foods as much as you can,” adds Challapalli. “At regular restaurants, dishes usually have quite a bit of salt in them too—more than what you'd use at home—so don’t add table salt.” When eating out, tell the person taking your order you’re on a low-sodium diet, as well. Most kitchens can accommodate DASH restrictions. 

Get in more whole grains

10 / 15 Get in more whole grains

Whole grains are ones that still have their kernels intact—think brown rice, instead of white. The kernel means whole grains have more fiber and essential nutrients like potassium, magnesium and folate than refined grains. That’s beneficial because:

  • Fiber helps to lower blood pressure and cholesterol 
  • Potassium is key to healthy blood pressure control
  • Fiber keeps you full longer and can help keep your blood sugar steady between meals  

Make batches of whole grains like bulgur, barley and rye during weekly meal prep. Add them to salads and wraps or enjoy as a side dish with mixed veggies.  

Embrace Meatless Mondays

11 / 15 Embrace Meatless Mondays

While you are allowed up to two servings of lean meat like chicken or salmon per day, you should generally avoid red meat on the DASH Diet—really, you should limit it on any diet since it’s associated with a greater risk of heart disease and colon cancer. Phase red meat out of your diet gradually, beginning with Meatless Mondays. Get started with six easy meatless meals for people who can’t cook

Cut back on alcohol and caffeine

12 / 15 Cut back on alcohol and caffeine

Many people with high blood pressure can have a small amount of caffeine daily—about two cups of coffee or less. Caffeine can raise blood pressure, but the effect is typically mild and temporary. But double check with your HCP to determine how much—if any—is appropriate for you, considering your personal history and lifestyle. Choose herbal teas like chamomile or rooibos over coffee to sidestep caffeine.

When it comes to alcohol, men should have no more than two servings daily, women no more than one. However, you may want to reduce your intake even more, according to 2017 research on the surprising effects of alcohol on brain health

Nosh on fruit and nuts

13 / 15 Nosh on fruit and nuts

Added sugar is restricted on the DASH Diet, but natural sweets are encouraged. Snack on fruit and unsalted nuts for a filling, protein-fiber combo between meals. Nuts may help lower your LDL or “bad” cholesterol and walnuts, specifically, are a brain-boosting food. Some tasty pairs:

  • Almonds and a banana
  • Pistachios and a pear
  • Walnuts and a fig
  • Grapes and peanuts
  • Cashews and orange slices

“In addition to fresh fruits and unsalted nuts, low fat dairy like cottage cheese or plain Greek yogurt is good for snacking,” says Challapalli. “But you have to be careful because most yogurts are processed and have added salt, sugar and other ingredients. Plain yogurt with your own ingredients is the way to go.”

Exercise is actually part of the diet

14 / 15 Exercise is actually part of the diet

Exercise is a proven way to help lower your blood pressure, so it’s considered a key part of the DASH Diet. Aim for 20 to 30 minutes of moderate activity on most days of the week. You can break that up into short bursts (as long as they last at least ten minutes each), but the important thing is to get a total two and a half hours of moderate-intensity exercise weekly—and more is even better.

Been a while since you’ve gotten moving? Start with a fifteen-minute walk each morning and evening, and try these “no workout” moves you can do anywhere. 

What if your blood pressure stays high?

15 / 15 What if your blood pressure stays high?

Talk to your HCP about a blood pressure goal and timeline that’s right for you. If you don’t meet your target after an agreed upon amount of time, your HCP may recommend reducing your salt intake to 1,500 mg daily, instead of 2,300 mg.

Some people need to take blood pressure medication in addition to making lifestyle changes. It’s important to continue eating right and exercising even if you start taking meds—doing so can make your prescriptions work more effectively. Some people are able to eventually taper off their meds with doctor supervision by following DASH guidelines, as well.

Take the RealAge Test to get personalized lifestyle tips that can help lower your blood pressure and reduce your disease risk.