In the Spotlight May 17, 2000 The DASH Diet: Eating To Lower Your Blood Pressure

The DASH Diet: Eating To Lower Your Blood Pressure

Research has shown that diet affects the development of high blood pressure (hypertension). Recently, a study found that a particular eating plan can lower elevated blood pressure.

What is high blood pressure?

Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mm Hg) and recorded as two numbers--systolic pressure (as the heart beats) over diastolic pressure (between heartbeats). Both numbers are important.

When blood pressure is too high, the heart is working harder than it should. Once developed, high blood pressure lasts a lifetime. It is a dangerous condition, which often has no warning signs or symptoms. If uncontrolled, it can lead to heart disease, kidney disease and stroke.

High blood pressure affects about 50 million--or one in four--adult Americans. High blood pressure is especially common among African Americans, who tend to develop it earlier and more often than whites. Many Americans also tend to develop high blood pressure as they age. About half of all Americans age 60 and older have high blood pressure.

High blood pressure can be controlled by the following steps: Lose weight, if overweight; become physically active; eat healthy, including choosing foods lower in salt and sodium; limit alcohol intake and, if prescribed, take high blood pressure pills. All steps but the last also help prevent high blood pressure.

What is DASH?

In the past, researchers had 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 nutrients as they occur together in food. The results were dramatic. The clinical study, called "DASH" for Dietary Approaches to Stop Hypertension, found that elevated blood pressures can be reduced with an eating plan low in saturated fat, total fat and cholesterol and rich in fruits, vegetables and low-fat dairy foods. The plan is rich in magnesium, potassium and calcium, as well as protein and fiber.

Results showed that the DASH eating plan reduced blood pressure by an average of about 6 mm Hg for systolic and 3 mm Hg for diastolic. It worked even better for those with high blood pressure--the systolic dropped on average about 11 mm Hg and the diastolic about 6 mm Hg. Further, the reductions came fast--within two weeks of starting the eating plan.

The DASH eating plan

The DASH eating plan shown below is based on 2,000 calories a day. The number of daily servings in a food group that you may need may vary, depending on your caloric needs.

You should be aware that the DASH plan has more daily servings of fruits, vegetables and grains than you may be used to eating. This makes it high in fiber, which can cause bloating and diarrhea. To get used to the new eating plan, gradually increase your servings of fruits, vegetables and grains.

THE DASH Eating Plan

The DASH eating plan is rich in various nutrients believed to benefit blood pressure and in other factors involved in good health. The amounts of the nutrients vary by how much you eat. If you eat about 2,000 calories a day on the plan, the nutrients you get will include:

• 4,700 milligrams of potassium
• 500 milligrams of magnesium
• 1,240 milligrams of calcium

Those totals are about two to three times the amounts most Americans get.

The amount of salt and sodium will vary, with an average of 2,400 mgs of sodium per day. Twenty-four hundred mgs of sodium equals about six grams, or one teaspoon, of table salt (sodium chloride). This amount follows the current recommendation of both the Federal Government's Dietary Guidelines for Americans and the NHLBI's National High Blood Pressure Education Program. The DASH eating plan makes it easier to consume less salt and sodium, because it is rich in fruits and vegetables, which are lower in sodium than many other foods. You can also keep salt and sodium down by using fewer already prepared foods and less salt at the table and in cooking.

How can I get started on DASH?

It's easy. The DASH eating plan requires no special foods and has no hard-to-follow recipes. Here are some ways to get started:

Change 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 your meals or have it as a snack;
• Use only half the butter, margarine or salad dressing you do now;
• Try low-fat or fat-free condiments, such as fat-free salad dressings;
• Gradually increase dairy products to three servings per day. For example, drink milk with lunch or dinner, instead of soda, alcohol or sugar-sweetened tea. Choose low-fat (one percent) or fat-free (skim) dairy products to reduce total fat intake.
  

Treat meat as one part of the whole meal, instead of the focus

• Buy less meat. If it's not there, you won't eat it;
• Limit meat to six ounces a day (two servings). Three to four ounces is about the size of a deck of cards;
• If you now eat large portions of meat, cut them back gradually--by a half or a third at each meal;
• Include two or more vegetarian-style (meatless) meals each week;
• Increase servings of vegetables, rice, pasta and dry beans in meals. Try casseroles, pasta and stir-fry dishes, having less meat and more vegetables, grains and dry beans.

Use fruits or low-fat foods as desserts and snacks

• Fruits and low-fat foods offer great taste and variety. Use fruits canned in their own juice. Fresh fruits require little or no preparation. Dried fruits are easy to carry with you.
  

Try these snack ideas: Unsalted pretzels or nuts mixed with raisins; graham crackers; low-fat and fat-free yogurt and frozen yogurt; plain popcorn with no salt or butter added and raw vegetables.

Remember that some days you may eat more than what is recommended from one food group and less of another. Don't worry--just be sure that the average of several days or a week comes close to what is recommended.

The DASH plan is a new way of eating--for a lifetime. If you slip from the eating plan for a few days, don't let it keep you from reaching your health goals; just get back on track.

One note: It's important that, if you have high blood pressure and take a medication, you should not stop your therapy. Use the DASH diet and talk about your drug treatment with your doctor.

Source: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Heart, Lung, and Blood Institute

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