High blood pressure: Using the DASH diet

Introduction

The DASH diet is an eating plan that is low in fat but rich in low-fat dairy foods, fruits, and vegetables. DASH stands for Dietary Approaches to Stop Hypertension. Hypertension is high blood pressure. Following the DASH diet may lower blood pressure. The DASH diet may also help you prevent high blood pressure if you have prehypertension (your blood pressure is between 120–139 over 80–89).¹

DASH also recommends eating whole grains, fish, poultry, nuts, seeds, and dried beans (legumes) as part of a balanced diet.

DASH is one of several lifestyle changes your doctor may recommend to lower your high blood pressure. Your doctor may also want you to decrease the amount of sodium and sodium-rich prepared foods in your diet. Lowering sodium while following DASH has been proven to lower blood pressure even further than just DASH alone.² You can cut down on your salt (sodium) intake by using a salt substitute. Talk to your doctor before trying a salt substitute.

Key points:

• Eating fewer processed foods, such as snack items, luncheon meats, and canned soups, will reduce the amount of sodium in your diet and help you lower your blood pressure.
• A diet high in calcium, potassium, and magnesium may lower your blood pressure.
• A diet high in sodium may cause high blood pressure.
• To increase the potassium in your diet, fruits and vegetables are excellent sources of this nutrient. Dairy products are high in calcium and magnesium. DASH recommends that you eat 8 to 10 servings of fruits and vegetables and 3 servings of low-fat dairy products each day.
• Eating a diet low in both saturated fat and total fat will also help lower your blood pressure. Only 30% of your total calories should be from fat, with only 7% to 10% of your fat calories from saturated fat. Saturated fat is found in meats, cheeses, butter, poultry, snack foods, and other processed foods.
• In general, vegetarian diets reduce blood pressure. The DASH diet could easily be a vegetarian diet if legumes were substituted for meat. Vegetarian diets tend to be higher in potassium, magnesium, and calcium, as is the DASH diet. Vegetarian diets also are higher in fiber and unsaturated fat than other diets.
• Controlling your weight, increasing your physical activity, and reducing sodium in your diet will help reduce your blood pressure even more when combined with the DASH diet.

 What can I do to incorporate DASH into my lifestyle?
 Why does adding more fruits and vegetables and low-fat dairy products to my diet help me lower my high blood pressure?
 How can I make sure I stay with the DASH eating plan?
 Where to go from here

More information about high blood pressure can be found in the topic:

• High Blood Pressure (Hypertension).

Return to topic:

What can I do to incorporate DASH into my lifestyle?

You can make small changes to incorporate the DASH diet into your lifestyle. Slowly change your eating habits to fulfill the following recommendations.

• Eat 8 to 10 servings of fruits and vegetables each day. If you are not eating this many yet, keep track of the fruits and vegetables you eat. Slowly add more to your diet. Check what counts as a serving in the food guide pyramid.
• Eat 3 servings of low-fat or nonfat dairy foods such as milk, yogurt, and cheese.
• Limit the amount of saturated fat you eat. Substitute monounsaturated and polyunsaturated oils instead.
• Limit the amount of sodium in your diet by cutting down on the amount of processed foods you eat, such as snack items, luncheon meats, and canned soups.

See a sample DASH menu.

Here are some ideas for eating with DASH:

• Think about including fruits and/or vegetables in every meal. Take fruit to work or school, for a snack.
• Drink nonfat milk. A glass of skim milk has only 80 calories and no fat and is packed with blood pressure–lowering nutrients. Have a "skinny" latte (caffe latte made with skim milk) as a way to add milk to your diet. If you don't drink coffee, try a skinny almond milk.
• Make a baked potato bar. Serve baked potatoes with a variety of vegetables, such as broccoli, and use other toppings, such as low-fat shredded cheese, chili, salsa, and refried beans. If you use canned or jar toppings, be sure to choose low-sodium varieties, or even better, make them yourself from fresh ingredients. Be creative. You could end up with 4 or 5 servings of vegetables at one meal.
• Use a variety of cut-up vegetables with a low-fat dip as an appetizer such as hummus, instead of high-fat chips and dips. Try some new vegetables. Make a stir-fry containing lots of different vegetables.
• Try some vegetarian meals featuring legumes (cooked dried beans and peas). Add garbanzo beans to a salad, use fat-free refried beans, and/or make split pea or black bean soup. Buy a vegetarian cookbook and try one recipe each month or each week.
• Combine a ready-made pizza crust with low-fat mozzarella cheese and lots of vegetable toppings. Use tomatoes, zucchini, spinach, carrots, cauliflower, and onions.
• For breakfast, have whole-grain cereal, fruit, and low-fat milk.
• For a snack, have a smoothie made with low-fat milk and frozen fruit chunks.
• Make a dip for fruit from low-fat vanilla yogurt and cinnamon.

Test Your Knowledge

1. To start incorporating the DASH diet into my lifestyle, I should slowly add more fruits and vegetables to my diet. My goal is 8 to 10 servings each day.
1. True
   

   The answer is correct

   To start with, think about changing only your fruit and vegetable intake. Keep track of the fruits and vegetables you eat, and slowly add more to your diet. Your goal is 8 to 10 servings a day.

   
2. False
   

   The answer is incorrect

   To start with, think about changing only your fruit and vegetable intake. Keep track of the fruits and vegetables you eat, and slowly add more to your diet. Your goal is 8 to 10 servings a day.

   
2. Nonfat milk is an important part of the DASH diet.
1. True
   

   The answer is correct

   A glass of skim milk has only 80 calories and no fat and is packed with blood pressure–lowering nutrients.

   
2. False
   

   The answer is incorrect

   A glass of skim milk has only 80 calories and no fat and is packed with blood pressure–lowering nutrients.

   

Continue to Why does adding more fruits and vegetables and low-fat dairy products to my diet help me lower my high blood pressure?
Return to High blood pressure: Using the DASH diet

Why does adding more fruits and vegetables and low-fat dairy products to my diet help me lower my high blood pressure?

People who eat mainly processed foods usually get too much sodium and not enough potassium, calcium, and magnesium in their diets. Not getting enough of these nutrients, which come from fruits, vegetables, and dairy products, may contribute to high blood pressure.

Researchers believe that it is the combination of 8 to 10 servings a day of fruits and vegetables and 3 servings of low-fat dairy products that causes the DASH diet to lower blood pressure. Simply adding calcium, potassium, and magnesium supplements to the diet does not lower blood pressure.

Good sources of potassium

All fresh fruits and vegetables and meats are good sources of potassium. Fruit and vegetable examples include:

• Bananas, cantaloupe, oranges, and orange juice.
• Raw or cooked spinach, lima beans, zucchini, broccoli, carrots, cauliflower, and artichokes.
• Potatoes.
• Legumes (cooked dried beans and peas) such as pinto beans, chickpeas, and lentils.

A serving size of fruits and vegetables includes:

• ¾ cup fruit or vegetable juice.
• ½ cup raw, canned, or cooked fruits or vegetables.
• 1 medium apple or ½ a banana.
• 1 cup raw, leafy vegetables.

Good sources of calcium

• Low-fat dairy products (yogurt, skim milk, cheese)

A serving size is:

• 1 cup milk or yogurt.
• 1.5 oz (42.5 g) to 2 oz (56.7 g) low-fat cheese.

Good sources of magnesium

• Legumes (cooked dried beans and peas), seeds, and nuts
• Halibut
• Milk and yogurt
• Brown rice and potatoes
• Tomatoes
• Bananas and watermelon
• Leafy green vegetables

A serving size includes:

• ¾ cup cooked dry beans.
• ½ cup brown rice.

Test Your Knowledge

1. A balanced, low-fat diet that contains 8 to 10 servings each day of fresh fruits and vegetables and 3 servings each day of low-fat dairy foods will help me lower my high blood pressure.
1. True
   

   The answer is correct

   People who mainly eat a diet of processed foods may not get enough potassium, calcium, and magnesium that come from eating a balanced diet with 8 to 10 servings each day of fresh fruits and vegetables and 3 servings each day of low-fat dairy products.

   
2. False
   

   The answer is incorrect

   People who mainly eat a diet of processed foods may not get enough potassium, calcium, and magnesium that come from eating a balanced diet with 8 to 10 servings each day of fresh fruits and vegetables and 3 servings each day of low-fat dairy products.

   

Continue to How can I make sure I stay with the DASH eating plan?
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How can I make sure I stay with the DASH eating plan?

Ask your doctor to recommend a registered dietitian who can work with you to change your eating habits and help you plan menus that follow the DASH eating style. See a sample DASH menu.

Use a form to track your eating habits. Record everything you eat before you start DASH, charting the number of servings you eat in the following food groups: grains; vegetables; fruits; dairy; meats (including poultry and fish); nuts, seeds, and beans; fats and oils; and sweets. As well as you can, record the amount of sodium in everything you eat. After you begin the DASH eating plan, keep the same charts, and compare your lists.

Use the following as a guide for the DASH eating plan:

Milk and dairy

• 3 servings a day. One serving equals: 8 ounces of nonfat or low-fat milk; 1 cup of low-fat yogurt; or 1½ ounces of low-fat cheese.

Fruits and vegetables

• 8 to 10 servings a day. One fruit serving equals: 1 medium fruit; ¼ cup dried fruit; ½ cup frozen or canned fruit; or 6 ounces of fruit juice. One vegetable serving equals: 1 cup raw, leafy vegetables; ½ cup cooked vegetables; or 6 ounces vegetable juice.

Grains

• 7 to 8 servings a day. One serving equals: 1 slice whole wheat bread; ½ cup dry or hot cereal; or ½ cup cooked brown rice, pasta, or other cooked grain.

Meat, fish, poultry

• 5 to 6 ounces a day. One serving equals: 3 ounces cooked meat, poultry, or fish (about the size of a deck of cards).

Nuts, seeds, dried beans

• 4 to 5 servings a week. One serving equals: 1/3 cup nuts; 2 tablespoons seeds; or 3/4 cup cooked dried beans. Use nuts, seeds, or dried beans to replace meat in some of your meals.

Test Your Knowledge

1. With the DASH eating plan, I don't have to worry about the number of servings I eat as long as I get a lot of fruits and vegetables in my diet.
1. True
   

   The answer is incorrect

   DASH is a proven scientific method for lowering blood pressure. If you don't follow the recommended number of servings in the important food groups, you may not be able to lower your blood pressure.

   
2. False
   

   The answer is correct

   DASH is a proven scientific method for lowering blood pressure. If you don't follow the recommended number of servings in the important food groups, you may not be able to lower your blood pressure.

   

Continue to Where to go from here
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Where to go from here

Now that you have read these tips on following the DASH diet, you are ready to change your eating habits to lower your high blood pressure.

For more sample menus and recipes for the DASH eating plan, go to www.nhlbi.nih.gov (under Health Information and Publications, click on High Blood Pressure) or write to the NHLBI Health Information Center, P.O. Box 30105, Bethesda, MD, 20824-0105, and request information on the DASH diet.

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