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Understanding the DASH Diet 9.374 Fact Sheet No. Food and Nutrition Series|Health by J. Clifford and K. Maloney* What is the DASH Diet? great news, especially considering that diet Quick Facts The DASH diet, or Dietary Approaches can be a safer alternative to medication, to Stop Hypertension, was developed and often costs less. • DASH stands for Dietary through research funded by the National Research has also shown that following Approaches to Stop Heart, Lung, and Blood Institute. It has a DASH diet can be beneficial for numerous Hypertension. been shown to be effective in lowering other medical concerns. To begin, the DASH • The DASH eating plan is rich blood pressure and blood lipid levels, diet is inversely associated with the risk for type II diabetes mellitus. When combined in fruits, vegetables, and which ultimately reduces the risk with exercise, it can result in significant whole grains. It focuses on for cardiovascular disease. This plan weight loss, which improves insulin consuming low-fat and fat-free emphasizes fruits, vegetables, whole grains, sensitivity, and can decrease the risk for dairy products, along with lean protein, low-fat dairy, and seeds, nuts, diabetes by as much as 37 percent. nuts, seeds, beans, and limited and legumes. It also recommends limiting Eating a DASH diet has also been shown amounts of lean meats, poultry, sugary beverages, sweets, sodium, and red to improve symptoms of gestational and fish. meats. The DASH diet is rich in magnesium, diabetes, improving the glucose tolerance potassium and calcium, which are and lipid profiles of patients. Furthermore, • Compared to the typical protective against high blood pressure. in studies it was associated with a American diet, the DASH eating Benefits of the DASH Diet decreased need to continue insulin therapy plan is lower in saturated after delivery, and a decreased risk for fat, cholesterol, and total fat The DASH eating plan has been caesarian section. and higher in potassium, shown to be effective for the prevention The DASH diet also appears to be magnesium, calcium, fiber, and and management of hypertension. beneficial for the brain. Not only does a protein. Hypertension is a clinical term used for DASH eating pattern decrease the risk for high blood pressure. Approximately 1 in stroke by decreasing hypertension, but it 3 American adults have hypertension. is also associated with decreased risk for This “silent killer,” which often lacks overt cognitive decline. Research has shown symptoms, can increase the risk for heart that eating a DASH style diet is protective disease, stroke, kidney disease, and against losses in episodic and semantic blindness. memory. Often, hypertension, a chronic disease, Furthermore, the DASH diet is is treated with prescription medications. supportive of digestive health, and However, diet and lifestyle changes can decreases the risk of the development significantly reduce blood pressure. of colorectal cancer. This may be due Research shows that in some individuals, to an increased level of fiber or higher the DASH eating plan may reduce consumption of dairy. blood pressure as much or more than The DASH eating pattern has also been prescribed drugs. The DASH eating plan, in shown to support kidney health. Studies combination with a sodium restricted diet have shown that a DASH diet decreases (1500mg/day), can produce even greater the risk for urinary albumin excretion results in lowering blood pressure. This is and protects against rapid decreases in glomerular filtration, both of which are © Colorado State University * Extension. 10/07. Reviewed 11/15 Jessica Clifford, Colorado State University food science and indicators of decreasing kidney function. It human nutrition research associate and extension specialist is also protective against the development www.ext.colostate.edu and Katie Maloney, graduate student; from original fact sheet of kidney stones. by J. Anderson, Ph.D., R.D., foods and nutrition specialist However, it is important to note and professor; S. Prior and D. Braithwaite, former graduate that aspects of the DASH diet may be interns, food science and human nutrition; and B. Sherman, Extension Agent, Golden Plains Area. Revised 11/2015 Table 1. The DASH Eating Plan. Try these easy approaches to add Food Group Daily Servings Serving Sizes more fruits and vegetables throughout (Except as noted) the day: 1 slice 100% whole grain bread • Top oatmeal or yogurt with fresh Whole Grains 6-8 1 cup whole grain cereal ½ cup cooked rice, quinoa, or whole grain pasta banana slices, berries, or peaches. 1 cup raw leafy vegetables • Have sliced fresh fruit or vegetable Vegetables 4-5 ½ cup cooked vegetable for a snack. (Add a yogurt dip) ½ cup vegetable juice • Cover a sandwich with lettuce, 1 medium whole fruit tomatoes, and a few thin avocado Fruits 4-5 ½ cup fresh or frozen fruit ¼ cup unsweetened dried fruit slices. Fat-free or low-fat 1 cup milk • Center meals around vegetables. dairy products 2-3 1 cup yogurt Try a meatless meal several times 1½ ounces cheese a week. Lean meats, 6 or less 1 ounces cooked lean meats, poultry, or fish • Stir some cooked veggies, like poultry, and fish 1 egg broccoli, zucchini, or carrots, into a Nuts, seeds, and 1/3 cup or 1 ½ ounces nuts spaghetti sauce, soup, or casserole. legumes 4-5 per week 2 tablespoons or ½ ounce seeds ½ cup cooked legumes (dried beans or peas) • Reduce the amount of meat in 1 tablespoon mayonnaise a recipe and then replace it with Fats and oils 2-3 2 tablespoons salad dressing vegetables. 1 teaspoon olive oil or vegetable oil Try new and different fruits and 1 tablespoon sugar vegetables to add variety. Smoothies Sweets and added 5 or less per week 1 tablespoon jelly or jam, or syrup sugars ½ cup sorbet, are a fun way to experiment with 1 cup lemonade a variety of fruit flavors and add a serving of dairy to the meal. contraindicated by certain medical substituting whole wheat flour for at least conditions. Speak with a doctor or half the amount of all-purpose flour in a registered dietitian before making the recipe. switch to a DASH eating plan, especially if suffering from chronic illness or disease. How to Follow the DASH Eating Plan Fruit Smoothie Recipe The DASH Eating Plan is similar to many of the recommendations Yield: 1 serving included in the 2010 Dietary Guidelines • 1 cup of fruit (berries, mango, for Americans. The 2005 Dietary peaches, or any combination of Guidelines for Americans based many fruits) recommendations on the DASH Diet • ½ cup low-fat or fat-free yogurt Eating Plan. Take note, however, that the (plain, vanilla, or fruit flavor) DASH Eating Plan measures food intake • ½ cup milk by ‘daily servings’ in each food group, whereas the Dietary Guidelines focus on total ‘amounts’ of foods from each group, Increase Fruits and Vegetables Directions: Puree fruit in a blender. Add rather than numbers of daily servings. yogurt and milk. Blend until smooth. Like whole grains, fruits and Yogurt may be replaced by milk for a vegetables are an excellent source of thinner smoothie. Use frozen fruit for a Choose Whole Grains fiber in the diet. Fruits and vegetables thicker smoothie. When experimenting Whole grains are higher in fiber, are also a rich source of potassium and with new combinations, consider adding vitamins, and minerals compared to magnesium, as well as many other greens, nut butter, avocado or fresh herbs refined grains. Whenever possible, choose nutrients that are required for healthy to smoothies. whole grains, such as wild rice, oatmeal, bodily function. Focus on fresh or frozen quinoa, or buckwheat. When buying fruits and vegetables. Canned products bread, cereals, pasta, or tortillas, look for typically contain more sodium and sugar. products that list ‘100% whole grain’ on When purchasing canned products, look the label. Otherwise, choose products for low sodium options and choose fruit that name ‘whole grain’ as the first item canned in its own juice to reduce sugar in the ingredient list. When baking, try intake. Table 2. Savor the flavor in your food. Herb/Spice Flavor and Aroma Uses Allspice Blend of cinnamon and clove Sauces, pumpkin, roasts, baked goods, teas, seasonings Anise Licorish-like (similar to fennel) Baked goods (cookies, cakes, breads), cheese, stews, fish, shellfish Basil Sweet fragrance Tomato-based sauces, pesto, pizza, cheese, vegetables Bay Leaves Aromatic, pungent Soups, stews, stocks, tomato dishes, meats Black Pepper Hot, biting Almost any food Celery Seed Celery-like Vegetables, salad dressings, breads, soups Cilantro Waxy, citrus Mexican dishes (salsa, chutney, beans, soups), salads Cinnamon Sweet, pungent Baked dishes, fruits Coriander Mildly sweet, spicy Beans, lentils, onions, potatoes, stews Cumin Aromatic, pungent Mexican, Thai, Vietnamese, Indian dishes Dill Weed Fresh, green Fish, shellfish, cottage and cream cheese, tomatoes Ginger Pungent, aromatic Curries, fruits Marjoram Minty, aromatic, slightly bitter Meats (lamb, beef, pork, chicken, fish), tomato dishes, breads, salad dressings, chowders Nutmeg Strongly aromatic, citrus, piney Sweet foods, baked goods Oregano Strongly aromatic, slightly bitter Italian dishes (tomato based), Mexican dishes Parsley Clean, “green” vegetable Soups, stews, stocks, egg dishes (often used as a garnish) Rosemary Sweet and fresh Poultry, lamb, vegetables Thyme Warming and pungent Meats, fish, stews, stuffings (Adapted from McCormick Spice Encyclopedia, available at: www.mccormick.com/content.cfm?ID=8219 Include Fat-free or Low-fat Dairy Select Lean Meats, Fish & Products Poultry Low-fat and fat-free dairy products The DASH eating plan also emphasizes consume reasonable portion sizes (one are an excellent source of calcium and on consuming lean meats, poultry, serving is approximately a small handful, protein. Potassium and magnesium are and fish rather than meats with a high or 1/3 of a cup); nuts are high in calories. also found in dairy products. Cheese can saturated fat content. Meats contribute Incorporate foods from this group in a be a considerable source of sodium in the protein and magnesium to the diet. Eggs variety of ways: diet, so be mindful of its consumption. are also an excellent source of lean protein. • Spice up salads by adding raw or When choosing yogurt, be sure to read Red meat can be included in the DASH unsalted dry-roasted nuts or seeds, the nutrition label and monitor the sugar Eating Plan, but consumption should be such as walnuts or sunflower seeds. content. Some yogurts are often very limited and leaner varieties, such as strip • Coat chicken or fish with a crushed nut high in added sugar. For this reason, steak or 90 percent lean ground beef mixture. consider purchasing plain yogurt and add are recommended. Grass-fed beef can • Try breads with nuts or seeds in them. any fruit or desired flavoring on your own. be a preferable selection because it can • Grab a handful of unsalted nuts for a Boost fat-free and low-fat dairy be lower in fat. When preparing a meal, snack. product intake with the following tips: trim the fat from meats beforehand, or • Try a cup of low-fat or fat-free plain set up a pan for fat to drip into during yogurt mixed with fruit and nuts, oats, cooking. Processed meats, such as hot or granola. dogs, breakfast meats, and deli meats are • Sprinkle low-fat mozzarella cheese on a significant source of sodium, so choose homemade pizza, quesadilla, or salad. these less often. • Grab a cool, refreshing glass of low-fat or fat-free milk with a snack or a meal. Incorporate Nuts, Seeds & Legumes If dairy products are difficult to digest, try cultured dairy foods, such as Nuts, seeds and legumes contribute buttermilk, yogurt, or cottage cheese. magnesium and potassium, along with Lactose-free milk or milk which has added protein, omega-3 fatty acids and fiber, to lactase enzyme are available, as well. If the diet. Legumes include beans, peas, problems persist, lactase enzyme pills lentils, and peanuts. Dry legumes are or drops (found at drug store or grocery preferable to canned products due to store) are several options. Dairy-free milk the sodium content. When selecting nuts alternatives, such as soy milk, may not and seeds, choose the raw or dry roasted provide the same nutrients. If struggling variety, which have lower sodium and with lactose-intolerance, work with a sugar content. Nuts that are honey roasted registered dietitian to ensure that dietary or salted are often very high in sugar and needs are being met. sodium, so be sure to look at the label and eat these varieties less often. Also, Consider Types of Fats and Oils for developing chronic diseases, like heart frozen green beans instead of canned The DASH eating plan includes disease. green beans. Another great option is approximately 27 percent of calories to prepare low sodium alternatives at from fat. Aim to consume only 6% of daily Reduce Sodium home. Make homemade baked goods, calories from saturated fats. Saturated fats marinades, and soups to considerably are often solid at room temperature, and Blood pressure decreases in response decrease the sodium content. are found in foods such as butter, coconut to a sodium-restricted diet. For the Instead of adding salt to your food, oil, meat, cheese, and whole fat dairy. greatest benefit, a maximum of 1500 enhance the flavor through the use of Furthermore, avoid trans fats, which are mg of sodium/day is recommended. herbs and spices. This is one very useful found in some fried foods, baked goods, Processed foods are often high in approach to add nutrients and reduce the snack foods, shortenings, and margarines. sodium. They are the greatest contributor sodium in a meal. Foods containing trans fats are becoming of sodium to the diet (77 percent). less common in grocery stores, but check Naturally occurring sodium accounts for Limit Sweets and Added Sugars ingredient lists for “partially hydrogenated approximately 12 percent of sodium in oil” before choosing to purchase a the diet, while 11 percent comes from The DASH eating plan also product. food added while cooking and eating. recommends limiting sweets and added Saturated fats and trans fats have been Foods high in sodium include snack sugars to five or fewer servings per shown to raise blood cholesterol levels. foods, canned foods, prepared tomato week. Be aware of the amount of sugar Monitoring intake of foods containing products, frozen pizza and microwave consumed from desserts, sweetened these fats can be an effective way to dinners, cheese, processed meats (deli beverages, and other sweets. Also, be manage cholesterol levels in some and breakfast meats), condiments, salad mindful that there are many hidden individuals. dressings, and instant cereals. Baked sources of added sugar in the diet, such as sauces, soups, breads and other baked goods, breakfast cereals, and flavored yogurt. Below are some tips to cut sugar consumption. • Make marinara and other sauces at home • Read nutrition labels carefully and purchase items with lower amounts of sugar • Replace jelly, jams, and syrup with nut butter or other alternatives • Replace dessert options with those that are naturally lower in sugar and fat, such as replacing ice cream with sorbet • Make fruit-based desserts • Replace sweetened tea with a flavorful herbal tea • Drink water or milk in place of soda or Focus on eating mono- and poly- goods such as bread, bagels, and English juice. unsaturated fats, which are typically liquid muffins also contribute sodium to the at room temperature, and are found in diet. However, low-sodium alternatives Making the Change foods such as fish, vegetable oils, nuts, are becoming more readily available. and avocado. In an American diet, it is Additionally, home-baked foods generally For many Americans, the DASH Eating important to be mindful of consuming have less sodium than processed versions. Plan is dramatically different from their adequate amounts of omega-3 fatty When the option exists, choose low- normal diet. If a person chooses to adopt acids. Canola oil, flaxseed oil, walnuts, sodium and no-sodium products. the DASH Eating Plan, the road to change and soybeans are all excellent sources of Read labels to determine the sodium can seem quite daunting. However, the omega-3 fatty acids, as are cold water fish content in foods. Products labelled “low most successful and lasting changes are a such as salmon, herring, and mackerel. sodium” have 140 mg of sodium or less result of gradual change. Start small and Fat is an important part of our diet, per serving, whereas products labelled be patient. providing essential energy and nutrients. “reduced sodium” have at least 25% less 1. Start by creating a food However, like any macronutrient, eating sodium than the original product. If a low- diary. This simply means writing down excessive amounts of fat can contribute to sodium option for a food isn’t available, everything (including amounts) of unwanted weight gain. Eating excessive consider substituting with a different what, when, and why you eat and drink amounts of fat may also increase the risk variety. For example, choose fresh or throughout the course of the day. After
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