The global population of individuals with high blood pressure is over one billion and is increasing.
High blood pressure has become a major health concern due to its association with increased risk of heart disease, stroke, and kidney failure, and has in fact increased twofold over the last four decades.
Scientists and policymakers have developed targeted dietary tactics to mitigate the role of diet in high blood pressure growth. This piece evaluates the DASH diet, formulated to control high blood pressure and lower the danger of heart disease.
The fundamental principles of the DASH Diet.
In the 1990s, the National Institutes of Health (NIH) financed several research projects to investigate the effects of various dietary interventions on blood pressure, which led to the development of the Dietary Approaches to Stop Hypertension (DASH) diet.
The significance of studying the DASH diet still stands relevant today due to the large number of Americans diagnosed with hypertension. This medical condition arises from constantly elevated blood pressure and heightens the likelihood of heart disease and stroke.
The DASH diet offers recommendations regarding the types of food that should be consumed on a daily or weekly basis, as well as the essential nutrients that should be increased or decreased. The diet emphasizes the consumption of fruits, vegetables, whole grains, fat-free or low-fat dairy, lean meats, fish, poultry, beans, nuts, and vegetable oils in a consistent manner.
Furthermore, the DASH diet advocates for reducing the consumption of added sugars (including sugar-sweetened drinks) and foods that are rich in saturated fat such as fatty meats, full-fat dairy products, and tropical oils like coconut oil.
The DASH diet recommends decreasing the consumption of sodium. This instruction is established through subsequent studies to the primary clinical trial of DASH, where it was found that the combination of sodium reduction and adherence to the DASH diet produced more significant decreases in blood pressure compared to only following the DASH diet.
The DASH diet advises to reduce sodium consumption to below 2,300 milligrams (mg) daily. However, certain DASH meal plans may propose a lower daily limit of 1,500 mg of sodium, taking into account personalized advice from a healthcare professional.
The National Academies of Sciences, Engineering, and Medicine have established comparable levels of daily sodium intake, which are likewise advised by the present Dietary Guidelines for Americans.
To summarize, the DASH diet recommends specific sodium intake levels for maintaining good health, which are:
- 2,300 mg or less per day for a standard DASH diet
- 1,500 mg or less per day for a lower-sodium DASH diet
It is crucial to bear in mind that while the DASH diet can aid in lowering blood pressure, it is only a component of a well-rounded healthy lifestyle plan. To obtain more extensive prevention and management of high blood pressure:
- Be physically active.
- Maintain a healthy weight.
- Limit alcohol intake.
- Manage and cope with stress.
- Quit smoking.
- Get plenty of sleep.
Maintaining Good Health with the DASH Diet
Numerous systematic reviews and meta-analyses were conducted to examine the association between the DASH diet and susceptibility to particular ailments and wellness issues.
High blood pressure
The DASH diet is widely recognized for its ability to decrease blood pressure and its potential advantages in decreasing the frequency and occurrence of hypertension.
The DASH clinical trial, first published in 1997, highlighted how the DASH diet was effective in reducing systolic blood pressure by 3.0 mmHg across the board, while also lowering diastolic blood pressure by 3.0 mmHg in people with hypertension.
In follow–up research published in 2001, the DASH-Sodium Collaborative Research Group examined the impact of two diets (control and DASH) at three sodium levels (3,500, 2,300 and 1,200 mg) on blood pressure.
When compared to the high-sodium control diet, the low-sodium DASH diet caused a decrease of 7.1 mmHg in systolic blood pressure among participants who did not have hypertension, and a decrease of 11.5 mmHg in systolic blood pressure among those who did have hypertension.
In a systematic review and meta-analysis conducted in 2020, which analyzed 30 randomized controlled trials including 5,545 participants, it was discovered that the DASH diet led to a considerable reduction in blood pressure among adults (specifically, a 3.2 mmHg decrease in systolic blood pressure and a 2.5 mmHg decrease in diastolic blood pressure), irrespective of whether the subjects had hypertension or not.
Chronic renal disease
A lowered risk of chronic kidney disease (CKD) is linked to the adoption of the DASH diet. An examination of six prospective cohort studies, encompassing 568,156 participants, conducted in 2019 shows that individuals who adhere to a DASH-like dietary regimen are less susceptible to the onset of CKD.
Diabetes Type 2
Following the DASH diet is associated with a decreased likelihood of developing type 2 diabetes.
A systematic review in 2019 covered 15 prospective cohort studies with a total of 942,140 subjects and 31 controlled trials with 4,414 subjects, through three and four systematic reviews and meta-analyses, respectively. These reviews found that the incidence of type 2 diabetes decreased with adherence to the DASH diet pattern.
Reworded: Cancer remains the same in meaning.
There is an association between following the DASH diet and a decrease in the likelihood of developing certain forms of cancer.
In 2019, a review of 17 cohort studies was conducted to examine possible links and connections between the DASH diet and cancer, including mortality from various cancer types and the occurrence of particular cancer types. The research revealed that the highest degree of adherence to the DASH diet corresponded with decreased mortality from all cancer types and a decreased likelihood of contracting colorectal, colon and rectal cancer.
Outcomes related to cognition
Improved cognitive outcomes have been found to be linked with adherence to the DASH diet. A study conducted by researchers in 2019 examined the impact of the DASH diet on both cognitive function and the risk of Alzheimer’s disease and dementia. The observational data analysis revealed that a higher adherence to the DASH diet was associated with enhanced cognitive function and a decreased risk of Alzheimer’s disease.
May Aid Weight Loss
Even if weight loss is not a goal, the DASH diet is likely to cause a decrease in blood pressure. Nevertheless, if you have hypertension, your doctor may have recommended weight loss.
Your blood pressure is more likely to be high if you weigh more. Furthermore, there is evidence that weight loss contributes to reduced blood pressure. The DASH diet may aid in weight loss, according to certain research.
Nonetheless, individuals who have shed weight on the DASH diet were instructed to consume fewer calories than they were expending, resulting in a regulated calorie deficit.
Some individuals may find that the DASH diet leads them to naturally lower their calorie consumption and shed pounds due to its avoidance of fatty and sweetened foods. However, others may need to deliberately decrease their intake.
Regardless, if you aim to shed weight with the DASH diet, you’ll need to adopt a diet that is low in calories.
The death rate in its entirety.
A correlation has been found between following the DASH diet and a reduced chance of death from any cause. An examination conducted in 2020 by researchers on 17 prospective cohort studies showed that those who follow the DASH diet have lesser all-cause mortality rates. Even minimal adherence to the DASH diet is linked with a reduced risk of dying from any cause.
Health complications such as heightened chances of heart disease, insulin resistance and fluid buildup have been associated with inadequate salt consumption. To prevent this, the DASH diet’s low-salt variation stipulates a daily intake of no more than 3/4 teaspoon (1,500 mg) of sodium.
It remains uncertain if decreasing salt consumption to such a low level has any advantages, particularly for individuals with hypertension. Despite the marginal decrease in blood pressure resulting from reduced salt intake, a recent analysis discovered no correlation between salt consumption and the likelihood of dying from heart ailments.
However, because most people eat too much salt, lowering your salt intake from very high amounts of 2–2.5 teaspoons (10–12 grams) a day to 1–1.25 teaspoons (5–6 grams) a day may be beneficial
Simply cutting back on highly processed foods and opting for whole foods can make achieving this goal easy. While it is advantageous for most individuals to reduce their salt consumption from processed foods, excessive salt restriction can also pose risks.
Rather than providing a list of specific foods, the DASH diet suggests particular serving sizes for various food groups. The quantity of servings allowed is based on the number of calories ingested. An illustration of food portions for a 2,000-calorie diet is given below.
Whole Grains: 6–8 Servings per Day
Whole grains such as oatmeal, quinoa, brown rice, bulgur, whole-grain breakfast cereals, and whole-wheat or whole-grain breads can be mentioned as examples.
Illustrations of a serving comprise:
- 1 slice of whole-grain bread
- 1 ounce (28 grams) of dry, whole-grain cereal
- 1/2 cup (95 grams) of cooked rice, pasta or cereal
Vegetables: 4–5 Servings per Day
The DASH diet permits the consumption of all kinds of vegetables. Some examples of a recommended serving are:
- 1 cup (about 30 grams) of raw, leafy green vegetables like spinach or kale
- 1/2 cup (about 45 grams) of sliced vegetables — raw or cooked — like broccoli, carrots, squash or tomatoes
Fruits: 4–5 Servings per Day
If you adhere to DASH principles, you will consume a substantial amount of fruit. Fruit options include apples, pears, peaches, berries, and exotic fruits such as pineapple and mango. A single serving size of fruit would be akin to the following examples.
- 1 medium apple
- 1/4 cup (50 grams) of dried apricots
- 1/2 cup (30 grams) of fresh, frozen or canned peaches
Dairy Products: 2–3 Servings per Day
Low-fat dairy products are recommended on the DASH diet. This includes skim milk, low-fat cheese, and yogurt. A serving size for these options may include:
- 1 cup (240 ml) of low-fat milk
- 1 cup (285 grams) of low-fat yogurt
- 1.5 ounces (45 grams) of low-fat cheese
Lean Chicken, Meat and Fish: 6 or Fewer Servings per Day
Opt for lean meat options and aim to consume red meat in limited quantities, preferably not more than once or twice per week. A serving size may consist of:
- 1 ounce (28 grams) of cooked meat, chicken or fish
- 1 egg
Nuts, Seeds and Legumes: 4–5 Servings per Week
Some types of nuts and seeds, along with kidney beans, lentils and split peas, are included. A serving can include: almonds, peanuts, hazelnuts, walnuts, sunflower seeds, flaxseeds, kidney beans, lentils and split peas.
- 1/3 cup (50 grams) of nuts
- 2 tablespoons (40 grams) of nut butter
- 2 tablespoons (16 grams) of seeds
- 1/2 cup (40 grams) of cooked legumes
Fats and Oils: 2–3 Servings per Day
In the DASH diet, vegetable oils such as canola, corn, olive or safflower are preferred over other oils like margarine. Additionally, the diet suggests the use of low-fat mayonnaise and light salad dressing. Examples of a recommended serving are:
- 1 teaspoon (4.5 grams) of soft margarine
- 1 teaspoon (5 ml) of vegetable oil
- 1 tablespoon (15 grams) of mayonnaise
- 2 tablespoons (30 ml) of salad dressing
Candy and Added Sugars: 5 or Fewer Servings per Week
To follow the DASH diet, it’s important to limit your consumption of candy, soda, and table sugar as added sugars are minimized. The diet also puts restrictions on unrefined sugars and alternative sources of sugar such as agave nectar. A serving size may look like:
- 1 tablespoon (12.5 grams) of sugar
- 1 tablespoon (20 grams) of jelly or jam
- 1 cup (240 ml) of lemonade
Rather than providing a list of particular foods, the DASH diet emphasizes the consumption of recommended amounts from various food groups.
Although research on the DASH diet discovered that individuals with the lowest salt intake experienced the most significant decreases in blood pressure, the impacts of salt reduction on overall health and longevity are not definitive.
Reducing salt intake has a significant impact on blood pressure among individuals who have high blood pressure, while the effects are considerably less for those who have normal blood pressure. This could partially be attributed to the theory that certain individuals are salt sensitive, indicating that salt has a greater impact on their blood pressure.
Lowering your salt intake can lead to significant health benefits, especially if you consume it in excess. However, restricting salt intake as prescribed in the DASH diet may not be advantageous for individuals without salt sensitivity or hypertension.
Notes on the side
The DASH diet places emphasis on consuming foods that are high in nutrients but is not overly restrictive in terms of food choices. It includes a diverse range of foods and has undergone extensive research.
The primary goal of this dietary plan is to mitigate or decrease high blood pressure. Certain studies indicate that following this regimen can enhance other aspects of health and potentially lower the likelihood of developing specific medical conditions.