DASH diet for Hypertension

What is DASH Diet?

DASH is the short form for Dietary Approaches to Stop Hypertension eating plan. DASH diet is a healthy eating plan to help manage blood pressure and lowering the risk of cardiac events such as heart attack, stroke and other diseases. The diet is originated in 1990s where the National Institute of Health (NIH) in the U.S. investigated on the effectiveness of the diet plan in treating hypertension. They have found that solely with dietary intervention, systolic Blood Pressure was decreased by about 6 to 11mmHg. The intervention were also useful in subjects without hypertension. Since then, DASH diet plays a huge role in the treatment for hypertension. 

A diet plan for Hypertension

Hypertension also known as high blood pressure is a non-communicable disease that develops over time due to unhealthy lifestyle choices and inadequate physical activity. Without the proper lifestyle modification or pharmacological treatment can damage your vital organs in many ways. In the long run, hypertension can damage your arteries which can impede the efficiency of oxygen delivering to your heart. Whereas, the damaged arteries could also cause strokes where the oxygen and blood supply to the brain cells are blocked. The good news is, high blood pressure can be managed to reduce risks of developing serious health problems.

What does the DASH diet comprise of?

Unlike other diet, DASH diet does not contain specific food but it is planned to provide adequate daily and weekly nutritional goals.

The diet emphasises healthy food that includes: 

• Eating more vegetables, fruits, and whole grains

• Fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils

At the same time limits on the intake of, 

• Foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils

• Sugar-sweetened beverages and sweets.

• Sodium (salt)

• Red meat

Figure 1: The picture is a breakdown of the DASH diet sourced from https://blog.ohiohealth.com/dash-diet-lower-blood-pressure/

Daily and Weekly DASH Eating Plan Goals for a 2,000-Calorie-a-Day Diet

Table 1: The above is the recommended Daily Servings for each food groups 

Further Studies on Dash Diet

According to four studies funded by National Heart, Lung, and Blood Institute, DASH diet has successfully shown its effectiveness in lowering blood pressure.

DASH diet vs Typical American diet vs Typical American diet with more fruits and vegetables (DASH Trial)

The study was conducted for 8 weeks where different diets were given to the participants. Surprisingly, DASH diet shows the greatest effect of lowering blood pressure out of all diet. On top of that, the diet also found to be able to lower LDL cholesterol levels. The lowering effect on both blood pressure and cholesterol levels are highly beneficial in preventing cardiovascular disease. 

DASH Diet, Sodium Intake and Blood Pressure (DASH-Sodium Trial) 

In this trial, they have investigated on the benefit of sodium reduction in DASH diet vs Typical American Diet. They found out that with DASH diet followed by sodium reduction is more beneficial in lowering the blood pressure as compared to neither of the diet alone.

Advice-only Program vs established treatment including counselling on Behavioural therapy vs established treatment include counselling and DASH diet (PREMIER trial)

After 6 months, blood pressure levels were found to be declined in all of the three groups. However, the participants who have received both counselling and DASH diet have shown the greatest effect in lowering the blood pressure. The combination of the counselling and diet helps people to lose weight while lowering their blood pressure.

Practical Ways to control Sodium and Calories Intake 

DASH diet emphasises on the healthy food choices especially during shopping, cooking and eating out. In order for the DASH diet to be effective, it is important to restrict daily intake of sodium levels to 2,300mg or 1,500mg and consume sufficient amount of calorie to maintain a healthy weight. 

Table 2: Tips on lowering sodium when shopping, cooking and eating out by National Heart, Lung and Blood Institute.

Sodium usually originated from processed foods such as breads, cold cuts, pizza, poultry, salty snacks, cheese and etc.

Hence, it is essential to choose low sodium option when shopping and eating out. 

Moreover, people who are looking to loose weight or maintain a healthy weight are required to watch out on the calorie intake. Before starting any diet plan you may consult with your doctor in order to plan a personalised diet plan depending on your daily calorie needs and goals. 

Tips for reducing daily calorie intake include:

• Eat smaller portions mroe frequently throughout the day

• Reduce amount of meat and increase amount of vegetables, fruits, whole grains or dry beans

• Replace unhealthy snacks to low-calorie foods such as choosing fruits/vegetables instead of sweets or dessert OR drinking water instead of soda. 

A lifelong plan for a healthy body

The key to benefit the best outcome of DASH diet is consistency. Though it is okay to slip or to have your cheat days once in a while but make sure to get back on track.
Here are some practical tips to help you to get back on:

• Look for the causes that got you off track and avoid it.  Find out what was the trigger and restart your diet plan. 

• Do not beat up yourself after a slip. It is never an easy process but most importantly to get back up. Remember, it is a long-term process.

• One step at a time. Avoid changing up too much at one go. Instead, try adding each step bit by bit which is more feasible.

• Journal the process. Keeping track of your progress can help you to understand what are your eating habits and how can you improve them.

• Reward yourself. Celebrate the small milestones in your diet plan. Instead of rewarding yourself with food replace it with movie nights, books, shopping or travel to your favourite spot. 

References

1. Challa HJ, Ameer MA, Uppaluri KR. DASH Diet To Stop Hypertension. In: StatPearls. StatPearls Publishing; 2022. Accessed February 2, 2021. http://www.ncbi.nlm.nih.gov/books/NBK482514/

2. DASH Eating Plan | NHLBI, NIH. Accessed February 2, 2021. https://www.nhlbi.nih.gov/education/dash-eating-plan

3. DASH Diet Foods for High Blood Pressure (Hypertension). Accessed February 2, 2021. https://www.webmd.com/hypertension-high-blood-pressure/guide/dash-diet#1

4. CDC. High Blood Pressure Symptoms, Causes, and Problems | cdc.gov. Centers for Disease Control and Prevention. Published May 18, 2021. Accessed February 2, 2021. https://www.cdc.gov/bloodpressure/about.htm

Written by

Ms Shannon Lip