Diet Guidelines for High Blood Pressure
What is the best dietary approach to combat a hypertension diagnosis? That’s easy! The DASH Diet was created for this very reason. DASH stands for Dietary Approaches to Stop Hypertension, a lifestyle approach to healthy eating to treat or prevent high blood pressure.
In addition to promoting healthy blood pressure and cholesterol, the DASH diet supports healthy weight loss and long-term adherence is associated with lower risk of stroke, heart failure, osteoporosis, several types of cancer, and lowers risk of kidney stones. New research also shows reduced risk of developing type 2 diabetes and some types of breast cancers.
In the standard DASH Diet, you can consume up to 2,300 milligrams (mg) of sodium a day. For a lower-sodium DASH Diet, you can consume up to 1,500 mg of sodium a day.
The DASH Diet approach places an emphasis on consuming vegetables, fruits, whole grains, fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils. An emphasis on foods high in potassium, calcium, magnesium, fiber and lean proteins is encouraged.
Now that you know what to eat, how much should you eat?
A balanced DASH eating plan based on 1,600 to 2,600 calories per day would include the following:
Vegetables: It is recommended to include at least 4-5 servings per day. This includes any and all vegetables! 1 serving would be 1 cup of raw, leafy greens or a ½ cup cut-up raw or cooked vegetables.
Tip: To keep sodium intake low, choose fresh or frozen vegetables. If you do get canned varieties, choose the low-sodium option and be sure to drain and rinse your vegetables prior to consumption to rid them of excess sodium.
Fruits: 4-5 servings per day is encouraged. 1 serving of fruit is 1 medium piece of fruit, ½ cup of fresh, frozen, or canned fruit or 4 ounces of 100% fruit juice.
Tip: Leave the peel on when possible. This is where most of the fiber is in both fruits and vegetables! Always choose 100% fruit juice or fruit canned in 100% juice or light-syrup. Also, remember that citrus fruits and grapefruit can interact with certain medications. Be sure to talk with your doctor to see if these fruits can be included in your diet regimen.
Grains: Make sure you are choosing whole grains. 6 -11 servings per day. This includes bread, cereal, rice and pasta. 1 serving of a whole-grain would be 1 slice of bread, 1 ounce of dry cereal or ½ cup of cooked cereal, rice, or pasta. The emphasis is on whole-grains because they include more fiber and are more nutrient dense than refined grains are. Whole grains that we don’t always think of include whole-grain crackers, oatmeal and pitas!
Tip: An example of a whole grain is brown rice instead of white rice or whole-grain pasta or bread with “100% whole-grain” or “100% whole wheat” as the first ingredient on the ingredient list. To keep your grains low in fat, avoid adding butter and cheese or cream based sauces.
Dairy: 2-3 servings of low-fat or fat-free dairy products are recommended daily. If you don’t choose the low-fat or fat-free options, chances are you are increasing your saturated fat intake, which is a fat that should be limited in your diet pattern. Dairy products like milk, yogurt and cheese are good sources of calcium, vitamin D, and protein.
Tip: Low-fat or fat-free frozen yogurt is a great option to reduce fat intake and increase protein intake when it comes to dessert choices! Add fruit for an additional serving in your day! Also, don’t overdo any variety (regular, low-fat, or fat-free) of cheeses because chances are they’re packed with sodium, regardless of their fat content!
Proteins: 6 1-ounce servings should be included in a daily eating pattern. Protein sources include lean meat, poultry, and fish. Meat is a good source of iron, zinc, and B-vitamins. A 1-ounce serving is equal to 1 egg or 1 ounce of cooked lean meat, poultry, or fish.
Tip: Trim excess fat on meat and poultry prior to cooking. Instead of frying in fat, it is encouraged that you bake, broil, grill or roast your proteins. Salmon includes omega-3 fatty acids, as does herring and tuna, to support heart health. If you prefer non-meat options, plant based protein like lentils, chickpeas, pea protein, and soy-based products like tofu, edamame, and TVP are great options. Make sure any processed options are unflavored. The flavored options tend to have a higher sodium content.
Nuts, seeds, and legumes: These are a good source of protein but also contain mono-unsaturated fat and omega-3 fatty acids which are our healthy fats. You should include 3-5 servings of these each week. Examples of one serving include 1/3 cup nuts, 2 tablespoons seeds or nut butter, or ½ cup cooked beans or peas.
Nuts also contain fiber and phytochemicals that are compounds in plants that may provide protection against cardiovascular disease and cancer.
Tip: Serving sizes are small and are intended to be consumed only a few times a week because these foods are higher in calories.
Fats and oils: Limit to 2-3 servings per day, making sure to avoid trans-fat and decreasing saturated fat intake. The DASH Diet strives for a healthy balance by limiting total fat to less than 30% of daily calories from fat, with a focus on the healthier mono-unsaturated fats. One serving includes 1 teaspoon of soft margarine, 1 tablespoon of mayonnaise or 2 tablespoons of salad dressing.
Tip: Fat helps your body absorb essential fat-soluble vitamins and helps the body's immune system. However, the DASH Diet places an emphasis on low-fat foods, as too much unhealthy-fat intake can increase your risk of heart disease, diabetes and obesity.
To limit unhealthy fat intake, the DASH Diet recommends limiting foods that are high in trans-fat (typically found in processed foods) and saturated fat (found in animal products), such as fatty meats and full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oil. Be sure to read food labels on margarine and salad dressing so that you can choose foods that are lowest in saturated fat.
Sweets: Intake of sweets should exceed no more than 5 servings per week. Choose those that are fat-free or low-fat, such as sorbets, fruit ices, jelly beans, hard candy, graham crackers or a low-fat cookie.
Tip: Sugar adds no nutritional value but can add calories quickly. This also means limiting sugar-sweetened beverages and replacing them with water.
Now that you know what foods to place an emphasis on, what can you do in addition to this?
Don’t add salt to your food! We live in a world where people salt their food before they even taste it! Challenge yourself to throw away your salt shaker!
Use salt-free seasonings. Mrs. Dash seasoning blends have a wide variety of salt-free seasonings to help you flavor your foods without excess sodium!
Increase physical activity! Adding physical activity to your daily regimen while making dietary changes can improve blood pressure even more than diet alone! Make sure you talk with your doctor before starting any kind of exercise routine to ensure you approach it safely for your individual needs.
Add brown rice and vegetables to a chicken stir-fry to get lean protein, vegetables and whole grains!
Try to incorporate plant-based dinners two nights per week!
Eat a variety of colors!
How effective is the DASH Diet?
Numerous studies show wide-ranging health benefits of the DASH diet. A consistent body of research has found that DASH lowers blood pressure in people with high blood pressure but also normal blood pressure even without lowering sodium intake. It can produce greater reductions in blood pressure if sodium is restricted to less than 2300 mg a day, and even more so with a 1500 mg sodium restriction. In addition, according to the 2020-2025 Dietary Guidelines for Americans, research has shown a direct relationship between sodium intake and blood pressure, and decreasing sodium intake "can help improve blood pressure control and reduce risk of hypertension”.
Sources:
1. https://dashdiet.org/dash-diet-research.html
3. Steinberg D, Bennett GG, Svetkey L. The DASH Diet, 20 Years Later. JAMA. 2017 Apr 18;317(15):1529-1530.
4. Sacks FM, et al.; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. NEJM. 2001 Jan 4;344(1):3-10.
5. Saneei P, Salehi-Abargouei A, Esmaillzadeh A, Azadbakht L. Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: a systematic review and meta-analysis on randomized controlled trials. Nutr Metab Cardiovasc Dis. 2014 Dec 31;24(12):1253-61.
