DASH Diet for Dummies.

Dash Nutrient Goal Overview

Research

Most research suggests that an ideal natural blood pressure is around 115/75

Dash Study Setup

• Randomized controlled trial. 459 men & women who all had high blood pressure (no higher than 160 systolic, 95 diastolic)

1. Everyone given standardized control diet for first 3 weeks, all meals & snacks controlled.
2. After 3 week period, each person randomly assigned to spend 8 weeks on one of the three experimental diets:
   • Control (Designed to mimic typical American Diet, high servings of meat low servings of fiber, fruits & vegetables)
   • Fruits & Vegetables (received 2.5x fruits & veggie servings as control) Still included same amount of fat & meat as the control diet.
   • DASH (Initial study kept sodium at 3,000 mg daily– high for current DASH)
3. Throughout study blood pressure measured at strict intervals + questionnaire given about symptoms & activity. Urine tests performed to assess potassium, magnesium, calcium & protein levels.

Results

Fruits & Vegetables Diet

• Compared with control diet, Systolic pressure dropped 2.8 pts and diastolic 1.1 pts
• A meaningful reduction in terms of stroke risk.

DASH Diet

• DASH dropped systolic by 5.5 pts and diastolic by 3 pts
• In people with hypertension, systolic dropped 11.4 pts & diastolic 5.5 pts– on par with results expected from medical therapy.

Basic Dietary Guidelines

General goal is less sodium (1,500 - 2,400 mg daily), less unhealthy fats (saturated fats), more magnesium, potassium, fiber.

Whole Grains

Servings (Per Day) : 6-8 Example Serving: 1 slice bread, 1 cup dry cereal, 1/2 cup cooked cereal or rice or pasta.

• Plenty of Fiber
• High in potassium, magnesium & anti-oxidants.
• Supports cardiovascular health
• Dramatic difference between refined & whole grain flour. Once it’s refined, most nutrients are stripped away.

Fruits + Vegetables = Blood Pressure Friendly Nutrients

Servings (Per Day) : 4-5 Example Serving: 10 grapes, 1 small banana, 1 medium apple, 1 cup raw vegetables, 1/2 cup cooked vegetables.

• high in potassium, fiber, vitamins & anti-oxidants.
• Overlap with whole grain benefits, but the body needs variety.

Low-Fat Dairy Foods

Servings (Per Day) : 2-3 Example Serving: 1 Cup Milk or Yogurt, 1 ounce cheese.

• “strongly linked to a lower risk for hypertension because they’re rich in vitamin D, calcium, magnesium, and potassium; high in protein; and low in saturated fats and calories.”
• Evidence that dairy foods may reduce likelihood of stroke (common occurrence with high blood pressure)

Lean Meats

Servings (Per Day) : 2 or fewer Example Serving: 3-4 ounces cooked (per day)

• Fish & Poultry
• Limit exposure to saturated fats

Nuts, Seeds, Legumes

Servings (Per Week) : 4-5 Example Serving: 1/3 cup nuts, 2 tablespoons nut butter, 2 tablespoons seeds.

• Heart healthy plant-based protein sources
• High in healthy fats, fiber & magnesium

Fats & Oils

Servings (Per Day) : 3-4 Example Serving: 1 teaspoon margarine, butter or oil; 2 tablespoons salad dressing.

• Fats & Oils + Sugary Treats not outright banned by dash, but should be limited
• Portion sizes matter

Sugary Treats

Servings (Per Week) : 5 or fewer Example Serving: 1/2 cup sorbet or frozen yogurt, 1 “fun-size” candy bar, 8 pieces gummy candy, 1 tablespoon jam, 1 ounce dark chocolate (70-85% cocoa)

Understanding Sodium Claims Per Serving

Low/no-sodium - < 5 mg sodium per serving Very low sodium - < 35mg sodium per serving Low sodium < 140 mg sodium per serving

Ten Lifestyle Changes to Curb Hypertension

1. Lose Weight and Keep It Off
   • Weight loss often #1 treatment for hypertension.
   • Being overweight strains your body and heart
   • Losing weight typically helps improve blood pressure
   • “A healthy diet is not a one-and-done situation.” you must maintain lifestyle changes to keep weight off
2. Develop an Exercise Routine
   • Helps keep weight under control
   • Improves cardiovascular health
   • Reduces stress level–which can curb hypertension in the long run.
   • Schedule 20-30 minute walk 5 days a week, add minutes each week. Once you’re up to 30/45 minutes walking increase your pace until you can walk a mile in 15 to 20 minutes.
3. Stick to DASH
   • DASH more about what you add versus what you limit (although you should dramatically limit sodium)
   • Fruits & Vegetables very important sources of potassium and magnesium which help lower blood pressure. Fiber helps keep cholesterol in check.
4. Eat less Salt
   • High-salt diet has been shown to raise blood pressure.
   • Daily goal should be between 1,300 and 2,300 mg sodium.
   • 3/4 of all salt in peoples diets comes from prepared foods.
5. Add Good Fats to Your Diet
   • Hypertension is a risk factor for heart disease, as is high cholesterol.
   • Heart healthy fats may improve the balance of good and bad cholesterol in the blood stream.
   • Avoid or limit saturated fats (found in red meat & tropical oils)
   • Seek monounsaturated fat (vegetable oils– olive, canola, avocado & peanut oils)
   • Nuts, seeds, avacados & olives good to add to diet.
6. Avoid Drinking Alcohol Excessively
   • Overindulging bad for heart & health.
   • If you’re a male > 2 drinks daily can lead to heart damage, high blood pressure & high triglycerides. ( > 1 drink for women)
   • 15 or more drinks per week considered heavy drinking for men.
7. Don’t Use Tobacco Products
   • Smoking causes corona heart disease, contributes to stroke & increases the risk of peripheral vascular disease.
   • Chewing tobacco raises blood pressure & harms arteries.
   • Tobacco a risk factor for dementia.
8. Stress Less
   • Stress has direct & indirect effects on blood pressure.
   • Stress can impact quality sleep which impacts blood pressure.
   • Regular exercise helps reduce stress as does meditation.
   • Breathing Exercise: Inhale to the count of four; then exhale to the count of 4.
9. Enlist Your Family and Friends
   • Support network can help you keep on track with lifestyle changes.
   • Turn eating well & exercising into a shared and social experience.
   • If your workout buddy misses a day, don’t use it as an excuse to slack off.
10. Follow Your Doctor’s Orders
    • Follow doctor’s advice
    • keep regular appointments
    • Annual physical exam

Misc

• US average diet includes 3,400mg sodium daily. Human body only requires 500mg sodium daily for normal function.
• Every 20pt rise in systolic or 10pt rise in diastolic blood pressure doubles the risk of heart disease & stroke.
• Losing just 10 lbs can reduce blood pressure by as much as 10pts.

Extra Weight

• Estimated that obesity shortens average lifespan 10-20 years.
• Increases risk for:
  • Dementia
  • Arthritis
  • Cancer
  • Diabetes
  • Heart disease
  • Intestinal disease
  • Lung disease
  • Stroke

Cholesterol

There are both good (HDL) & bad cholesterol (LDL)

HDL Cholesterol (high-density lipoprotein)

• Pulls bad cholesterol out of arteries, takes it back to the liver to be processed & eliminated
• Higher the HDL the better.
• Monounsaturated fats (olive oil, avocados, nuts) and exercise raise HDL.
• Can help protect against heart attack and stroke.

LDL Cholesterol (low-density lipoprotein)

• Small amount is required to keep cell membranes healthy, brain working & healthy hormone levels.
• Clogs arteries
• Most LDL generated in your liver, which can make cholesterol out of lots of food.
• High LDL increases likelihood of heart attack & stroke.