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Dietary Approaches to Stop Hypertension (DASH) is an eating plan created to manage high blood pressure, also known as hypertension. The diet was first developed in 1992 when the National Institutes of Health (NIH) funded several research projects to identify interventions to manage hypertension (Challa, 2020).
The DASH clinical trial followed 459 adults with high blood pressure for 11 weeks to assess the effects of dietary patterns on blood pressure. They found that a diet rich in fruits, vegetables, and low-fat dairy foods, yet low in saturated and total fat, substantially lowered blood pressure (Appel, 1997). Now known as the DASH diet, the eating plan lowered systolic blood pressure (the top number when you get your blood pressure checked) by 5.5 mm Hg and diastolic blood pressure (the bottom number when you get your blood pressure checked) by 3.0 mm Hg compared with a control diet.
- Dietary Approaches to Stop Hypertension (DASH) was developed in the 1990s to manage hypertension (high blood pressure), which is a risk factor for heart disease.
- The popular eating plan is rich in fruits, vegetables, and low-fat dairy foods, yet low in saturated and total fat.
- Research shows that DASH is more effective when combined with regular exercise, meaning 30 minutes of activity each day.
Over the last three decades, countless studies have supported the DASH diet’s ability to help lower blood pressure, ward off heart disease, and lead to general health and wellness.
A 2014 study published in the American Journal of Hypertension found that following the DASH diet for 16 weeks was linked with lower systolic blood pressure for the next eight months (systolic blood pressure is the top number when you have your blood pressure taken) (Hinderliter, 2014). Another study found that reducing sodium (salt) intake and following the DASH diet lowered systolic blood pressure throughout pre-hypertension and stage 1 hypertension, with the greatest reductions seen among people with higher baseline systolic blood pressure (Juraschek, 2017).
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For context, normal blood pressure is considered to be around 120/80 mm Hg. The pre-hypertension range is 120–129/<80 mm Hg. Stage 1 hypertension ranges from 130–139/80–89 mm Hg (AHA, n.d.).
Today, DASH is promoted by the American Heart Association (AHA) and is highly regarded among doctors, dietitians, and other healthcare providers. It’s also one of the three healthy diets recommended in the 2015–2020 US Dietary Guidelines; the Mediterranean diet and a vegetarian diet claimed the other top spots (USDA, 2015).
What is the DASH diet, and how does it work?
If those ringing endorsements are enough to pique your interest, you might be wondering what exactly this heart-healthy diet entails.
In a nutshell, DASH is a diet rich in fruits, vegetables, and whole grains. It also promotes fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils. The idea is that these nutrient-dense foods are high in fiber, protein, potassium, magnesium, and calcium—which are all linked to lowering blood pressure and improving heart health. Conversely, DASH limits foods that are high in saturated fat, such as red meat and full-fat dairy products, as well as sugar-sweetened beverages and treats.
Importantly, DASH encourages people to consume less sodium. Too much sodium in the bloodstream pulls water into the blood vessels, which increases the vessels’ volume of blood. The extra fluid and increased pressure on the blood vessel walls lead to high blood pressure (AHA, 2018).
Depending on your specific health needs, there are two versions of the diet designed to reduce sodium intake compared with the typical American diet (based on 2,000 calories per day).
- The standard DASH diet limits sodium consumption to 2,300 mg per day.
- The lower-sodium DASH diet limits sodium consumption to 1,500 mg per day.
According to the FDA, the DASH sodium guidelines are much lower than the average American’s daily sodium consumption; most of us eat around 3,400 mg of sodium per day (FDA, 2020).
When you’re aware of just how much salt is found on restaurant menus, it’s easy to understand how that number got so high. A bowl of Panera’s ten vegetable soup (serving size is 1.5 cups) is 1,090 mg, bacon & gruyère sous vide egg bites from Starbucks are 680 mg (serving size is two bites), and a medium french fry order from McDonald’s will set you back 260 mg of sodium.
The same goes for frozen foods at the grocery store. At Trader Joe’s, chicken enchiladas (1,130 mg), pork gyoza potstickers (680 mg), and macaroni & cheese bowl (500 mg) can eat up a big chunk of your daily sodium budget.
The DASH diet focuses largely on whole grains and produce, and calls for a specific number of servings from each of the approved food groups. For a 2,000-calorie daily diet, this translates to:
- 6–8 servings of grains or grain products (whole grains recommended)
- 4–5 servings of vegetables
- 4–5 servings of fruits
- 2–3 servings of low-fat dairy
- 2–3 servings of fats and oils
- 2 or fewer 3-ounce servings of lean meats, poultry, or fish
- 4–5 servings of nuts, seeds, or dry beans per week.
- Less than 5 servings of sweets and added sugars per week
The National Heart Lung and Blood Institute (NHLBI) offers serving sizes for 1,600- and 2,600-calorie diets as well. Additional details on the diet plan can be found in “Your Guide To Lowering Your Blood Pressure With DASH” (NIH, 2015).
In a world full of strict diets and regimented food lists, DASH is a relatively straightforward method for healthy eating. The diet was designed to be a flexible eating plan that allows people to make manageable changes to their diets to help lower blood pressure.
The AHA also recommends that people with high blood pressure consider quitting tobacco since smoking is a proven risk factor for heart attack and stroke.
Health benefits of the DASH diet
Since DASH was put into place 30 years ago, there have been countless studies reporting its ability to reduce blood pressure and improve heart health. The diet was originally designed to help people living with hypertension, a family history of heart disease, and an increased risk of type 2 diabetes, and it’s been instrumental in allowing them to lead a heart-healthy lifestyle.
That said, more recent studies have emerged, showcasing its beneficial effect on other health conditions (Challa, 2020).
A study published in the British Journal of Nutrition found that following the DASH diet might improve a person’s cardiovascular health (Maddock, 2018). Among people aged 24–28 years, the diet was linked to higher levels of HDL cholesterol and lower pulse wave velocity (a measure of arterial health).
There’s also evidence that the DASH diet can lower the incidence of colorectal cancer, as well as reduce blood pressure in patients with type 2 diabetes (Challa, 2020).
Although the DASH diet’s primary focus is to manage high blood pressure, its emphasis on whole foods and portion control can lead to unexpected weight loss. According to the NIH, the DASH Eating Plan can support weight loss efforts by replacing higher calorie foods such as sweets with more fruits and vegetables. The plan suggests incorporating physical fitness, such as walking or swimming, to help with immediate weight loss and maintaining the weight loss over time. The guide offers various exercise suggestions, but the key is 30 minutes of activity each day (NIH, 2015).
Considerations for the DASH diet
Although the DASH diet was originally created to help reduce hypertension, it’s now recommended as a viable option for anyone who is interested in adopting a healthier diet. The 2019 US News & World Report ranked DASH Diet as number two in best overall diets beat only by the Mediterranean Diet.
If you’re considering DASH, there are a few things to consider.
Instead of going cold turkey with your previous eating habits, the National Heart, Lung, and Blood Institute (NHLBI) recommends gradually switching to the DASH diet over a week or two. Although the plan is simple to follow, slowly incorporating more fresh fruits and veggies might make the transition more sustainable. Begin to buy low-fat milk instead of full fat, and consider cutting down on processed foods.
Gradually increasing your intake of fruits, vegetables, and whole grains might also prevent digestive issues. All of these foods are high in fiber, and too much too quickly can lead to bloating, diarrhea, and overall discomfort (NIH, 2015).
As always, it’s important to discuss your plans with your healthcare provider. DASH is meant to complement your medication management for high blood pressure or cholesterol, not to replace it.