Hypertension: DASH Diet

Clinician Summary Consumer Summary
A change in overall diet pattern that emphasizes fruits, vegetables, and low-fat dairy products, and which includes whole grains, fish, poultry, and nuts but limits saturated fat, red meat, sweets, and sugar-containing beverages. The dietary changes result in a reduced consumption of sodium and an increased consumption of potassium, calcium and magnesium compared with a typical Australian diet. There are strong similarities between the DASH diet and the Mediterranean diet. However, the DASH diet does not emphasize olive oil and fish and does not include wine.

Reduction of blood pressure: The DASH diet has been shown to reduce BP within 2 to 4 weeks (by 6 mmHg systolic and 3 mmHg diastolic). After this initial reduction the blood pressure is maintained rather than reduced further. Effects are more pronounced in people who are hypertensive rather than normotensive.

The DASH diet may further reduce cardiovascular disease (CVD) risk through reduction in total cholesterol, low density lipoproteins (LDLs) and body mass index (BMI).

Changes achieved with the DASH diet predict a reduction of CVD of approximately 13% using the 10-year Framingham risk score.

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The DASH diet plan includes the following:

 

Tips and challenges

Referral to a dietitian is recommended for tailored advice and ongoing follow-up. Refer to Dietitians Association of Australia.

 

Consumer Resources

There are numerous books about the DASH diet (e.g. The DASH diet, The DASH diet for beginners, The DASH diet action plan The DASH diet for weight loss).

Most consumer resources for the DASH diet have been developed in the United States (US). The National Heart, Lung and Blood Institute (part of the US Department of Health and Human Services) promotes the DASH diet as a well-balanced diet for the general public as well as those with hypertension. Some call it the American version of the Mediterranean diet.

  • The US Department of Health and Human Services has produced a brief guide to lowering blood pressure with the DASH diet and a more general guide to lowering blood pressure
  • WebMD offers some tips to starting and staying on the DASH diet
  • It also has an action set for using the DASH diet
  • DASH Diet Oregon provides some useful information and resources about the DASH diet. While this is a free site, it is paid for by the Oregon Dairy Council.
  • A US-based paid site offers online DASH diet programs (including education, support, meal plans, tracking tools and recipes).

NHMRC Level 2 evidence.

References

  1. Salehi-Abargouei A, Maghsoudi Z, Shirani F. Effects of Dietary Approaches to Stop Hypertension (DASH)-style diet on fatal or nonfatal cardiovascular diseases – incidence: a systematic review and meta-analysis on observational prospective studies. Nutrition 2013; 29:611–618.
  2. Siervo M, Lara J, Chowdhury S et al. Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. Br J Nutr 2015;113:1–15.

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