DASH DIET

Introduction

High blood pressure affects more than a billion people worldwide. Often known as the “silent killer”, it can significantly strain the healthcare system. One out of every third individual is affected globally and this is estimated to increase by 20% by the year 2025. High blood pressure is a risk factor for various health conditions like cardiac diseases, kidney disease, and stroke. It is usually managed by medications, but research suggests that lifestyle changes with a particular focus on diet, can play a crucial role. Specific dietary patterns and nutrients can potentially reduce blood pressure.(1) In this blog, we will understand what a DASH (Dietary Approaches to Stop Hypertension) diet is and how the DASH diet is effective for hypertension (high blood pressure). 

What is a DASH Diet?

The DASH diet was originally designed by the National Institute of Health (NIH). This diet includes nutrients that help lower blood pressure and limits the intake of saturated fat found in full-fat milk, cheese and butter, red meat (beef, pork, and lamb), sweets and sugars, and sodium to about 1500mg/dl.(2,3)  The DASH diet for hypertension involves intake of protein, dietary fibers, and minerals such as potassium, calcium, and magnesium.(2) Let’s take a closer look at what is a DASH diet. 

Serving guide for a patient following the DASH diet for hypertension is as follows:(3,4)

Vegetables: 5 servings per day

1 cup raw leafy vegetable

1/2 cup cooked vegetable

6 oz vegetable juice

Fruits: 5 meals per day

1 medium piece of fruit 

1/4th cup dried fruit

1/2 cup fresh, frozen, or canned fruit

6 oz fruit juice

Carbohydrates: 7 servings of healthy carbohydrates per day

1 slice bread

1 cup of ready-to-eat cereal

1/2 cup cooked rice, pasta or cereal

Low-fat dairy products: 2 servings per day

8 oz milk

1 cup yoghurt

1 1/2 oz cheese

Lean meat products: less than 2 servings per day

3 oz lean meats, skinless poultry or fish

Nuts and seeds: 2 to 3 times per week 

1/3 cup nuts

1 tbsp seed

1/2 cup cooked dry beans. 

A wholesome DASh diet plan includes vegetables, fruits, carbs, dairy, meat, and nuts. Along with lowering the blood pressure, a balanced nutrition plan can help promote a healthy lifestyle.

How Does DASH Diet Lower High Blood Pressure?

The DASH diet can potentially reduce systolic and diastolic blood pressure. The benefit is that it lowers blood pressure no matter what your starting level is. Such a simple lifestyle change can result in extensive reduction of blood pressure. 

Once you incorporate this diet into your lifestyle, it helps clear excess sodium in the body. The clearance of sodium and its interaction with the hormone system of the body results in the relaxation of blood vessels. When the blood vessels relax, they widen, making it easier for the blood to flow. Blood pressure is reduced because there is less force against the blood vessels.(5)

Possible Risks & Side Effects

Although the DASH diet is safe and effective, some precautions are necessary in certain situations.

If you have kidney disease:  Medications that lower potassium levels in the body are prescribed to individuals who have kidney disease. In this situation, following a DASH diet could lead to an imbalance in the electrolyte (body salt) levels.(6)

If you take certain medications: If you take medicines that lower your blood pressure, you need to be precautious. These medicines, along with the diet which already lowers the pressure, can cause it to drop too much.(7)

If you feel bloated, it may be because: Eating more fiber could slow down how quickly the stomach empties, which can make you feel bloated.(8)

If you have diabetes: the DASH diet is composed of food content with low glycemic index (food that causes slow rise in the blood glucose level). Due to this reason, you might experience occasional lower blood sugar levels.(9)

If you take the necessary precautions, you can avoid these side effects of following the DASH diet.

Conclusion

In a nutshell, the DASH diet is an alternate way to effectively manage high blood pressure. This approach to diet includes high-fiber food content, carbohydrates, and proteins,  along with restrictions on intake of saturated fat, cholesterol, and sodium. It helps in removing excess sodium from the body. This results in the relaxation of blood vessels which helps in lowering the blood pressure. Consulting your dietitian, gathering information on the process, and making use of technology can help in the smooth implementation of the diet plan. Although the DASH diet is safe and effective, some precautions are necessary in certain situations such as if you are taking blood pressure-lowering medicines or if you have kidney disease or diabetes.

FAQs

1. How can the DASH diet be adapted for vegetarians?

A diet that includes beans and whole grains which is a rich source of protein along with fruits and vegetables can be followed by vegetarians.(4)

2. Are eggs ok to eat on a DASH diet?

Eggs can be included in the DASH diet as a source of animal protein.(3)

3. Do you need to exercise while on the DASH diet? 

When you combine exercise with the DASH diet, it improves blood vessel function and nervous system control. This combination significantly enhances the diet's effects.(2)

4. Can I have Coffee On The DASH Diet?

Coffee intake can temporarily increase blood pressure, which may interfere with the DASH diet's goal of reducing it. Therefore, it may be best to avoid coffee.(10)

5. What About Alcohol Consumption?

Alcoholic beverages can increase blood pressure in both men and women. Avoiding alcohol is the best way to maximize the benefits of the DASH diet.(11)

References

1. Altawili AA, Altawili M, Alwadai AM, et al. An Exploration of Dietary Strategies for Hypertension Management: A Narrative Review. Cureus. 2023;15(12):e50130. Published 2023 Dec 7.

2. Onwuzo C, Olukorode JO, Omokore OA, et al. DASH Diet: A Review of Its Scientifically Proven Hypertension Reduction and Health Benefits. Cureus. 2023;15(9):e44692. Published 2023 Sep 4.

3. Challa HJ, Ameer MA, Uppaluri KR. DASH Diet To Stop Hypertension. [Updated 2023 Jan 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482514

4. Campbell AP. DASH Eating Plan: An Eating Pattern for Diabetes Management. Diabetes Spectr. 2017;30(2):76-81.

5. Filippou CD, Tsioufis CP, Thomopoulos CG, et al. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2020;11(5):1150-1160.

6. Lv Y, Aihemaiti G, Guo H. Effect of Dietary Approaches to Stop Hypertension (DASH) on Patients with Metabolic Syndrome and Its Potential Mechanisms. Diabetes Metab Syndr Obes. 2024;17:3103-3110. Published 2024 Aug 23.

7. Tyson CC, Nwankwo C, Lin PH, Svetkey LP. The Dietary Approaches to Stop Hypertension (DASH) eating pattern in special populations. Curr Hypertens Rep. 2012;14(5):388-396.

8. Peng AW, Juraschek SP, Appel LJ, Miller ER 3rd, Mueller NT. Effects of the DASH Diet and Sodium Intake on Bloating: Results From the DASH-Sodium Trial. Am J Gastroenterol. 2019;114(7):1109-1115.

9. Peairs AD, Shah AS, Summer S, Hess M, Couch SC. Effects of the dietary approaches to stop hypertension (DASH) diet on glucose variability in youth with Type 1 diabetes. Diabetes Manag (Lond). 2017;7(5):383-391.

10. Kujawska A, Kujawski S, Hajec W, et al. Coffee Consumption and Blood Pressure: Results of the Second Wave of the Cognition of Older People, Education, Recreational Activities, Nutrition, Comorbidities, and Functional Capacity Studies (COPERNICUS). Nutrients. 2021;13(10):3372. Published 2021 Sep 25.

11. Fuchs FD, Fuchs SC. The Effect of Alcohol on Blood Pressure and Hypertension. Curr Hypertens Rep. 2021;23(10):42. Published 2021 Nov 11.