What to Expect on the DASH Diet

The DASH diet (which stands for Dietary Approaches to Stop Hypertension) was developed as a dietary approach to treat or prevent hypertension. The DASH diet has been studied extensively and in research dating back to 1997 has been shown to improve blood pressure and provide other health benefits. As a result of the clinical evidence, the DASH diet has been recommended by health organizations including the American Heart Association and the National Institutes of Health.

However, studies have also shown that sticking to the diet can be challenging. Following the eating program requires eliminating or reducing certain types of foods that many of us are used to eating. But even if you don’t have high blood pressure, it’s still an excellent way to eat. For many people, even taking small steps towards eating a DASH-style diet may provide benefits.

What to Eat

When following the DASH diet, you can expect to eat plenty of fruits and vegetables, whole grains, fish, poultry, legumes, and low- or non-fat dairy products. It also allows you to consume some nuts and seeds. The diet is low in fat and sodium.

But every diet requires you to cut back on something and the DASH diet requires that you cut back on salty foods, sugary beverages, greasy foods, sweets, and red or processed meats.

Compliant Foods

Grains

Grains include bread, cereal, pasta, and rice. When you follow the DASH diet, you are encouraged to choose whole grains (such as whole wheat bread or brown rice) rather than refined grains (such as white bread, white pasta, white rice, etc.). Also, read labels carefully. Some breakfast cereals and baked goods—even those made with whole grains—are high in sodium.

Try to consume six to eight servings of grains per day. Very active individuals may consume up to 11 servings per day. One serving is equal to one slice of bread, 3/4 cup dry cereal, or 1/2 cup cooked cereal, rice or pasta.

Vegetables

Eat a variety of brightly colored and dark green varieties every day. Vegetables such as broccoli, carrots, collards, green beans, green peas, kale, lima beans, and spinach are recommended, either cooked or raw. You can buy veggies fresh, frozen, or canned, but canned goods may be high in sodium so read labels before buying. Avoid frozen vegetable blends that include sauces that are high in fat and sodium.

Try to consume three to five servings of vegetables each day. Very active individuals may consume up to six servings. One serving of vegetables is one cup of raw leafy greens or a half cup of chopped vegetables.

Fruits

Fresh and dried fruit along with fruit juice is recommended on this diet. Selections such as apples, apricots, bananas, dates, grapes, oranges, grapefruit, or grapefruit juice are suggested. You can purchase fresh, frozen, or canned fruit but read labels carefully. Try to avoid frozen or canned fruit or fruit juice that lists any type of added sugar in the ingredients.

Try to consume four to five servings of fruit each day. Very active individuals may consume up to six servings. One serving of fruit is one whole medium fruit, a half cup of fresh, frozen, or canned fruit, 1/4 cup of dried fruit or 1/2 cup of fruit juice.

Dairy

Choose non-fat and low-fat dairy products. Avoid whole milk, butter, cream, cheese, half and half, and regular sour cream. Look for reduced fat versions of yogurt, milk and sour cream. You’ll have to cut way back on most cheese—not only is it usually high in fat, but it’s also high in sodium.

Try to consume two to three servings of low-fat milk or milk products each day. Very active individuals can consume three servings. A serving is one cup of milk or yogurt or 1 1/2 ounces of cheese.

Lean Meat, Poultry, and Fish

Eat fish and seafood, or skinless chicken and turkey. Cut back on red meat, and only choose lean cuts. All meats should be served without heavy sauces and should be baked, broiled or steamed with visible fat trimmed away.

Try to consume three to six servings of lean protein each day. Very active individuals can consume six servings. Smaller individuals and those who are less active should consume less. A serving is one ounce of cooked meat, poultry, or fish or one egg.

Note that because eggs are high in cholesterol, you should limit egg yolk intake to no more than four per week. Two egg whites have the same protein content as one ounce of meat.

Nuts, Seeds, and Legumes

Nuts and seeds are good for you, but they’re higher in fat, so make sure you keep an eye on serving sizes when consuming foods from this group. Almonds, hazelnuts, sunflower seeds, and peanut butter are suggested. Keep in mind that seasoned mixed nuts are often very high in sodium and should be avoided (raw or plain roasted nuts won't be high in sodium).

Legumes such as kidney beans, lentils, and split peas are good sources of protein, and they are low in fat. But canned beans usually contain more sodium than is recommended.

Try to consume three to five servings from this group per week. Very active individuals are advised to consume one serving per day. A serving is ⅓ cup or 1½ ounce nuts, two tablespoons of peanut butter, two tablespoons or ½ ounce seeds, or ½ cup cooked legumes.

Non-Compliant Foods

Processed High-Sodium Foods

Instructions for following the DASH diet prepared by the National Institutes of Health note that most of the sodium we consume comes from processed foods, such as baked goods, certain cereals, soy sauce, and even some antacids. They suggest we read food labels to check the amount of sodium in different food products.

Sweets and Added Sugars

Sweet treats include candy, sorbet, jelly, jam, sugary soft drinks, and low-fat cookies. Most don’t need to avoid sweet treats entirely, but you shouldn't eat more than one small treat per day. Also, the sweets you choose should be low in fat.

Those who consume fewer calories (smaller individuals and those who are not physically active) should try to completely avoid foods with added sugars. This might include sugary beverages, hard candy, jelly, and syrup. Those who consume a moderate caloric intake can consume up to five treats per week and those who are very active may consume up to two per day.

A single serving is one tablespoon of sugar, one tablespoon of jelly or jam, ½ cup sorbet, or one cup of lemonade.

Fats and Oils

On the DASH diet, you don't necessarily avoid fats and oils, but you should limit their intake. Examples include soft margarine, vegetable oil (such as canola, corn, olive, or safflower), low-fat mayonnaise, or light salad dressing, according to NIH sources.

Try to limit the intake of these foods to two to three servings per day. Very active individuals may consume up to three servings per day. A single serving is one teaspoon of oil or margarine, one tablespoon of mayonnaise, or two tablespoons of salad dressing.

Keep in mind, however, that the fat content of the food you choose impacts the recommended serving size. For example, one tablespoon of regular salad dressing equals one serving. But one tablespoon of low-fat dressing equals one-half serving and one tablespoon of fat-free dressing equals zero servings.

Excessive Red Meat

Red meat is higher in saturated fat than the recommended protein sources on the DASH diet. For that reason, red meat should be limited on the plan. There is no "allowed" or recommended amount, but experts recommend that If you usually eat large portions of meat, you can begin to reduce them over several days, cutting your intake by half or a third at each meal.

Excessive Alcohol

Adult beverages such as beer, wine, and spirits are not off limits, but experts recommend that you limit your intake. According to the guidelines, if you drink alcoholic beverages, do so in moderation. Moderate drinking is defined as no more than one drink per day for women and no more than two drinks per day for men.

Added Salt

The primary goal of the DASH diet is to manage or reduce your risk for hypertension. Evidence has shown that reducing salt intake may help you to lower your numbers. For that reason, DASH experts advise that you keep the salt shaker off the table when dining and resist adding salt to your food. Instead, use herbs, spices, lemon, lime, vinegar, wine, and salt-free seasoning blends in cooking to flavor your food.

Recommendations

Sodium Intake

The DASH diet allows two different sodium intake levels based on clinical evidence regarding salt intake and health outcomes.

Because the DASH diet emphasizes fruits and vegetables—which are naturally lower in sodium—and limits processed foods which tend to be higher in sodium, it is easier for you to reach these targets than it is when you consume a typical American diet.

Nutrient Balance

On the DASH diet, you are not required to count calories. The eating plan simply calls for a certain number of daily servings from various food groups. However, the number of servings depends on the number of calories you’re allowed each day. So you'll have to determine your calorie goal once when starting the diet to determine your daily serving recommendations.

Listed below is a table that recommends the calories needed for each activity level according to gender and age as provided by the National Institutes of Health.

If you consume a 2,000 calorie per day diet, you'll likely consume nutrients in the following ranges:

• Total fat: 64–68 grams
• Calories from fat: 28% to 30% of total calories
• Saturated fat: 13–16 grams
• Protein: 18% of total calories
• Carbohydrate: 55% of total calories
• Cholesterol: 114–129 milligrams
• Sodium: 1,500–2,300 milligrams
• Potassium: 4,715–4,721 milligrams
• Calcium: 1,370–1334 milligrams
• Magnesium: 535–542 milligrams
• Fiber: 34 grams

Exercise

The DASH diet provides recommendations for daily exercise. Experts suggest that you are physically active for at least two hours and 30 minutes each week. This can be broken into small daily segments or even multiple segments per day. They suggest that for more health benefits, you can gradually increase to five hours per week. Activities such as walking and housecleaning are suggested as examples of moderate physical activity.

Resources and Tips

There are many different sources that provide information and tips to help you follow the DASH diet. Countless books and websites are available, as well as numerous smartphone apps and tools.

A smart downloadable guide is also provided in a comprehensive six-page format by the National Institutes of Health. This guide also provides worksheets to help you monitor your progress and a sample food plan.

Also, the NIH guide is also updated regularly. The DASH diet has gone through changes through the years based on the extensive research that has been conducted. If you choose a DASH diet book or non-government website, be sure that it conforms to the latest guidelines to gain the greatest benefit.

As you prepare your kitchen and stock your pantry to follow the DASH diet, you'll find that the foods you need are easily found in your local grocery store. When you first begin, it may be helpful to take one day each week to plan meals.

The following tips may help you to adjust to the DASH lifestyle:

• Focus on increasing veggie intake first. Replace starchy side dishes at lunch and add a serving of vegetables instead. Eventually, follow the same practice at dinner.
• Keep fresh cut fruit on hand to replace sugary treats.
• Increase your use of fat-free and low-fat milk products to three servings a day.
• Practice portion control when consuming protein. Limit meat, seafood, or poultry to three ounces per meal, which is about the size of a deck of cards.
• Remove the salt shaker from the dinner table and from your food prep area. Experiment with non-sodium spice mixes instead.

Modifications

Because there are no "required" foods on this plan, those who follow special diets should be able to eat according to DASH guidelines. For example, those on a gluten-free diet can choose safe grains such as buckwheat or quinoa.

Vegan and vegetarian eaters will also be able to eat according to DASH guidelines. In fact, vegetarian meals are encouraged. Dairy consumption is not required on the plan, and some studies have even suggested that non-dairy components of the eating plan (rather than milk products) are responsible for the health benefits.

Lastly, if you prefer to consume more fat, there is some evidence that eating a higher fat version of the DASH plan may offer the same health benefits.

A 2016 study published in the American Journal of Clinical Nutrition found that a higher fat version of the DASH diet lowered blood pressure to the same extent as the traditional DASH diet without significantly increasing LDL cholesterol. In the study, those following the higher fat version of the diet consumed full-fat dairy products instead of low-fat or nonfat dairy and also reduced their sugar intake by limiting consumption of fruit juice.

If you choose to follow the DASH diet for health reasons and want to make modifications, speak to your health care provider about the ways in which your desired modification might affect your health. Sometimes, making adjustments to a diet can help you stick to the eating plan, but it is smart to get the input of your provider to keep your overall health goals on track.