The DASH eating plan requires no special foods and has no hard-to-follow recipes. One way to begin is by
seeing how DASH compares with your current food habits.
Remember that on some days the foods you eat may add up to more than the recommended servings from one food group and less from another. Similarly, you may have too much sodium on a particular day. But don't worry. Try your best to keep the average of several days close to the DASH eating plan and the sodium level recommended for you.
The Dietary Guidelines determined that the DASH eating plan is an example of a healthy eating plan and recommends it as a plan that not only meets your nutritional needs but can accommodate varied types of cuisines and special needs.
Remember that the DASH eating plan used along with other lifestyle changes can help you prevent and control your blood pressure. Important lifestyle recommendations for you include: achieve and maintain a healthy weight, participate in your favorite regular physical activity, and, if you drink, use moderation in alcohol
consumption (defined as up to one drink per day for women and up to two drinks per day for men).
One important note: If you take medication to control high blood pressure, you should not stop using it. Follow the DASH eating plan and talk with your doctor about your medication treatment. The tips in box 15 on page 27 can help you continue to follow the DASH eating plan and make other healthy lifestyle changes for a lifetime.
Change gradually
● If you now eat one or two vegetables a day, add a serving at lunch and another at dinner.
● If you don't eat fruit now or have juice only at breakfast, add a serving to your meals or have it as a snack.
● Gradually increase your use of fat-free and low-fat milk and milk products to three servings a day. For example, drink milk with lunch or dinner, instead of soda, sugar-sweetened tea, or alcohol. Choose fat-free (skim) or low-fat (1 percent) milk and milk products to reduce your intake of saturated fat, total fat,
cholesterol, and calories and to increase your calcium.
● Read the Nutrition Facts label on margarines and salad dressings to choose those lowest in saturated fat and trans fat.
Treat meats as one part of the whole meal, instead of the focus
● Limit lean meats to 6 ounces a day—all that's needed. Have only 3 ounces at a meal, which is about the size of a deck of cards.
● If you now eat large portions of meats, cut them back gradually— by a half or a third at each meal.
● Include two or more vegetarian-style (meatless) meals each week.
● Increase servings of vegetables, brown rice, whole wheat pasta, and cooked dry beans in meals. Try casseroles, whole wheat pasta, and stir-fry dishes, which have less meat and more vegetables, grains, and dry beans.
Use fruits or other foods low in saturated fat, trans fat, cholesterol, sodium, sugar, and calories as desserts and snacks
● Fruits and other lower fat foods offer great taste and variety. Use fruits canned in their own juice or packed in water. Fresh fruits require little or no preparation. Dried fruits are a good choice to carry with you or to have ready in the car.
● Try these snacks ideas: unsalted rice cakes; nuts mixed with raisins; graham crackers; fat-free and low-fat yogurt and frozen yogurt; popcorn with no salt or butter added; raw vegetables.
Try these other tips
● Choose whole grain foods for most grain servings to get added nutrients, such as minerals and fiber. For example, choose whole wheat bread or whole grain cereals.
● If you have trouble digesting milk and milk products, try taking lactase enzyme pills (available at drugstores and groceries) with the milk products. Or, buy lactose-free milk, which has the lactase enzyme already added to it.
● If you are allergic to nuts, use seeds or legumes (cooked dried beans or peas).
● Use fresh, frozen, or low-sodium canned vegetables and fruits.
Tuesday
Monday
Potassium
Vegetables Potassium (mg)
Potato, 1 medium 926
Sweet Potato, 1 medium 540
Spinach, cooked, 1/2 cup 290
Zucchini, cooked, 1/2 cup 280
Tomato, fresh, 1/2 cup 210
Kale, cooked, 1/2 cup 150
Romaine lettuce, 1 cup 140
Mushrooms, 1/2 cup 110
Cucumber, 1/2 cup 80
Fruit
Banana, 1 medium 420
Apricots, 1/4 cup 380
Orange, 1 medium 237
Cantaloupe chunks, 1/2 cup 214
Apple, 1 medium 150
Nuts, seeds, and legumes
Cooked soybeans, 1/2 cup 440
Cooked lentils, 1/2 cup 370
Cooked kidney beans, 1/2 cup 360
Cooked split peas, 1/2 cup 360
Almonds, roasted, 1/3 cup 310
Walnuts, roasted, 1/3 cup 190
Sunflower seeds, roasted, 2 Tbsp 124
Peanuts, roasted, 1/3 cup 120
Low-fat or fat-free milk and milk products
Milk, 1 cup 380
Yogurt, 1 cup 370
Lean meats, fish, and poultry
Fish (cod, halibut, rockfish, trout, tuna), 3 oz 200 - 400
Pork tenderloin, 3 oz 370
Beef tenderloin, chicken, turkey, 3 oz 210
Potato, 1 medium 926
Sweet Potato, 1 medium 540
Spinach, cooked, 1/2 cup 290
Zucchini, cooked, 1/2 cup 280
Tomato, fresh, 1/2 cup 210
Kale, cooked, 1/2 cup 150
Romaine lettuce, 1 cup 140
Mushrooms, 1/2 cup 110
Cucumber, 1/2 cup 80
Fruit
Banana, 1 medium 420
Apricots, 1/4 cup 380
Orange, 1 medium 237
Cantaloupe chunks, 1/2 cup 214
Apple, 1 medium 150
Nuts, seeds, and legumes
Cooked soybeans, 1/2 cup 440
Cooked lentils, 1/2 cup 370
Cooked kidney beans, 1/2 cup 360
Cooked split peas, 1/2 cup 360
Almonds, roasted, 1/3 cup 310
Walnuts, roasted, 1/3 cup 190
Sunflower seeds, roasted, 2 Tbsp 124
Peanuts, roasted, 1/3 cup 120
Low-fat or fat-free milk and milk products
Milk, 1 cup 380
Yogurt, 1 cup 370
Lean meats, fish, and poultry
Fish (cod, halibut, rockfish, trout, tuna), 3 oz 200 - 400
Pork tenderloin, 3 oz 370
Beef tenderloin, chicken, turkey, 3 oz 210
Sunday
Salt
Because it is rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH eating plan makes it easier to consume less salt and sodium. Still, you may want to begin by adopting the DASH eating plan at the level of 2,300 milligrams of sodium per day and then further lower your sodium intake to
1,500 milligrams per day.
The DASH eating plan also emphasizes potassium from food, especially fruits and vegetables, to help keep blood pressure levels healthy. A potassium-rich diet may help to reduce elevated or high blood pressure, but be sure to get your potassium from food sources, not from supplements. Many fruits and vegetables, some
milk products, and fish are rich sources of potassium. However, fruits and vegetables are rich in the form of
potassium (potassium with bicarbonate precursors) that favorably affects acid-base metabolism. This form of potassium may help to reduce risk of kidney stones and bone loss. While salt substitutes containing potassium are sometimes needed by persons on drug therapy for high blood pressure, these supplements can be harmful
to people with certain medical conditions. Ask your doctor before trying salt substitutes or supplements.
Only a small amount of sodium occurs naturally in foods. Most sodium is added during processing. The table below gives examples of sodium in some foods.
Whole and other grains and grain products* Sodium (mg)
Cooked cereal, rice, pasta, unsalted, 1/2 cup 0 - 5
Ready-to-eat cereal, 1 cup 0 - 360
Bread, 1 slice 110 - 175
Vegetables
Fresh or frozen, cooked without salt, 1/2 cup 1 - 70
Canned or frozen with sauce, 1/2 cup 140 -460
Tomato juice, canned, 1/2 cup 330
Fruit
Fresh, frozen, canned, 1/2 cup 0 - 5
Low-fat or fat-free milk and milk products
Milk, 1 cup 107
Yogurt, 1 cup 175
Natural cheeses, 11/2 oz 110 - 450
Process cheeses, 2 oz 600
Nuts, seeds, and legumes
Peanuts, salted, 1/3 cup 120
Peanuts, unsalted, 1/3 cup 0 - 5
Beans, cooked from dried or frozen, without
salt, 1/2 cup 0 - 5
Beans, canned, 1/2 cup 400
Lean meats, fish, and poultry
Fresh meat, fish, poultry, 3 oz 30 - 90
Tuna canned, water pack, no salt added, 3 oz 35 - 45
Tuna canned, water pack, 3 oz 230 - 350
Ham, lean, roasted, 3 oz 1,020
* Whole grains are recommended for most grain servings.
● Choose low- or reduced-sodium, or no-salt-added versions of foods and condiments when available.
● Choose fresh, frozen, or canned (low-sodium or no-salt-added) vegetables.
● Use fresh poultry, fish, and lean meat, rather than canned, smoked, or processed types.
● Choose ready-to-eat breakfast cereals that are lower in sodium.
● Limit cured foods (such as bacon and ham); foods packed in brine (such as pickles, pickled vegetables, olives, and sauerkraut); and condiments (such as mustard, horseradish, ketchup, and barbecue sauce). Limit even lower sodium versions of soy sauce and teriyaki sauce. Treat these condiments sparingly as you do table salt.
● Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes, which usually have added salt.
● Choose “convenience” foods that are lower in sodium. Cut back on frozen dinners, mixed dishes such as pizza, packaged mixes, canned soups or broths, and salad dressings—these often have a lot of sodium.
● Rinse canned foods, such as tuna and canned beans, to remove some of the sodium.
● Use spices instead of salt. In cooking and at the table, flavor foods with herbs, spices, lemon, lime, vinegar, or salt-free seasoning blends. Start by cutting salt in half.
Reducing Salt and Sodium When Eating Out
● Ask how foods are prepared. Ask that they be prepared without added salt, MSG, or salt-containing ingredients. Most restaurants are willing to accommodate requests.
● Know the terms that indicate high sodium content: pickled, cured, smoked, soy sauce, broth.
● Move the salt shaker away.
● Limit condiments, such as mustard, ketchup, pickles, and sauces with salt-containing ingredients.
● Choose fruit or vegetables, instead of salty snack foods.
Compare Nutrition Facts Labels on Foods Read the Nutrition Facts labels on foods to compare the amount of sodium in products. Look for the sodium content in milligrams and the Percent Daily Value. Aim for foods that are less than 5 percent of the Daily Value of sodium. Foods with 20 percent or more Daily Value of
sodium are considered high. You can also check out the amounts of the other DASH goal nutrients.
Compare the food labels of these two versions of canned tomatoes. The regular canned tomatoes (right) have 15 times as much sodium as the low-sodium canned tomatoes.
Low-Sodium Canned Diced Tomatoes
Nutrition Facts
Serving Size 1/2 cup (130g)
Servings Per Container 31/2
Amount Per Serving
Calories 25 Calories from Fat 0
% Daily Value*
Total Fat 0g 0%
Saturated Fat 0g 0%
Trans Fat 0g
Cholesterol 0mg 0%
Sodium 10mg 1%
Potassium 270mg 8%
Total Carbohydrate 5g 2%
Dietary Fiber 1g 4%
Sugar 3g
Protein 1g
Vitamin A 5% Vitamin C 30%
Calcium 4% Iron 4%
*Percent Daily Values are based on a 2,000 calorie
Canned Diced Tomatoes
Nutrition Facts
Serving Size 1/2 cup (130g)
Servings Per Container 31/2
Amount Per Serving
Calories 25 Calories from Fat 0
% Daily Value*
Total Fat 0g 0%
Saturated Fat 0g 0%
Trans Fat 0g
Cholesterol 0mg 0%
Sodium 150mg 6%
Potassium 230mg 6%
Total Carbohydrate 5g 2%
Dietary Fiber 1g 4%
Sugar 3g
Protein 1g
Vitamin A 5% Vitamin C 20%
Calcium 4% Iron 6%
*Percent Daily Values are based on a 2,000 calorie diet.
Food labels can help you choose items lower in sodium, saturated fat, trans fat, cholesterol, and calories and higher in potassium and calcium. Look for the following label information on cans, boxes, bottles, bags, and other packaging:
Sodium free or salt free Less than 5 mg per serving
Very low sodium 35 mg or less of sodium per serving
Low sodium 140 mg or less of sodium per serving
Low-sodium meal 140 mg or less of sodium per 31/2 oz (100 g)
Reduced or less sodium At least 25 percent less sodium than the regular version
Light in sodium 50 percent less sodium than the regular version
Unsalted or no salt added No salt added to the product during
processing (this is not a sodium-free food)
Fat
Fat-free Less than 0.5 g per serving
Low saturated fat 1 g or less per serving and 15% or less of calories from sat. fat
Low-fat 3 g or less per serving
Reduced fat At least 25 percent less fat than the regular version
Light in fat Half the fat compared to the regular version
1,500 milligrams per day.
The DASH eating plan also emphasizes potassium from food, especially fruits and vegetables, to help keep blood pressure levels healthy. A potassium-rich diet may help to reduce elevated or high blood pressure, but be sure to get your potassium from food sources, not from supplements. Many fruits and vegetables, some
milk products, and fish are rich sources of potassium. However, fruits and vegetables are rich in the form of
potassium (potassium with bicarbonate precursors) that favorably affects acid-base metabolism. This form of potassium may help to reduce risk of kidney stones and bone loss. While salt substitutes containing potassium are sometimes needed by persons on drug therapy for high blood pressure, these supplements can be harmful
to people with certain medical conditions. Ask your doctor before trying salt substitutes or supplements.
Only a small amount of sodium occurs naturally in foods. Most sodium is added during processing. The table below gives examples of sodium in some foods.
Whole and other grains and grain products* Sodium (mg)
Cooked cereal, rice, pasta, unsalted, 1/2 cup 0 - 5
Ready-to-eat cereal, 1 cup 0 - 360
Bread, 1 slice 110 - 175
Vegetables
Fresh or frozen, cooked without salt, 1/2 cup 1 - 70
Canned or frozen with sauce, 1/2 cup 140 -460
Tomato juice, canned, 1/2 cup 330
Fruit
Fresh, frozen, canned, 1/2 cup 0 - 5
Low-fat or fat-free milk and milk products
Milk, 1 cup 107
Yogurt, 1 cup 175
Natural cheeses, 11/2 oz 110 - 450
Process cheeses, 2 oz 600
Nuts, seeds, and legumes
Peanuts, salted, 1/3 cup 120
Peanuts, unsalted, 1/3 cup 0 - 5
Beans, cooked from dried or frozen, without
salt, 1/2 cup 0 - 5
Beans, canned, 1/2 cup 400
Lean meats, fish, and poultry
Fresh meat, fish, poultry, 3 oz 30 - 90
Tuna canned, water pack, no salt added, 3 oz 35 - 45
Tuna canned, water pack, 3 oz 230 - 350
Ham, lean, roasted, 3 oz 1,020
* Whole grains are recommended for most grain servings.
● Choose low- or reduced-sodium, or no-salt-added versions of foods and condiments when available.
● Choose fresh, frozen, or canned (low-sodium or no-salt-added) vegetables.
● Use fresh poultry, fish, and lean meat, rather than canned, smoked, or processed types.
● Choose ready-to-eat breakfast cereals that are lower in sodium.
● Limit cured foods (such as bacon and ham); foods packed in brine (such as pickles, pickled vegetables, olives, and sauerkraut); and condiments (such as mustard, horseradish, ketchup, and barbecue sauce). Limit even lower sodium versions of soy sauce and teriyaki sauce. Treat these condiments sparingly as you do table salt.
● Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes, which usually have added salt.
● Choose “convenience” foods that are lower in sodium. Cut back on frozen dinners, mixed dishes such as pizza, packaged mixes, canned soups or broths, and salad dressings—these often have a lot of sodium.
● Rinse canned foods, such as tuna and canned beans, to remove some of the sodium.
● Use spices instead of salt. In cooking and at the table, flavor foods with herbs, spices, lemon, lime, vinegar, or salt-free seasoning blends. Start by cutting salt in half.
Reducing Salt and Sodium When Eating Out
● Ask how foods are prepared. Ask that they be prepared without added salt, MSG, or salt-containing ingredients. Most restaurants are willing to accommodate requests.
● Know the terms that indicate high sodium content: pickled, cured, smoked, soy sauce, broth.
● Move the salt shaker away.
● Limit condiments, such as mustard, ketchup, pickles, and sauces with salt-containing ingredients.
● Choose fruit or vegetables, instead of salty snack foods.
Compare Nutrition Facts Labels on Foods Read the Nutrition Facts labels on foods to compare the amount of sodium in products. Look for the sodium content in milligrams and the Percent Daily Value. Aim for foods that are less than 5 percent of the Daily Value of sodium. Foods with 20 percent or more Daily Value of
sodium are considered high. You can also check out the amounts of the other DASH goal nutrients.
Compare the food labels of these two versions of canned tomatoes. The regular canned tomatoes (right) have 15 times as much sodium as the low-sodium canned tomatoes.
Low-Sodium Canned Diced Tomatoes
Nutrition Facts
Serving Size 1/2 cup (130g)
Servings Per Container 31/2
Amount Per Serving
Calories 25 Calories from Fat 0
% Daily Value*
Total Fat 0g 0%
Saturated Fat 0g 0%
Trans Fat 0g
Cholesterol 0mg 0%
Sodium 10mg 1%
Potassium 270mg 8%
Total Carbohydrate 5g 2%
Dietary Fiber 1g 4%
Sugar 3g
Protein 1g
Vitamin A 5% Vitamin C 30%
Calcium 4% Iron 4%
*Percent Daily Values are based on a 2,000 calorie
Canned Diced Tomatoes
Nutrition Facts
Serving Size 1/2 cup (130g)
Servings Per Container 31/2
Amount Per Serving
Calories 25 Calories from Fat 0
% Daily Value*
Total Fat 0g 0%
Saturated Fat 0g 0%
Trans Fat 0g
Cholesterol 0mg 0%
Sodium 150mg 6%
Potassium 230mg 6%
Total Carbohydrate 5g 2%
Dietary Fiber 1g 4%
Sugar 3g
Protein 1g
Vitamin A 5% Vitamin C 20%
Calcium 4% Iron 6%
*Percent Daily Values are based on a 2,000 calorie diet.
Food labels can help you choose items lower in sodium, saturated fat, trans fat, cholesterol, and calories and higher in potassium and calcium. Look for the following label information on cans, boxes, bottles, bags, and other packaging:
Sodium free or salt free Less than 5 mg per serving
Very low sodium 35 mg or less of sodium per serving
Low sodium 140 mg or less of sodium per serving
Low-sodium meal 140 mg or less of sodium per 31/2 oz (100 g)
Reduced or less sodium At least 25 percent less sodium than the regular version
Light in sodium 50 percent less sodium than the regular version
Unsalted or no salt added No salt added to the product during
processing (this is not a sodium-free food)
Fat
Fat-free Less than 0.5 g per serving
Low saturated fat 1 g or less per serving and 15% or less of calories from sat. fat
Low-fat 3 g or less per serving
Reduced fat At least 25 percent less fat than the regular version
Light in fat Half the fat compared to the regular version
Saturday
Weight Loss On DASH
If you need to lose weight, even a small weight loss will help to lower your risks of developing high blood pressure and other serious health conditions. At the very least, you should not gain weight. A recent study showed that people can lose weight while following the DASH eating plan and lowering their sodium intake. In a study of 810 participants, one-third were taught how to lower their sodium intake and follow the DASH eating plan on their own. Most of them needed to lose weight as well. They followed the DASH eating plan at lower calorie levels and they increased their physical activity. Over the course of 18 months, participants lost weight and improved their blood pressure control.
The best way to take off pounds is to do so gradually, get more physical activity, and eat a balanced diet that is lower in calories and fat. For some people at very high risk for heart disease or stroke, medication
will be necessary. To develop a weight-loss or weight-maintenance program that works well for you, consult with your doctor or registered dietitian.
Combining the DASH eating plan with a regular physical activity program, such as walking or swimming, will help you both shed pounds and stay trim for the long term. You can do an activity for 30 minutes at one time, or choose shorter periods of at least 10 minutes each. The important thing is to total about 30 minutes of activity each day. (To avoid weight gain,try to total about 60 minutes per day.)
You should be aware that the DASH eating plan has more daily servings of fruits, vegetables, and whole grain foods than you may be used to eating. Because the plan is high in fiber, it can cause bloating and diarrhea in some persons. To avoid these problems, gradually increase your intake of fruit, vegetables, and whole
grain foods.
This booklet gives menus and recipes from the DASH studies for both 2,300 and 1,500 milligrams of daily sodium intake. Twentythree hundred milligrams of sodium equals about 6 grams, or 1 teaspoon, of table salt (sodium chloride); 1,500 milligrams of sodium equals about 4 grams, or 2/3 teaspoon, of table salt.
The key to reducing salt intake is making wise food choices. Only a small amount of salt that we consume comes from the salt added at the table, and only small amounts of sodium occur naturally in food. Processed foods account for most of the salt and sodium Americans consume. So, be sure to read food labels to choose
products lower in sodium. You may be surprised to find which foods have sodium. They include baked goods, certain cereals, soy sauce, seasoned salts, monosodium glutamate (MSG), baking soda, and some antacids—the range is wide.
The DASH eating plan can be adopted to promote weight loss. It is rich in lower-calorie foods, such as fruits and vegetables. You can make it lower in calories by replacing higher calorie foods such as sweets with more fruits and vegetables—and that also will make it easier for you to reach your DASH goals. Here are some examples:
To increase fruits—
● Eat a medium apple instead of four shortbread cookies. You’ll save 80 calories.
● Eat 1/4 cup of dried apricots instead of a 2-ounce bag of pork rinds. You’ll save 230 calories.
To increase vegetables—
● Have a hamburger that’s 3 ounces of meat instead of 6 ounces. Add a 1/2-cup serving of carrots and a 1/2-cup serving of spinach. You’ll save more than 200 calories.
● Instead of 5 ounces of chicken, have a stir fry with 2 ounces of chicken and 11/2 cups of raw vegetables. Use a small amount of vegetable oil. You'll save 50 calories. To increase fat-free or low-fat milk products—
● Have a 1/2-cup serving of low-fat frozen yogurt instead of a 1/2-cup serving of full-fat ice cream. You’ll save about 70 calories. And don’t forget these calorie-saving tips:
● Use fat-free or low-fat condiments.
● Use half as much vegetable oil, soft or liquid margarine, mayonnaise, or salad dressing, or choose available low-fat or fat-free versions.
● Eat smaller portions—cut back gradually.
● Choose fat-free or low-fat milk and milk products.
● Check the food labels to compare fat content in packaged foods—items marked fat-free or low-fat are not always lower in calories than their regular versions.
● Limit foods with lots of added sugar, such as pies, flavored yogurts, candy bars, ice cream, sherbet, regular soft drinks, and fruit drinks.
● Eat fruits canned in their own juice or in water.
● Add fruit to plain fat-free or low-fat yogurt.
● Snack on fruit, vegetable sticks, unbuttered and unsalted popcorn, or rice cakes.
● Drink water or club soda—zest it up with a wedge of lemon or lime.
Thirty minutes of moderate-intensity physical activity each day can help.
● If your blood pressure is moderately elevated, 30 minutes of brisk walking on most days a week may be enough to keep you off medication.
● If you take medication for high blood pressure, 30 minutes of moderate physical activity can make your medication work more effectively and make you feel better.
● If you don’t have high blood pressure, being physically active can help keep it that way. If you have normal blood pressure—but are not active—your chances of developing high blood pressure increase, especially as you get older or if you become overweight or obese or develop diabetes. Getting started: Your physical activity program can be as simple as a 15-minute walk around the block each morning and evening. Gradually
build up your program and set new goals to stay motivated. The important thing is to find something you enjoy, and do it safely. And remember—trying too hard at first can lead to injury and cause you to give up. If you have a chronic health problem or a family history of heart disease at an early age, be sure to talk with your doctor before launching a new physical activity program.
1. Set a schedule and try to keep it.
2. Get a friend or family member to join you. Motivate each other to keep it up.
3. Cross-train. Alternate between different activities so you don’t strain one part of your body day after day.
4. Set goals.
5. Reward yourself. At the end of each month that you stay on your exercise program, reward yourself with something new—new clothes, a compact disc, a new book—something that will help keep you committed. But don't use food as a reward.
The best way to take off pounds is to do so gradually, get more physical activity, and eat a balanced diet that is lower in calories and fat. For some people at very high risk for heart disease or stroke, medication
will be necessary. To develop a weight-loss or weight-maintenance program that works well for you, consult with your doctor or registered dietitian.
Combining the DASH eating plan with a regular physical activity program, such as walking or swimming, will help you both shed pounds and stay trim for the long term. You can do an activity for 30 minutes at one time, or choose shorter periods of at least 10 minutes each. The important thing is to total about 30 minutes of activity each day. (To avoid weight gain,try to total about 60 minutes per day.)
You should be aware that the DASH eating plan has more daily servings of fruits, vegetables, and whole grain foods than you may be used to eating. Because the plan is high in fiber, it can cause bloating and diarrhea in some persons. To avoid these problems, gradually increase your intake of fruit, vegetables, and whole
grain foods.
This booklet gives menus and recipes from the DASH studies for both 2,300 and 1,500 milligrams of daily sodium intake. Twentythree hundred milligrams of sodium equals about 6 grams, or 1 teaspoon, of table salt (sodium chloride); 1,500 milligrams of sodium equals about 4 grams, or 2/3 teaspoon, of table salt.
The key to reducing salt intake is making wise food choices. Only a small amount of salt that we consume comes from the salt added at the table, and only small amounts of sodium occur naturally in food. Processed foods account for most of the salt and sodium Americans consume. So, be sure to read food labels to choose
products lower in sodium. You may be surprised to find which foods have sodium. They include baked goods, certain cereals, soy sauce, seasoned salts, monosodium glutamate (MSG), baking soda, and some antacids—the range is wide.
The DASH eating plan can be adopted to promote weight loss. It is rich in lower-calorie foods, such as fruits and vegetables. You can make it lower in calories by replacing higher calorie foods such as sweets with more fruits and vegetables—and that also will make it easier for you to reach your DASH goals. Here are some examples:
To increase fruits—
● Eat a medium apple instead of four shortbread cookies. You’ll save 80 calories.
● Eat 1/4 cup of dried apricots instead of a 2-ounce bag of pork rinds. You’ll save 230 calories.
To increase vegetables—
● Have a hamburger that’s 3 ounces of meat instead of 6 ounces. Add a 1/2-cup serving of carrots and a 1/2-cup serving of spinach. You’ll save more than 200 calories.
● Instead of 5 ounces of chicken, have a stir fry with 2 ounces of chicken and 11/2 cups of raw vegetables. Use a small amount of vegetable oil. You'll save 50 calories. To increase fat-free or low-fat milk products—
● Have a 1/2-cup serving of low-fat frozen yogurt instead of a 1/2-cup serving of full-fat ice cream. You’ll save about 70 calories. And don’t forget these calorie-saving tips:
● Use fat-free or low-fat condiments.
● Use half as much vegetable oil, soft or liquid margarine, mayonnaise, or salad dressing, or choose available low-fat or fat-free versions.
● Eat smaller portions—cut back gradually.
● Choose fat-free or low-fat milk and milk products.
● Check the food labels to compare fat content in packaged foods—items marked fat-free or low-fat are not always lower in calories than their regular versions.
● Limit foods with lots of added sugar, such as pies, flavored yogurts, candy bars, ice cream, sherbet, regular soft drinks, and fruit drinks.
● Eat fruits canned in their own juice or in water.
● Add fruit to plain fat-free or low-fat yogurt.
● Snack on fruit, vegetable sticks, unbuttered and unsalted popcorn, or rice cakes.
● Drink water or club soda—zest it up with a wedge of lemon or lime.
Thirty minutes of moderate-intensity physical activity each day can help.
● If your blood pressure is moderately elevated, 30 minutes of brisk walking on most days a week may be enough to keep you off medication.
● If you take medication for high blood pressure, 30 minutes of moderate physical activity can make your medication work more effectively and make you feel better.
● If you don’t have high blood pressure, being physically active can help keep it that way. If you have normal blood pressure—but are not active—your chances of developing high blood pressure increase, especially as you get older or if you become overweight or obese or develop diabetes. Getting started: Your physical activity program can be as simple as a 15-minute walk around the block each morning and evening. Gradually
build up your program and set new goals to stay motivated. The important thing is to find something you enjoy, and do it safely. And remember—trying too hard at first can lead to injury and cause you to give up. If you have a chronic health problem or a family history of heart disease at an early age, be sure to talk with your doctor before launching a new physical activity program.
1. Set a schedule and try to keep it.
2. Get a friend or family member to join you. Motivate each other to keep it up.
3. Cross-train. Alternate between different activities so you don’t strain one part of your body day after day.
4. Set goals.
5. Reward yourself. At the end of each month that you stay on your exercise program, reward yourself with something new—new clothes, a compact disc, a new book—something that will help keep you committed. But don't use food as a reward.
Friday
Following the DASH Plan
Grains 6 to 8 daily servings - 1 slice bread , 1 oz dry cereal† , 1/2 cup cooked rice, pasta, or cereal.
Vegetables 4 to 5 daily servings - 1 cup raw leafy vegetable, 1/2 cup cut-up raw or cooked vegetable,
1/2 cup vegetable juice
Fruits 4 to 5 daily servings - 1 medium fruit, 1/4 cup dried fruit, 1/2 cup fresh, frozen, or canned fruit,
1/2 cup fruit juice
Fat-free or low-fat milk and milk products - 2 to 3 daily servings - 1 cup milk or yogurt, 11/2 oz cheese
Lean meats, poultry, and fish 6 or less daily servings - 1 oz cooked meats, poultry, or fish, 1 egg‡
Nuts, seeds, and legumes 4 to 5 servings per week - 1/3 cup or 11/2 oz nuts, 2 Tbsp peanut butter
2 Tbsp or 1/2 oz seeds, 1/2 cup cooked legumes (dry beans and peas)
Fats and oils§ 2 to 3 daily servings - 1 tsp soft margarine, 1 tsp vegetable oil, 1 Tbsp mayonnaise
2 Tbsp salad dressing
Sweets and added sugars 5 or less servings per week - 1 Tbsp sugar, 1 Tbsp jelly or jam, 1/2 cup sorbet, gelatin, 1 cup lemonade
* Whole grains are recommended for most grain servings as a good source of fiber and nutrients.
† Serving sizes vary between 1/2 cup and 11/4 cups, depending on cereal type. Check the product's Nutrition Facts label.
Whole wheat bread and rolls, whole wheat Major sources of energy and fiber
pasta, English muffin, pita bread, bagel,
cereals, grits, oatmeal, brown rice, unsalted
pretzels and popcorn
Broccoli, carrots, collards, green beans, green Rich sources of potassium, magnesium, and fiber.
peas, kale, lima beans, potatoes, spinach,
squash, sweet potatoes, tomatoes
Apples, apricots, bananas, dates, grapes, Important sources of potassium, magnesium, and
oranges, grapefruit, grapefruit juice, fiber.
mangoes, melons, peaches, pineapples,
raisins, strawberries, tangerines
Fat-free (skim) or low-fat (1%) milk or buttermilk, Major sources of calcium and protein
fat-free, low-fat, or reduced-fat cheese,
fat-free or low-fat regular or frozen yogurt
Select only lean; trim away visible fats; broil,
roast, or poach; remove skin from poultry Rich sources of protein and magnesium
Almonds, hazelnuts, mixed nuts, peanuts,
walnuts, sunflower seeds, peanut butter,
kidney beans, lentils, split peas Rich sources of energy, magnesium, protein, and fiber.
Soft margarine, vegetable oil (such as canola,
corn, olive, or safflower), low-fat mayonnaise,
light salad dressing The DASH study had 27 percent of calories fat, including fat in or added to foods.
Fruit-flavored gelatin, fruit punch, hard candy,
jelly, maple syrup, sorbet and ices, sugar Sweets should be low in fat
‡ Since eggs are high in cholesterol, limit egg yolk intake to no more than four per week; two egg whites have the same protein content as 1 oz of meat. § Fat content changes serving amount for fats and oils. For example, 1 Tbsp of regular salad dressing equals one serving; 1 Tbsp of a low-fat dressing equals
one-half serving; 1 Tbsp of a fat-free dressing equals zero servings.
Below are servings for other calorie diets
1600 calories 2600 calories 3100 calories
Grains* 6 10 - 11 12 - 13
Vegetables 3 - 4 5 - 6 6
Fruits 4 5 - 6 6
Fat-free or lowfat 2 - 3 3 3 - 4
milk and milk
products
Lean meats, 3 - 6 6 6 - 9
poultry, and fish
Nuts, seeds, and 3/a week 1 1
legumes
Fats and oils 2 3 4
Sweets and 0 2 2
added sugars
* Whole grains are recommended for most grain servings as a good source of fiber and nutrients.
Vegetables 4 to 5 daily servings - 1 cup raw leafy vegetable, 1/2 cup cut-up raw or cooked vegetable,
1/2 cup vegetable juice
Fruits 4 to 5 daily servings - 1 medium fruit, 1/4 cup dried fruit, 1/2 cup fresh, frozen, or canned fruit,
1/2 cup fruit juice
Fat-free or low-fat milk and milk products - 2 to 3 daily servings - 1 cup milk or yogurt, 11/2 oz cheese
Lean meats, poultry, and fish 6 or less daily servings - 1 oz cooked meats, poultry, or fish, 1 egg‡
Nuts, seeds, and legumes 4 to 5 servings per week - 1/3 cup or 11/2 oz nuts, 2 Tbsp peanut butter
2 Tbsp or 1/2 oz seeds, 1/2 cup cooked legumes (dry beans and peas)
Fats and oils§ 2 to 3 daily servings - 1 tsp soft margarine, 1 tsp vegetable oil, 1 Tbsp mayonnaise
2 Tbsp salad dressing
Sweets and added sugars 5 or less servings per week - 1 Tbsp sugar, 1 Tbsp jelly or jam, 1/2 cup sorbet, gelatin, 1 cup lemonade
* Whole grains are recommended for most grain servings as a good source of fiber and nutrients.
† Serving sizes vary between 1/2 cup and 11/4 cups, depending on cereal type. Check the product's Nutrition Facts label.
Whole wheat bread and rolls, whole wheat Major sources of energy and fiber
pasta, English muffin, pita bread, bagel,
cereals, grits, oatmeal, brown rice, unsalted
pretzels and popcorn
Broccoli, carrots, collards, green beans, green Rich sources of potassium, magnesium, and fiber.
peas, kale, lima beans, potatoes, spinach,
squash, sweet potatoes, tomatoes
Apples, apricots, bananas, dates, grapes, Important sources of potassium, magnesium, and
oranges, grapefruit, grapefruit juice, fiber.
mangoes, melons, peaches, pineapples,
raisins, strawberries, tangerines
Fat-free (skim) or low-fat (1%) milk or buttermilk, Major sources of calcium and protein
fat-free, low-fat, or reduced-fat cheese,
fat-free or low-fat regular or frozen yogurt
Select only lean; trim away visible fats; broil,
roast, or poach; remove skin from poultry Rich sources of protein and magnesium
Almonds, hazelnuts, mixed nuts, peanuts,
walnuts, sunflower seeds, peanut butter,
kidney beans, lentils, split peas Rich sources of energy, magnesium, protein, and fiber.
Soft margarine, vegetable oil (such as canola,
corn, olive, or safflower), low-fat mayonnaise,
light salad dressing The DASH study had 27 percent of calories fat, including fat in or added to foods.
Fruit-flavored gelatin, fruit punch, hard candy,
jelly, maple syrup, sorbet and ices, sugar Sweets should be low in fat
‡ Since eggs are high in cholesterol, limit egg yolk intake to no more than four per week; two egg whites have the same protein content as 1 oz of meat. § Fat content changes serving amount for fats and oils. For example, 1 Tbsp of regular salad dressing equals one serving; 1 Tbsp of a low-fat dressing equals
one-half serving; 1 Tbsp of a fat-free dressing equals zero servings.
Below are servings for other calorie diets
1600 calories 2600 calories 3100 calories
Grains* 6 10 - 11 12 - 13
Vegetables 3 - 4 5 - 6 6
Fruits 4 5 - 6 6
Fat-free or lowfat 2 - 3 3 3 - 4
milk and milk
products
Lean meats, 3 - 6 6 6 - 9
poultry, and fish
Nuts, seeds, and 3/a week 1 1
legumes
Fats and oils 2 3 4
Sweets and 0 2 2
added sugars
* Whole grains are recommended for most grain servings as a good source of fiber and nutrients.
Thursday
The DASH Eating Plan
Blood pressure can be unhealthy even if it stays only slightly above the normal level of less than 120/80 mmHg. The more your blood pressure rises above normal, the greater the health risk. Scientists supported by the National Heart, Lung, and Blood Institute (NHLBI) conducted two key studies. Their findings showed that blood pressures were reduced with an eating plan that is low in saturated fat, cholesterol, and total fat and that emphasizes fruits, vegetables, and fat-free or low-fat milk and milk products. This eating plan—known as the DASH eating plan—also includes whole grain products, fish, poultry, and nuts. It is reduced in lean red meat, sweets, added sugars, and sugar-containing beverages compared to the typical American diet. It is rich in potassium, magnesium, and calcium, as well as protein and fiber.
For a 2100 calorie eating plan
Total fat 27% of calories Sodium 2,300 mg*
Saturated fat 6% of calories Potassium 4,700 mg
Protein 18% of calories Calcium 1,250 mg
Carbohydrate 55% of calories Magnesium 500 mg
Cholesterol 150 mg Fiber 30 g
* 1,500 mg sodium was a lower goal tested and found to be even better for lowering blood pressure. It was particularly effective for middle-aged and older individuals, African Americans, and those who already had high blood pressure.
The DASH eating plan follows heart healthy guidelines to limit saturated fat and cholesterol. It focuses on increasing intake of foods rich in nutrients that are expected to lower blood pressure, mainly minerals (like potassium, calcium, and magnesium), protein, and fiber. It includes nutrient-rich foods so that it meets other
nutrient requirements as recommended by the Institute of Medicine.
The first DASH study involved 459 adults with systolic blood pressures of less than 160 mmHg and diastolic pressures of 80–95 mmHg. About 27 percent of the participants had high blood pressure. About 50 percent were women and 60 percent were African Americans. It compared three eating plans: a plan that includes foods similar to what many Americans regularly eat; a plan that includes foods similar to what many Americans regularly eat plus more fruits and vegetables; and the DASH eating plan. All three plans included about 3,000 milligrams of sodium daily. None of the plans was vegetarian or used specialty foods.
Results were dramatic. Participants who followed both the plan that included more fruits and vegetables and the DASH eating plan had reduced blood pressure. But the DASH eating plan had the greatest effect, especially for those with high blood pressure. Furthermore, the blood pressure reductions came fast—within
2 weeks of starting the plan.
The second DASH study looked at the effect on blood pressure of a reduced dietary sodium intake as participants followed either the DASH eating plan or an eating plan typical of what many Americans consume. This second study involved 412 participants. Participants were randomly assigned to one of the two eating plans and then followed for a month at each of the three sodium levels. The three sodium levels were a higher intake of about 3,300 milligrams per day (the level consumed by many Americans), an intermediate intake of about 2,300 milligrams per day, and a lower intake of about 1,500 milligrams per day.
Results showed that reducing dietary sodium lowered blood pressure for both eating plans. At each sodium level, blood pressure was lower on the DASH eating plan than on the other eating plan. The greatest blood pressure reductions were for the DASH eating plan at the sodium intake of 1,500 milligrams per day. Those with high blood pressure saw the greatest reductions, but those with prehypertension also had large decreases.
Together these studies show the importance of lowering sodium intake—whatever your eating plan. For a true winning combination, follow the DASH eating plan and lower your intake of salt and sodium.
The DASH studies were sponsored by the NHLBI and conducted at four medical centers. There was also a central coordinating center at Kaiser Permanente Center for Health Research in Portland, OR. The four medical centers were: Brigham and Women's Hospital, Boston, MA; Duke Hypertension Center and the
Sarah W. Stedman Nutrition and Metabolism Center, Durham, NC; Johns Hopkins Medical Institutions, Baltimore, MD; and Pennington Biomedical Research Center, Baton Rouge, LA.
For a 2100 calorie eating plan
Total fat 27% of calories Sodium 2,300 mg*
Saturated fat 6% of calories Potassium 4,700 mg
Protein 18% of calories Calcium 1,250 mg
Carbohydrate 55% of calories Magnesium 500 mg
Cholesterol 150 mg Fiber 30 g
* 1,500 mg sodium was a lower goal tested and found to be even better for lowering blood pressure. It was particularly effective for middle-aged and older individuals, African Americans, and those who already had high blood pressure.
The DASH eating plan follows heart healthy guidelines to limit saturated fat and cholesterol. It focuses on increasing intake of foods rich in nutrients that are expected to lower blood pressure, mainly minerals (like potassium, calcium, and magnesium), protein, and fiber. It includes nutrient-rich foods so that it meets other
nutrient requirements as recommended by the Institute of Medicine.
The first DASH study involved 459 adults with systolic blood pressures of less than 160 mmHg and diastolic pressures of 80–95 mmHg. About 27 percent of the participants had high blood pressure. About 50 percent were women and 60 percent were African Americans. It compared three eating plans: a plan that includes foods similar to what many Americans regularly eat; a plan that includes foods similar to what many Americans regularly eat plus more fruits and vegetables; and the DASH eating plan. All three plans included about 3,000 milligrams of sodium daily. None of the plans was vegetarian or used specialty foods.
Results were dramatic. Participants who followed both the plan that included more fruits and vegetables and the DASH eating plan had reduced blood pressure. But the DASH eating plan had the greatest effect, especially for those with high blood pressure. Furthermore, the blood pressure reductions came fast—within
2 weeks of starting the plan.
The second DASH study looked at the effect on blood pressure of a reduced dietary sodium intake as participants followed either the DASH eating plan or an eating plan typical of what many Americans consume. This second study involved 412 participants. Participants were randomly assigned to one of the two eating plans and then followed for a month at each of the three sodium levels. The three sodium levels were a higher intake of about 3,300 milligrams per day (the level consumed by many Americans), an intermediate intake of about 2,300 milligrams per day, and a lower intake of about 1,500 milligrams per day.
Results showed that reducing dietary sodium lowered blood pressure for both eating plans. At each sodium level, blood pressure was lower on the DASH eating plan than on the other eating plan. The greatest blood pressure reductions were for the DASH eating plan at the sodium intake of 1,500 milligrams per day. Those with high blood pressure saw the greatest reductions, but those with prehypertension also had large decreases.
Together these studies show the importance of lowering sodium intake—whatever your eating plan. For a true winning combination, follow the DASH eating plan and lower your intake of salt and sodium.
The DASH studies were sponsored by the NHLBI and conducted at four medical centers. There was also a central coordinating center at Kaiser Permanente Center for Health Research in Portland, OR. The four medical centers were: Brigham and Women's Hospital, Boston, MA; Duke Hypertension Center and the
Sarah W. Stedman Nutrition and Metabolism Center, Durham, NC; Johns Hopkins Medical Institutions, Baltimore, MD; and Pennington Biomedical Research Center, Baton Rouge, LA.
Wednesday
What Is High Blood Pressure?
Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mmHg) and recorded as two numbers—systolic pressure (when the heart beats) over diastolic pressure (when the heart relaxes between beats). Both numbers are important. Blood pressure rises and falls during the day. But when it stays elevated over time, then it's called high blood pressure. High blood pressure is dangerous because it makes the heart work too hard, and the high force of the blood flow can harm arteries and organs such
as the heart, kidneys, brain, and eyes. High blood pressure often has no warning signs or symptoms. Once it occurs, it usually lasts a lifetime. If uncontrolled, it can lead to heart and kidney disease, stroke, and blindness.
High blood pressure affects more than 65 million—or 1 in 3—American adults. About 28 percent of American adults ages 18 and older, or about 59 million people, have prehypertension, a condition that also increases the chance of heart disease and stroke. High blood pressure is especially common among African Americans, who tend to develop it at an earlier age and more often than Whites. It is also common among older Americans—individuals with normal blood pressure at age 55 have a 90 percent lifetime risk for developing high blood pressure. High blood pressure can be controlled if you take these steps:
■ Maintain a healthy weight.
■ Be moderately physically active on most days of the week.
■ Follow a healthy eating plan, which includes foods lower in sodium.
■ If you drink alcoholic beverages, do so in moderation.
■ If you have high blood pressure and are prescribed medication,
take it as directed.
All steps but the last also help to prevent high blood pressure.
Normal is less than 120/less than 80, Prehypertension 120-139/80to89, Hypertension 140 +/90+
Good for you! Could be a problem. You have high blood pressure.
as the heart, kidneys, brain, and eyes. High blood pressure often has no warning signs or symptoms. Once it occurs, it usually lasts a lifetime. If uncontrolled, it can lead to heart and kidney disease, stroke, and blindness.
High blood pressure affects more than 65 million—or 1 in 3—American adults. About 28 percent of American adults ages 18 and older, or about 59 million people, have prehypertension, a condition that also increases the chance of heart disease and stroke. High blood pressure is especially common among African Americans, who tend to develop it at an earlier age and more often than Whites. It is also common among older Americans—individuals with normal blood pressure at age 55 have a 90 percent lifetime risk for developing high blood pressure. High blood pressure can be controlled if you take these steps:
■ Maintain a healthy weight.
■ Be moderately physically active on most days of the week.
■ Follow a healthy eating plan, which includes foods lower in sodium.
■ If you drink alcoholic beverages, do so in moderation.
■ If you have high blood pressure and are prescribed medication,
take it as directed.
All steps but the last also help to prevent high blood pressure.
Normal is less than 120/less than 80, Prehypertension 120-139/80to89, Hypertension 140 +/90+
Good for you! Could be a problem. You have high blood pressure.
Tuesday
High Blood Pressure and the DASH Diet
What you choose to eat affects your chances of developing high blood pressure, or hypertension (the medical term). Recent studies show that blood pressure can be lowered by following the DietaryApproaches to Stop Hypertension (DASH) eating plan—and by eating less salt, also called sodium.While each step alone lowers blood pressure, the combination of the eating plan and a reduced sodium intake gives the biggest benefit and may help prevent the development of high blood pressure.
This booklet, based on the DASH research findings, tells how to follow the DASH eating plan and reduce the amount of sodium you consume. It offers tips on how to start and stay on the eating plan, as well as a week of menus and some recipes. The menus and recipes are given for two levels of daily sodium consumption—2,300 and 1,500 milligrams per day. Twenty-three hundred milligrams is the highest level considered acceptable by the National High Blood Pressure Education Program. It is also the highest amount recommended for healthy Americans by the 2005 “U.S.Dietary Guidelines for Americans.” The 1,500 milligram level can lower blood pressure further and more recently is the amount recommended by the Institute of Medicine as an adequate intake level and one that most people should try to achieve. The lower your salt intake is, the lower your blood pressure. Studies have found that the DASH menus containing 2,300 milligrams of sodium can lower blood pressure and that an even
lower level of sodium, 1,500 milligrams, can further reduce blood pressure. All the menus are lower in sodium than what adults in the United States currently eat—about 4,200 milligrams per day in men and 3,300 milligrams per day in women. Those with high blood pressure and prehypertension may benefit especially from following the DASH eating plan and reducing their sodium intake.
This booklet, based on the DASH research findings, tells how to follow the DASH eating plan and reduce the amount of sodium you consume. It offers tips on how to start and stay on the eating plan, as well as a week of menus and some recipes. The menus and recipes are given for two levels of daily sodium consumption—2,300 and 1,500 milligrams per day. Twenty-three hundred milligrams is the highest level considered acceptable by the National High Blood Pressure Education Program. It is also the highest amount recommended for healthy Americans by the 2005 “U.S.Dietary Guidelines for Americans.” The 1,500 milligram level can lower blood pressure further and more recently is the amount recommended by the Institute of Medicine as an adequate intake level and one that most people should try to achieve. The lower your salt intake is, the lower your blood pressure. Studies have found that the DASH menus containing 2,300 milligrams of sodium can lower blood pressure and that an even
lower level of sodium, 1,500 milligrams, can further reduce blood pressure. All the menus are lower in sodium than what adults in the United States currently eat—about 4,200 milligrams per day in men and 3,300 milligrams per day in women. Those with high blood pressure and prehypertension may benefit especially from following the DASH eating plan and reducing their sodium intake.
