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Dietary Approaches To Stop Hypertension

The Dietary Approaches to Stop Hypertension (DASH) lowers blood pressure. Now researchers know why - and the findings are consistent with cutting down on hypertension drugs.

Reducing high blood pressure requires deliberate changes in lifestyle and, often, medical intervention. Looking for a non-drugs approach to reduce high blood pressure, researchers from several leading medical centers have developed a promising diet.

The DASH diet encourages the use of specific food-groups for the purpose of lowering total blood pressure while, at the same time, reducing the risks of other chronic diseases.

In fact, according to a recent review published in a supplement to the Journal of the American Dietetic Association, an important consideration in designing the DASH combination diet was that it be fully compatible with diets recommended for prevention of cancer, osteoporosis, and heart disease.

New blood pressure guidelines show that hypertension is a problem for tens of millions of Americans. And a huge clinical trial recently showed that nearly everyone with high blood pressure should be taking diuretic drugs - "water pills." These are relatively safe drugs, but they do have side effects.

Now researchers find that the dietary approaches to stop hypertension (DASH) diet, created to fight high blood pressure, work just like water pills. One member of the study team is Frank M. Sacks, MD, professor of cardio-vascular disease prevention at the Harvard School of Public Health - one of the inventors of the DASH diet. Sacks states that, like water pills, the DASH diet speeds the rate at which a person gets rid of excess sodium. If they followed a low-salt version of the DASH diet, he says, many people could stop taking hypertension drugs.

Sacks continues: "There are people who can avoid any hypertensive drug use. If people eat the DASH diet with low salt intake - especially older people - their blood pressure goes down 15 points. That is what most people need to reach their goal."

What is the DASH diet?

The DASH diet targets specific nutrients in the form of whole foods believed to improve blood pressure. A 2,100 calorie DASH-compliant diet, for example, targets 4,700 milligrams of potassium, 500 milligrams of magnesium, and 1,240 milligrams of calcium. These micro-nutrient values are believed to be as much as two to three times higher than the average American currently obtains.

The DASH diet calls for:

  • 4-5 servings of vegetables a day
  • 4-5 servings of fruit each day
  • 7-8 servings of grains or grain products a day
  • 2-3 servings of low- or nonfat dairy products a day
  • No more than two 3-ounce servings of lean meat, poultry, or fish in any day
  • 2-3 tablespoons of fats and oils a day (27% of calories as fat, including fat already in other foods)

"The DASH diet is really, really good for you. It's heart healthy. It's low fat, so you'll stay trim. It can also cut your risk of getting cancer", says Maureen Gardner, RD, a clinical dietitian at the Moffitt Cancer Center in Tampa, Fla.

For most of us, of course, there is a drawback. "It would be difficult for the average person to follow this if he or she now is eating the average American diet," Gardner admits. "But people can learn to do the DASH diet. They could start small and make gradual changes. Try to include a fruit at every meal and eat fruits for snacks instead of candy. Treat meat as a condiment to go with your food, not as the focus of every meal."

Sacks says he's getting pretty good at following his own advice. He's been on the low-salt DASH diet himself. But he says that even if you can't go this far, you can still help your heart.

"It takes a lot of effort to eat the full DASH diet and to cut salt intake to very low levels," he says. "The idea here is that many people will do some of both and get the benefits."

The new DASH findings appear in the July 2003 issue of Hypertension, a journal of the American Heart Association.


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