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The DASH Diet to lower high blood pressure

The Heart and Stroke Foundation encourages Canadians to eat a healthy diet, control salt intake, and be physically active to lower blood pressure. The latest results from the DASH study – Dietary Approaches to Stopping Hypertension – has confirmed these recommendations, providing more encouragement for people to choose a healthier diet. Research has shown that following a plan for healthy eating can reduce the risk of developing high blood pressure and lower already elevated blood pressure.

What are the DASH studies?
The DASH Diet is based on two studies, DASH and DASH-Sodium, that looked at ways of reducing blood pressure through changes in diet. In the DASH study, people were given one of three eating plans: a plan similar in nutrients to what most North Americans eat; the same plan but with extra vegetables and fruit; or the DASH diet, which is rich in vegetables, fruit and low-fat dairy foods and lower in saturated fat, total fat and cholesterol.

The results were compelling. The diet higher in vegetables and fruit and the DASH diet both reduced blood pressure. The DASH diet had the greatest effect on blood pressure, lowering levels within two weeks of starting the plan. Not only was blood pressure reduced, but total cholesterol and low-density lipoprotein (LDL) or "bad cholesterol" were lower, too.

In the DASH-Sodium study, participants were given one of three sodium plans: the DASH diet with 3,300 mg of sodium per day (a normal amount for many North Americans); 2,300 mg of sodium (a moderately restricted amount); or 1,500 mg of sodium (a more restricted amount, about 2/3 of a teaspoon of salt). Blood pressure was lower for everyone on the DASH diet. However, the less salt people consumed, the greater the decrease in blood pressure. People who already had high blood pressure had the largest decrease in blood pressure.

Why is a healthy blood pressure important?
High blood pressure causes the heart to work harder to pump nutrient- and oxygen-rich blood to the body. The arteries that deliver the blood become scarred and less elastic. Although these changes happen to everyone as they age, they happen more quickly in people with high blood pressure. As the arteries stiffen, the heart has to work even harder, causing the heart muscle to become thicker, weaker and less able to pump blood. When high blood pressure damages arteries, they are not able to deliver enough blood to organs for their proper functioning. As a result, organs may become damaged, too. For example, this type of damage can affect the heart, causing a heart attack, the brain, causing a stroke, and the kidneys, leading to kidney failure.

How is DASH different from Canadian recommendations?
The DASH diet isn’t unique – it is very similar to Canada’s Food Guide produced by Health Canada and endorsed by the Heart and Stroke Foundation.

Canada’s Food Guide has a greater range in the number of servings than the DASH diet, which also recommends a higher level of vegetable and fruit intake.  

The DASH eating plan  

DASH Food Groups

DASH Daily Servings
(except as noted)

DASH Serving Sizes

Vegetables

4-5

250 mL (1 cup) raw leafy  vegetables
125 mL (½ cup)  cooked vegetables
170 ml (6 oz) juice 

Fruit

4-5

1 medium piece of fruit
63 mL (¼ cup) dried fruit
125 mL (½ cup) fresh, frozen or canned fruit

Grains
(mainly whole grains)

7-8

1 slice bread
250 mL (1 cup)  ready to eat cereal
125 mL (½ cup) cooked rice, pasta or cereal

Low  Fat or No-Fat Dairy Foods

2-3

250 mL (1 cup) milk
250 ml (1 cup) yogurt
50 g (1½ oz) cheese

Lean meats, poultry and fish

2 or less

3 ounces cooked lean meats, skinless poultry,
or fish

Nuts, seeds and dry beans

4-5 per week

1/3 cup (1.5 oz.) nuts
30 mL (2 tbsp) peanut butter
2 tbsp (1/2 oz.) seeds
1/2 cup cooked dry beans or peas

Fats and Oils

2-3

5 ml (1 tsp) soft margarine
15mL (1 tbsp) low-fat mayonnaise
30 mL (2 tbsp)  light salad dressing
5 ml (1 tsp) vegetable oil

What about medication?
High blood pressure affects approximately a quarter of Canadian adults. Many people require medication to control their blood pressure. Lifestyle modification, which includes healthy eating and regular physical activity, may be the only treatment needed in those with mild high blood pressure. In those that require medication to control their blood pressure, following a healthy lifestyle may reduce the need for, or the amount of, medication required.

What next?
A full healthy lifestyle, including healthy eating, is part of the Canadian recommendations for the management of high blood pressure. The Heart and Stroke Foundation is involved in developing blood pressure guidelines, which are updated every year. To control your blood pressure and reduce the risk of heart disease, the guidelines recommend that you:

  • Be active 30 to 60 minutes most days of the week.
  • Choose the following more often: vegetables, fruit, low-fat dairy products, foods lower in saturated and trans fat and salt, whole grains and fish, poultry and lean meat. Limit fast foods, canned or prepared foods, as they usually contain higher levels of sodium.
  • If you are overweight, losing about 10 lb (5 kg) will lower your blood pressure. Reducing your weight to within a healthy range for your age and gender will lower your blood pressure even more.
  • Eat less salt by:
    • limiting your use of salt in cooking and at the table
    • avoiding salty foods
    • choosing fresh or plain frozen food
    • avoiding canned or prepared foods that are high in salt
    • reading the Nutrition Facts table on food packages for sodium content
    • using other seasonings such as herbs, spices, lemon juice and garlic during food preparation
  • If you drink alcohol, limit yourself to no more than 2 drinks a day, to a weekly maximum of 10 for women and 3 drinks a day to a weekly maximum of 15 for men. (Do not drink when you are driving a vehicle, taking medications or other drugs that interact with alcohol, pregnant or are planning to be pregnant, making important decisions, doing any kind of dangerous physical activity, living with alcohol dependence or mental or physical health problems, or responsible for the safety of others. If you are concerned about how drinking may affect your health, talk to your doctor.)
  • Be smoke-free. It is important to stop smoking if you have high blood pressure. Smoking increases the risk of developing heart problems and other diseases. Your home and workplace should also be smoke-free.
  • Take your medication as prescribed.
  • Monitor your blood pressure regularly.

Changing your diet means a life-long commitment to healthier lifestyle choices. People who make small changes in their diet over a longer period of time, rather than a dramatic change all at once, are more likely to stay committed to a healthier diet.

If you are considering starting on the DASH diet, discuss it with your healthcare provider first.

How much salt?
The Heart and Stroke Foundation recommends Canadians consume no more than 2,300 mg of sodium (about 1 teaspoon/5 mL of table salt) a day. The amount of salt you eat isn’t just what you shake onto your food – it is already added in large quantities to prepared foods, canned products, snack foods and restaurant meals.

Easy ways to get started on the DASH diet

Change gradually

  • If you now eat one or two vegetables a day, add another serving at lunch and dinner.
  • If you don’t eat fruit now or have only juice at breakfast, add a serving to your meals or have it as a snack.

Treat meat as one part of the whole meal, instead of the main focus.

  • Limit meat and alternatives to about 6 oz (170 g) a day, over two meals (two servings). Each serving is about the size of a deck of cards or the palm of your hand.

Choose fruit or low-fat foods as desserts and snacks.

  • Fruit and low-fat foods offer great taste and variety. Fresh fruit require little or no preparation. Dried fruit is easy to carry with you.

If you would like to create a personalized action plan for healthier living, take the Heart&Stroke Risk Assessment.

Last reviewed April 2013
Last modified August 2013