DASH Diet: A Dietary Cure-all for Hypertension?

Last updated on November 29, 2021.

What is a DASH diet? | DASH diet tips on sodium | A typical DASH diet | Health benefits

Hypertension (also known as high blood pressure) is a common urban disease. Hong Kong is no exception, it is not hard to fathom why with eating out being so popular. Most dishes served in local Chinese restaurants contain high-sodium, high-fat content, and they are the real culprits on the run you should watch out for.

According to the “Eating out for lunch” survey conducted by the Centre for Health Protection in 2015, more than 80% of Hong Kong people eat out for lunch at least once a week, and almost half of the people eat out more than 5 times a week. A typical meal-on-one-plate in cha chaan teng, like fried rice noodles with sliced beef (干炒牛河) and steamed rice with barbecued pork (叉燒飯), may already exceed the daily recommendation for sodium intake, according to the Centre for Food Safety.

Hypertension (a hidden killer!) usually strikes without physical symptoms and signs. It is also associated with other serious health problems, such as higher risk of heart disease, kidney failure and stroke. Apart from medications, you can also consider the low sodium food therapy, DASH diet, proposed by the National Health, Lung, and Blood Institute in 1997. It is arguably the magic formula for  preventing and treating this urban disease.

What is a DASH diet?

The DASH diet stands for the Dietary Approach to Stop Hypertension, it is a diet designed to control and prevent hypertension. The DASH diet highlights “low salt, low sugar and low oil”, with consumption of foods high in potassium, magnesium, calcium, dietary fiber and quality protein, as well as  a low intake of sodium, added sugar, saturated fat and trans fat.

The DASH diet is a heart-healthy eating pattern, so even without hypertension, you may still follow this diet to regulate blood pressure and “bad” low-density lipoprotein (LDL) cholesterol in blood so as to maintain heart health.

The general principles of a DASH diet:

  1. Eat fiber-rich whole grains, vegetables and fruits
  2. Eat lean protein (e.g. chicken, fish, beans) instead of red meat
  3. Include nuts, dried beans and vegetable oils
  4. Include fat-free or low-fat dairy products
  5. Limit salt intake
  6. Avoid sugary drinks
  7. Avoid foods high in saturated fat, e.g. fatty meats, full-fat dairy products

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DASH diet and sodium

The standard DASH diet limits sodium intake to 2,300mg a day, which is equivalent to 1 teaspoon of table salt. An even lower-sodium version of the DASH diet restricts sodium intake to 1,500mg a day, which is equivalent to ¾ teaspoon of table salt. According to the DASH-Sodium Trial, the lower the salt intake, the greater the reduction of blood pressure.

To further cut sodium, try out the following tips provided by the Mayo Clinic:

When grocery shopping,

  • Choose fresh or frozen vegetables and fruits instead of canned ones
  • Choose fresh or frozen skinless poultry, fish and lean cuts instead of cured meat
  • Read food labels carefully and choose low-sodium or no-salt-added options

When cooking,

  • Use sodium-free spices, herbs and flavorings or fresh lemon juice instead of salt
  • Do not add salt when cooking rice, pasta and hot cereal

Extra low-sodium tips for eating out:

  • Ask for less salt, less sauce or even no sauce
  • Order poached vegetables without oil and soy sauce
  • Order toast and sandwich without butter
  • Remove fatty portion of meats
  • Avoid drinking soup in the bowl of noodles
  • Avoid fried rice and fried noodle

It may take a while for your appetite to adapt to a low-sodium diet; but once you are used to it, you may find that the natural flavor of the foods come out tasting even better without so much salt.

What does a typical DASH diet look like?

The DASH diet provides recommendations on the daily and/or weekly servings of each food group based on your daily calorie needs and activity level. They are easy to follow, comprising common foods that are readily accessible  at your local grocery store.

Recommended daily servings in a DASH diet

Based on the National Heart, Lung, and Blood Institute, a person who requires 2,000 daily calories, i.e. a 19-30-year-old female with sedentary activity level or a male with sedentary activity level aged over 51, has to consume:

Food Group

Daily Servings

Grains

6-8

Meats, poultry, and fish

6 or less

Vegetables

4-5

Fruit

4-5

Low-fat or fat-free dairy products

2-3

Fats and oils

2-3

Sodium

2,300mg

Weekly Servings

Nuts, seeds, dry beans, and peas

4-5

Sweets

5 or less

A typical DASH eating plan

Food group

Sample of one serving

Examples

Importance to the DASH diet

6-8 daily servings of grains

1 slice of bread


1 ounce of dry cereal


½ cup of cooked rice, pasta or cereal

Whole-wheat bread and rolls, whole-wheat pasta, English muffin, pita bread, bagel, cereals, grits, oatmeal, brown rice, unsalted pretzels and popcorn

Major sources of energy and fiber

Less than 6 daily servings of meats, poultry, and fish

1 oz cooked meats, poultry or fish


1 egg

Select only lean; trim away visible fats; broil, roast, or poach; remove skin from poultry

Rich sources of protein and magnesium

4-5 daily servings of vegetables

1 cup of raw leafy vegetable


½ cup of cut-up raw or cooked vegetable


½ cup vegetable juice

Broccoli, carrots, collards, green beans, green peas, kale, lima beans, potatoes, spinach, squash, sweet potatoes, tomatoes

Rich sources of potassium, magnesium and fiber

4-5 daily servings of fruit

1 medium fruit


¼ cup dried fruit


½ cup fresh, frozen or canned fruit


½ cup fruit juice

Apples, apricots, bananas, dates, grapes, oranges, grapefruit, grapefruit juice, mangoes, melons, peaches, pineapples, raisins, strawberries, tangerines

Important sources of potassium, magnesium and fiber

2-3 daily servings of low-fat or fat-free dairy products

1 cup milk or yogurt


1½ oz cheese

Fat-free milk or buttermilk; fat-free, low-fat, or reduced-fat cheese; fat-free/low-fat regular or frozen yogurt

Major sources of calcium and protein

2-3 servings of fats and oils

1 tsp soft margarine


1 tsp vegetable oil


1 tbsp mayonnaise


2 tbsp salad dressing

Soft margarine, vegetable oil (canola, corn, olive, safflower), low-fat mayonnaise, light salad dressing

The DASH study had 27% of calories as fat, including fat in or added to foods

4-5 weekly servings of nuts, seeds, dry beans, and peas

⅓ cup or 1½ oz nuts


2 tbsp peanut butter


2 tbsp or ½ oz seeds


½ cup cooked legumes (dried beans, peas)

Almonds, filberts, mixed nuts, peanuts, walnuts, sunflower seeds, peanut butter, kidney beans, lentils, split peas

Rich sources of energy, magnesium, protein and fiber

Less than 5 weekly servings of sweets

1 tbsp sugar


1 tbsp jelly or jam


½ cup sorbet, gelatin dessert


1 cup lemonade

Fruit-flavored gelatin, fruit punch, hard candy, jelly, maple syrup, sorbet and ices, sugar

Sweets should be low in fat

The eating plan in a DASH diet only plays a partial role in lowering blood pressure. To achieve optimal hypertension control and prevention, it is vital to integrate lifestyle changes as follows:

Body weight

Apart from food, body weight is also a determinant of hypertension. A 1988 review article from Belgium reveals that heavyweight people face higher chances of developing hypertension. To control calorie intake and manage body weight, you may consider higher intake of fiber-rich food as it can provide satiety without contributing any calories.

Eating pattern

Eating slowly is key to controlling body weight. Since the feeling of satiety usually only comes 20 minutes after eating, if you extend the period of chewing, your food intake is more likely  to reduce. Ideally,  drink soup or water first, then eat vegetables, followed by rice, and lastly meat in order to minimize the consumption of rice and meat.

Note that it is essential to avoid mixing sauce with rice as this would add unnecessary sodium to your diet.

Alcohol

Hypertensive patients should completely steer clear of alcohol. Despite containing high antioxidants, even moderate consumption of alcohol is linked with high blood pressure, according to American College of Cardiology.

Exercise

At least 150 minutes of moderate-intensity or 75 minutes of high-intensity physical activity, or a combination of both per week are recommended for healthy adults to maintain normal body weight.

Health benefits of a DASH diet

As the name entails, the DASH diet helps lower blood pressure. Besides, the DASH diet also offers numerous health benefits:

Blood pressure reduction

According to the Centre for Health Protection, hypertension is defined as exceeding 140 mmHg in systolic blood pressure and 90 mmHg in diastolic blood pressure respectively. In general, the healthy range of blood pressure is below 120 mmHg in systolic pressure and below 80 mmHg in diastolic blood pressure.

In a clinical trial at the Boston University Medical Center, the DASH diet significantly reduced blood pressure of hypertensive patients with a reduction of 11 mmHg in systolic blood pressure and 8 mmHg in diastolic blood pressure, achieving a similar blood pressure- deflating effect as hypertensive drugs. A DASH diet can further lower blood LDL cholesterol levels along with blood pressure, both of which  are major risk factors of cardiovascular disease.

Weight loss

Although weight loss is not the intended purpose of the DASH diet, some studies suggested that people lost weight on it.

The proposed mechanism is that fixed servings of different food groups and the rich fiber from whole grains, vegetables and fruits in a DASH diet, altogether, produce a prolonged feeling of satiety, which lessens the urge to consume more food. This can lower the overall calorie intake and result in weight loss.

FAQs

What does a typical DASH diet look like?

For reference, a person who requires 2,000 daily calories, i.e. a 19-30-year-old female with sedentary activity level or a male with sedentary activity level aged over 51, has to consume:

Food Group

Daily Servings

Grains

6-8

Meats, poultry, and fish

6 or less

Vegetables

4-5

Fruit

4-5

Low-fat or fat-free dairy products

2-3

Fats and oils

2-3

Sodium

2,300mg

Weekly Servings

Nuts, seeds, dry beans, and peas

4-5

Sweets

5 or less

Any tips to lower sodium intake when eating out?

Some low-sodium tips for eating out:

  • Ask for less salt, less sauce or even no sauce
  • Order poached vegetables without oil and soy sauce
  • Order toast and sandwich without butter
  • Remove fatty portion of meats
  • Avoid drinking the soup in the bowl of noodles
  • Avoid fried rice and fried noodle

Any potential drawbacks of a DASH diet?

Excessive restriction of sodium intake may lead to health problems, such as increased risk of insulin resistance and fluid retention. There is no need to eliminate sodium intake, you are advised to keep a reasonable intake of around 1,500-2,300mg of sodium per day.

 

This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.