sunflower). Saturated and trans fat consumption
should be decreased.Sweets: 5 servings a week. A serving is 1 tbl pure fruit
jam, syrup, honey, and sugar. The plan still allows
for treats, but the healthier the better.
An example breakfast menu is: cornflakes (1 cup)
with 1 tsp sugar, skimmed milk (1 cup), orange juice
(1/2 cup), a banana and a slice of whole wheat bread
with 1-tablespoon jam. Suggested snacks during the
day include dried apricots (1/4 cup), low fat yogurt (1
cup) and mixed nuts (1.5 oz, 40g).
These guidelines are available in the National
Institutes of Health (NIH) updated booklet ‘‘Your
Guide to Lowering Your Blood Pressure with
DASH’’, which also provides background informa-
tion, weekly menus, and recipes.
Although the DASH diet provides two to three
times the amount of some nutrients currently con-
sumed in the average American diet, the recommen-
dations are not dissimilar to the 2005 U.S. dietary
guidelines (United States Department of Agriculture
(USDA) and U.S. Department of Health and Human
Services). It also resembles the USDA Food Guide
Pyramid, which advocates low-fat dairy products
and lean meats. The main difference is the emphasis
on more fruit and vegetables servings, 8 to 10 as
opposed to the 5 to 13 as in the U.S. dietary recom-
mendations. In addition, it separates nuts, seeds, and
beans from the meat, fish, and poultry food groups
and recommends four to five weekly servings of nuts,
seeds, and dry beans.
The Dash diet was not designed for weight loss
but it can be adapted for lower calorie intakes. The
NIH booklet provides guidelines for a 1,600-calorie
diet. Vegetarians can also use the diet, as it is high in
fruits, vegetables, beans, seeds, and low-fat dairy,
which are the main sources ofproteinin a vegetarian
diet.FunctionTheDASHmealplanisahealthydietrecom-
mended for those with and without high blood pressure.BenefitsThe DASH diet may lower blood pressure as
much as taking medication, but without the risk of
unwanted side effects. The dietary changes can also
have immediate effects comparable with drug ther-
apy. A blood pressure reduction of the degree seen
in the DASH study is estimated to reduce the inci-
dence of coronary artery disease by 15% and stroke
by 27%.
The DASH plan may also lower blood pressure as
well as restrictive low salt diets with 3-4 g of salt per
day. Low salt foods tend to be bland and with 75-80%
of salt intake coming from salt added to processed
foods, including baked foods such as breads, adher-
ence may pose a problem with low salt diets. The
DASH diet is an adaptation on healthy eating, so itKEY TERMS
Cardiac arrhythmia—A group of conditions in
which the muscle contraction of the heart is irreg-
ular or is faster or slower than normal.
Cochrane reviews—Evaluations based on the best
available information about healthcare interven-
tions. They explore the evidence for and against
the effectiveness and appropriateness of treatments
in specific circumstances.
Dietary guidelines for Americans—Dietary guide-
lines published every five years since 1980 by the
Department of Health and Human Services (HHS)
and the U.S. Department of Agriculture (USDA).
They provide authoritative advice for people two
years and older about how good dietary habits can
promote health and reduce risk for major chronic
diseases. They serve as the basis for federal food
and nutrition education programs.
High density lipoprotein (HDL)—Often referred to
as good cholesterol. HDL carries cholesterol away
from cells and back to the liver where it is broken
down or excreted.
Hypertensives—Individuals with high blood
pressure.
Low density lipoprotein (LDL)—Often referred to
as bad cholesterol. It carries cholesterol from the
liver to the cells and can cause harmful build-up of
cholesterol.
MyPyramid—A guide of what to eat each day cre-
ated by the U.S. Department of Agriculture based
on the 2005 dietary guidelines for Americans.
Normotensives—Individuals with normal blood
pressure.
PREMIER Study—A research study that tested the
effects of comprehensive and simultaneous lifestyle
changes on blood pressure—weight loss, exercise,
and a healthy diet.DASH diet