Hypertension, more commonly referred to as high blood pressure, is a widespread public health problem over the last few decades. It is a major risk factor for heart disease, affects 1 billion people worldwide, and accounts for 1 in 8 death each year. Despite the extensive use of antihypertensive medications, the prevalence of hypertension is still increasing. In Malaysia, there is one – third Malaysian adults are hypertensive.
In the early 1990s, scientists have created dietary approaches to stop hypertension; in short – DASH diet. The DASH diet is a low sodium diet and focus on vegetables, fruits, whole grains, low-fat dairy and lean protein. It has the potential to lower blood pressure as well as or better than many anti-hypertension medications. In addition to its impact on blood pressure, it is intended to be a well-balanced diet solution for the general population. The DASH diet was awarded for “best overall diet” and ranked no.1 in the “healthy eating” and “heart disease prevention” categories.
So, what’s in the DASH diet?
The DASH diet is based on the following foods: vegetables, fruits, low fat or fat free dairy, whole grains, fish, poultry, legumes and nuts. It recommends reducing sodium, foods and beverages with added sugar and red meat. It also limits saturated and trans fat, while increasing the intake of potassium, magnesium, calcium, protein, fibre and nutrients thought to help control blood pressure.
The National Heart, Lung and Blood Institute (NHLBI) provides sample plans with specific number of servings based on 1600, 2000 or 2600 calories daily. For 2000 calories per day, this translates to:
- 6-8 servings of grains or grain products (preferable whole-grain)
- Major sources of energy and fiber that provide satiety.
- Examples are whole-wheat bread and rolls, whole-wheat pasta, grits, oatmeal, brown rice and popcorn.
- Avoid refined grains such as white rice and white flour.
- 4-5 servings of vegetables
- Beneficial sources of potassium, magnesium, and fiber.
- Examples include broccoli, carrots, collards, green beans, green peas, kale, lima beans, sweet potatoes, spinach, squash, tomatoes and peppers.
- When buying frozen and canned vegetables, choose those labeled as low sodium or without added salt.
- 4-5 servings of fruits
- Beneficial sources of potassium, magnesium, and fiber.
- Examples are apricots, bananas, dates, grapes, oranges, grapefruit, mangoes, melons, papaya, peaches, pears, pineapples, raisins, raspberries, strawberries and tangerines.
- If you choose canned fruit or juice, make sure no sugar is added.
- 2-3 servings of low-fat dairy foods
- Major sources of calcium, potassium, protein, and vitamin D in fortified products.
- Examples include fat-free or low-fat milk or buttermilk, low-fat or reduced-fat cheese, and fat-free or low-fat regular or frozen yogurt.
- Nondairy nut/grain/soy-based milks that are fortified with calcium and vitamin D and low in sugar are acceptable alternatives.
- Avoid yoghurts and flavoured milks with added sugar.
- 2-3 servings of fats and oils
- Fat helps your body absorb essential vitamins and helps your body’s immune system.
- Examples include soft margarine, vegetable oil (canola, corn, olive, soybean, safflower), low-fat mayonnaise, and light salad dressing.
- Limit saturated fat and avoid sources with trans fat and added salt or sugar.
- 2 or fewer servings of meat, poultry or fish
- Beneficial sources of protein, B vitamins, magnesium, iron and zinc.
- Only lean or extra lean meats should be selected; visible fats should be trimmed away.
- Meat should be broiled, roasted, or poached; and skin should be removed from poultry.
- Limit red meat.
- Daily alcohol limitations
- Men limit alcohol to no more than two drinks a day.
- Women to one or less a day.
- Weekly limitations of 4-5 servings of nuts, seeds or dry beans
- Beneficial sources of energy, magnesium, protein, phytochemicals and fiber.
- Examples are almonds, hazelnuts, mixed nuts, peanuts, walnuts, pistachios, sunflower seeds, pumpkin seeds, peanut butter, kidney beans, lentils and split peas.
- Choose salt-free products.
- Weekly limitations of sweets and food with added sugars limited to a maximum of 5 servings
- Examples are soft drinks, fruit drinks, sports drinks, energy drinks, sweetened tea and coffee drinks, candy, cake, cookies, pies, cobblers, sweet rolls, pastries, doughnuts, granola bars and ice cream.
In addition to the standard DASH diet, there is also a lower sodium version of the diet. You can choose the version of the diet that meets your health needs:
Standard DASH diet: You can consume up to 2,300 milligrams (mg) of sodium a day.
Lower sodium DASH diet: You can consume up to 1,500 mg of sodium a day.
Note: 1g salt is equivalent to 200mg sodium.
Following this DASH diet, one must decide their calorie level and then divide the suggested servings of each food group throughout the day. This requires some planning ahead. On a side note, some people may at first experience gas and bloating due to the high fibre content of plant foods such as fruits, vegetables and whole grain. This can be partially alleviated with M101 Microbe Hack. Click here for more information.
Your heart health will certainly improve if you follow this low sodium diet. But since DASH diet can be promotes plenty of nutritional foods, you can expect some weight loss, especially if you’re replacing high-calorie, processed foods on a daily basis with DASH-approved meals. Protect your heart and let’s begin your DASH journey today!
- “Diet Review: DASH”. The Nutrition Source. Harvard School of Public Health. 16 January 2018.
- Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223–237. https://doi.org/10.1038/s41581-019-0244-2
- Soo, M. J., Chow, Z. Y., Ching, S. M., Tan, C. H., Lee, K. W., Devaraj, N. K., … Chia, Y. C. (2020). Prevalence, awareness and control of hypertension in Malaysia from 1980-2018: A systematic review and meta-analysis. World Journal of Meta-Analysis, 8(4), 320–344. https://doi.org/10.13105/wjma.v8.i4.320
- Van Horn, L., Carson, J. A., Appel, L. J., Burke, L. E., Economos, C., Karmally, W., … Kris-Etherton, P. (2016). Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association. Circulation, 134(22). https://doi.org/10.1161/cir.0000000000000462