High blood pressure: Using the DASH diet

You can make small changes to incorporate the DASH diet into your lifestyle. Slowly change your eating habits to fulfill the following recommendations.

• Eat 8 to 10 servings of fruits and vegetables each day. If you are not eating this many yet, keep track of the fruits and vegetables you eat. Slowly add more to your diet. Check what counts as a serving in the food guide pyramid.
• Eat 3 servings of low-fat or nonfat dairy foods such as milk, yogurt, and cheese.
• Limit the amount of saturated fat you eat. Substitute monounsaturated and polyunsaturated oils instead.
• Limit the amount of sodium in your diet by cutting down on the amount of processed foods you eat, such as snack items, luncheon meats, and canned soups.

See a sample DASH menu.

Here are some ideas for eating with DASH:

• Think about including fruits and/or vegetables in every meal. Take fruit to work or school, for a snack.
• Drink nonfat milk. A glass of skim milk has only 80 calories and no fat and is packed with blood pressure-lowering nutrients. Have a "skinny" latte (caffe latte made with skim milk) as a way to add milk to your diet. If you don't drink coffee, try a skinny almond milk.
• Make a baked potato bar. Serve baked potatoes with a variety of vegetables, such as broccoli, and use other toppings, such as low-fat shredded cheese, chili, salsa, and refried beans. If you use canned or jar toppings, be sure to choose low-sodium varieties, or even better, make them yourself from fresh ingredients. Be creative. You could end up with 4 or 5 servings of vegetables at one meal.
• Use a variety of cut-up vegetables with a low-fat dip as an appetizer such as hummus, instead of high-fat chips and dips. Try some new vegetables. Make a stir-fry containing lots of different vegetables.
• Try some vegetarian meals featuring legumes (cooked dried beans and peas). Add garbanzo beans to a salad, use fat-free refried beans, and/or make split pea or black bean soup. Buy a vegetarian cookbook and try one recipe each month or each week.
• Combine a ready-made pizza crust with low-fat mozzarella cheese and lots of vegetable toppings. Use tomatoes, zucchini, spinach, carrots, cauliflower, and onions.
• For breakfast, have whole-grain cereal, fruit, and low-fat milk.
• For a snack, have a smoothie made with low-fat milk and frozen fruit chunks.
• Make a dip for fruit from low-fat vanilla yogurt and cinnamon.

Test Your Knowledge

1. To start incorporating the DASH diet into my lifestyle, I should slowly add more fruits and vegetables to my diet. My goal is 8 to 10 servings each day.

   1. True

      This answer is correct.

      To start with, think about changing only your fruit and vegetable intake. Keep track of the fruits and vegetables you eat, and slowly add more to your diet. Your goal is 8 to 10 servings a day.

   2. False

      This answer is incorrect.

      To start with, think about changing only your fruit and vegetable intake. Keep track of the fruits and vegetables you eat, and slowly add more to your diet. Your goal is 8 to 10 servings a day.

2. Nonfat milk is an important part of the DASH diet.

   1. True

      This answer is correct.

      A glass of skim milk has only 80 calories and no fat and is packed with blood pressure-lowering nutrients.

   2. False

      This answer is incorrect.

      A glass of skim milk has only 80 calories and no fat and is packed with blood pressure-lowering nutrients.

People who eat mainly processed foods usually get too much sodium and not enough potassium, calcium, and magnesium in their diets. Not getting enough of these nutrients, which come from fruits, vegetables, and dairy products, may contribute to high blood pressure.

Researchers believe that it is the combination of 8 to 10 servings a day of fruits and vegetables and 3 servings of low-fat dairy products that causes the DASH diet to lower blood pressure. Simply adding calcium, potassium, and magnesium supplements to the diet does not lower blood pressure.

Good sources of potassium

All fresh fruits and vegetables and meats are good sources of potassium. Fruit and vegetable examples include:

• Bananas, cantaloupe, oranges, and orange juice.
• Raw or cooked spinach, lima beans, zucchini, broccoli, carrots, cauliflower, and artichokes.
• Potatoes.
• Legumes (cooked dried beans and peas) such as pinto beans, chickpeas, and lentils.

A serving size of fruits and vegetables includes:

• ¾ cup fruit or vegetable juice.
• ½ cup raw, canned, or cooked fruits or vegetables.
• 1 medium apple or ½ a banana.
• 1 cup raw, leafy vegetables.

Good sources of calcium

• Low-fat dairy products (yogurt, skim milk, cheese)

A serving size is:

• 1 cup milk or yogurt.
• 1.5 oz (42.5 g) to 2 oz (56.7 g) low-fat cheese.

Good sources of magnesium

• Legumes (cooked dried beans and peas), seeds, and nuts
• Halibut
• Milk and yogurt
• Brown rice and potatoes
• Tomatoes
• Bananas and watermelon
• Leafy green vegetables

A serving size includes:

• ¾ cup cooked dry beans.
• ½ cup brown rice.

Test Your Knowledge

1. A balanced, low-fat diet that contains 8 to 10 servings each day of fresh fruits and vegetables and 3 servings each day of low-fat dairy foods will help me lower my high blood pressure.

   1. True

      This answer is correct.

      People who mainly eat a diet of processed foods may not get enough potassium, calcium, and magnesium that come from eating a balanced diet with 8 to 10 servings each day of fresh fruits and vegetables and 3 servings each day of low-fat dairy products.

   2. False

      This answer is incorrect.

      People who mainly eat a diet of processed foods may not get enough potassium, calcium, and magnesium that come from eating a balanced diet with 8 to 10 servings each day of fresh fruits and vegetables and 3 servings each day of low-fat dairy products.

Ask your doctor to recommend a registered dietitian who can work with you to change your eating habits and help you plan menus that follow the DASH eating style. See a sample DASH menu.

Use a form to track your eating habits. Record everything you eat before you start DASH, charting the number of servings you eat in the following food groups: grains; vegetables; fruits; dairy; meats (including poultry and fish); nuts, seeds, and beans; fats and oils; and sweets. As well as you can, record the amount of sodium in everything you eat. After you begin the DASH eating plan, keep the same charts, and compare your lists.

Use the following as a guide for the DASH eating plan:

Milk and dairy

• 3 servings a day. One serving equals: 8 ounces of nonfat or low-fat milk; 1 cup of low-fat yogurt; or 1½ ounces of low-fat cheese.

Fruits and vegetables

• 8 to 10 servings a day. One fruit serving equals: 1 medium fruit; ¼ cup dried fruit; ½ cup frozen or canned fruit; or 6 ounces of fruit juice. One vegetable serving equals: 1 cup raw, leafy vegetables; ½ cup cooked vegetables; or 6 ounces vegetable juice.

Grains

• 7 to 8 servings a day. One serving equals: 1 slice whole wheat bread; ½ cup dry or hot cereal; or ½ cup cooked brown rice, pasta, or other cooked grain.

Meat, fish, poultry

• 5 to 6 ounces a day. One serving equals: 3 ounces cooked meat, poultry, or fish (about the size of a deck of cards).

Nuts, seeds, dried beans

• 4 to 5 servings a week. One serving equals: 1/3 cup nuts; 2 tablespoons seeds; or 3/4 cup cooked dried beans. Use nuts, seeds, or dried beans to replace meat in some of your meals.

Test Your Knowledge

1. With the DASH eating plan, I don't have to worry about the number of servings I eat as long as I get a lot of fruits and vegetables in my diet.

   1. True

      This answer is incorrect.

      DASH is a proven scientific method for lowering blood pressure. If you don't follow the recommended number of servings in the important food groups, you may not be able to lower your blood pressure.

   2. False

      This answer is correct.

      DASH is a proven scientific method for lowering blood pressure. If you don't follow the recommended number of servings in the important food groups, you may not be able to lower your blood pressure.

Now that you have read these tips on following the DASH diet, you are ready to change your eating habits to lower your high blood pressure.

For more sample menus and recipes for the DASH eating plan, go to www.nhlbi.nih.gov (under Health Information and Publications, click on High Blood Pressure) or write to the NHLBI Health Information Center, P.O. Box 30105, Bethesda, MD, 20824-0105, and request information on the DASH diet.