Deepak Gupta, a cardiologist and associate professor of medicine at Vanderbilt University Medical Center, says that when he discusses blood pressure management strategies with patients, they usually come forward, saying they know they should reduce their salt intake. “But that’s not the only dietary change that helps,” he adds.
More than 20 years ago, researchers showed that the Nutritional Initiatives to Control Hypertension (Dash) diet, rich in fruits, vegetables and whole grains, can dramatically reduce blood pressure and was effective even when clinical trial participants they consumed high levels of sodium.
According to Stephen Juraschek, an internist and associate professor at Harvard Medical School, half of North American adults suffer from this condition, which means that many people would benefit from adopting this diet.
Few, however, manage to follow him. In an online survey of 3,000 people conducted in March, just 1% of participants said they had tried to maintain it in the past 12 months. “Which is surprising, because there is no shortage of evidence to support this,” comments Juraschek.
What is the Dash Diet?
An important feature of this regime is the presence of lots of fruit and vegetables: four or five servings a day.
For those maintaining a two-thousand-calorie-a-day diet, that means including six to eight servings of grains (mostly whole grains); two to three servings of low- or non-fat dairy products; and up to six 30-gram servings of lean protein (red meat, chicken or fish). Four to five servings of nuts, seeds and legumes throughout the week are also recommended.
“Because the diet emphasizes consumption of fruits, vegetables and dairy products, it is rich in potassium, an element that studies show reduces blood pressure. It is also rich in fiber, calcium and magnesium and discourages high sodium consumption, added sugars and saturated fats,” explains Juraschek.
However, the diet allows for up to five servings of sweets per week, each of which can contain about half a cup of ice cream or a small cookie.
According to Lawrence Appel, a professor at Johns Hopkins University School of Medicine who helped create the diet, researchers can’t say exactly how Dash helps lower blood pressure, but it’s very likely that potassium plays an important role.
What does science suggest?
The Dash diet was first described and tested in a clinical study published in the “New England Journal of Medicine” in 1997. In it, 459 adults with normal or high blood pressure followed the typical North American diet, which is relatively low in fruit. , vegetables and dairy products and full of sweets and delicacies – for three weeks. They were then randomly assigned to adopt one of the following options for two months: maintain the typical U.S. schedule; a similar version, but with more fruits, vegetables and greens; or Dash.
The researchers found that those on the Dash diet had a significant reduction in blood pressure compared to the other two groups. Those in the second also showed a reduction, but more limited.
According to Appel, the benefits were surprising, especially among hypertensive patients. “The decreases were similar to those seen in subjects taking medications. And they remained so, even with the person consuming about three grams of sodium per day, which is much more than the 2.3-gram limit suggested by federal guidelines.”
In a subsequent follow-up study with a similar group, published in 2001, the team concluded that both Dash and the low-sodium version of the typical North American diet – with amounts ranging from 1.15 to 2.3 grams of sodium per day – were effective in reducing blood pressure. However, the values dropped further when the two treatments were combined in a low-sodium diet model.
Since then, more than 25 clinical studies have confirmed Dash’s incredible ability to lower blood pressure. Research also suggests that vegetarian, Mediterranean and low-carb diets have the same effect, but the former is supported by the best evidence, as highlighted by the American Heart Association and the American College of Cardiology in their 2017 guidelines .
“For lowering blood pressure, there’s nothing better,” says Crystal Tyson, a nephrologist and hypertension specialist at Duke University School of Medicine.
“And it has other benefits. Even if you don’t follow it exactly, research suggests that the diet is associated with a reduced risk of developing heart and kidney disease, stroke, type 2 diabetes, some types of cancer and cognitive decline,” he adds. Juraschek.
How to start following it?
Tyson acknowledges that, as with any diet, adoption can be complicated, but suggests looking for a reliable meal plan or recipe book online. “And don’t forget there’s room for flexibility.”
In a 2005 study of 164 people, Appel and his team found that those who ate the version higher in protein and/or healthy fats were just as likely to reduce their blood pressure as those who followed the original diet. “If you don’t like dairy or are intolerant to it, focus on other food groups,” Tyson advises.
He concludes: “The best way to change the way you eat is to start gradually, with one serving of fruit or vegetables a day for a week – a banana with yogurt or sautéed spinach with eggs, for example. And the following week, move on to two When it’s time to snack, grab a serving of nuts. A little is better than nothing, and you don’t have to be perfect.
Interview: Exploring the Dash Diet and Its Impact on Blood Pressure Management
Interviewer (Time.news Editor): Welcome, Dr. Deepak Gupta. It’s a pleasure to have you here today to discuss the Dash diet and its significant role in managing blood pressure. As a cardiologist at Vanderbilt University Medical Center, you must have seen firsthand the impact of dietary choices on patients’ health.
Dr. Deepak Gupta: Thank you for having me! Yes, dietary choices are crucial in blood pressure management. When I talk to my patients, they often mention they are aware of the need to reduce salt intake, but there are many other dietary adjustments that can make a real difference.
Interviewer: It sounds like there’s a broader conversation to have beyond just salt reduction. Can you elaborate on the Dash diet and the evidence supporting its effectiveness?
Dr. Gupta: Certainly! The Dash diet, which stands for Dietary Approaches to Stop Hypertension, emphasizes a rich intake of fruits, vegetables, whole grains, and lean proteins. Research has shown that this diet can significantly lower blood pressure, even in individuals consuming higher sodium levels. It’s remarkable that such dietary modifications can be as effective as some medications!
Interviewer: That’s impressive! I’m aware of a recent survey indicating that despite this evidence, compliance with the Dash diet is quite low. What do you think are the barriers preventing people from adopting it?
Dr. Gupta: You’re right. The survey you mentioned found that only 1% of participants maintained the Dash diet over the past year, which is concerning. I believe several factors contribute to this lack of adherence. For one, people’s lifestyles and eating habits are deeply ingrained. Additionally, the perception that healthy eating is complicated or restrictive can be discouraging.
Interviewer: That makes sense. What specific recommendations would you give to someone looking to start the Dash diet or improve their dietary habits?
Dr. Gupta: I would suggest starting small. Focus on adding more servings of fruits and vegetables each day and opt for whole grains over refined options. Another important aspect is incorporating low-fat dairy products and lean proteins like fish and chicken. It’s also about finding a balance; the diet even allows for five servings of sweets a week, which can make healthy eating feel more manageable.
Interviewer: I love that. It allows for enjoyment without compromising health. Dr. Stephen Juraschek highlighted that the Dash diet is rich in potassium. Could you elaborate on why that’s important for blood pressure?
Dr. Gupta: Absolutely. Potassium plays a vital role in lowering blood pressure because it helps balance out sodium levels in the body. High potassium intake can ease tension in blood vessel walls, contributing to lower blood pressure overall. The diet’s focus on potassium-rich foods like fruits, vegetables, and dairy is a key reason for its success in managing hypertension.
Interviewer: It sounds like science has really backed the efficacy of the Dash diet. Since its inception, what does current research suggest about its long-term benefits?
Dr. Gupta: Long-term studies have consistently demonstrated that the Dash diet can provide significant blood pressure reduction and overall cardiovascular health benefits. Research indicates that adopting this diet can lower blood pressure similarly to some antihypertensive medications. It’s fascinating that the benefits can persist even at higher sodium intakes, which underscores the diet’s fundamental role in health management.
Interviewer: That truly is fascinating. Before we wrap up, what final thoughts would you like to leave with our readers regarding blood pressure management and the Dash diet?
Dr. Gupta: I encourage everyone to consider the Dash diet not just as a temporary fix but as a sustainable lifestyle choice. Making these dietary changes can lead to significant health improvements. Remember that small steps can lead to big changes, so don’t hesitate to start incorporating more fruits and vegetables into your meals. Together, we can make strides in managing hypertension and improving overall health.
Interviewer: Thank you so much for your insights, Dr. Gupta! It’s been enlightening to explore the Dash diet and its tremendous potential for health improvement.
Dr. Gupta: Thank you for having me! It’s been a pleasure to share this important information.