Hypertension/High Blood Pressure Health Center

High Blood Pressure and the DASH Diet

One step to lower high blood pressure -- incorporate the DASH diet into your lifestyle. Doctors recommend:

• Eating more fruits, vegetables, and low-fat dairy foods
• Cutting back on foods that are high in saturated fat, cholesterol, and total fat
• Eating more whole grain products, fish, poultry, and nuts
• Eating less red meat and sweets
• Eating foods that are rich in magnesium, potassium, and calcium

The DASH diet, which stands for Dietary Approaches to Stop Hypertension, is an example of such an eating plan. In studies, patients who were on the DASH diet reduced their blood pressure within two weeks. Another diet -- DASH-Sodium -- calls for reducing sodium (salt) to 1,500 mg a day (about 2/3 teaspoon). Studies of patients on the DASH-Sodium plan significantly lowered their blood pressure.

Starting the DASH Diet

The DASH diet calls for a certain number of servings daily from various food groups. The number of servings you require may vary, depending on your caloric need. When beginning the diet, start slowly and make gradual changes. Consider adopting a diet plan that allows 2,400 milligrams of salt per day (about 1 teaspoon) and then once your body has adjusted to the diet further lower your salt intake to 1,500 mg per day (about 2/3 teaspoon). These amounts include all salt consumed, including that in food products, used in cooking, and added at the table.

Here are some tips to get you started on the DASH diet:

• Add a serving of vegetables at lunch and at dinner.
• Add a serving of fruit to your meals or as a snack. Canned and dried fruits are easy to use.
• Use only half the butter, margarine, or salad dressing, and use low-fat or fat-free condiments.
• Drink low-fat or skim dairy products three times a day.
• Limit meat to six ounces a day. Try eating some vegetarian meals.
• Add more vegetables, rice, pasta, and dry beans to your diet.
• Instead of typical snacks (chips, etc.), eat unsalted pretzels or nuts, raisins, graham crackers, low-fat and fat-free yogurt and frozen yogurt; unsalted plain popcorn with no butter, and raw vegetables.
• Read food labels carefully to choose products that are lower in sodium.

Staying on the DASH Diet

The following is a list of food groups and suggested serving amounts for the DASH diet:

• Grains: 7-8 daily servings
• Vegetables: 4-5 daily servings
• Fruits: 4-5 daily servings
• Low-fat or fat-free dairy products: 2-3 daily servings
• Meat, poultry and fish: 2 or less daily servings
• Nuts, seeds, and dry beans: 4-5 servings per week
• Fats and oils: 2-3 daily servings
• Sweets: try to limit to less than 5 servings per week

How Much Is a Serving?

When you're trying to follow a healthy eating plan, it may help to know how much of a certain kind of food is considered a "serving." The following table offers some examples.

SERVING SIZES

Food/amount

1/2 cup cooked rice or pasta

1 slice bread

1 cup raw vegetables or fruit

1/2 cup cooked vegetables or fruit

8oz. of milk

1 teaspoon olive oil

3 ounces cooked meat

3 ounces tofu

How Much Fat Can I Eat?

You will need to estimate your total calorie needs and the number of fat calories. Then figure grams of fat to eat daily. It is best to calculate a range of intakes instead of a single number so that you can have flexibility in your eating without freaking out if you eat 100 extra calories one day.

1. Multiply your present weight by the appropriate factor to estimate baseline calorie needs.

Men: _________ pounds x 11 = _________ (don't write on the screen when you do this).

Women: _________ pounds x 10 = _________

2. Multiply your weight by the appropriate activity factor* to estimate calories needed for activity.

Sedentary Light Moderate Heavy

Men: 3.2 6 7.2 10.5

Women: 3.0 5 6 9

_________ pounds x _________ (factor) = _________

*Sedentary = little exercise & sit-down job
Light = some exercise or standing job
Moderate = exercise 3 - 5 times a week and/or moderately active job
Heavy = exercise 5 or more times a week or very active job (construction work)

3. Add together the calories from steps 1 & 2 to estimate your total calorie needs per day.

_________ + _________ = _________

(Add 500 calories to total if currently underweight. Subtract 200 calories if currently overweight).

4. Multiply the total calories by .20 or .30 for 20% or 30% fat calories.
Eat approximately 20% fat calories to help lose excess body fat.

_________ x .20 = _________

_________ x .30 = _________

5. Divide the calories from fat by 9 to get your daily fat gram allotment.

20% = _________/9 = _________

30% = _________ /9 = _________

Maintaining Good Eating Habits

I am including a Kathy Smith bit of advice for consistency with eating. I will bold a few items, as well as comment with italics.
Melissa

Consistency also applies to eating - which is another question I'm often asked: How do you have the willpower to be good all the time?

Answer: I don't think in terms of "good" or "bad." Rather, I focus on eating in a way that serves me, my health, and my body. And that includes eating all kinds of foods, some of which many people may consider "bad." (Remember: bad foods are really only bad when not eaten in moderation).

If I had to explain it in terms of "good" and "bad," I'd say that you only have to be "good" 80 percent of the time. That allows you, pretty much, to do whatever you want with the other twenty and still not upset the equation. You can splurge on a Nestle's Crunch bar. Indulge your craving for Ben & Jerry's. Give in to the tempting smell of apple pie. Just be consistently on track the other 80 percent of the time.

By the same token, the 80-20 rule frees you from the trap of thinking that just because you ate four potato chips, you might as well eat the whole bag. (Don't eat the whole bag. That wouldn't be in moderation, now, would it?)

For instance, when I was pregnant with my first daughter, Katie, I developed the strongest craving for bacon, lettuce, and tomato sandwiches. While this might not seem strange to you, I'd not eaten a piece of bacon for fifteen years. And yet, I could sit down and eat not one but two BLTs at a single meal. Concerned, I checked with my doctor, who assured me that the craving was normal, and perhaps I needed a little more salt in my diet.

After Katie was born, I fortunately lost my craving for bacon. Unfortunately, I've never lost my craving for chocolate. (How many of you regularly crave chocolate?) This is an ongoing issue for me. In fact, I'm learning to control my relationship with chocolate. I allow myself to eat it once a week - no guilt, no shame, no worry. The other days, I nibble on fresh fruit, or homemade rice pudding, or suck on a piece of hard candy to satisfy my sweet tooth. (I find that making yourself eat fruit throughout the day - for snacks - helps ease that refined sugar craving). I've also learned not to keep large quantities of chocolate around the house. If there were, I'd be tempted to nibble on it every day. I know myself. Giving myself permission to indulge has taken chocolate out of the "bad" food category - and it's no longer an obsession.

I feel a sense of calm about my eating habits. I never feel deprived, and I don't like to listen to someone talk about calories or carbohydrates when I'm eating. (Me neither. Just eat and be happy :) My attitude is, when you're eating, enjoy. And when you're satisfied, stop.

That's what I tell people when they ask for my health and fitness secrets. I tell them, the secret is consistency. The three-month, give-it-all mentality is only good for players in the Super Bowl. But when it comes to developing a healthy lifestyle, it's a day in, day out, week in, week out, year in, year out game plan that leads to success.