Eating Plan: Facts About
Eating Plan: Facts About
Eating Plan: Facts About
The
Wh at I s H i g h B loo d Pr e s s u r e ?
Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mmHg) and recorded as two numberssystolic pressure (as the heart beats) over diastolic pressure (as the heart relaxes between beats). Both numbers are important. (See box 1 below.) Blood pressure rises and falls during the day. When it stays elevated over time, its called high blood pressure. High blood pressure is dangerous because it makes the heart work too hard, and the force of its blood flow can harm arteries. High blood pressure often has no warning signs or symptoms. Once it occurs, it usually lasts a lifetime. Uncontrolled, it can lead to heart and kidney disease and stroke. High blood pressure affects about 50 millionor 1 in 4adult Americans. High blood pressure is especially common among African Americans who tend to develop it at an earlier age and more often than Whites. It also is common among older Americansindividuals with normal blood pressure at age 55 have a 90 percent lifetime risk for developing hypertension. High blood pressure can be controlled if you take these steps: maintain a healthy weight; be physically active; follow a healthy eating plan, which includes foods lower in salt and sodium; if you drink alcoholic beverages, do so in moderation; and, if you have high blood pressure and are prescribed medication, take it as directed. All steps but the last also help to prevent high blood pressure.
box 1
Hypertension
140 or higher
or
90 or higher
For adults ages 18 and older who are not on medicine for high blood pressure and do not have a short-term serious illness. Source: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; NIH Publication No. 03-5230, National High Blood Pressure Education Program, May 2003. If systolic and diastolic pressures fall into different categories, overall status is the higher category. Millimeters of mercury.
DASH compared three eating plans: A plan similar in nutrients to what many Americans consume; a plan similar to what Americans consume but higher in fruits and vegetables; and the DASH eating plan. All three plans included about 3,000 milligrams of sodium daily. None of the plans was vegetarian or used specialty foods. Results were dramatic: Both the fruits and vegetables plan and the DASH eating plan reduced blood pressure. But the DASH eating plan had the greatest effect, especially for those with high blood pressure. Furthermore, the blood pressure reductions came fastwithin 2 weeks of starting the plan. The second study was called DASH-Sodium, and it looked at the effect on blood pressure of a reduced dietary sodium intake as participants followed either the DASH eating plan or an eating plan typical of what many Americans consume. DASH-Sodium involved 412 participants. Their systolic blood pressures were 120159 mmHg and their diastolic blood pressures were 8095 mmHg. About 41 percent of them had high blood pressure. About 57 percent were women and about 57 percent were African Americans. Participants were randomly assigned to one of the two eating plans and then followed for a month at each of three sodium levels. The three sodium levels were: a higher intake of about 3,300 milligrams per day (the level consumed by many Americans); an intermediate intake of about 2,400 milligrams per day; and a lower intake of about 1,500 milligrams per day. Results showed that reducing dietary sodium lowered blood pressure for both eating plans. At each sodium level, blood pressure was lower on the DASH eating plan than on the other eating plan. The biggest blood pressure reductions were for the DASH eating plan at the sodium intake of 1,500 milligrams per day. Those with hypertension saw the biggest reductions, but those without it also had large decreases. Those on the 1,500-milligram sodium intake eating plan, as well as those on the DASH eating plan, had fewer headaches. Other than that and blood pressure levels, there were no significant effects caused by the two eating plans or different sodium levels. DASH-Sodium shows the importance of lowering sodium intake whatever your eating plan. But for a true winning combination, follow the DASH eating plan and lower your intake of salt and sodium.
box 2
Serving Sizes
78
1 slice bread 1 oz dry cereal* 1/2 cup cooked rice, pasta, or cereal 1 cup raw leafy vegetable 1/2 cup cooked vegetable 6 oz vegetable juice
Whole wheat bread, English muffin, pita bread, bagel, cereals, grits, oatmeal, crackers, unsalted pretzels and popcorn Tomatoes, potatoes, carrots, green peas, squash, broccoli, turnip greens, collards, kale, spinach, artichokes, green beans, lima beans, sweet potatoes Apricots, bananas, dates, grapes, oranges, orange juice, grapefruit, grapefruit juice, mangoes, melons, peaches, pineapples, prunes, raisins, strawberries, tangerines Fat free (skim) or lowfat (1%) milk, fat free or lowfat buttermilk, fat free or lowfat regular or frozen yogurt, lowfat and fat free cheese Select only lean; trim away visible fats; broil, roast, or boil, instead of frying; remove skin from poultry Almonds, filberts, mixed nuts, peanuts, walnuts, sunflower seeds, kidney beans, lentils,
Vegetables
45
Fruits
45
6 oz fruit juice 1 medium fruit 1/4 cup dried fruit 1/2 cup fresh, frozen, or canned fruit 8 oz milk 1 cup yogurt 11/2 oz cheese
23
2 or less
45 per week
1/3 cup or 11/2 oz nuts 2 Tbsp or 1/2 oz seeds 1/2 cup cooked dry beans peas
23
1 tsp soft margarine 1 Tbsp lowfat mayonnaise 2 Tbsp light salad dressing 1 tsp vegetable oil 1 Tbsp sugar 1 Tbsp jelly or jam 1/2 oz jelly beans 8 oz lemonade
Soft margarine, lowfat mayonnaise, light salad dressing, vegetable oil (such as olive, corn, canola, or safflower) Maple syrup, sugar, jelly, jam, fruit-flavored gelatin, jelly beans, hard candy, fruit punch, sorbet, ices
Sweets
5 per week
Equals 1/2 1 1/4 cups, depending on cereal type. Check the products Nutrition Facts Label. Fat content changes serving counts for fats and oils: For example, 1 Tbsp of regular salad dressing equals 1 serving; 1 Tbsp of a lowfat dressing equals 1/2 serving; 1 Tbsp of a fat free dressing equals 0 servings.
Eat a medium apple instead of four shortbread cookies. Youll save 80 calories. Eat 1/4 cup of dried apricots instead of a 2-ounce bag of pork rinds. Youll save 230 calories.
To increase vegetables
Have a hamburger thats 3 ounces of meat instead of 6 ounces. Add 1/2 cup serving of carrots and 1/2 cup serving of spinach. Youll save more than 200 calories. Instead of 5 ounces of chicken, have a stir-fry with 2 ounces of chicken and 11/2 cups of raw vegetables. Use a small amount of vegetable oil. Youll save 50 calories.
Have a 1/2 cup serving of lowfat frozen yogurt instead of a 1 1/2-ounce milk chocolate bar. You'll save about 110 calories.
Use lowfat or fat free condiments. Use half as much vegetable oil, soft or liquid margarine, or salad dressing, or choose fat free versions. Eat smaller portionscut back gradually. Choose lowfat or fat free dairy products to reduce total fat intake. Check the food labels to compare fat content in packaged foodsitems marked lowfat or fat free are not always lower in calories than their regular versions. Limit foods with lots of added sugar, such as pies, flavored yogurts, candy bars, ice cream, sherbet, regular soft drinks, and fruit drinks. Eat fruits canned in their own juice. Add fruit to plain yogurt. Snack on fruit, vegetable sticks, unbuttered and unsalted popcorn, or bread sticks. Drink water or club soda.
box 4
box 5
Grains and grain products Cooked cereal, rice, pasta, unsalted, 1/2 cup Ready-to-eat cereal, 1 cup Bread, 1 slice Vegetables Fresh or frozen, cooked without salt, 1/2 cup Canned or frozen with sauce, 1/2 cup Tomato juice, canned 3/4 cup Fruit Fresh, frozen, canned, 1/2 cup Lowfat or fat free dairy foods Milk, 1 cup Yogurt, 8 oz Natural cheeses, 1 1/2 oz Processed cheeses, 1 1/2 oz Nuts, seeds, and dry beans Peanuts, salted, 1/3 cup Peanuts, unsalted, 1/3 cup Beans, cooked from dried, or frozen, without salt, 1/2 cup Beans, canned, 1/2 cup Meats, fish, and poultry Fresh meat, fish, poultry, 3 oz Tuna canned, water pack, no salt added, 3 oz Tuna canned, water pack, 3 oz Ham, lean, roasted, 3 oz
05 100360 110175
05
120 05 05 400
You should be aware that the DASH eating plan has more daily servings of fruits, vegetables, and whole grain foods than you may be used to eating. Because the plan is high in fiber, it can cause bloating and diarrhea in some persons. To avoid these problems, gradually increase your intake of fruit, vegetables, and whole grain foods. This fact sheet gives menus and recipes for both 2,400 and 1,500 milligrams of daily sodium intake. Twenty-four hundred milligrams of sodium equals about 6 grams, or 1 teaspoon, of table salt (sodium chloride); 1,500 milligrams of sodium equals about 4 grams, or 2/3 teaspoon, of table salt. These amounts include all salt consumed that in food products, used in cooking, and added at the table. Only small amounts of sodium occur naturally in food. Processed foods account for most of the salt and sodium Americans consume. So, be sure to read food labels to choose products lower in sodium. You may be surprised at many of the foods that have sodium. They include soy sauce, seasoned salts, monosodium glutamate (MSG), baking soda, and some antacidsthe range is wide. Because it is rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH eating plan makes it easier to consume less salt and sodium. Still, you may want
box 6
Use reduced sodium or no-salt-added products. For example, choose low- or reduced-sodium, or no-salt-added versions of foods and condiments when available. Buy fresh, plain frozen, or canned with no-salt-added vegetables. Use fresh poultry, fish, and lean meat, rather than canned, smoked, or processed types. Choose ready-to-eat breakfast cereals that are lower in sodium. Limit cured foods (such as bacon and ham), foods packed in brine (such as pickles, pickled vegetables, olives, and sauerkraut), and condiments (such as MSG, mustard, horseradish, catsup, and barbecue sauce). Limit even lower sodium versions of soy sauce and teriyaki saucetreat these condiments as you do table salt. Use spices instead of salt. In cooking and at the table, flavor foods with herbs, spices, lemon, lime, vinegar, or salt-free seasoning blends. Start by cutting salt in half. Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes, which usually have added salt. Choose convenience foods that are lower in sodium. Cut back on frozen dinners, mixed dishes such as pizza, packaged mixes, canned soups or broths, and salad dressingsthese often have a lot of sodium. Rinse canned foods, such as tuna, to remove some sodium.
to begin by adopting the DASH eating plan at the level of 2,400 milligrams of sodium per day and then further lower your sodium intake to 1,500 milligrams per day. Boxes 6, 7, and 8 offer tips on how to reduce the salt and sodium content in your diet, and how to use food labels to find lower sodium products. Next, read the Getting Started suggestions in box 10 on page 11. How can you get started on the DASH eating plan? Its easy. The DASH eating plan requires no special foods and has no hard-to-follow recipes. One way to begin is by
box 7
Ask how foods are prepared. Ask that they be prepared without added salt, MSG, or salt-containing ingredients. Most restaurants are willing to accommodate requests. Know the terms that indicate high sodium content: pickled, cured, soy sauce, broth. Move the salt shaker away. Limit condiments, such as mustard, catsup, pickles, and sauces with salt-containing ingredients. Choose fruits or vegetables instead of salty snack foods.
box 8
% Daily Value*
% Daily Value*
Total Fat 0 g Saturated Fat 0 g Cholesterol 0 mg Sodium 20 mg Total Carbohydrate 6 g Dietary Fiber 2 g Sugars 4 g Protein 1 g
0% 0% 0% 1% 2% 8%
Total Fat 0 g Saturated Fat 0 g Cholesterol 0 mg Sodium 200 mg Total Carbohydrate 6 g Dietary Fiber 2 g Sugars 4 g Protein 1 g
0% 0% 0% 8% 2% 8%
box 9
Label Language
Food labels can help you choose items lower in sodium and saturated and total fat. Look for the following labels on cans, boxes, bottles, bags, and other packaging:
Phrase
Sodium Sodium free or salt free Very low sodium Low sodium Low sodium meal Reduced or less sodium Light in sodium Unsalted or no salt added Fat Fat free Low saturated fat Lowfat Reduced fat Light in fat
What It Means
Less than 5 mg per serving 35 mg or less of sodium per serving 140 mg or less of sodium per serving 140 mg or less of sodium per 3 1/2 oz (100 g) At least 25 percent less sodium than the regular version 50 percent less sodium than the regular version No salt added to the product during processing Less than 0.5 g per serving 1 g or less per serving 3 g or less per serving At least 25 percent less fat than the regular version Half the fat compared to the regular version
seeing how DASH compares with your current food habits. Use the Whats on Your Plate? form. (See box 11 on page 12.) Fill it in for 12 days and see how it compares with the DASH plan. This will help you see what changes you need to make in your food choices. Remember that some days the foods you eat may add up to more than the recommended servings from one food group and less from another. Similarly, you may have too much sodium on a particular day. Dont worry. Just be sure that the average of several days or a week comes close to whats recommended for the food groups and for your chosen daily sodium level. Finally, use the menus that begin on page 13or make up your own. One important note: If you take medication to control high blood pressure, you should not stop using it. Follow the DASH eating plan, and talk with your doctor about your drug treatment.
box 10
Getting Started
Its easy to adopt the DASH eating plan. Here are some ways to get started:
Change gradually.
If you now eat one or two vegetables a day, add a serving at lunch and another at dinner. If you don't eat fruit now or have only juice at breakfast, add a serving to your meals or have it as a snack. Gradually increase your use of fat free and lowfat dairy products to three servings a day. For example, drink milk with lunch or dinner, instead of soda, sugar-sweetened tea, or alcohol. Choose lowfat (1 percent) or fat free (skim) dairy products to reduce your intake of saturated fat, total fat, cholesterol, and calories. Read food labels on margarines and salad dressings to choose those lowest in saturated fat and trans fat. Some margarines are now trans-fat free.
Treat meat as one part of the whole meal, instead of the focus.
Limit meat to 6 ounces a day (2 servings)all thats needed. Three to four ounces is about the size of a deck of cards. If you now eat large portions of meat, cut them back graduallyby a half or a third at each meal. Include two or more vegetarian-style (meatless) meals each week. Increase servings of vegetables, rice, pasta, and dry beans in meals. Try casseroles and pasta, and stir-fry dishes, which have less meat and more vegetables, grains, and dry beans.
Use fruits or other foods low in saturated fat, cholesterol, and calories as desserts and snacks.
Fruits and other lowfat foods offer great taste and variety. Use fruits canned in their own juice. Fresh fruits require little or no preparation. Dried fruits are a good choice to carry with you or to have ready in the car. Try these snack ideas: unsalted pretzels or nuts mixed with raisins; graham crackers; lowfat and fat free yogurt and frozen yogurt; popcorn with no salt or butter added; and raw vegetables.
Choose whole grain foods to get added nutrients, such as minerals and fiber. For example, choose whole wheat bread or whole grain cereals. If you have trouble digesting dairy products, try taking lactase enzyme pills or drops (available at drugstores and groceries) with the dairy foods. Or, buy lactose-free milk or milk with lactase enzyme added to it. Use fresh, frozen, or no-salt-added canned vegetables.
box 11
Food
Vegetables
Breakfast Example: whole wheat bread and soft margarine 2 slices 2 tsp 299 102 2 2
Lunch
Dinner
Snacks
45 daily
45 daily
23 daily
2 or less
45 a week
23 daily
5 a week
* Read food labels to compare the sodium content of foods. See page 9 to learn how to find sodium information on food labels.
Sweets
Grains
Fruits
Dairy
Sodium (mg)
Sodium (mg)
Vegetables
2,400 mg Sodium Menu Breakfast cup bran cereal 1 slice whole wheat bread 1 medium banana 1 cup fruit yogurt, fat free, no sugar added 1 cup fat free milk 2 tsp jelly
2/3
161 149 1 53 126 5 201 299 372 8 1 306 5 52 163 12 7 28 86 1 148 51 0 126 5 2 2
1 1 1 1 1
2/3
Lunch 3/4 cup chicken salad* 2 slices whole wheat bread 1 Tbsp Dijon mustard salad: 1/2 cup fresh cucumber slices 1/2 cup tomato wedges 2 Tbsp ranch dressing, fat free 1/2 cup fruit cocktail, juice pack Dinner 3 oz beef, eye of round 2 Tbsp beef gravy, lowfat 1 cup green beans, cooked from frozen 1 small baked potato: 2 Tbsp sour cream, fat free 2 Tbsp grated cheddar cheese, natural, reduced fat 1 Tbsp chopped scallions 1 small whole wheat roll 1 tsp soft margarine 1 small apple 1 cup fat free milk Snack 1/3 cup almonds, unsalted 1/4 cup raisins 1 cup orange juice
127 2 196 1 1
84 1 1
5 2 1
1/4
Totals
Sodium Level
Nutrients Per Day Calories Total fat Percent calories from fat Saturated fat Percent calories from saturated fat Cholesterol
* Recipe on page 20.
5 1/3
3 1/4
2/3
Sodium Level
Nutrients Per Day Sodium Calcium Magnesium Potassium Fiber 2,400 mg 2,363 mg 1,257 mg 572 mg 4,780 mg 34 g 1,500 mg 1,320 mg 1,338 mg 589 mg 4,745 mg 34 g
Sweets
Grains
Fruits
Dairy
1
DAY 1
Sodium (mg)
Sodium (mg)
Vegetables
2,400 mg Sodium Menu Breakfast cup instant oatmeal, flavored 1 mini whole wheat bagel 1 medium banana 1 cup fat free milk 1 Tbsp cream cheese, fat free
1/2
104 84 1 126 75
1 1 1 1
Lunch chicken breast sandwich: 2 slices (3 oz) chicken breast, skinless 2 slices whole wheat bread 1 slice (3/4 oz) American cheese, reduced fat 1 large leaf romaine lettuce 2 slices tomato 1 Tbsp mayonnaise, lowfat 1 medium peach 1 cup apple juice Dinner 3/4 cup vegetarian spaghetti sauce* 1 cup spaghetti 3 Tbsp Parmesan cheese spinach salad: 1 cup fresh spinach leaves 1/4 cup fresh carrots, grated 1/4 cup fresh mushrooms, sliced 2 Tbsp vinaigrette dressing 1/2 cup corn, cooked from frozen 1/2 cup canned pears, juice pack Snack
1/3 cup almonds 1/4 cup dried apricots
1 1 1 1/3
459 1 349 24 10 1 0 4 4
260 2
1 1/2
1/2
1
1/2 1/2 3/4
1 1
5 3 107
1 1 1
5 1/4
5 1/3
1 3/4
Sodium Level
Nutrients Per Day Calories Total fat Percent calories from fat Saturated fat Percent calories from saturated fat Cholesterol
* Recipe on page 20. Recipe on page 21.
Sodium Level
Nutrients Per Day Sodium Calcium Magnesium Potassium Fiber 2,400 mg 2,152 mg 1,351 mg 502 mg 4,513 mg 32 g 1,500 mg 1,577 mg 1,494 mg 509 mg 4,440 mg 34 g
Sweets
Grains
Fruits
Dairy
2
DAY 2
Sodium (mg)
Sodium (mg)
Vegetables
2,400 mg Sodium Menu Breakfast cup wheat flakes cereal 1 slice whole wheat bread 1 medium banana 1 cup fat free milk 1 cup orange juice 1 tsp soft margarine
3/4
1 1 1 1 1 1/3
Lunch beef barbeque sandwich: 2 oz beef, eye of round 1 Tbsp barbeque sauce 2 slices (1 1/2 oz) cheddar cheese, reduced fat 1 sesame roll 1 large leaf romaine lettuce 2 slices tomato 1 cup new potato salad* 1 medium orange Dinner 3 oz cod: 1 tsp lemon juice 1/2 cup brown rice, long grain 1/2 cup spinach, cooked from frozen 1 small corn bread muffin 1 tsp soft margarine
2/3
109 1
1/4 1/2
2 1
89 1 5 88 363 51 1 small white dinner roll 1 tsp soft margarine, unsalted 146 1
1 1 1 1 1
Snack 1 cup fruit yogurt, fat free, no added sugar 1/4 cup dried fruit 2 large graham cracker rectangles 1 Tbsp peanut butter, reduced fat Totals
1/2
3 3/4
4 1/3
1 2/3
1/2
Sodium Level
Nutrients Per Day Calories Total fat Percent calories from fat Saturated fat Percent calories from saturated fat Cholesterol
* Recipe on page 21.
Sodium Level
Nutrients Per Day Sodium Calcium Magnesium Potassium Fiber 2,400 mg 2,303 mg 1,490 mg 495 mg 4,752 mg 29 g 1,500 mg 1,519 mg 1,502 mg 526 mg 4,759 mg 30 g
Sweets
Grains
Fruits
Dairy
3
DAY 3
Sodium (mg)
Sodium (mg)
Vegetables
223 53 0 8 126
1 1
1
1/2
cup fruit yogurt, fat free, no added sugar 1 medium apple 1 cup grape juice 1 cup fat free milk Lunch ham and cheese sandwich: 2 oz smoked ham, lowfat, low sodium 1 slice (3/4 oz) cheddar cheese, natural, reduced fat 2 slices whole wheat bread 1 large leaf romaine lettuce 2 slices tomato 1 Tbsp mayonnaise, lowfat 1 cup carrot sticks Dinner chicken and Spanish rice*
1/2
1 1 1/3 1
35
1/ 2
2/ 3
2
1/4 1/2
1 2
226
1 1 2 1 1
cup green peas, cooked from frozen 1 cup cantaloupe 1 small whole wheat roll 1 cup fat free milk 1 tsp soft margarine Snack 1/3 cup almonds, unsalted 1/2 cup fruit cocktail 1 cup apple juice Totals
5 5 7 5 3 3/4
Sodium Level
Nutrients Per Day Calories Total fat Percent calories from fat Saturated fat Percent calories from saturated fat Cholesterol
* Recipe on page 21.
Sodium Level
Nutrients Per Day Sodium Calcium Magnesium Potassium Fiber 2,400 mg 2,259 mg 1,200 mg 491 mg 5,152 mg 32 g 1,500 mg 1,441 mg 1,203 mg 502 mg 4,914 mg 32 g
Sweets
Grains
Fruits
Dairy
4
DAY 4
Sodium (mg)
Sodium (mg)
Vegetables
2 slices whole wheat bread 1 medium banana 1 cup fat free milk 1 cup orange juice 1 tsp soft margarine 2 tsp jelly, no added sugar Lunch salad plate: 1/2 cup tuna salad* 1 large leaf romaine lettuce 6 wheat crackers, fat free
1/2
3 299 1 126 5 51 0
1
1/4
cup cottage cheese, 2% 1 cup canned pineapple, juice pack 4 small celery sticks 2 Tbsp ranch dressing, fat free Dinner 3 oz turkey meatloaf* 1 Tbsp catsup 1 small baked potato: 1 tsp soft margarine 1 Tbsp sour cream, lowfat 1 scallion stalk, chopped 1 cup collard greens, cooked from frozen 1 medium peach 1 cup fat free milk Snack 1 Tbsp peanut butter, reduced fat 1/2 medium bagel (3-inch diameter) 1/2 cup fruit yogurt, fat free, no added sugar Totals
6 wheat crackers, fat free, unsalted 1/2 cup cottage cheese, 2%, unsalted
18 23
1
1/4
2
1/2
84
62 178 7 51 15 2 15 0 126
2 1 1
101 152 53
3 1
1/2
1/2
3 3/4
51/3
23/4
1/2
Sodium Level
Nutrients Per Day Calories Total fat Percent calories from fat Saturated fat Percent calories from saturated fat Cholesterol
* Recipe on page 22.
Sodium Level
Nutrients Per Day Sodium Calcium Magnesium Potassium Fiber 2,400 mg 2,495 mg 1,293 mg 429 mg 4,609 mg 27 g 1,500 mg 1,493 mg 1,360 mg 475 mg 4,826 mg 30 g
Sweets
Grains
Fruits
Dairy
5
DAY 5
Sodium (mg)
Sodium (mg)
Vegetables
2,400 mg Sodium Menu Breakfast 1 lowfat granola bar 1 medium banana 1 cup fruit yogurt, fat free, no sugar added 1 cup orange juice 1 cup fat free milk Lunch turkey breast sandwich: 3 oz turkey breast 2 slices whole wheat bread 2 slices (1 1/2 oz) natural cheddar cheese, reduced fat 1 large leaf romaine lettuce 2 slices tomato 2 tsp mayonnaise, lowfat 1 Tbsp Dijon mustard 1 cup broccoli steamed from frozen 1 medium orange Dinner 3 oz spicy baked fish* 1 cup scallion rice 1/2 cup spinach, cooked from frozen 1 cup carrots, cooked from frozen 1 small whole wheat roll 1 tsp soft margarine 1 cup fat free milk Snack 2 large rectangle graham crackers 1 cup fat free milk 1/4 cup dried apricots Totals
71 1 107 2 126
1/2
1 1 1 1/3 1
48 299 260
1 2 2 slices (1 1/2 oz) cheddar cheese, natural, reduced fat, low sodium 3 1
1 22 60 372 44 0
60 2 1
93 3 88 96 148 51 126
156 126 3
Sodium Level
Nutrients Per Day Calories Total fat Percent calories from fat Saturated fat Percent calories from saturated fat Cholesterol
* Recipe on page 22. Recipe on page 23.
Sodium Level
Nutrients Per Day Sodium Calcium Magnesium Potassium Fiber 2,400 mg 2,331 mg 1,858 mg 549 mg 5,555 mg 34 g 1,500 mg 1,568 mg 1,851 mg 572 mg 5,575 mg 35 g
Sweets
Grains
Fruits
Dairy
6
DAY 6
Sodium (mg)
Sodium (mg)
Vegetables
2,400 mg Sodium Menu Breakfast 1 cup whole grain oat rings cereal 1 medium banana 1 cup fruit yogurt, fat free, no sugar added 1 cup fat free milk Lunch tuna salad sandwich: 1/2 cup tuna, drained, rinsed 1 Tbsp mayonnaise, lowfat 1 large leaf romaine lettuce 2 slices tomato 2 slices whole wheat bread 1 medium apple 1 cup fat free milk Dinner 1/6 recipe zucchini lasagna* salad: 1/2 cup fresh spinach leaves 1/2 cup tomatoes wedges 2 Tbsp croutons, seasoned 2 Tbsp vinaigrette dressing, reduced fat 1 small whole wheat roll 1 cup grape juice 1 tsp soft margarine Snack cup almonds, unsalted 2 slices (1 1/2 oz) cheddar cheese, natural, reduced fat 6 whole wheat crackers
1/3
212
1 1 1 1
1 107 126
57 90 1 22 299 0 126
1 1
1/4 1/2
2 1 1
380
196
12 8 62 312 148 7 51
1/2
1 1
Totals
8 1/4
3 1/4
3 1/3
2 3/4
Sodium Level
Nutrients Per Day Calories Total fat Percent calories from fat Saturated fat Percent calories from saturated fat Cholesterol
* Recipe on page 23 Recipe on page 21
Sodium Level
Nutrients Per Day Sodium Calcium Magnesium Potassium Fiber 2,400 mg 2,471 mg 1,587 mg 527 mg 4,556 mg 31 g 1,500 mg 1,498 mg 1,589 mg 527 mg 4,588 mg 31 g
Sweets
Grains
Fruits
Dairy
7
DAY 7
1
DAY 1
1 3
Chicken Salad
1/4
31/4
1/2 1/8
chicken, cooked, cubed, skinless celery, chopped lemon juice onion powder salt mayonnaise, lowfat
Makes 5 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber 183 7 2 78 0
Serving size: 3/4 cup Sodium Calcium Magnesium Potassium 201 17 25 240 mg mg mg mg
g g mg g
1. Bake chicken, cut into cubes, and refrigerate. 2. In a large bowl, combine all ingredients with chilled chicken and mix well.
To reduce sodium: Do not add salt. New sodium total = 127 mg.
& 1 5 2
DAYS 1 and 5
8 2 2 2
Yogurt Salad Dressing oz cup Tbsp Tbsp Tbsp plain yogurt, fat free mayonnaise, fat free chives, dried dill, dried lemon juice Makes 8 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber 23 0 0 1 0 Serving size: 2 Tbsp Sodium Calcium Magnesium Potassium 84 72 10 104 mg mg mg mg
1/4
g g mg g
DAY 2
Vegetarian Spaghetti Sauce Tbsp small cloves cups Tbsp Tbsp 8-oz can 6-oz can medium cup olive oil onions, chopped garlic, chopped zucchini, sliced oregano, dried basil, dried tomato sauce tomato paste tomatoes, chopped water Makes 6 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber 102 5 1 0 5 Serving size: 3/4 cup Sodium Calcium Magnesium Potassium 459 42 37 623 mg mg mg mg
2 2 3 11/4 1 1 1 1 2 1
g g mg g
To reduce sodium: Use a 6-oz can of no-salt-added tomato paste. New sodium total = 260 mg.
1. In a medium skillet, heat oil. Saut onions, garlic, and zucchini in oil for 5 minutes on medium heat. 2. Add remaining ingredients and simmer covered for 45 minutes. Serve over spaghetti.
20 High Blood Pressure
2
DAY 2
1 1 1
Vinaigrette Salad Dressing bulb cup Tbsp tsp Tbsp tsp garlic, separated and peeled water red wine vinegar honey virgin olive oil black pepper Serving size: 2 Tbsp Sodium Calcium Magnesium Potassium 0 2 1 9 mg mg mg mg 1. Place the garlic cloves into a small saucepan and pour enough water (about 1/2 cup) to cover them. 2. Bring water to a boil, then reduce heat and simmer until garlic is tender, about 15 minutes. 3. Increase the heat for 3 minutes, and reduce the liquid to 2 Tbsp. 4. Pour the contents into a small sieve over a bowl and, with a wooden spoon, mash the garlic through the sieve. 5. Whisk the vinegar and honey into the garlic mixture; mix in the oil and seasoning.
Makes 4 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber 33 3 1 0 0
g g mg g
3
DAY 3
new potatoes (5 cups) olive oil green onions, chopped black pepper dill weed, dried
Makes 5 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber 187 6 1 0 3
1. Thoroughly clean the potatoes with a vegetable brush and water. 2. Boil potatoes for 20 minutes or until tender. 3. Drain and cool potatoes for 20 minutes. 4. Cut potatoes into quarters and mix with olive oil, onions, and spices. 5. Refrigerate and serve.
g g mg g
4
DAY 4
2 1 1
1/2
11/4 5 31/2
cup cup tsp 8-oz can tsp tsp tsp cup cups
onions, chopped green peppers vegetable oil tomato sauce parsley, chopped black pepper garlic, minced cooked rice (in unsalted water) chicken breast, cooked (skin and bone removed), diced
Makes 5 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber 406 6 2 75 2
Serving size: 11/2 cups Sodium Calcium Magnesium Potassium 367 45 57 527 mg mg mg mg
g g mg g
1. In a large skillet, saut onions and green peppers in oil for 5 minutes on medium heat. 2. Add tomato sauce and spices. Heat through. 3. Add cooked rice and chicken, and heat through.
To reduce sodium: Use one 4-oz can of no-salt-added tomato sauce and one 4-oz can of regular tomato sauce. New sodium total = 226 mg.
5
DAY 5
Tuna Salad 2
1/2 1/3
61/2
tuna, packed in water raw celery, chopped green onions, chopped mayonnaise, reduced fat
Makes 5 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber
1. Rinse and drain tuna for 5 minutes. Break apart with a fork. 2. Add celery, onion, and mayonnaise, and mix well.
146 7 0 25 1
g g mg g
158 15 19 201
mg mg mg mg
5
DAY 5 DAY 6
Turkey Meatloaf 1
1/2
1 1
1/4
ground turkey, lean oats, regular, dry egg, whole onion, dehydrated catsup
Makes 5 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber 196 7 2 103 1
Serving size: 1 slice (3 oz) Sodium Calcium Magnesium Potassium 217 33 35 292 mg mg mg mg
1. Combine all ingredients and mix well. 2. Bake in a loaf pan at 350 F for 25 minutes or to internal temperature of 165 F. 3. Cut into five slices and serve.
g g mg g
6
22 High Blood Pressure
Spicy Baked Fish 1 1 1 pound Tbsp tsp cod (or other fish) fillet olive oil spicy seasoning, salt free Makes 4 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber 133 1 0 77 0 Serving size: 1 piece (3 oz) Sodium Calcium Magnesium Potassium 119 20 67 394 mg mg mg mg
1. Preheat oven to 350 F. Spray a casserole dish with cooking oil spray. 2. Wash and dry fish. Place in dish. Mix oil and seasoning, and drizzle over fish. 3. Bake uncovered for 15 minutes or until fish flakes with fork. Cut into 4 pieces. Serve with rice.
g g mg g
6
DAY 6
cooked rice (in unsalted water) bouillon granules, unsalted scallions (green onions), chopped
Makes 5 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber
1. Cook rice according to directions on the package. 2. Combine the cooked rice, scallions, and bouillon granules, and mix well. 3. Measure 1 cup portions and serve.
185 1 0 0 1
g g mg g
3 24 20 80
mg mg mg mg
7
DAY 7
Zucchini Lasagna
1/2 3/4
pound cup cups cup cups cups tsp tsp cup clove tsp
11/2
1/4
11/2 21/2 2 2
1/4
1
1/8
cooked lasagna noodles (in unsalted water) mozzarella cheese, part-skim, grated cottage cheese, fat free Parmesan cheese, grated zucchini, raw, sliced tomato sauce, no salt added basil, dried oregano, dried onion, chopped garlic black pepper
Makes 6 servings. Per Serving: Calories Total fat Saturated fat Cholesterol Fiber
1. Preheat oven to 350 F. Lightly spray a 9 x 13 inch baking dish with vegetable oil spray. 2. In a small bowl, combine 1/8 cup mozzarella and 1 Tbsp Parmesan cheese. Set aside. 3. In a medium bowl, combine remaining mozzarella and Parmesan cheese with all of the cottage cheese. Mix well and set aside. 4. Combine tomato sauce with remaining ingredients. Spread a thin layer of tomato sauce in the bottom of the baking dish. Add a third of the noodles in a single layer. Spread half of the cottage cheese mixture on top. Add a layer of zucchini. Repeat layering. Add a thin coating of sauce. Top with noodles, sauce, and reserved cheese mixture. Cover with aluminum foil. 5. Bake 30 to 40 minutes. Cool for 10 to 15 minutes. Cut into 6 portions. mg mg mg mg
276 5 2 11 5
g g mg g
To reduce sodium: Use unsalted cottage cheese. New sodium total = 196 mg.
box 12
Was it at a party? Were you feeling stress at home or work? Find out what triggered your sidetrackand start again with the DASH plan.
Everyone slipsespecially when learning something new. Remember that changing your lifestyle is a long-term process.
Often, those starting a new lifestyle try to change too much at once. Instead, change one or two things at a time. Slowly but surely is the best way to succeed.
This not only keeps you from trying to do too much at once, but also keeps the changes simpler. Break complex goals into smaller, simpler steps, each of which is attainable.
Write it down.
Use the table on page 12 to keep track of what you eat. This can help you find the problem. Besides noting what you eat, also record: where you are, what you're doing, and how you feel. Keep track for several days. You may find, for instance, that you eat high fat foods while watching television. If so, you could start keeping a substitute snack on hand to eat instead of the high fat foods. This record also helps you be sure youre getting enough of each food group.
Celebrate success.
National Heart, Lung, and Blood Institute National High Blood Pressure Program
NIH Publication No. 03-4082 Originally Printed 1998 Reprinted February 1999 Revised May 2003