Lowering Your Blood Pressure With DASH

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I N

BRI EF:

Your Guide To

Lowering Your Blood


Pressure With DASH
What you eat affects your chances of developing
high blood pressure (hypertension). Research
shows that high blood pressure can be prevented
and loweredby following the Dietary Approaches
to Stop Hypertension (DASH) eating plan, which
includes eating less sodium.
High blood pressure is blood pressure higher than
140/90 mmHg*, and prehypertension is blood
pressure between 120/80 and 139/89 mmHg. High
blood pressure is dangerous because it makes your
heart work too hard, hardens the walls of your
arteries, and can cause the brain to hemorrhage
or the kidneys to function poorly or not at all.
If not controlled, high blood pressure can lead
to heart and kidney
disease, stroke,
and blindness.

* Blood pressure
is usually measured
in millimeters of
mercury, or mmHg.

But high blood pressure can be preventedand


loweredif you take these steps:
Follow a healthy eating plan, such as DASH,
that includes foods lower in sodium.
Maintain a healthy weight.
Be moderately physically active for at least
2 hours and 30 minutes per week.
If you drink alcoholic beverages, do so in
moderation.

If you already have high blood pressure and


your doctor has prescribed medicine, take your
medicine, as directed, and follow these steps.

The DASH Eating Plan


The DASH eating plan is rich in fruits, vegetables,
fat-free or low-fat milk and milk products, whole
grains, fish, poultry, beans, seeds, and nuts. It also
contains less sodium; sweets, added sugars, and
beverages containing sugar; fats; and red meats
than the typical American diet. This heart-healthy
way of eating is also lower in saturated fat, trans
fat, and cholesterol and rich in nutrients that are
associated with lowering blood pressuremainly
potassium, magnesium, calcium, protein, and fiber.

How Do I Make the DASH?


The DASH eating plan requires no special foods
and has no hard-to-follow recipes. It simply calls
for a certain number of daily servings from various
food groups.
The number of servings depends on the number of
calories youre allowed each day. Your calorie level
depends on your age and, especially, how active you
are. Think of this as an energy balance systemif
you want to maintain your current weight, you
should take in only as many calories as you burn by
being physically active. If you need to lose weight,
eat fewer calories than you burn or increase your
activity level to burn more calories than you eat.
What is your physical activity level? Are you mostly:
Sedentary? You do only light physical activity
that is part of your typical day-to-day routine.
Moderately active? You do physical activity
equal to walking about 1 to 3 miles a day at 3 to
4 miles per hour, plus light physical activity.
Active? You do physical activity equal to walking
more than 3 miles per day at 3 to 4 miles per
hour, plus light physical activity.

Use the chart below to estimate your daily


calorie needs.

Your Daily Calorie Needs


Calories Needed for Each Activity Level
Gender

Age
(years)

Female

Male

Sedentary

Moderately
Active

Active

1930

2,000

2,0002,200

2,400

3150

1,800

2,000

2,200

51+

1,600

1,800

2,0002,200

1930

2,400

2,6002,800

3,000

3150

2,200

2,4002,600

2,8003,000

51+

2,000

2,2002,400

2,4002,800

Now that you know how many calories youre


allowed each day, find the closest calorie level to
yours in the chart on page 3 called Following the
DASH Eating Plan. This shows roughly the number
of servings from each food group that you can eat
each day.

Next, compare DASH with your current eating


pattern. Fill in the Whats on Your Plate and How
Much Are You Moving? chart on page 4 for 1 or
2 days to compare what you usually eat with the
DASH eating planand note how active you are.
This should help you decide what changes you need
to make in your food choicesand in the sizes of the
portions you eat.
A Day With the DASH Eating Plan on page 6
shows a sample menu based on about 2,000 calories
a day. Increase or decrease the serving sizes for your
own calorie level. This chart also shows the two
levels of sodium, 2,300 and 1,500 milligrams (mg),
that DASH allows each day. Because fruits and
vegetables are naturally lower in sodium than
many other foods, DASH makes it easier to eat
less sodium. Try it at the 2,300 mg level (about
1 teaspoon of table salt). Then, talk to your doctor
about gradually lowering it to 1,500 mg a day. Keep
in mind: The less sodium you eat, the more you may
be able to lower your blood pressure.
Choose and prepare foods with less sodium and salt,
and dont bring the salt shaker to the table. Be
creativetry herbs, spices, lemon, lime, vinegar,
wine, and salt-free seasoning blends in cooking and
at the table. And, because most of the sodium that
we eat comes from processed foods, be sure to read
food labels to check the amount of sodium in
different food products. Aim for foods that contain
5 percent or less of the Daily Value of sodium.
Foods with 20 percent or more Daily Value of
sodium are considered high. These include baked
goods, certain cereals, soy sauce, and some antacids
the range is wide.

DASH Tips for Gradual Change


Make these changes over a couple of days or weeks
to give yourself a chance to adjust and make them
part of your daily routine:
Add a serving of vegetables at lunch one day and
dinner the next, and add fruit at one meal or as
a snack.
Increase your use of fat-free and low-fat milk
products to three servings a day.
Limit lean meats to 6 ounces a day3 ounces a
meal, which is about the size of a deck of cards.
If you usually eat large portions of meats, cut
them back over a couple of daysby half or a
third at each meal.
Include two or more vegetarian-style, or meatless,
meals each week.

Following the DASH Eating Plan


Use this chart to help you plan your menusor take it with you when you go to the store.
Food Group

Grains*

Servings Per Day


1,600
Calories

2,000
Calories

2,600
Calories

68

1011

Serving Sizes

Examples and Notes

Significance of Each
Food Group to the
DASH Eating Plan

1 slice bread

Whole wheat bread and


rolls, whole wheat pasta,
English muffin, pita bread,
bagel, cereals, grits,
oatmeal, brown rice,
unsalted pretzels and
popcorn

Major sources of
energy and fiber

Broccoli, carrots, collards,


green beans, green
peas, kale, lima beans,
potatoes, spinach,
squash, sweet potatoes,
tomatoes

Rich sources
of potassium,
magnesium, and fiber

Apples, apricots,
bananas, dates, grapes,
oranges, grapefruit,
grapefruit juice, mangoes,
melons, peaches,
pineapples, raisins,
strawberries, tangerines

Important sources
of potassium,
magnesium, and fiber

Fat-free (skim) or low-fat


(1%) milk or buttermilk;
fat-free, low-fat, or
reduced-fat cheese; fatfree or low-fat regular or
frozen yogurt

Major sources of
calcium and protein

Select only lean meats;


trim away visible fat; broil,
roast, or poach; remove
skin from poultry

Rich sources
of protein and
magnesium

Almonds, hazelnuts,
mixed nuts, peanuts,
walnuts, sunflower seeds,
peanut butter, kidney
beans, lentils, split peas

Rich sources of
energy, magnesium,
protein, and fiber

Soft margarine, vegetable


oil (such as canola, corn,
olive, or safflower), low-fat
mayonnaise, light salad
dressing

The DASH study had


27 percent of calories
as fat, including fat in
or added to foods

Fruit-flavored gelatin, fruit


punch, hard candy, jelly,
maple syrup, sorbet and
ices, sugar

Sweets should be
low in fat

1 oz dry cereal
cup cooked rice,
pasta, or cereal
Vegetables

34

45

56

1 cup raw leafy vegetable


cup cut-up raw or
cooked vegetable
cup vegetable juice

Fruits

45

56

1 medium fruit
cup dried fruit
cup fresh, frozen, or
canned fruit
cup fruit juice

Fat-free or
low-fat milk
and milk
products

23

Lean meats,
poultry, and
fish

36

Nuts, seeds,
and legumes

3 per
week

23

1 cup milk or yogurt


1 oz cheese

6 or less

1 oz cooked meats,
poultry, or fish
1 egg

45 per
week

cup or 1 oz nuts
2 Tbsp peanut butter
2 Tbsp or oz seeds
cup cooked legumes
(dry beans and peas)

Fats and
oils

23

1 tsp soft margarine


1 tsp vegetable oil
1 Tbsp mayonnaise
2 Tbsp salad dressing

Sweets and
added sugars

5 or less
per week

<2

1 Tbsp sugar
1 Tbsp jelly or jam
cup sorbet, gelatin
1 cup lemonade

Whole grains are recommended for most grain servings as a good source of fiber and nutrients.
Serving sizes vary between cup and 1 cups, depending on cereal type. Check the products Nutrition Facts label.
Because eggs are high in cholesterol, limit egg yolk intake to no more than four per week; two egg whites have the same protein content as 1 oz of meat.
Fat content changes serving amount for fats and oils. For example, 1 Tbsp of regular salad dressing equals one serving; 1 Tbsp of a low-fat dressing
equals one-half serving; 1 Tbsp of a fat-free dressing equals zero servings.

Abbreviations: oz = ounce; Tbsp = tablespoon; tsp = teaspoon


3

Whats on Your Plate and How Much Are You Moving?


Use this form to track your food and physical activity habits before you start on the DASH eating plan or to see
how youre doing after a few weeks. To record more than 1 day, just copy the form. Total each days food
groups and compare what you ate with the DASH eating plan at your calorie level.

Nuts, seeds,
and legumes

Fats and oils

Sweets and
added sugars

2,300 or 68
1,500 mg per
day
per day

45
per
day

45
per
day

23
per
day

6 or
less
per
day

Fruits

Vegetables

Amount
(serving size)

Grains

Food

Sodium (mg)

Meats, fish,
and poultry

Number of Servings by DASH Food Group


Milk products

Date:

Example:
whole wheat bread, with soft
(tub) margarine

2 slices
2 tsp

299
52

Breakfast

Lunch

Dinner

Snacks

Days Totals

2,000 calorie-level example:


Compare yours with the DASH
eating plan at your calorie level.

Enter your calorie level and


servings per day:

Physical Activity Log


Aim for at least 2 hours and 30 minutes of
moderate-intensity physical activity per week.
When your heart is beating noticeably faster, the
activity is probably moderately intense.
Record your minutes per day for each activity:

30 min Moderate walking


5 min Cleaning

Time:

Type of activity:

45
per
week
-

23
per
day
-

5 or
less
per
week
-

Increase servings of vegetables, brown rice,


whole wheat pasta, and cooked dry beans. Try
casseroles and stir-fry dishes, which have less
meat and more vegetables, grains, and dry beans.
For snacks and desserts, use fruits or other
foods low in saturated fat, trans fat, cholesterol,
sodium, sugar, and caloriesfor example,
unsalted rice cakes; unsalted nuts or seeds;
raisins; graham crackers; fat-free, low-fat, or
frozen yogurt; popcorn with no salt or butter
added; or raw vegetables.
Use fresh, frozen, or low-sodium canned
vegetables and fruits.

DASH Hints

Be aware that the DASH eating plan has more


servings of fruits, vegetables, and whole grain foods
than you may be used to eating. These foods are high
in fiber and may cause some bloating and diarrhea.
To avoid these problems, gradually increase the
amount of fruit, vegetables, and whole grain foods
that you eat over several weeks.
If you have trouble digesting milk products, try taking
lactase-enzyme pills (available at drug stores and
groceries) with milk products. Or buy lactose-free milk,
which includes the lactase enzyme.
If you dont like or are allergic to nuts, use seeds or
legumes (cooked dried beans or peas).
If you take medicines to control your high blood
pressure, keep taking them. But tell your doctor that
you are now eating the DASH way.

Other Lifestyle Changes


Making other lifestyle changes while following the
DASH eating plan is the best way to prevent and
control high blood pressure.
Lose Weight, If Necessary, While Following DASH
DASH is rich in lower-calorie foods, such as fruits
and vegetables, so it easily can be changed to support
weight loss. You can reduce calories even more by
replacing higher calorie foods, such as sweets, with
more fruits and vegetables. The best way to take
off pounds is to do it slowly, over time, by getting
more physical activity and eating fewer calories.
To develop a weight-loss or weight-maintenance
program thats tailored for you, talk to your doctor
or a registered dietitian.

Be Physically Active While Following the DASH


Eating Plan
Combining DASH with a regular physical activity
program, such as walking or swimming, will help
you shed pounds and stay trim for the long term.
Start with a simple 15-minute walk during your
favorite time of day, and gradually increase the
amount of time you are active. You can do an
activity for 30 minutes at one time, or choose shorter
periods of at least 10 minutes each. The important
thing is to total at least 2 hours and 30 minutes per
week of activities at a moderate intensity level. For
more health benefits, gradually increase to 5 hours
per week.

Make the DASH for Life


DASH can help you prevent and control high blood
pressure. It also can help you lose weight, if you
need to. It meets your nutritional needs and has
other health benefits for your heart. So get started
today, and make the DASH for a healthy life.

To Learn More
Contact the National Heart, Lung, and Blood
Institute (NHLBI) for information on heart disease
and heart health.
NHLBI Health Information Center
P.O. Box 30105
Bethesda, MD 208240105
Phone: 3015928573
TTY: 2406293255
Fax: 3015928563
Also check out these heart health resources:
NHLBI Website: http://www.nhlbi.nih.gov
Aim for a Healthy Weight: http://www.nhlbi.nih.
gov/health/educational/lose_wt/index.htm
DASH Health Topic: https://www.nhlbi.nih.gov/
health/health-topics/topics/dash
Dietary Guidelines for Americans 2010:
http://www.health.gov/dietaryguidelines/
NHLBI Delicious Heart Healthy Recipes:
https://healthyeating.nhlbi.nih.gov/

A Day With the DASH Eating Plan


Substitution to Reduce
Sodium to 1,500 mg

2,300 mg Sodium (Na) Menu


Breakfast
cup instant oatmeal
1 mini whole wheat bagel:
1 Tbsp peanut butter
1 medium banana
1 cup low-fat milk

cup regular oatmeal with 1 tsp cinnamon

Lunch
Chicken breast sandwich:
2 slices (3 oz) chicken breast, skinless
2 slices whole wheat bread
1 slice ( oz) natural cheddar cheese, reduced-fat
1 large leaf romaine lettuce
2 slices tomato
1 Tbsp low-fat mayonnaise
1 cup cantaloupe chunks
1 cup apple juice

1 slice ( oz) natural Swiss cheese, low-sodium

Dinner
1 cup cooked spaghetti:
cup low-salt vegetarian spaghetti sauce
3 Tbsp Parmesan cheese
Spinach salad:
1 cup fresh spinach leaves
cup fresh carrots, grated
cup fresh mushrooms, sliced
1 Tbsp vinegar and oil dressing
cup corn, cooked from frozen
cup canned pears, juice pack
Snacks
-

cup almonds, unsalted


cup dried apricots
1 cup fruit yogurt, fat-free, no sugar added
Nutrients Per Day

2,300 mg

1,500 mg

Calories

2,027

2,078

Total fat

64 g

68 g

Calories from fat

28%

30%

Saturated fat

13 g

16 g

6%

7%

Calories from saturated fat


Cholesterol

114 mg

129 mg

Sodium

2,035 mg

1,560 mg

Calcium

1,370 mg

1,334 mg

535 mg

542 mg

4,715 mg

4,721 mg

34 g

34 g

Magnesium
Potassium
Fiber

Abbreviations: mg = milligram; Tbsp = tablespoon;


tsp = teaspoon; oz = ounce; g = gram
6

NIH Publication No. 06-5834


Originally printed December 2006
Revised August 2015

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