The DASH diet, or Dietary Approaches to Stop Hypertension, was originally developed to help lower blood pressure. However, over the years, research has shown that the DASH diet has numerous other health benefits as well. In this blog post, we’ll explore the DASH diet, including its pros and cons and whether or not it’s good for people with heart failure.
What is the DASH Diet?
Foods Included
The DASH diet is a dietary pattern that emphasizes whole, nutrient-dense foods, like fruits, vegetables, whole grains, lean proteins, and low-fat dairy products with the goal of lowering blood pressure.
Foods Not Included (or greatly limited!)
Foods that are high in saturated and trans fats, as well as sweets and sugary beverages are not part of the DASH diet.
So, the DASH diet gets rid of a lot of stuff that’s truly not good for you and not good for your heart.
Think cured meats, ham, pepperoni, bacon, hots dogs, sausage–all super high in salt and saturated fat!!! And think about chips, cookies, junk food, candy–high in sugar and fat with very little nutrition. These foods are not part of the DASH diet.
Lori’s Side Note: This is hard, and I get it. While none of us is perfect all the time, it’s important to understand which foods truly do not help us. They may do more harm than good for someone with heart failure if eaten on a regular basis. So, if you have something like that once in a blue moon, it’s probably okay, but once a week is too much.
Nutrients!
Additionally, the DASH diet is rich in nutrients that have been shown to lower blood pressure like potassium, magnesium, and calcium. Think fruits, veggies, nuts, and beans! Check out my article on beans here Beans for Heart Health: The Nutritional Benefits and Latest Research
Where Did it Come From?
The DASH diet was initially developed by the National Institutes of Health (NIH) to help lower blood pressure in individuals with hypertension.
Here’s How the DASH Diet Works:
- Vegetables: 4 to 5 servings per day
- Fruits: 4 to 5 servings per day
- Grains: 6 to 8 servings per day
- Lean proteins: 6 or fewer servings per day
- Low-fat dairy: 2 to 3 servings per day
- Fats and oils: 2 to 3 servings per day
- Sweets and sugary beverages: 5 or fewer servings per week
Overall, the DASH diet is a healthy and effective way to improve your diet and overall health. By focusing on whole, nutrient-dense foods and limiting processed and unhealthy foods, the DASH diet can help lower blood pressure, reduce the risk of cardiovascular disease, and promote weight loss.
Pros of the DASH Diet
1. Lower Blood Pressure
The primary benefit of the DASH diet is its ability to lower blood pressure. High blood pressure is a risk factor for heart failure. And if you have heart failure, high blood pressure can make it worse, damage your heart and kidneys, and speed up the progression of your disease.
A study published in the New England Journal of Medicine found that the DASH diet was effective in reducing blood pressure in individuals with hypertension.
2. Reduced Risk of Cardiovascular Disease
In addition to lowering blood pressure, the DASH diet has also been shown to reduce the risk of cardiovascular disease. This is because it’s low in unhealthy fats, high in fiber, and all of the foods that are good for your heart!
A study published in the American Journal of Clinical Nutrition found that the DASH diet was associated with a reduced risk of cardiovascular disease in women.
3. Weight Loss
The DASH diet can help you lose weight. Because the diet emphasizes whole, nutrient-dense foods and limits processed and unhealthy foods, it can help you feel full and satisfied while consuming fewer calories.
A study published in the Journal of the Academy of Nutrition and Dietetics found that the DASH diet was effective in promoting weight loss.
Cons of the DASH Diet
1. Restrictive
One of the drawbacks of the DASH diet is that it can feel restrictive, especially for individuals who are used to eating a diet that’s high in processed and unhealthy foods.
- Take things one step at a time.
- Make changes slowly and give yourself time to get used to a new way of eating.
- Changing what you eat is really really hard! I know it is.
- Don’t be too hard on yourself but don’t give up either!
2. Requires Planning
The diet requires a significant amount of meal planning and preparation, which can be challenging for busy individuals. But, your health is worth it. And there are ways to make meals quicker and easier.
You don’t have to spend all day in the kitchen and you don’t have to be a gourmet chef. I mean, what’s easier than steaming some veggies and baking a potato? Fruit comes in its own package. No prep needed.
Also, remember that you can use frozen foods and unsalted canned foods. While it’s great to have fresh foods when you can, there is absolutely nothing wrong with using frozen or canned options.
3. Expensive
Hmmm…the DASH diet can be expensive if you are not careful but it doesn’t have to be. It takes a little while to learn the ins and outs of this way of eating, but there are ways to make the DASH diet more affordable.
- Buy things in bulk
- Keep it simple
- Use dry beans, brown rice, squash, greens, and potatoes as staples of your diet. They are healthy, filling, and affordable.
- Buy things in season.
- Don’t buy raspberries in December or oranges in August. Keep an eye on the fruits and vegetables that are native to your area. Here is a link to a seasonal produce guide: https://fruitsandveggies.org Keep in mind that this varies depending on where you live. You can always do a search of the seasonal fruits and vegetables in your region or visit a farmer’s market if you have one available.
Fall and Winter are root vegetable season. However most root vegetables like beets and potatoes are widely available and affordable most of the year due to their ability to be stored for long periods of time.
Peppers are in season from summer to mid autumn in the southeast.
Strawberries are in season from April until June in the southeast.
Is the DASH Diet Good for Heart Failure?
The quick answer is “yes!” (although I have plenty of suggestions to make it simpler and better which I will discuss in the next section.)
DASH emphasizes whole, nutrient-dense foods, like fruits, vegetables, whole grains, lean proteins, and low-fat dairy products, which can help improve overall health and reduce the risk of cardiovascular disease.
The DASH diet is naturally low in sodium because you are getting rid of a lot of processed junk foods, cured meats, and cheese. We all know that a low sodium diet is super important if you have heart failure, as high sodium can increase blood pressure, cause fluid retention, stress the heart and stress the kidneys. (See my articles Salt Shockers: Discovering the Hidden Sources of Sodium in Your Diet and The Best Diet for Heart Failure Patients )
And here we have some actual research to back this up. A study published in the Journal of the American College of Cardiology found that following the DASH diet was associated with a lower risk of heart failure hospitalization and death in individuals with heart failure.
Here’s a link to the abstract and full study! https://www.sciencedirect.com/science/article/pii/S0735109718347603
The CHF Dietitian’s Take on The DASH Diet
Some people have criticized the DASH diet, saying it can be difficult to sustain over the long term. That’s because it requires significant changes to your eating habits. But any big lifestyle change, especially with eating habits, is not easy!
IT TAKES WORK
IT TAKES CONSISTENCY
IT TAKES MOTIVATION
Some of us thrive with a lot of structure and some of us need a different approach. I can assure you that DASH is a great option but not the only option for eating healthy.
Warning: if you put too much stress on yourself to count up servings, and measure everything, it can really get old quickly. I can tell you that this approach is hard for me. I don’t like to measure things, so I only measured to learn approximate serving sizes, then I never did it again.
But, I have clients that really need and like the exactness of the DASH diet. The structure keeps them on track and actually makes things easier–less stressful. If this is you, give the DASH diet a try.
And, if you are the type that does not want to count and measure, break things down into steps.
- One by one, replace some high fat meats and cheese with vegetables, plant based protein, or healthier lean meats/fish like grilled chicken breast or fish (if you eat animal foods).
- Increase greens, being sure to have greens every day.
- Have a small handful of nuts each day.
- Change grains to whole grains.
- Increase the variety of fruits and vegetables, with an eventual goal of 25-30 different plant foods per week.
Make these changes over several weeks, giving yourself time to adjust. And give yourself a break if it doesn’t always go perfectly! Don’t get discouraged. You will likely see an improvement in your blood pressure. Some people actually decrease their medications.
And one of the best motivators of all is that you will start to feel better. I see it over and over again. You feel better when you eat healthy foods!
Side Note…
My family follows a plant based diet, and has for eight years. So if you want my honest recommendation, I would say to consider giving a “100% Plant Based” or version of the DASH diet a try.
The DASH diet can be “ plant based” by making some simple modifications. Here are some tips:
Emphasize plant-based proteins: Instead of meat, include plant-based sources of protein such as beans, lentils, tofu, and tempeh. These foods are rich in protein, fiber, and other important nutrients.
That’s it. It’s really that simple!
Swap out the meat proteins for plant protein foods and ditch the cheese and dairy in favor of plant based versions.
One word of caution…
Read those labels
Processed plant foods like “plant based sausage” may have less saturated fats than the regular version but these foods can have tons of sodium. And just because a food is labeled as plant based does not mean it is heart healthy.
The same rules apply. You want low sodium and low saturated fat plant based options.
If you incorporate more beans, tofu, edamame, tempeh, and lentils into your diet, you will have no trouble getting adequate protein. Please don’t waste time adding up grams of protein. Focus on a high quality diet and you will be fine.
Sample DASH Menus
Here are two menus to give you an idea of what a day of eating the DASH Diet looks like. I don’t want you to weigh and measure food, so I didn’t put portion sizes next to everything. Just keep your portions reasonable and eat enough to be comfortably full.
And the photo below is an example of a portion of quinoa topped with berries and nuts with a dollop of plant based yogurt on top. Many of my clients eat oatmeal, quinoa, or brown rice for breakfast most days of the week.
Plant Based (The CHF Dietitian’s Pick)
Breakfast:
- 1 cup cooked oatmeal
- 1 medium banana
- 1 cup low-fat almond or soy milk
- 1 tsp cinnamon
- Top with dried apricots, raisins, or cranberries and 8-10 walnuts
Snack:
- Carrot sticks with hummus
Lunch:
- Veggie wrap with whole wheat tortilla, mixed greens, avocado, cucumber, shredded carrots, black beans, and hummus
- 1 small apple
Snack:
- Handful of mixed nuts
- 1 medium orange
Dinner:
- Tofu stir-fry with mixed vegetables (such as broccoli, bell peppers, and onions) and brown rice
- Large salad with mixed greens, cherry tomatoes, and balsamic vinaigrette dressing
Dessert:
- 1 small square of dark chocolate or a plant based yogurt
Plant Forward/Flexitarian (You can Mix and Match these with the menu above!)
Breakfast:
- Egg white Omelet with peppers, onions, spinach, and tomato
- Grits or Toast with 1 tsp plant based butter
- 1 Orange
Morning Snack:
- 1 medium apple
- 1 tablespoon almond butter or peanut butter (unsalted)
Lunch:
- 2 slices whole grain bread
- 3 ounces grilled salmon
- 1 large mixed greens salad with cucumber, tomato, carrots, and bell pepper
- 2 tablespoons olive oil and vinegar dressing
Afternoon Snack:
- 1 cup low fat yogurt–almond milk, soy milk or cow’s milk based
- 1 cup blueberries, raspberries and/or strawberries
Dinner:
- 1 large sweet potato, baked
- 1 cup chick peas (try roasting them with your veggies)
- 2 cups roasted vegetables (such as zucchini, bell pepper, and onion)
- 1 tablespoon olive oil and lemon juice dressing
Evening Snack:
- 1 ounce mixed unsalted nuts
- 1 small square dark chocolate
I hope you enjoyed this article. Be sure to check out the NIH guide to the DASH Diet for more recipes. https://www.nhlbi.nih.gov/education/dash-eating-plan And check out my other articles on the blog as well as my mailing list. If you sign up for my mailing list, you’ll automatically get free tips for Low Sodium restaurant eating delivered to your inbox. No spam and no hassle, just good info!
References:
Appel, L. J., Moore, T. J., Obarzanek, E., Vollmer, W. M., Svetkey, L. P., Sacks, F. M., … & Karanja, N. M. (1997). A clinical trial of the effects of dietary patterns on blood pressure. New England Journal of Medicine, 336(16), 1117-1124.
DASH Eating Plan. NHLBI, NIH https://www.nhlbi.nih.gov/education/dash-eating-plan Accessed on April 10, 2023.
Djoussé, L., Petrone, A. B., Blackshear, C. T., Griswold, M., Harman, J. L., Clark, C. R., Talegawkar, S. A., Hickson, D. A., Gaziano, J. M., Dubowitz, T., & Tucker, K. L. (2018). Adherence to a DASH-style diet and risk of incident heart failure: the Multi-Ethnic Study of Atherosclerosis. Journal of the American College of Cardiology, 71(21), 2277-2284.
