Diet

Scorecard Overall Weight Loss Short-term Weight Loss Long-term Easy to Follow Nutrition Safety For Diabetes For Heart Health Scores are based on experts' reviews Pros & Cons Heart healthy Nutritionally sound Lots of grunt work Somewhat pricey Do's & Don'ts Do: Serve up lean poultry and fish in moderation See more Do's & Don'ts Overview Type: Balanced. Resembles these U.S. News-rated diets: TLC Diet, Mediterranean Diet, Mayo Clinic Diet, Vegetarian Diet The aim: Preventing and lowering high blood pressure (hypertension). The claim: A healthy eating pattern is key to deflating high blood pressure – and it may not hurt your waistline, either. The theory: Nutrients like potassium, calcium, protein and fiber are crucial to fending off or fighting high blood pressure. You don’t have to track each one, though. Just emphasize the foods you’ve always been told to eat (fruits, veggies, whole grains, lean protein and low-fat dairy), while shunning those we’ve grown to love (calorie- and fat-laden sweets and red meat). Top it all off by cutting back on salt, and voilà! How does the DASH Diet work? First, decide how much you want to read. The National Heart, Lung, and Blood Institute (NHLBI), which helped develop DASH, publishes free guides on the plan. One (PDF here) is 64 pages while another (PDF here) is six. Both take you through the same process of determining how many calories you should eat for your age and activity level, tell you where those calories should come from, and remind you to go easy on salt. It’s as simple as that. For a 2,000-calorie diet, you should shoot each day (unless otherwise noted) for 6-8 servings of grains; 4-5 each of veggies and fruit; 2-3 of fat-free or low-fat dairy; 6 or fewer of lean meat, poultry and fish, with one serving being equivalent to an ounce; 4-5 (a week) of nuts, seeds and legumes; 2-3 of fats and oils; and 5 or fewer (a week) of sweets. DASH suggests capping sodium at 2,300 milligrams a day and eventually working to stay under 1,500 mg. It’s OK to ease into DASH. Try adding just one vegetable serving to a meal, and a fruit serving to another. Go (sort of) vegetarian by preparing two or more meat-free dishes each week. And start using the herbs and spices hiding in the back of the pantry – they’ll make you forget the salt’s not on the table. Meanwhile, you’ll be encouraged to stick to a regular physical-activity program. As for weight loss, you’re advised to ask your doctor about how to best tailor your plan. Because DASH emphasizes so many healthful foods, it can easily support weight loss. Just move more and eat slightly less, says the NHLBI. Will you lose weight? Likely, provided you follow the rules, and especially if you design your plan with a “calorie deficit.” Though not originally developed as a weight-loss diet, some studies have looked at DASH’s potential to help dieters shed pounds. Here’s a closer look at the data: In one study, published in 2010 in the Archives of Internal Medicine, 144 overweight or obese adults with high blood pressure were assigned to one of three approaches: DASH, DASH plus exercise and classes on weight loss, and a control diet where participants maintained their usual eating habits. After four months, those in the beefed up DASH group lost on average 19 pounds – while the other groups either lost a little or gained weight. In another study, published in the Annals of Internal Medicine in 2006, researchers randomly assigned 810 adults with borderline or mild high blood pressure to three groups. The first received general advice on lifestyle changes to control blood pressure. The second had goals of staying under 2,300 mg. of sodium a day, losing weight, exercising and limiting alcohol. The third mirrored the second but participants were also told to follow DASH’s dietary guidelines. After 18 months, the second group lost an average of about 8 pounds while the DASH group lost about 9½ – both significantly more than the first group’s 3 pounds. Does it have cardiovascular benefits? Yes. Rigorous studies show DASH can lower blood pressure, which if too high can trigger heart disease, heart failure and stroke. (In fact, the name DASH stands for Dietary Approaches to Stop Hypertension – hypertension being the medical term for high blood pressure.) It’s also been shown to increase “good” HDL cholesterol and decrease “bad” LDL cholesterol and triglycerides, a fatty substance that in excess has been linked to heart disease. Overall, DASH reflects the medical community’s widely accepted definition of a heart-healthy diet – it's heavy on fruits and vegetables and light on saturated fat, sugar and salt. [See: U.S. News Quiz: Do You Know How to Stave Off a Heart Attack?] Can it prevent or control diabetes? A few studies show favorable results, and the approach is generally viewed as an ideal eating pattern for both. Moreover, DASH echoes dietary advice touted by the American Diabetes Association. Prevention: Being overweight is one of the biggest risk factors for Type 2 diabetes. Although DASH isn’t specifically designed for weight loss, it will likely help you lose weight and keep it off – almost certainly tilting the diabetes odds in your favor. Combining DASH with calorie restriction has also been found to reduce risk factors associated with metabolic syndrome, which increases the chances of developing diabetes and heart problems. Control: A small study published in 2011 in Diabetes Care found Type 2 diabetics on DASH reduced their levels of A1C – a measure of blood sugar over time – and their fasting blood sugar after eight weeks. Because there are no rigid meal plans or prepackaged foods, you can ensure that what you’re eating doesn’t go against your doctor’s advice. [Read: How to Eat After a Type 2 Diabetes Diagnosis.] Are there health risks? No. However, if you have a health condition, check with your doctor to be sure DASH is right for you. How well does it conform to accepted dietary guidelines? Fat. You’ll stay within the government’s recommendation that 20 to 35 percent of daily calories come from total fat. As for saturated fat, you’ll stay well below the government’s 10 percent max. Protein. DASH is within the acceptable range for protein consumption. Carbohydrates. DASH provides the recommended amount of carbohydrates. Salt. The majority of Americans eat too much salt. The recommended daily maximum is 2,300 mg., but if you’re 51 or older, African-American or have hypertension, diabetes or chronic kidney disease, that limit is 1,500 mg. DASH has specific meal plans for both sodium caps. Other key nutrients. The 2010 Dietary Guidelines call these “nutrients of concern” because many Americans get too little of one or more of them: Fiber. Getting the recommended daily amount – 22 to 34 grams for adults – helps you feel full and promotes good digestion. DASH provides more than enough. Potassium. A sufficient amount of this important nutrient, according to the 2010 Dietary Guidelines, counters salt’s ability to raise blood pressure, decreases bone loss and reduces the risk of developing kidney stones. It’s not that easy to get the recommended daily 4,700 mg. from food. (Bananas are high in potassium, yet you’d have to eat 11 a day.) Most Americans take in far too little. At about 4,900 mg., DASH more than meets the government’s recommendation – one of few diets that manages to do so. Calcium. This mineral is essential not only to build and maintain bones but to make blood vessels and muscles function properly. Many Americans don’t get enough. Women and anyone older than 50 should try especially hard to meet the government’s recommendation of 1,000 mg. to 1,300 mg. You shouldn’t have trouble on DASH. Vitamin B-12. Adults should shoot for 2.4 micrograms of this nutrient, which is critical for proper cell metabolism. DASH provides more than enough. Vitamin D. Adults who don’t get enough sunlight need to meet the government’s 15 microgram recommendation with food or a supplement to lower the risk of bone fractures. DASH comes up a little short, but choosing a vitamin-D fortified cereal can help. Also, just 3 ounces of sockeye salmon, which packs almost 20 micrograms of vitamin D, will satisfy the requirement. Supplement recommended? No. How easy is it to follow? While it may be difficult to give up your favorite fatty, sugary and salty fare, DASH doesn’t restrict entire food groups, upping your chances of sticking with it long-term. Convenience: Although recipe options are boundless, alcohol is not. The DASH PDF is packed with tips to make it all easier. Recipes. The NHLBI offers numerous recipes in its 64-page PDF. Otherwise, lots of reputable organizations, like the Mayo Clinic, provide long lists of DASH-friendly recipes. Eating out. Difficult, since restaurant meals are notoriously salty, oversized and fatty. If you do dine out, NHLBI suggests avoiding salt by shunning pickled, cured or smoked items; limiting condiments; choosing fruits or vegetables instead of soup; and requesting the chef find other ways to season your meal. Alcohol. Too much can elevate blood pressure and damage the liver, brain and heart. If you drink, do so in moderation – that’s one drink a day for women, two a day for men. (A drink is considered 12 ounces of beer, 5 ounces of wine or 1½ ounces of liquor.) Time-savers. None, unless you hire somebody to plan your meals, shop for them and prepare them. And you can’t pay someone to exercise for you. Extras. NHLBI’s PDF serves up a week of DASH meal plans, offers tips on reading nutrition labels, lists the sodium and potassium content of various foods, and provides exercise ideas. Fullness: Nutrition experts stress the importance of satiety, the satisfied feeling that you’ve had enough. DASH emphasizes lean protein and fiber-filled fruits and veggies, which should keep you feeling full – even if you’ve reduced your calorie level slightly to support weight loss. Taste: Although you may miss salty popcorn and potato chips, your taste buds should eventually adjust. Avoid blandness by getting friendly with herbs and spices. How much does it cost? Fresh fruits, veggies and whole-grain products are generally pricier than the processed, fatty, sugary foods most Americans consume. Does the diet allow for restrictions and preferences? Anyone can follow DASH – choose your preference for more information. Vegetarian and vegan DASH is well-suited for vegetarians and vegans. The PDFs don’t offer specific guidance or meal plans, though, so it’ll be up to you to make sure you’re getting the nutrients you need without meat and/or dairy. Gluten-free Just choose gluten-free foods that are in line with DASH’s guidelines. Low-salt Yes. DASH provides a lot of guidance for those who need to stay under 1,500 mg. of daily sodium. Kosher Yes, you have the freedom to use only kosher ingredients. Halal Yes, but it’s up to you to ensure your food conforms. What is the role of exercise? Recommended, especially if you want to lose weight. [Read: The Case for Exercising Alone.] Read More To get started, try a 15-minute walk around the block each morning and night, and then slowly ratchet up intensity and duration if you can. Just find activities you like (jazzercise, swimming, gardening), set goals and stick to them. What You'll Eat No food group is off-limits—you’ll get your share of lean meat, poultry, and fish; whole grains; fruits and vegetables; dairy; legumes, nuts, and seeds; a little fat; and a few sweets. Foods rich in potassium, calcium, protein, and fiber, which are crucial to fending off or fighting high blood pressure, are emphasized. Foods packed with salt, which is known to hike blood pressure, and saturated fats, which raise the risk for heart disease, are all but squeezed out. You’ve got lots of room to personalize your plan. You can eat when you want and pluck recipes from any cuisine to suit your taste buds. Recipe Resources There’s no shortage of free, official DASH recipes available to help you create your menus, but you can also comb a plethora of online recipe collections and low-sodium cookbooks. Sample Menu Here’s a day of typical meals on a 2,000-calorie DASH diet at a 2,300 mg. sodium level. Substitutions for a 1,500 mg. sodium level are in parentheses. Breakfast ¾ cup bran flakes cereal (¾ cup shredded wheat cereal) with 1 medium banana and 1 cup low-fat milk 1 slice whole-wheat bread with 1 tsp. (unsalted) margarine 1 cup orange juice Lunch Sandwich— 2 slices whole-wheat bread ¾ cup (unsalted) chicken salad 1 tbsp. Dijon (regular) mustard Salad— ½ cup fresh cucumber slices ½ cup tomato wedges 1 tbsp. sunflower seeds 1 tsp. low-calorie Italian dressing ½ cup fruit cocktail Dinner 3 oz. beef, eye of the round, with 2 tbsp. fat-free beef gravy 1 cup green beans, sautéed with ½ tsp. canola oil 1 small baked potato topped with 1 tbsp. fat-free sour cream, 1 tbsp. grated, reduced-fat natural (low-sodium) cheddar cheese and 1 tbsp. chopped scallions 1 small whole-wheat roll with 1 tsp. (unsalted) soft margarine 1 small apple 1 cup low-fat milk Snacks 1/3 cup almonds, unsalted ¼ cup raisins ½ cup fat-free, no-sugar-added fruit yogurt Nutrition Here’s a breakdown of the nutritional content of a day’s meals on two sodium levels of DASH, alongside recommendations from the government’s 2010 Dietary Guidelines for Americans. Because this diet is highly individualized, your actual intake will vary. Diet figures were supplied by NHLBI. 1,500 mg. DASH Diet 2,300 mg. DASH Diet Recommended Calories 2,037 2,062 Women Men 21-25: 2,000 26-50: 1,800 51+: 1,600 21-40: 2,400 41-60: 2,200 61+: 2,000 Total Fat 26% 27% 20%-35% Saturated 5% 6% Less than 10% Trans 0% 0% N/A Total Carbohydrates 56% 55% 45%-65% Sugars (total except as noted) N/A N/A N/A Fiber 36 g. 37 g. Women Men 19-30: 28 g. 31-50: 25 g. 51+: 22 g. 19-30: 34 g. 31-50: 31 g. 51+: 28 g. Protein 18% 18% 10%-35% Sodium 1,507 mg. 2,101 mg. Under 2,300 mg., under 1,500 mg. for 51+ Potassium 4,855 mg. 4,909 mg. At least 4,700 mg. Calcium 1,218 mg. 1,220 mg. 19-50: 1,000 mg. 51+: 1,200 mg. Vitamin B-12 4.4 mcg. 6.7 mcg. 2.4 mcg. Vitamin D 11 mcg. 11 mcg. 15 mcg. Recommendations apply to adults 19 and older except as noted. Recommended calories assume a sedentary lifestyle. g.: grams. mg.: milligrams. mcg.: micrograms.