The DASH Eating Plan as Part of a Heart-Healthy Lifestyle

Have you been looking for a heart-healthy way to eat that is balanced, flexible, and requires no special foods? The DASH eating plan might be for you! DASH stands for Dietary Approaches to Stop Hypertension. By following the DASH eating plan, individuals may be able to reduce blood pressure and cardiovascular disease risk factors and find a heart-healthy eating style for life.

This plan is simple and recommends:

• Eating vegetables, fruits, and whole grains
• Choosing fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
• Cutting back on foods that are high in saturated fats, such as red meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils
• Choosing foods that are lower in sodium
• Limiting sweets and sugar-sweetened beverages

The DASH diet was originally implemented as a dietary plan to lower blood pressure. At that time, research was conducted to test the benefits of the DASH diet. The results of these studies proved that the DASH diet lowered blood pressure and LDL (low-density lipoprotein), also known as "bad" cholesterol in the blood. These are two major risk factors for cardiovascular disease. Now we know that the DASH eating plan has many advantages for health, including that it may reduce the risk of stroke, heart disease, some cancers, and kidney stone formation. Focusing on whole foods, this heart-healthy plan is high in fiber and low in saturated fats and added sugars. It can be a way of eating for the whole family. This heart-healthy eating plan also provides nutrients that are in short supply in many Americans' diets.

When following the DASH eating plan, it is important to choose foods that are:

• Low in saturated fats
• Rich in potassium, calcium, magnesium, fiber, and protein
• Lower in sodium

Let's review each food group to learn the recommended daily servings needed to follow the DASH eating plan.

In the grains group, it is recommended to consume 6 to 8 servings per day. Some examples of a serving size from this group include 1 slice of bread, 1 ounce dry cereal, or ½ cup cooked cereal, rice, or pasta. These should be mostly whole grains. Grains are divided into two subgroups, whole grains and refined grains. Whole grains contain the entire grain kernel—the bran, germ, and endosperm. Examples of whole grains include whole-wheat flour, oatmeal, brown rice, whole-wheat pasta, and quinoa. Whole grains are good sources of fiber and important nutrients. Refined grains have been milled, a process that removes the bran and germ. This removes dietary fiber, iron, and many B vitamins. Some examples of refined grain products are white flour, de-germed cornmeal, white bread, and white rice.

The DASH eating plan recommends 4 to 5 servings per day of both vegetables and fruits. A serving is 1 cup of raw leafy vegetable, ½ cup cut raw or cooked vegetable, 1 medium fruit, ¼ cup dried fruit, or ½ cup fresh, frozen, or canned fruit. These are great sources of potassium, which has been proved to help lower blood pressure. Choose fresh, frozen, canned, and dried sources. If you choose canned, buy lower sodium vegetables and fruits canned in their own juice.

Choose 2 to 3 servings per day of fat-free or low-fat dairy products. One cup of milk or yogurt or 1½ ounces of cheese is considered a serving size. Dairy products contain calcium, which is important for bone health and instrumental in blood pressure regulation. Choosing fat-free or low-fat dairy will lower your intake of saturated fats, which are limited for heart health. Milk, buttermilk, cheeses, and yogurt are all available in lower fat versions.

It is recommended to get 6 ounces or less of meats, poultry, and fish each day. When eating meat, choose lean selections such as fish, skinless chicken and turkey, pork tenderloin, extra-lean ground beef, and round or sirloin beef cuts. Meats do not naturally contain sodium, but it is commonly added in the prepared and ready-to-eat processed versions of these foods. For example, a plain fish filet is lower in sodium than fish sticks, and a chicken breast is lower than a chicken patty. Further, limit smoked or processed meats, such as deli meats. Also, if you buy canned tuna and chicken, choose the lower sodium options.

Eat no more than 2 to 3 daily servings of fats and oils. Select soft margarines, vegetable oils like olive and canola, and low-fat mayonnaise and salad dressings. A good rule to follow is to choose liquid oils over solid fats. Examples of 1 serving include 1 teaspoon
soft margarine, 1 teaspoon vegetable oil, 1 tablespoon low-fat mayonnaise, or 2 tablespoons light salad dressing.

Additional recommendations include eating no more than 2,300 milligrams (mg) of sodium per day.

Read the nutrition label to determine how much sodium is in a food. To lower your blood pressure even more, limit daily sodium consumption to 1,500 mg.

Throughout the course of the week, the DASH eating plan also recommends consuming a total of 4 to 5 servings of nuts, seeds, and legumes. Almonds, walnuts, kidney beans, lentils, chickpeas (garbanzos), and sunflower seeds are great options, though try using the unsalted or low-salt varieties. Nuts provide monounsaturated fats, the type that helps lower your bad cholesterol (LDL) and increase your good cholesterol (HDL).

Also consume 5 or less servings of sweets and sweetened beverages each week. Satisfy your sweet cravings with fresh or dried fruits, ices, or sorbet. Layer low-fat yogurt with granola and fruit for a sweet treat. Try pudding made with fat-free milk or enjoy graham crackers with peanut butter. Substitute soda with an unsweetened beverage that you enjoy such as tea, coffee, low-fat milk, or water. This includes water flavored with lemon or other fruits.

Overall, the guidelines in the DASH eating plan include choosing foods low in saturated fats, lower in sodium, and rich in potassium, calcium, magnesium, fiber, and protein. Remember that these recommendations are based on a 2,000-calorie diet. The number of servings you should consume will depend on your daily calorie needs. Your age and physical activity level will determine how many calories you need each day.

Daily and Weekly DASH Eating Plan Goals for a 2,000-Calorie-a-Day Diet

*1,500 milligrams (mg) sodium lowers blood pressure even more than 2,300 mg sodium daily.

Here are a few additional tips to help you follow the DASH lifestyle:

• Cook with fresh foods or choose frozen or canned foods that contain no added sodium. Many canned foods and flavored frozen foods, when seasoned, have a significant amount of sodium added to them.
• Include a vegetable at both lunch and dinner. Even try to add one at breakfast with a smoothie that contains spinach or a vegetable omelet.
• Include a fruit at each meal and snack and consider this your dessert at these meals.
• Limit your meat intake to 6 ounces or less each day and plan meatless meals at least one or two times a week.
• Use fat-free or low-fat dairy products in your coffee.
• Eat more legumes (beans, peas, and lentils) as a protein source.
• To limit your fat intake, cut your serving sizes of butter, margarine, and salad dressings in half. Use vegetable oil in place of a solid fat in your skillet.
• Snack choices can include fat-free or low-fat yogurt, fresh fruit, raw vegetables, hummus or bean spreads, unsalted plain popcorn, homemade whole-grain cereal mixes with nuts, seeds, and dried fruits, whole-grain crackers with part-skim mozzarella string cheese, and low-fat whole-grain pretzels.
• Read food labels and choose items that are made from whole food ingredients. These will be lower in sodium, sugar, and fat.

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Black Bean and Corn Salad with Chipotle-Honey Vinaigrette

Makes 6 servings (1 cup per serving)

Ingredients

• 2 ears of corn, 2 cups of frozen corn, or 1 can (15.5 oz) corn, rinsed and drained
• 1 can (14.5 oz) black beans, rinsed and drained
• 1 medium red onion, chopped (about 1 cup)
• 1 red bell pepper, diced (about 1 cup)
• ½ cup loosely packed fresh chopped cilantro (plus a bit more for garnish)
• 1 avocado (use only when serving)
• 2 Tbsp red wine vinegar
• 2 Tbsp lime juice (from 1 or 2 limes)
• 2 Tbsp honey
• 3 Tbsp olive oil
• 1 large garlic clove, roughly chopped
• ¼ tsp dried oregano
• ¾ tsp cumin
• ¼ tsp black pepper
• Dash of salt, if desired
• 2 small peppers from canned chipotle peppers in adobo sauce

Preparation

1. In a large bowl, mix the corn, beans, red onion, red bell pepper, and cilantro.
2. Make the dressing by combining all remaining ingredients in a blender or mini food processor; process until smooth. Whisk the ingredients together, making sure the chipotle peppers are well blended.
3. Pour the dressing over the salad and toss well. Cover and refrigerate for at least 1 hour or, preferably, overnight.
4. Right before serving, slice the avocado in half. Remove the pit; using a butter knife, cut a grid in each half. Holding the avocado halves over the salad, use a spoon to scoop out the diced flesh.
5. Toss the salad gently, then taste and adjust seasoning if necessary (add more lime juice to freshen it up). Garnish with a bit of fresh chopped cilantro, if desired. Serve cold.

Nutrition Facts

Serving size: approximately 1 cup

• Calories: 250
• Fat: 12g
• Saturated fat: 1.5g
• Carbohydrates: 32g
• Sugar: 9g
• Fiber: 7g
• Protein: 6g
• Sodium: 230mg
• Cholesterol: 0mg

Recipe source: Once Upon a Chef: Black Bean and Corn Salad with Chipotle-Honey Vinaigrette

The DASH eating plan is just one part of living a heart-healthy lifestyle. Combine it with other lifestyle changes such as getting regular physical activity, managing and coping with stress, getting enough sleep, limiting alcohol intake, maintaining a healthy weight, and quitting if you smoke.

Resources

"Cut Down on Sodium," Office of Disease Prevention and Health Promotion.

"DASH Diet: Reducing Hypertension through Diet and Lifestyle," reviewed by Taylor Wolfram, MS, RDN, LDN, eatright.org. Academy of Nutrition and Dietetics.

"DASH Eating Plan," National Institutes of Health, National Heart, Lung, and Blood Institute

Mayo Clinic—Healthy Lifestyle—Nutrition and Healthy Eating: "These Tips Make It Easy to Shop and Prepare DASH-Friendly Dishes."

WebMD—"DASH Diet and High blood Pressure."
"Your Guide to Lowering Your Blood Pressure with DASH," NIH Publication No. 06-5834.

Prepared by Nancy Routch, extension educator.