DASH stands for Dietary Approaches to Stop Hypertension. The name is literal. It loads your plate with fruit, vegetables, whole grains and low-fat dairy while easing off sweets and red meat. In controlled trials the pattern dropped systolic pressure by about 11 points in people with hypertension.
The original randomised trial in 459 adults found the fruit-and-vegetable-rich, low-fat dairy combination lowered systolic pressure by 5.5 mmHg overall and by 11.4 mmHg in those with hypertension, rivalling a starting blood-pressure tablet (Appel et al., NEJM 1997). A larger follow-up trial in 412 adults showed the DASH pattern and sodium reduction each lower pressure independently and combine additively (Sacks et al., NEJM 2001). Outside trials, 24 years of follow-up in more than 88,000 nurses found those eating closest to a DASH-style pattern had about a quarter lower risk of coronary heart disease than those eating furthest from it (Fung et al., 2008). It grades moderate rather than strong for one honest reason: the outcome data in healthy free-living people is observational, and no large trial has tested DASH itself against heart attacks and strokes as endpoints. The blood-pressure trials are excellent, so if your pressure is high this is among the best-eaten prescriptions available.
Doing it: Work toward 4 to 5 servings each of fruit and vegetables a day, 2 to 3 of low-fat dairy, whole grains over refined ones, and sweets only occasionally. Pair it with the sodium target above for the biggest fall in pressure, and keep taking prescribed blood-pressure tablets unless your doctor says otherwise.
Who it suits: Anyone with raised or high-normal blood pressure, and anyone whose doctor has mentioned prehypertension; useful alongside medication, not instead of it
Sources
- Appel LJ, et al. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 1997.
- Sacks FM, et al. Effects on blood pressure of reduced dietary sodium and the DASH diet. N Engl J Med 2001.
- Fung TT, et al. Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med 2008.
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