DASH Diet: Guidelines, Foods, Benefits, Risks

If you’ve been diagnosed with hypertension (the medical term for high blood pressure), your healthcare provider may recommend following the DASH diet. DASH stands for dietary approaches to stop hypertension. The DASH diet is an eating pattern that emphasizes heart healthy foods that are known to help reduce blood pressure levels.

Your body has many mechanisms in place for regulating blood pressure levels, but factors like genetics, age, diet, and lifestyle choices can also influence your blood pressure. 

High blood pressure is associated with a greater risk of adverse cardiovascular events, including heart attacks and strokes. 

The DASH diet emphasizes foods rich in minerals known to lower blood pressure levels, such as potassium and magnesium. It also minimizes foods that contain excess sodium, added sugars, and saturated fat, all of which can contribute to high blood pressure. 

Eating salty foods can increase blood pressure levels because high sodium levels promote fluid retention in the blood. More fluid in the blood can lead to greater pressure against the walls of the arteries. The heart also has to pump more blood when sodium levels are high, which can increase blood pressure as well.

Minerals like potassium work in opposition to sodium. The more dietary potassium you consume, the more sodium your kidneys will excrete through the urine. (Consuming excess potassium may not be safe for people who have kidney disease or another condition that impacts potassium levels).

The DASH diet is full of nutrient-dense foods that are rich in lean protein and fiber, and low in sodium and saturated fat. 

The American Heart Association reported the DASH diet earned a perfect rating by meeting all of the organization’s recommendations for a heart healthy eating plan, scoring even higher than Mediterranean-style, vegetarian, and pescatarian diets.

The DASH diet focuses on hitting daily and weekly nutritional goals rather than eating specific foods. However, certain food groups may be limited or encouraged.

The diet prioritizes vegetables, fruits, and whole grains and limits foods high in sugar, sodium, and saturated fats. The plan also recommends including fat-free or low-fat dairy products, fish, lean meats, legumes, and vegetable oils.

When following the DASH diet, your daily or weekly servings of each food will depend on your calorie needs. This can vary based on your age, gender, activity levels, and additional health conditions. You can work with your healthcare provider to determine which serving sizes are right for you.

Here is an example of daily or weekly serving amounts that fit within the DASH diet, based on a target of 2,000 calories per day:

• Grains: 6-8 servings per day (one serving is one slice of bread or ½ cup of cooked pasta)
• Lean meats, poultry, eggs, and fish: 6 or fewer servings per day (one serving is 1 ounce of cooked meat or one egg)
• Vegetables: 4-5 servings per day (one serving is 1 cup of raw vegetables or ½ cup of cooked vegetables) 
• Fruit: 4-5 servings per day (one serving is one piece of medium fruit, ½ cup of fresh fruit, or ¼ cup of dried fruit)
• Low-fat or fat-free dairy: 2-3 servings per day (one serving is 1 cup of milk or yogurt or 1 ½ ounces of cheese)
• Fats and oils: 2-3 servings per day (one serving is 1 teaspoon of olive oil or 2 tablespoons of salad dressing) 
• Sodium: 2,300 milligrams or less per day (some individuals with hypertension may be encouraged to consume less sodium, closer to 1,500 milligrams of sodium daily)
• Nuts, seeds, beans, and peas: 4-5 servings per week (one serving is ⅓ cup of nuts, 2 tablespoons of nut butter or ½ cup of cooked beans or peas) 
• Sweets: 5 servings or less per week (one serving is 1 tablespoon of jam or ½ cup of sorbet)

The DASH diet emphasizes fruits, vegetables, whole grains, legumes, lean proteins, and low-fat dairy products for adequate fiber and protein. However, you can eat other foods in moderation.

When following the DASH diet, you are encouraged to eat:

• Grains: Whole wheat breads, pastas, pitas, English muffins, and whole grains like brown rice, millet, quinoa, oatmeal, unsalted popcorn 
• Lean meats: Extra lean (such as 93% lean) ground beef or leaner cuts of beef with fat trimmed  
• Poultry: Extra lean (such as 93% lean) ground chicken and turkey, and breasts or thighs with skin removed
• Whole eggs (in moderation)
• Seafood: Salmon, halibut, snapper, cod, trout, sardines, mackerel, clams, mussels, and shrimp
• Fruits: All fresh, frozen, or canned (in water) fruits
• Vegetables: All fresh, frozen, or low-sodium canned vegetables, with an emphasis on potatoes (with skin on), beet greens, tomatoes, Swiss chard, acorn squash, and spinach—all of which are rich in potassium 
• Fat-free or low-fat dairy: Plain Greek yogurt, cow’s milk, cheese, and low-sodium cottage cheese
• Heart healthy fats: Avocado, vegetable oils like olive oil and avocado oil, and unsalted nuts and seeds
• Legumes: White beans, soybeans, lima beans, pinto beans, lentils, kidney beans, and split peas
• Plant-based proteins: Tofu, tempeh, edamame 

Any drinks that are unsweetened or naturally sweetened are appropriate on the DASH diet. These may include:

• Water
• Seltzer (not club soda, which contains sodium)
• Unsweetened coffee
• Unsweetened teas
• Low-fat milk
• Unsweetened plant-based milks
• No-sodium vegetable juices
• Natural fruit juices (½ cup serving)

The DASH diet limits foods known to contribute to high blood pressure, such as high-sodium foods and foods rich in saturated fat, the type of dietary fat that raises LDL cholesterol.

Here is a list of foods to limit or avoid on the DASH diet:

• Fatty meats: Bacon and fatty cuts of beef like ribeye
• Fried foods
• Tropical oils: Coconut, palm kernel and palm oils
• High sodium foods: Jerky, chips, canned soups, broths, seasoning mixes, bouillon cubes, tomato juices, sausages, pepperoni, deli meat, hot dogs, frozen meals
• High-fat dairy products: Ice cream, butter, heavy cream, full-fat milks, yogurts, and cheeses
• Sweets: Candy, cookies, cakes, packaged desserts 

Any drinks that are high in added sugars or salt are not recommended on the DASH diet. 

The diet also recommends consuming alcohol in moderation, as alcohol can raise blood pressure levels. Men should consume no more than two drinks daily, while women should consume no more than one drink daily. 

If you’re following the DASH diet, try your best to minimize or eliminate:

• Sweetened energy drinks
• Soda
• Juices
• Sweetened coffees
• Sweetened teas 
• Alcohol, including wine, beer, mixed drinks, and hard liquors

You can create many meal variations using DASH diet-friendly foods. A day of eating on the DASH diet could look like: 

• Breakfast: Plain 1% Greek yogurt with fresh fruit and a side of whole wheat toast with unsalted natural peanut butter
• Lunch: Green salad with grilled chicken breast, avocado, tomatoes, cucumbers, chickpeas, unsalted sunflower seeds, and an olive oil-based dressing 
• Snack: Hard boiled egg and baby carrots dipped in guacamole 
• Dinner: Baked salmon with roasted sweet potato wedges and broccoli 

Research shows following the DASH diet significantly improves cardiovascular health. There are a few specific benefits that make this a heart-healthy eating plan. 

Lowers Blood Pressure

Study findings support the DASH diet’s ability to lower blood pressure levels.

In the original DASH trial, researchers found following the DASH diet produced greater reductions in blood pressure levels compared to simply increasing consumption of fruits and vegetables.

More recently, combining the DASH diet with a daily sodium restriction of 2,000 milligrams per day was found to be more effective in lowering systolic blood pressure levels (the top number) when compared with salt restriction alone.

Can Help Lower Cholesterol

The DASH diet limits foods high in saturated fat, which can help lower LDL cholesterol levels in the blood. When LDL cholesterol levels are too high, the cholesterol builds up in the blood vessels creating “plaque” which can lead to conditions like heart disease and stroke. Saturated fat is the primary cause of high LDL cholesterol and conditions that follow from it, including heart attacks. 

Assists in Weight Loss

The DASH diet has been shown to produce significant reductions in both body mass index (BMI) and waist circumference.

The eating plan may support weight loss due to its exclusion of ultra-processed foods. The DASH diet also emphasizes lean proteins and high fiber foods, both of which can support weight loss by helping you feel full for longer.

Reduces the Risk of Gout

Gout is a form of arthritis caused by high levels of uric acid in the blood. Uric acid can build up in the blood for different reasons. For example, eating a standard American diet high in red and processed meats, refined carbohydrates, and added sugars, salt, and fats can lead to an excess of uric acid.

One study found men who reported eating a DASH-style diet had a 32% lower risk of developing gout over the 26-year study period compared to men who reported eating a standard American diet.

The DASH diet is generally considered safe. If you’re taking medication to help manage hypertension, ask your healthcare provider about the optimal level of daily sodium intake for you.

Eating a very low-sodium diet may enhance the effectiveness of antihypertensive medications, which could potentially raise your risk of hypotension, or dangerously low blood pressure.

Many of the foods encouraged on the DASH diet are also high in fiber, including fruits, vegetables, and whole grains. Suddenly adding more fiber into your diet may cause gastrointestinal discomfort. Make sure to increase your fiber intake slowly, and drink plenty of fluids.

Drawbacks

The DASH diet is generally well tolerated and may not feel as restrictive as other popular eating plans. However, changing your diet and becoming more intentional about the foods you’re eating can require more planning when food shopping, creating meals, and cooking.

You may also need to be more conscientious about buying pre-made foods and eating out at restaurants. Many convenience foods and meals prepared by fast food chains or restaurants are high in sodium, which conflicts with the DASH diet’s goal of lowering sodium intake.

Planning meals ahead, cooking at home to control added salt, and keeping healthy snacks with you on-the-go can help you be more prepared and stick to your goals on the DASH diet.

The DASH diet is a heart-healthy eating plan that can help lower blood pressure levels. The diet emphasizes whole foods like fruits, vegetables, whole grains, lean proteins, low-fat dairy and healthy fats. It also limits foods high in sodium and saturated fats.

The DASH diet has been shown to have several other benefits, including lowering cholesterol and assisting in weight loss. The diet is considered safe for most people, but it’s a good idea to talk to your healthcare provider before starting a new diet for health benefits.