DASH Diet: Effective Control of Your Blood Pressure

A low-fat and high-protein meal plan is good for balancing your blood pressure. Discover how to incorporate the DASH diet to treat hypertension.

Woman pours oatmeal to a blender at a home kitchen environment

Going to a barbecue every week seems like a dream, but the aftermath is not something we are ready to face. For people who have high blood pressure, food that is high in saturated fats is off-limits. However, hypertension doesn’t mean eating bland food every day. Enter Dietary Approaches to Stop Hypertension or aptly called DASH diet.   

Ranked as among the best and healthiest diet for hypertension, the DASH diet allows you to have an enjoyable meal while lowering blood pressure. Sounds too good to be true?  

Here are several concepts you should know about this diet to keep your blood pressure in check. 

What is the DASH Diet? 

As modern medicine continues to claim new grounds, our odds against many diseases increase, and life expectancy grows longer. However, as we live longer, chances that we need to worry about hypertension – elevated blood pressure – increase too. A survey conducted in 2018 showed that close to 50% of adults in Malaysia had hypertension, and the proportions were higher in people who were older, had diabetes or with higher body mass index. 

Hypertension is a major risk factor for many debilitating diseases that cripple health or cause death. When the blood pressure is high, it causes the heart to work harder and prevents kidneys from working well. Factors contributing to hypertension are complex, ranging from genetics, environmental to nutritional. 

While some factors such as genes are beyond our control, scientists turned their attention to what we eat to determine whether blood pressure can be lowered through a proper diet. With that in mind, a large study group of researchers, clinicians, dieticians, and statisticians developed DASH in the 1990’s to prevent hypertension through food. In the first-ever DASH diet study, study subjects showed lower blood pressure, even in those without hypertension, while receiving a diet rich in fruits and vegetables for 8 weeks. Since then, researchers have carried out more studies to refine the DASH diet approach. Today, the DASH diet is recognised as an effective dietary intervention to reduce blood pressure. 

Key Concepts of the DASH Diet 

The DASH diet is designed not to be restrictive but rather a flexible and well-balanced eating plan. There is no need to count your calories after each meal or go all the way to obtain expensive ingredients to comply with the dietary plan. 

The DASH diet consists mainly of vegetables, fruits, and low-fat dairy products. It also includes whole grains, lean fish or poultry, legumes and nuts. 

The DASH diet puts emphasis on: 

  • Consuming low amounts of sodium (2300 milligrams per day or 1 teaspoon of table salt; a more restrictive version of the diet limits sodium consumption to 1500 milligrams per day) 
  • High-quality protein (almond, eggs, fish, soy, lean meats and low-fat milk) 
  • Low-fat food content and avoiding saturated and trans-fats 
  • High-quality carbohydrates (apples, beans, pears, peas and green vegetables) 
  • High-fibre fruits and vegetables 
  • Being rich in other micronutrients (calcium, magnesium and potassium) 
  • Leading a healthy lifestyle (exercise, healthy weight, sleep well, less stress, limit alcohol consumption, quit smoking) 

If you’re considering or currently on a DASH diet, these are the foods that you should avoid: 

  • Full cream dairy products or fatty meats 
  • Sugar-sweetened beverages 
  • Candies and sweets 
  • Processed food and beverages with high sodium content 

Sample Meal Based on the US National Institute of Health

Assortment of healthy food ingredients for cooking on a kitchen table
A DASH diet is rich in fruits and vegetables.

A 2000-calorie-a-day diet consists of: 

  • Grains: 6-8 servings 
  • Meat, poultry, and fish: 6 or less servings 
  • Vegetables: 4-5 servings 
  • Fruits: 4-5 servings 
  • Low-fat or fat-free dairy products: 2-3 servings 
  • Fats and oil: 2-3 servings 
  • Sodium: 2300 mg (2.3 g) 

Additionally, you can add a weekly serving of:  

  • Nuts, seeds, dry beans and peas: 4-5 servings 
  • Sweets: less than 6 servings 

Traditional Chinese Medicine and the DASH Diet

A bowl of bird’s nest and goji berries on a wooden desk
Bird’s nest is high in protein and other micronutrients that are suitable for the DASH diet.

While ancient Traditional Chinese Medicine (TCM) texts do not have the record of hypertension as a disease, the record of diseases in ancient TCM texts like “vertigo”, “headache”, “chest pain” and “stroke” reflect the similar symptoms of hypertension in modern medicine.  The treatment for the conditions caused by high blood pressure is well documented. Real Health Medical’s Chief TCM Physician Chu I Ta says, “TCM considers hypertension as a blood circulation disorder, leading to heart disorder and also poor spleen, liver or kidney functions. Conditions associated with this, such as vertigo and headaches, are also believed to be caused by disturbances to qi and blood circulation. A proper diet is essential to improve qi and blood flow in the body.” 

Huangdi Neijing 《黄帝内经》, an ancient Chinese medical textbook, recommends five grains provide nourishment, five fruits provide support, five domestic animals provide enrichment, five vegetables provide filling (五谷为养,五果为助,五畜为益,五菜为充). This is probably the first dietary guideline in the world that fulfills our body’s nutritional needs and perfectly coincides with the concept of the DASH diet. 

From a modern nutrition perspective, consuming foods rich in potassium, calcium, and magnesium help control blood pressure. Green vegetables like Swiss chard and black beans contain potassium. Kale, okra and chia seeds contain calcium, while you can find magnesium in spinach, cashews and almonds. 

The mineral compounds have similar health substances as the ancient text elaboration of the foods that keep your body healthy. Physician Chu explains, “Green goes to the liver to restore and regulate the blood, and red goes into the heart to propel the blood. Yellow goes into the spleen (pi) to govern the blood, while white goes into the lungs to move qi to enhance blood circulation. Black goes into the kidneys to store essence for the blood.” 

Snacking While on a DASH Diet 

People who practice the DASH diet are often discouraged from snacking due to excessive calories or sodium intake. In Western countries, people on this diet would satisfy their desires for snacks with nuts and low-fat dairy products (e.g., low-fat yoghurt, fat-free cheese, or skim milk). However, dairy products may not be as popular in many parts of Asia compared to the Western world. 

Edible bird’s nest (yan wo, 燕窝) is a befitting alternative for a snack rich in protein, low in digestible carbohydrates and practically zero fat content. Potassium, calcium and magnesium are among the top mineral micronutrients found in bird’s nest. When served in a modest concentration of rock sugar syrup, people on this diet can indulge in this soothing treat either as a snack or a dessert without worrying about derailing their diet plan. Other tantalising traditional dessert treats that fit the DASH dietary requirements are those made using snow fungus (bai mu er, 白木耳) or goji berries (gou qi zi, 枸杞子). 

Alternatively, drinking herbal infusions may help lower your blood pressure. Chrysanthemum tea helps restore liver balance and nourish the eyes. Steep 5-10 flowers in 800 millilitres to 1.2-litre boiling water for 15-20 minutes. To improve digestion, promote qi circulation and resolve stasis, you can try hawthorn berry infusion. This gives the effect of vasodilation and reduces blood pressure and blood glucose. Boil 800 millilitres to 1.2-litre water and immerse 5 grams of Hawthorn berry in the boiling water for 15-20 minutes.

However, when making herbal teas, consult a TCM physician for any additional ingredients to add in each tea for more specific indication purpose. 

Other Benefits of the DASH Diet 

Apart from lowering blood pressure, the DASH diet also effectively reduces low-density lipoprotein levels (the ‘bad’ cholesterol) and weight loss. This is due to decreased sodium and carbohydrate meal plan, which can reduce your daily calories intake. The general tips for maximising the benefits of this diet are to eat smaller portions of food more frequently and switch high-calorie snacks with healthier ones like fruits or vegetables. 

Regardless of your health status, the convenient and nutritious DASH diet is worth a go. Consult your dietician or health practitioner for the best DASH diet plan tailored for you.

References

  1. Zaki, NAM., Ambak, R., Othman, F., et al. J Health Popul Nutr. 2021. The prevalence of hypertension among Malaysian adults and its associated risk factors: data from Malaysian Community Salt Study (MyCoSS). [Accessed 6 October 2021]
  2. World Health Organization. 2021. Hypertension. [Accessed 6 October 2021] 
  3. Appel LJ., Moore TJ., Obarzanek E., et al. N Engl J Med1997. A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure. [Accessed 6 October 2021] 
  4. National Institutes of Health. 2021. Dietary Approaches to Stop Hypertension – Sodium Study (DASH-Sodium). [Accessed 6 October 2021] 
  5. Saengkrajang W., Matan M., Matan N., et al. J Food Compost Anal. 2013. Nutritional composition of the farmed edible bird’s nest (Collocalia fuciphaga) in Thailand. [Accessed 6 October 2021] 
  6. Challa HJ., Ameer MA., Uppaluri KR. StatPearls. 2021. DASH Diet to Stop Hypertension.[Accessed 6 October 2021] 

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