DASH stands for Dietary Approaches to Stop Hypertension. It is an eating plan that is based on research studies sponsored by the National Heart, Lung, and Blood Institute (NHLBI). These studies showed that DASH lowers high blood pressure and improves levels of cholesterol. This reduces your risk of getting heart disease.

The DASH eating plan

• Emphasizes vegetables, fruits, and whole-grains
• Includes fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
• Limits foods that are high in saturated fat. These foods include fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils.
• Limits sugar-sweetened beverages and sweets

Along with DASH, other lifestyle changes can help lower your blood pressure. They include staying at a healthy weight, exercising, and not smoking.

The DASH eating plan requires no special foods and instead provides daily and weekly nutritional goals. This plan recommends:

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

Based on these recommendations, the following table shows examples of daily and weekly servings that meet DASH eating plan targets for a 2,000-calorie-a-day diet.

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

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

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

About 1 in 3 adults in the U.S. has high blood pressure, but many don’t realize it. High blood pressure is sometimes called a “silent killer,” because it usually has no warning signs, yet it can lead to life-threatening conditions like heart attack or stroke. The good news is that high blood pressure, or hypertension, can often be prevented or treated. Early diagnosis and simple, healthy changes can keep high blood pressure from seriously damaging your health.

Normal blood flow delivers nutrients and oxygen to all parts of your body, including important organs like your heart, brain, and kidneys. Your beating heart helps to push blood through your vast network of blood vessels, both large and small. Your blood vessels, in turn, constantly adjust. They become narrower or wider to maintain your blood pressure and keep blood flowing at a healthy rate.

It’s normal for your blood pressure to go up and down throughout each day. Blood pressure is affected by time of day, exercise, the foods you eat, stress, and other factors. Problems can arise, though, if your blood pressure stays too high for too long.

High blood pressure can make your heart work too hard and lose strength. The high force of blood flow can damage your blood vessels, making them weak, stiff, or narrower. Over time, hypertension can harm several important organs, including your heart, kidneys, brain, and eyes.

“Hypertension is a leading risk factor for death and disability worldwide,” says Dr. Paul Whelton, an expert in hypertension and kidney disease at Tulane University. “High blood pressure raises the risk of having a heart attack, heart failure, stroke, or kidney disease.”

Anyone, even children, can develop high blood pressure. But the risk for hypertension rises with age. “Once people are in their 60s, about two-thirds of the population is affected by hypertension,” Whelton says.

Excess weight or having a family history of high blood pressure also raises your risk for hypertension.

African Americans are especially likely to get hypertension. Compared to Caucasian or Hispanic American adults, African Americans tend to develop hypertension at a younger age and to have a higher blood pressure on average.

Because it usually has no symptoms, the only way to know for sure that you have hypertension is to have a blood pressure test. This easy, painless test involves placing an inflated cuff with a pressure gauge around your upper arm to squeeze the blood vessels. A health care provider may then use a stethoscope to listen to your pulse as air is released from the cuff, or an automatic device may measure the pressure.

Blood pressure is given as 2 numbers. The first number represents the pressure in your blood vessels as the heart beats (called systolic pressure). The second is the pressure as your heart relaxes and fills with blood (diastolic pressure). Experts generally agree that the safest blood pressure—or “normal” blood pressure—is 120/80 or lower, meaning systolic blood pressure is 120 or less and diastolic pressure is 80 or less.

“Hypertension is defined as having an average blood pressure of above 140/90,” says NIH’s Dr. Lawrence Fine, who oversees research on the treatment and prevention of hypertension. Since blood pressure can vary widely from day to day, a diagnosis of hypertension is usually based on an average of 2 or more readings taken on 2 or more occasions.

If your blood pressure falls between “normal” and “hypertension,” it’s sometimes called prehypertension. People with prehypertension are more likely to end up with high blood pressure if they don’t take steps to prevent it.

“We know we can prevent high blood pressure through diet, weight loss, and physical activity,” Whelton says. “We can also treat it, and we can treat it effectively.”

If you’re diagnosed with high blood pressure, your doctor will prescribe a treatment plan. You’ll likely be advised to make healthy lifestyle changes (see the Wise Choices box). You may also need to take medications. The goal of treatment is to reduce your blood pressure enough to avoid more serious problems.

How low should you aim when reducing your blood pressure? The answer depends on many factors, which is why it’s important to work with your doctor on blood pressure goals. Most current guidelines recommend aiming for a systolic pressure below 140. These medical guidelines are sometimes adjusted as new research is reported.

A large NIH-funded study recently found there may be benefits to aiming for a much lower systolic pressure—120 or less, instead of 140—at least for some people. The study looked at adults ages 50 and up who had increased risk for cardiovascular disease but didn’t have diabetes. Half aimed for a systolic pressure of 120. The rest aimed for a pressure of 140.

The study was stopped early, after about 3 years, when clear benefits were seen in the lower blood pressure group. “When treating to the lower goal of 120, the risk of having a cardiovascular complication such as a heart attack or stroke was reduced by 25%, and the risk of death from all causes was reduced by 27%,” Fine says. This lower-goal group, though, tended to need 1 additional blood pressure medication; they also had more hospitalizations for side effects, including low blood pressure, fainting, and possible kidney damage.

“Results to date suggest that for older people with hypertension and an increased risk for cardiovascular disease, it may make sense to aim for a lower blood pressure. But there may be drawbacks as well, and each patient is different,” Whelton says. “Researchers generate the evidence, so health care providers can have informed discussions with their patients about blood pressure targets.”

NIH-funded studies have clearly shown that healthy lifestyle changes can improve your blood pressure. “Making even small changes over time can really add up,” says Kathryn McMurry, a nutrition science expert at NIH. “In terms of diet, our best advice is to follow the DASH eating plan.”

DASH stands for Dietary Approaches to Stop Hypertension. “It’s not a diet to go on for a short period of time, but one that’s meant to be part of a healthy lifestyle and enjoyed for life,” McMurry says.

The DASH eating plan requires no special foods. Instead, it provides daily and weekly nutritional goals. It’s high in vegetables, fruit, whole grains, and low-fat dairy foods but low in saturated fat and added sugar.

“DASH is beneficial even for people who have normal blood pressure or who have prehypertension. It can help keep blood pressure from progressing to higher levels,” McMurry says. Learn more about DASH at www.nhlbi.nih.gov/health/health-topics/topics/dash.

For more heart-healthy food ideas, visit healthyeating.nhlbi.nih.gov, which has nearly 200 recipes developed with input from professional chefs. “The recipes are tasty, heart healthy, and easy to make. They’re meals the whole family will enjoy,” McMurry says.

For Healthy Blood Pressure

• Keep a healthy weight. Ask your doctor if you need to lose weight.
• Be physically active. Get moving for at least 30 minutes most days of the week.
• Eat a healthy diet. Choose an eating plan rich in vegetables, fruits, whole grains, and low-fat dairy and low in saturated fat and added sugars.
• Cut down on salt. Many Americans eat more sodium (found in salt) than they need. Most of the salt comes from processed food (such as soup and baked goods).
• Drink alcohol in moderation, if at all. Men should have no more than 2 drinks a day; women no more than 1 drink a day.
• Don’t smoke. Smoking raises your risk for heart disease, stroke, and other health problems.
• Get a good night’s sleep. Tell your doctor if you’ve been told you snore or sound like you stop breathing briefly when you sleep—a possible sign of sleep apnea. Treating sleep apnea and getting a good night’s sleep can help reduce blood pressure.
• Take prescribed drugs as directed. If you need drugs to help lower your blood pressure, you still should follow the lifestyle changes described above.

Potassium and sodium are electrolytes that help your body function normally by maintaining fluid and blood volume. However, consuming too little potassium and too much sodium can raise your blood pressure.

Though the words salt” and “sodium” are often used interchangeably, they do not mean the same thing. Salt (also known by its chemical name, “sodium chloride”) is a crystal-like compound that is common in nature. Sodium is a mineral, and one of the chemical elements found in salt.

Most potassium we eat naturally occurs in vegetables, fruit, seafood, and dairy products. On the other hand, most sodium we eat is added to packaged and restaurant foods.

Potassium, Sodium, High Blood Pressure, Heart Disease, and Stroke

Increasing potassium intake can help decrease your blood pressure if you have high blood pressure. By lowering blood pressure, increasing potassium intake can also reduce your risk for heart disease and stroke. In contrast, consuming too much sodium can raise your blood pressure. Limiting sodium intake is especially important if you have high blood pressure, also known as hypertension. High blood pressure increases your risk of heart disease and stroke.

Sodium and Children

Nearly 9 in 10 US children eat more sodium than recommended and about 1 in 9 children has raised blood pressure, a major risk factor for heart disease and stroke. Lowering sodium in children’s diets can help lower blood pressure and may prevent heart disease later in life.

Potassium in the Food Supply and Potassium Intake

Most Americans eat too little potassium and too much sodium. Some good sources of potassium include bananas, oranges and melons, cooked spinach and broccoli, and potatoes and sweet potatoes.

The majority of sodium in our diets comes from packaged and restaurant food (not the salt shaker) as a result of food processing. Even foods that may not taste salty can be major sources of sodium. Foods with only moderate amounts of sodium, such as bread, can be major sources of sodium because they’re eaten so frequently. Americans consume more than 3,400 milligrams (mg) of sodium each day, on average. This is well above the 2020-2025 Dietary Guidelines for Americans recommendation.

You can find potassium and sodium content, and percent Daily Values (%DV) on Nutrition Facts Labels for packaged foods.

1. Assess where you are now. The DASH eating plan requires no special foods and has no hard-to-follow recipes. One way to begin is by using the free, interactive, online Body Weight Planner (niddk.nih.gov/bwp) to find out how many calories you need per day to maintain or reach your goal weight. Then fill in the What’s on Your Plate? worksheet for a few days and see how your current food habits compare with the DASH plan. This will help you see what changes you need to make.

2. Discuss medication with your doctor. If you take medication to control high blood pressure or cholesterol, you should not stop using it. Follow the DASH eating plan and talk with your doctor about your medication treatment as part of an overall plan for wellness.

3. Make DASH a part of your healthy life. The DASH eating plan along with other lifestyle changes can help you control your blood pressure and lower blood cholesterol. Important lifestyle recommendations include: achieve and maintain a healthy weight, get regular physical activity, and, if you drink alcohol, do so in moderation (up to one drink per day for women and up to two drinks per day for men).

4. DASH is for everyone in the family. Start with the meal plans in A Week With the DASH Eating Plan if you want to follow the menus similar to those used in the DASH trial— then make up your own using your favorite foods. In fact, your entire family can eat meals using the DASH eating plan because it can be adapted to meet varied nutritional needs, food preferences, and dietary requirements.

5. Don’t worry. Remember that on some days the foods you eat may add up to more than the recommended servings from one food group and less from another. Or, you may have too much sodium on a particular day. Just try your best to keep the average of several days close to the DASH eating plan and the sodium level recommended for you.

The DASH eating plan is easy to follow using common foods available in your grocery store. The plan includes daily servings from different food groups. The number of servings you should have depends on your daily calorie (energy) needs.

Calorie Needs

To figure out your calorie needs, you need to consider your age and physical activity level. If you want to maintain your current weight, you should eat only as many calories as you burn by being physically active. This is called energy balance.

If you need to lose weight, you should eat fewer calories than you burn or increase your activity level to burn more calories than you eat.

Consider your physical activity level. Are you sedentary, moderately active, or active?

• Sedentary means that you do only light physical activity as part of your typical daily routine.
• Moderately active means that you do physical activity equal to walking about 1.5 to 3 miles a day at 3 to 4 miles per hour, plus light physical activity.
• Active means that you do physical activity equal to walking more than 3 miles per day at 3 to 4 miles per hour, plus light physical activity.

Use the chart below to estimate your daily calorie needs.

Daily Calorie Needs for Women

Daily Calorie Needs for Men

After figuring out your daily calorie needs, go to the table below and find the closest calorie level to yours. This table estimates the number of servings from each food group that you should have. Serving quantities are per day, unless otherwise noted.

DASH Eating Plan—Number of Food Servings by Calorie Level

a Whole grains are recommended for most grain servings as a good source of fiber and nutrients.

b For lactose intolerance, try either lactase enzyme pills with dairy products or lactose-free or lactose-reduced milk.

c Fat content changes the serving amount for fats and oils. For example, 1 Tbsp regular salad dressing = one serving; 1 Tbsp low-fat dressing = one-half serving; 1 Tbsp fat-free dressing = zero servings.

d The DASH eating plan has a sodium limit of either 2,300 mg or 1,500 mg per day.

DASH Eating Plan—Serving Sizes, Examples, and Significance

a Whole grains are recommended for most grain servings as a good source of fiber and nutrients.

b Serving sizes vary between ½ cup and 1¼ cups, depending on cereal type. Check the product's Nutrition Facts label.

c For lactose intolerance, try either lactase enzyme pills with dairy products or lactose-free or lactose-reduced milk.

d Fat content changes the serving amount for fats and oils. For example, 1 Tbsp regular salad dressing = one serving; 1 Tbsp low-fat dressing = one-half serving; 1 Tbsp fat-free dressing = zero servings.

Most people eat much more sodium (salt) than they need. This can lead to health problems like high blood pressure. To lower the amount of sodium in your diet, follow these tips when you go food shopping:

• Choose fresh instead of processed foods when you can
• Use the Nutrition Facts label to check the amount of sodium — you can compare labels to find products with less sodium
• Look for foods labeled “low sodium” or “no salt added”

Take the list below with you the next time you go food shopping to help you choose foods that are lower in sodium.

Vegetables and Fruits

Buy plenty of vegetables and fruits, like:

• Any fresh fruits, like apples, oranges, or bananas
• Any fresh vegetables, like spinach, carrots, or broccoli
• Frozen vegetables without added butter or sauce
• Canned vegetables that are low in sodium or have no salt added — you can rinse them off to remove some of the sodium
• Low-sodium vegetable juice
• Frozen, canned, or dried fruits with no added sugars

Whole Grains

Compare labels to find products with less sodium. Look for foods with 5% Daily Value (DV) or less for sodium. A DV of 20% or more is high.

Here are some good options to try:

• Whole grains like brown or wild rice, quinoa, or barley
• Whole-wheat or whole-grain pasta and couscous — just don’t add salt to the water when you cook it
• Whole-grain hot or cold breakfast cereals with no added sugars, like oatmeal or shredded wheat
• Unsalted popcorn or low-sodium chips and pretzels
• Whole-grain breads, bagels, English muffins, tortillas, and crackers

Proteins

Choose fresh or frozen seafood, poultry, and meats instead of processed options. Some meat, poultry, and seafood has added sodium. If the package has a Nutrition Facts label, look for 5% DV or less.

Choose options like:

• Fresh or frozen fish or shellfish
• Chicken or turkey breast without skin or marinade
• Lean cuts of beef or pork
• Unsalted nuts and seeds
• Dried beans, peas, and lentils — like black beans and garbanzo beans (chickpeas)
• Canned beans labeled “no salt added” or “low sodium” — rinse them off to remove some of the sodium
• Eggs

Dairy

Choose fat-free or low-fat dairy products, lactose-free dairy products, or fortified soy alternatives like:

• Fat-free or low-fat (1%) milk
• Fat-free or low-fat plain yogurt
• Low-sodium or reduced-sodium cheese — be sure to check the label since cheese can be high in sodium
• Soy milk or soy yogurt with added calcium, vitamin A, and vitamin D

Dressings, Oils, and Condiments

When you cook, use ingredients that are low in sodium or have no sodium at all — for example:

• Unsalted margarine and spreads (soft, tub, or liquid) with less saturated fat than butter
• Vegetable oils (canola, corn, olive, peanut, safflower, soybean, or sunflower)
• Low-sodium salad dressing — or oil and vinegar
• Low-sodium or "no salt added" ketchup
• Low-sodium salsa or picante sauce

Seasonings

Try these seasonings instead of salt to flavor your food:

• Herbs, spices, or salt-free seasoning blends
• Chopped vegetables — like garlic, onions, and peppers
• Lemon and lime juice
• Ginger

The holidays are full of family, friends and festive gatherings. Healthy eating during the holidays may seem challenging but it doesn’t always mean foregoing your favorite desserts and sweets. With a few small changes, it is possible to maintain healthy eating habits during the holiday season.

Baking for the holidays? Small changes can make desserts healthier and reduce calories without sacrificing taste.
We have some simple substitutions that can make baked goods healthier or lower calorie counts.

The DASH (Dietary Approaches to Stop Hypertension) eating plan promotes a heart-healthy eating style for life. DASH requires no special foods. The plan encourages eating vegetables, fruits, whole grains, fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils. It provides shopping tips, menus, and recipes to help you limit foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils. It also encourages limiting sugar-sweetened beverages and sweets.

5 Ways to Make Holiday Baking Healthier!

1. Substitute Whole-Wheat. Flour Most recipes that call for flour can substitute wheat flour in a 1 to 1 measurement. Wheat flour has more fiber and helps to slow digestion and increase fullness. Not all recipes can take a wheat flour substitute due to coloring or taste concerns. Sugar cookies, for example, need white flour to keep their traditional coloring.
2. Cut the Sugar. Holiday desserts often call for sugar, honey, maple syrup, and molasses. These sweeteners can raise your blood sugar. For many recipes, you can reduce the amount of sugar recommended without changing the taste. Sugar substitutes can also be used as alternatives to sugar and provide sweetness to desserts and foods without adding a lot of extra calories. In some cases, a sugar substitute can replace half of the sugar called for in a recipe.
3. Cut the Saturated Fat. Your body needs healthy fats for energy and other functions. But too much saturated fat can cause cholesterol to build up in your blood vessels. Saturated fats raise your LDL (bad) cholesterol. High LDL cholesterol increases your risk for heart disease and stroke. In most baking recipes, you can reduce the saturated fat (butter, shortening, oil) by half without compromising your dessert. If a recipe calls for 1 cup of butter, try ½ cup instead. You can replace the remaining ½ cup with an alternative ingredient to ensure your dessert has the same texture. Some replacements can be fat-free sour cream, low-fat buttermilk, orange juice, low-fat yogurt, applesauce, or low-fat cream cheese.
4. Use Light Products. Substituting lower-fat and lower-sugar ingredients in your baking recipes can make them healthier and lower in calories. You can substitute sour cream with low-fat sour cream, light cream cheese for regular, and low-sugar jams and jellies for the regular brand. Other quick substitutes include light whipped cream and fat-free half-and-half.

Other Tips to Keep You on the Track to Healthy Eating

• Control your portions. A small adjustment in portion size can help you avoid overeating. One way to control your portions by putting food on individual plates instead of putting large serving dishes on your table. Try eating snacks in a small container instead of the original package. You can also replace candy dishes with bowls of fruit or vegetables.
• Cut down on overeating and snacking. Making a point to be mindful of what and when you are eating can help you avoid overeating and excessive snacking. Snacks are plentiful and can be consumed in larger quantities because their small size is often overlooked. For example: chocolate kisses (22 calories each), peppermint bark candies (66 calories each), toffee (67 calories), fudge (70 calories on square), and sugar cookies (113 calories each plain). Prepare healthy snacks in advance so they are available if you feel hungry between meals. Move the healthier food to the front at eye level. Store tempting foods, like cookies, chips, or ice cream, out of direct eyesight.
• Don’t have dessert at every dinner. Try to split a dessert with a family member or friend or avoid having a dessert at every meal. Check out these healthy eating tips and resources to create a holiday eating plan.
• Remember your mental health. During this holiday time, don’t forget about your mental health! The holidays can be a stressful time, which can contribute to overeating. Be sure to stay aware of your stress levels, and check out these resources for good mental health and ways to reduce stress during the holidays!

Understanding the DASH eating plan will help you start and follow this plan for life.

Part of a Heart-Healthy Lifestyle

The DASH eating plan is just one key part of a heart-healthy lifestyle, and combining it with other lifestyle changes such as physical activity can help you control your blood pressure and LDL-cholesterol for life.

To help prevent and control high blood pressure:

• Be physically active.
• Maintain a healthy weight.
• Limit alcohol intake.
• Manage and cope with stress.

Other lifestyle changes can improve your overall health, such as:

• If you smoke, quit.
• Get plenty of sleep.

To help make lifelong lifestyle changes, try making one change at a time and add another when you feel that you have successfully adopted the earlier changes. When you practice several healthy lifestyle habits, you are more likely to achieve and maintain healthy blood pressure and cholesterol levels.

Controlling Daily Sodium and Calories

To benefit from the proven DASH eating plan, it is important to limit daily sodium levels to 2,300 mg, or 1,500 mg if desired, and to consume the appropriate amount of calories to maintain a healthy weight or lose weight if needed.

Ways to Control Sodium Levels

The key to lowering your sodium intake is to make healthier food choices when you’re shopping, cooking, and eating out.

Tips For Lowering Sodium When Shopping, Cooking, And Eating Out

*Examples of convenience foods are frozen dinners, prepackaged foods, and soups; examples of condiments are mustard, ketchup, soy sauce, barbecue sauce, and salad dressings.

Most of the sodium Americans eat comes from processed and prepared foods, such as breads, cold cuts, pizza, poultry, soups, sandwiches and burgers, cheese, pasta and meat dishes, and salty snacks. Therefore, healthier choices when shopping and eating out are particularly important.

Ways to Control Calories

To benefit from the DASH eating plan, it is important to consume the appropriate amount of calories to maintain a healthy weight. To help, read nutrition labels on food, and plan for success with the DASH Eating Plan: Healthy Eating, Proven Results and other heart-healthy recipes.

The DASH eating plan can be used to help you lose weight. To lose weight, follow the DASH eating plan and try to reduce your total daily calories gradually. Find out your daily calorie needs or goals with the Body Weight Planner and find tips to lowering you calorie intake on DASH.

General tips for reducing daily calories include:

• Eat smaller portions more frequently throughout the day.
• Reduce the amount of meat that you eat while increasing the amount of fruits, vegetables, whole grains, or dry beans.
• Substitute low-calorie foods, such as when snacking (choose fruits or vegetables instead of sweets and desserts) or drinking (choose water instead of soda or juice), when possible.

Increasing Daily Potassium

The DASH eating plan is designed to be rich in potassium, with a target of 4,700 mg potassium daily, to enhance the effects of reducing sodium on blood pressure. The following are examples of potassium-rich foods.

Sample Foods And Potassium Levels

When changing lifestyle habits, it is normal to slip off track occasionally. Follow these tips to get you back on track.

• Ask yourself why you got off track. Find out what triggered your sidetrack, and restart the DASH eating plan.
• Don’t worry about a slip. Everyone slips, especially when learning something new. Remember that changing your lifestyle is a long-term process.
• Don’t change too much at once. When starting a new lifestyle, try to avoid changing too much at once. Slow changes lead to success.
• Break down the process. Break goals into smaller, simpler steps, each of which is attainable.
• Write it down. Use the Daily DASH Log to keep track of what you eat and what you’re doing while you are eating. You may find that you eat unhealthy foods while watching television. If so, you could start keeping a healthier substitute snack on hand.
• Celebrate success. Instead of eating out to celebrate your accomplishments, try a night at the movies, go shopping, visit the library or bookstore, or watch your favorite TV show.