DASH diet

The DASH diet (Dietary Approaches to Stop Hypertension) is a dietary pattern promoted by the U.S.-based National Heart, Lung, and Blood Institute (part of the National Institutes of Health (NIH), an agency of the United States Department of Health and Human Services) to prevent and control hypertension. The DASH diet is rich in fruits, vegetables, whole grains, and low-fat dairy foods; includes meat, fish, poultry, nuts, and beans; and is limited in sugar-sweetened foods and beverages, red meat, and added fats. In addition to its effect on blood pressure, it is designed to be a well-balanced approach to eating for the general public. DASH is recommended by the United States Department of Agriculture (USDA) as one of its ideal eating plans for all Americans. The DASH diet (Dietary Approaches to Stop Hypertension) is a dietary pattern promoted by the U.S.-based National Heart, Lung, and Blood Institute (part of the National Institutes of Health (NIH), an agency of the United States Department of Health and Human Services) to prevent and control hypertension. The DASH diet is rich in fruits, vegetables, whole grains, and low-fat dairy foods; includes meat, fish, poultry, nuts, and beans; and is limited in sugar-sweetened foods and beverages, red meat, and added fats. In addition to its effect on blood pressure, it is designed to be a well-balanced approach to eating for the general public. DASH is recommended by the United States Department of Agriculture (USDA) as one of its ideal eating plans for all Americans. The DASH diet is based on NIH studies that examined three dietary plans and their results. None of the plans were vegetarian, but the DASH plan incorporated more fruits and vegetables, low fat or nonfat dairy, beans, and nuts than the others studied. The DASH diet reduced systolic blood pressure by 6 mm Hg and diastolic blood pressure by 3 mm Hg in patients with high normal blood pressure (formerly called 'pre-hypertension'). Those with hypertension dropped by 11 and 6 mm Hg, respectively. These changes in blood pressure occurred with no changes in body weight. The DASH dietary pattern is adjusted based on daily caloric intake ranging from 1,600 to 3,100 dietary calories. The DASH diet was further tested and developed in the Optimal Macronutrient Intake Trial for Heart Health (OmniHeart diet). 'The DASH and DASH-sodium trials demonstrated that a carbohydrate-rich diet that emphasizes fruits, vegetables, and low-fat dairy products and that is reduced in saturated fat, total fat, and cholesterol substantially lowered blood pressure and low-density lipoprotein cholesterol. OmniHeart demonstrated that partial replacement of carbohydrate with either protein (about half from plant sources) or with unsaturated fat (mostly monounsaturated fat) can further reduce blood pressure, low-density lipoprotein cholesterol, and coronary heart disease risk.' In January 2018, DASH was named the number 1 for 'Best Diets Overall', 'For Healthy Eating', and 'Best Heart-Healthy Diet'; and tied number 2 'For Diabetes'(out of 40 diets tested) in the U.S. News & World Report's annual “Best Diets” rankings. Currently, hypertension is thought to affect roughly 50 million people in the U.S. and approximately 1 billion worldwide. According to the National Heart, Lung and Blood Institute (NHLBI), citing data from 2002, “The relationship between BP and risk of cardiovascular disease (CVD) events is continuous, consistent, and independent of other risk factors. The higher the BP, the greater is the chance of heart attack, heart failure, stroke, and kidney disease. For individuals 40–70 years of age, each increment of 20 mm Hg in systolic BP (SBP) or 10 mm Hg in diastolic BP (DBP) doubles the risk of CVD across the entire BP range from 115/75 to 185/115 mm Hg.”. The prevalence of hypertension led the U.S. National Institutes of Health (NIH) to propose funding to further research the role of dietary patterns on blood pressure. In 1992 the NHLBI worked with five of the most well-respected medical research centers in different cities across the U.S. to conduct the largest and most detailed research study to date. The DASH study used a rigorous design called a randomized controlled trial (RCT), and it involved teams of physicians, nurses, nutritionists, statisticians, and research coordinators working in a cooperative venture in which participants were selected and studied in each of these five research facilities. The chosen facilities and locales for this multi-center study were: (1) Johns Hopkins University in Baltimore, Maryland, (2) Duke University Medical Center in Durham, North Carolina, (3) Kaiser Permanente Center for Health Research in Portland, Oregon, (4) Brigham and Women's Hospital in Boston, Massachusetts, and (5) Pennington Biomedical Research Center in Baton Rouge, Louisiana. Two DASH trials were designed and carried out as multi-center, randomized, outpatient feeding studies with the purpose of testing the effects of dietary patterns on blood pressure. The standardized multi-center protocol is an approach used in many large-scale multi-center studies funded by the NHLBI. A unique feature of the DASH diet was that the foods and menu were chosen based on conventionally consumed food items so it could be more easily adopted by the general public if results were positive. The initial DASH study was begun in August 1993 and ended in July 1997. Contemporary epidemiological research had concluded that dietary patterns with high intakes of certain minerals and fiber were associated with low blood pressures. The nutritional conceptualization of the DASH meal plans was based in part on this research. Two experimental diets were selected for the DASH study and compared with each other, and with a third: the control diet. The control diet was low in potassium, calcium, magnesium and fiber and featured a fat and protein profile so that the pattern was consistent with a “typical American diet at the time”. The first experimental diet was higher in fruits and vegetables but otherwise similar to the control diet (a “fruits and vegetables diet” ), with the exception of fewer snacks and sweets. Magnesium and Potassium levels were close to the 75th percentile of U.S. consumption in the fruits-and-vegetables diet, which also featured a high fiber profile. The second experimental diet was high in fruits-and-vegetables and in low-fat dairy products, as well as lower in overall fat and saturated fat, with higher fiber and higher protein compared with the control diet—this diet has been called “the DASH Diet”. The DASH diet (or combination diet) was rich in potassium, magnesium and calcium—a nutrient profile roughly equivalent with the 75th percentile of U.S. consumption. The combination or “DASH” diet was also high in whole grains, poultry, fish, and nuts while being lower in red meat content, sweets, and sugar-containing beverages. The DASH diet was designed to provide liberal amounts of key nutrients thought to play a part in lowering blood pressure, based on past epidemiologic studies. One of the unique features of the DASH study was that dietary patterns rather than single nutrients were being tested. The DASH diet also features a high quotient of anti-oxidant rich foods thought by some to retard or prevent chronic health problems including cancer, heart disease, and stroke.