The DASH Diet for Hypertension

by Mark Jenkins, Thomas J. Moore

Overview

More than 50 million Americans suffer from high blood pressure, and most of them control it by taking prescription drugs with potentially dangerous side effects. But there is a natural, affordable, and easy-to-manage alternative to medication: the DASH (Dietary Approaches to Stop Hypertension) diet. Developed by a world-class team of doctors and nutritionists, the DASH diet is clinically proven to lower blood-pressure levels and thereby reduce the risk of heart failure, stroke, and kidney disease. Now, with The DASH Diet for Hypertension, readers can benefit from:

• A hearty and healthful selection of DASH menus, recipes, even grocery lists

• DASH weight-loss and exercise programs for everyday living

• The science behind DASH, including calorie worksheets and a formula to calculate body-mass

...and much more from this revolutionary program, which is recommended by the American Heart Association; the National Heart, Lung, and Blood Institute; the American Society for Hypertension; and other leading medical authorities.

Product Details

ISBN-13:	9781439140598
Publisher:	Atria Books
Publication date:	06/21/2011
Sold by:	SIMON & SCHUSTER
Format:	eBook
Pages:	368
Sales rank:	170,560
File size:	2 MB

About the Author

Tom Moore, M.D., senior author, has spent more than 20 years studying the causes of high blood pressure. He has published more than 100 articles and book chapters on this subject for medical professionals. Dr. Moore has been a member of the faculty of Harvard Medical School for 25 years. He served as the Chairman of the Steering Committee of the DASH trial, the landmark medical study that proved that the DASH diet works. He lives in Boston, Massachusetts.

Pao-Hwa Lin, Ph.D. has been a faculty member at the Sarah W. Stedman Nutrition Center at Duke University Medical Center since 1992. She was closely involved in the design and development of the DASH diet and was chairperson of the diet commitee for the DASH-Sodium study. She lives in Durham, North Carolina.

Njeri Karanja, Ph.D., a Research Associate Professor of Medicine in the division of Endocrinology/Metabolism and Clinical Nutrition at Oregon Health & Science University, led the data coordinating activities for the DASH study. Karanja lives in Portland, Oregon.

Laura Pata Svetkey, M.D. is the Director of Clinical Research at the Sarah W. Stedman Nutrition and Metabolism Center as well as the Director of the Duke Hypertension Center and has more than 20 years of experience in clinical research. She has been Principal Investigator on four NIH-sponsored multi-center studies on nutritional approaches to controlling hypertension and other obesity-related cardiovascular risk factors, including the landmark DASH (Dietary Approaches to Stop Hypertension) clinical trial. 

Mark Jenkins is a journalist and the author of several health books, including the Sports Medicine Bible, and is a consultant to the Harvard Medical School system.

Read an Excerpt

Chapter 1: Introducing DASH

The Isosceles Triangle Diet. The Bacon Grease and Beer Diet. We haven't heard of either of these diets, but it wouldn't surprise us to learn they existed! No doubt about it, our society has an insatiable appetite for wonder diets that will cure all our ills -- and the wackier the premise, the better. There's no reason to think people with high blood pressure are any different, especially when you consider this medical condition is so serious that it is a leading cause of heart attack, stroke, enlarged heart, and kidney damage.

If you bought this book hoping to find a blood-pressure-lowering diet with a nifty formula or handy-dandy gimmick, you'll be disappointed. The same goes if you're seeking a diet to lower your blood pressure based on some oddball theory. In a day and age when uncomplicated is unfashionable, our diet isn't high-tech or even low-tech. It's no-tech.

What our easy-to-understand blood-pressure-lowering diet has going for it is that not only is it safe, natural, fast-acting, and hearty enough that it won't leave you hungry, but more important, it works -- and we have proved it.

This is no small achievement when you consider how much hype and hyperbole surround the field of health and nutrition. So many wild claims are passed off as fact. A good number of the diets being foisted on the American public by seemingly reputable people simply don't work, while others are plain dangerous -- whether their promoters are promising to help us lose weight, live longer, or beat cancer.

Our diet to lower high blood pressure, on the other hand, was tested under carefully controlled scientific conditions. It was the subject of two of the biggest clinical research studies of their kind ever done. The studies were conducted at several of the nation's finest medical institutions under the auspices of the prestigious National Institutes of Health. More than 80 physicians, nutritionists, and technicians were involved, along with 800 study participants.

The goal was to harness the power of certain whole foods that contain the key minerals and other nutrients that we believed have the ability to lower blood pressure. This combination of nutrients had never before been tested in a "regular folks" diet.

The men and women who participated in our study followed the special diet we created. The results were beyond our wildest expectations. Our diet lowered participants' blood pressure as much as a typical blood pressure medication, and it did so quickly -- within 14 days of beginning the diet. To demonstrate the effectiveness of the DASH diet, in this chapter we'll share some of the personal success stories of individual study participants.

Take Melody Smith, for example. She is quite typical of the person with high blood pressure who participated in the DASH study. After being diagnosed with high blood pressure 10 years ago, this 42-year-old computer software salesperson tried several antihypertensive medications to keep her blood pressure down. However, Melody hated the side effects of the medications, not to mention their high cost. Sometimes she stopped taking her medications without her doctor's permission. That's when she asked us about participating in the DASH study. Melody was skeptical when she started the study but hopeful she would find a natural way to improve her blood pressure. Imagine Melody's surprise when she was informed that after just two weeks eating the DASH diet her blood pressure had dropped from 144/94 (in the "high" range) down to 132/88. The blood-pressure-lowering effect she got from the DASH diet was just about what she had gotten from the drugs she had taken before -- but without the side effects. Equally important for Melody, her doctor agreed that she no longer needed to take antihypertensive medications.

The medical implications of the DASH diet are profound. If, like Melody Smith, you are one of the tens of millions of Americans with hypertension, lowering your blood pressure will enable you to significantly reduce the life-threatening consequences of this disease, including heart attack, stroke, and hardening of the arteries.

The DASH diet will help you even if you don't have high blood pressure right now. Blood pressure tends to go up the older you get, and by their mid-sixties more than half of all Americans have high blood pressure. Following the DASH diet will help you avoid this eventuality. This is not an issue just for older people. Since blood pressure naturally starts going up in the teen years, it's almost never too early to encourage young people to start incorporating the DASH diet into their lives.

You are especially likely to develop high blood pressure if your blood pressure level is in the "high-normal" range or if you have a family history of high blood pressure. Again, eating the DASH diet can reduce the likelihood you will develop high blood pressure if you are predisposed for these reasons.

Another DASH success story is Charles Runnel, a 64-year-old retired chemistry professor. With blood pressure in the "high-normal" range (136/88), Dr. Runnel was a prime candidate for developing hypertension before he enrolled in the DASH study. Two weeks after he started eating the DASH diet, his blood pressure had dropped to 126/80. Like numerous other men and women with "high-normal" blood pressure who continued eating the DASH way after participating in the DASH study, Dr. Runnel avoided the virtual certainty he would eventually develop hypertension.

For both Melody Smith and Charles Runnel, taking medication for their blood pressure was a big issue -- Melody wanted to get off her medication and Charles wanted to avoid starting one. In fact, most people who have high blood pressure are eventually prescribed medications that are often expensive and can have unpleasant and possibly harmful side effects. If you're on blood pressure medication and would like to get off or if you want to avoid ever taking medication, the DASH diet may offer more good news:

• If you have stage 1, or "mild," high blood pressure and you are not yet taking blood pressure medications, following the DASH diet could lower your blood pressure to the "healthy" range and help you avoid the possibility of ever having to take drugs for blood pressure (see the table on page 14 for classifications of the different stages of high blood pressure).
  
  
• If you are taking medications to keep your blood pressure at a healthy level and your doctor thinks you should keep taking them, following the DASH diet may help you keep your blood pressure in the healthy range on fewer medications or lower doses.
  
  
• If you have a family history of high blood pressure or "high-normal" blood pressure (again, see page 14 for classifications), the DASH diet can be an effective preventive therapy and may help you avoid ever having to take blood pressure medications.
  

Remember, never change your medication or stop taking a medication without first getting clearance from your doctor and having your blood pressure properly monitored.

In addition to its role in lowering blood pressure, our diet has other important benefits. The foods in the plan help to lower the risk of heart disease and osteoporosis. Surveys of the men and women who participated in our study showed that the diet actually made them feel better, physically and mentally. This is what the DASH diet can do for you:

• Lower your blood pressure in 14 days.
  
• Lower your cholesterol.
  
• Reduce your risk of heart disease and stroke.
  
• Reduce your risk of osteoporosis.
  
• Increase antioxidant levels in your system.
  
• Improve your mood and quality of life.
  

Above all, though, this is a diet for lowering blood pressure. Although high blood pressure is very common, it is also widely misunderstood even by those who suffer from it. Before we take a much closer look at the DASH study, it's important to learn more about the deadly disease that made this diet necessary, which we'll do in the next chapter

Take the 14-Day DASH Diet Challenge!

We want to get you started as soon as possible on our lifesaving diet. For that reason we are issuing you our "14-day challenge." We challenge you to eat our simple diet of nutritious foods for two weeks and see the difference it makes in your blood pressure. Believe it or not, your blood pressure will drop significantly to a much healthier level.

If you have "mild" high blood pressure (stage 1), your blood pressure may go down to a level where you can go off your medication if your doctor says it's okay. If you have more severe high blood pressure, your blood pressure may go down to a level where you may be allowed to reduce your blood pressure medication dosage, making it easier to keep up with your drug regimen.

Sticking to the DASH diet will keep your blood pressure down, and it also has a host of other profound physical and mental health benefits, including reduced risk of heart disease, osteoporosis, and various cancers. For all these reasons, eating the DASH diet can literally save your life.

Skeptical? Don't believe a straightforward diet could have as powerful an effect as high-priced medications? Then take the 14-day challenge!

How do you take us up on our challenge? First, schedule an appointment with your doctor or nurse to get your blood pressure tested. Then start eating the DASH diet. At the end of 14 days, get another blood pressure reading. If you've stuck to the diet, your blood pressure will have dropped to a much healthier level. If you continue to eat the DASH diet, your blood pressure will stay at a healthy level.

Why are we so confident your blood pressure will respond? Because we achieved these results in hundreds of men and women who participated in the DASH study.

Caution

Keep in mind, the 14-day challenge may not be for everyone. Some people with kidney problems may not tolerate the amount of potassium contained in DASH foods. If this applies to you, talk to your doctor before starting the diet. But for most people the DASH diet is a healthy eating plan that has been proven to lower blood pressure. For guidance on easing into the DASH diet, refer to page 117.

And remember our admonition to get clearance from your doctor before making any change in your medication regimen.

Copyright © 2001 by Thomas Moore, Laura Svetkey, Lawrence Appel, George Bray, and William Vollmer

Table of Contents

Contents

Preface

Part One

Why We Need DASH and How It Works

1. Introducing DASH
   
   Take the 14-Day DASH Diet Challenge!
   
   
2. Why DASH? Hypertension: The Silent Killer
   
   A Deadly Disease That Affects Millions
   
   What Is High Blood Pressure/Hypertension?
   
   What Causes High Blood Pressure?
   
   Who Is Most at Risk for Hypertension?
   
   Understanding Blood Pressure Readings
   
   Truth and Consequences
   
   How High Blood Pressure Is Treated
   
   
3. Proving the Diet Works: How We Did It
   
   Top-Level Study Finally Launched
   
   DASH Study Design
   
   The Results
   
   The Science Behind DASH
   
   Implications of the Diet
   
   A "Feel-Good" Diet Too!
   
   A Postmodern Diet
   

Part Two

Making the Most of Your Commitment

1. Optimizing the Diet: Salt Reduction Is the Answer
   
   The DASH-Sodium Study
   
   How Salt Influences Blood Pressure
   
   Lowering Your Salt/Sodium Intake: Here's How
   
   
2. DASH Plus: Weight Loss, Exercise, and Limiting Alcohol Consumption
   
   Bring Your Body Fat to a Healthy Level
   
   Start an Exercise Program
   
   Launching a Vigorous Exercise Program
   
   Limit Your Alcohol Consumption
   
   
3. Want to Lose Weight? DASH Has the Answer
   
   Fundamentals of Weight Loss
   
   Customizing the DASH Diet for Weight Loss
   
   The Substitution Solution
   
   The Skinny on Fat
   
   Nutrition Facts Panel and Food Labeling
   
   Keeping It Off
   

Part Three

DASH in Action

1. Putting DASH into Action: How to Start Eating the DASH Way
   
   DASH in Three Easy Moves
   
   Preparing to DASH
   
   Vegetables
   
   Fruits/Fruit Juices
   
   Dairy Foods (Milk, Cheese, and Yogurt)
   
   Grains (Bread, Cereal, Rice, and Pasta)
   
   Meat, Poultry, and Fish
   
   Nuts, Seeds, and Legumes
   
   Added Fats and Oils
   
   Sweets
   
   Healthy Hints for Home Cooking
   
   DASH-Friendly Cooking Methods
   
   Supermarket Savvy: How to Shop for DASH
   
   Dining Out on DASH
   
   Eating the DASH Way: Any Tom, Dick, or Harriet Can Do It
   
   Track Your Food Habits
   
   
2. Make DASH Part of Your Life...for Life!
   
   Step 1: Recognize Your Food Issues
   
   Step 2: Believe You Will Succeed
   
   Step 3: Time It Right
   
   Step 4: One Step Leads You to the Next
   
   Step 5: Develop a SMART Action Plan
   
   Step 6: "Just Do It"
   
   Step 7: Assess Your Progress
   
   Step 8: Ask for Help If Things Aren't Going Well
   
   And the Final Step: Celebrate Every Success, No Matter How Small!
   

Part Four

DASH Menu Plans and Recipes

1. Fourteen Days on the DASH Diet
   
   Meeting Your Calorie-Intake Requirement
   
   How the Menu Plans Break Down
   
   Week 1: 2,000-Calorie Menus
   
   Week 2: 2,000-Calorie Menus
   
   Snacking on the DASH Diet
   
   
2. DASH Recipes
   
   Main Dishes
   
   Baked Catfish • Baked Macaroni and Cheese • BBQ Pork Chops • Blackened Beef with Greens and Red Potatoes • Chicken and Broccoli Bake • Chicken Fruity Stir-fry • Chicken with Rice • Dave's Cajun Catfish • Fettuccine with Chicken and Vegetables • Grilled Tuna • Hawaiian Chicken Sandwich • Mango and Black Bean Salad with Grilled Shrimp • New Orleans Red Beans and Rice • Northeast Gumbo • Snapper with Greens • Spicy Cod • Sweet-and-Sour Pork with Vegetables • Swiss Cheese Sandwich • Turkey Burger • Vegetarian Lasagna • Vegetarian Spaghetti Sauce • Vermont Roast with Brown Mustard
   
   Soups
   
   Gingered Butternut Squash Soup • Tomato Bisque • Tomato-Orange Soup • Tortellini and Bean Soup
   
   Vegetable Side Dishes
   
   Broccoli Rabe • Green Beans with Almonds • Kale with Sesame Seeds • Limas and Spinach • Molasses-Braised Collards • Sautéed Collard Greens • Stuffed Acorn Squash • Sweet-Potato Chips
   
   Grains
   
   Apple Cobbler • Blueberry Pancakes • Bulgur Wheat with Tomatoes • Couscous with Broccoli • Scallion Rice • Wild Rice Pilaf
   
   Salads
   
   Broccoli and Walnut Salad • Cherry Tomato and Scallion Salad • Coleslaw with Dates • Fresh Fruit Salad • Hot Red Potato and Spinach Salad • Soybean Salad • Spicy Carrot Salad • Three-Bean Salad • Tomato and Red Onion Salad • Tossed Salad I • Tossed Salad II
   
   Breads
   
   Baked Brown Bread • Banana Raisin Nut Bread • Lemon Muffins • Lighter Sweet Country Corn Bread • Quick Pumpkin Bread
   
   Desserts
   
   Apple Crisp • Baked Apple • Chocolate-Dipped Fruit • Crustless Pumpkin Pie • Low-Calorie Walnut Brownies • Orange-Banana Fruit Salad • Smoothie • Sweet Potato Pie • Tapioca with Mandarin Oranges • Tropical Delight • Vanilla Pudding with Banana
   
   
3. DASH Meal Plans
   
   Breakfast
   
   Lunch
   
   Dinner
   

Appendix A The Science Behind DASH

The Role of Key Nutrients in Keeping Blood Pressure Healthy
How Potassium, Calcium, and Magnesium Combine to Lower Blood Pressure
Fiber Matters, Too
Appendix B A Formula to Calculate Your Daily Calorie Intake

Appendix C A Formula to Calculate Your Body Mass Index (BMI)

Appendix D Scientific Articles about the DASH Diet

Index