The DASH Eating Plan as Part of a Heart-Healthy Lifestyle

High blood pressure is a common health concern among many Americans. One effective strategy to address high blood pressure is an eating plan called DASH. DASH stands for Dietary Approaches to Stop Hypertension (“hypertension” is the technical term for high blood pressure). By following the DASH eating plan, individuals may be able to reduce their blood pressure and risk factors for cardiovascular disease while also finding a heart-healthy eating style that they can maintain for life.

Developed by the National Heart, Lung, and Blood Institute (NHLBI 2021a), the DASH eating plan is simple and provides the following specific recommendations:

• Eat vegetables, fruits, and whole grains
• Include fat-free or low-fat dairy products as well as fish, poultry, beans, nuts, and vegetable oils
• Limit foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils (like coconut, palm kernel, and palm)
• Limit sugar-sweetened beverages and sweets

Benefits of DASH

The DASH eating plan can lower not only blood pressure but also low-density lipoprotein (LDL; “bad”) cholesterol and triglycerides (Challa et al. 2023; NHLBI 2021d). This eating plan may also help people lose weight and manage or prevent type 2 diabetes and heart disease. In addition, it may lower the risks for stroke and colorectal cancer.

By encouraging people to eat whole foods, this heart-healthy plan emphasizes foods high in fiber and low in sodium, saturated fat, and added sugars. These foods are also rich in nutrients and are often lacking in the American diet. DASH can be a way of eating that the entire family can enjoy.

When following the DASH eating plan (NHLBI 2021a), choose foods that are:

• Rich in potassium, calcium, magnesium, fiber, and protein
• Lower in sodium
• Low in saturated fat and added sugars

What Does DASH Look Like?

Let us explore the DASH eating plan by looking at what and how much to eat within each food group if we were to eat a 1,800- to 2,000-calorie diet. Of note, the DASH eating plan refers to “servings” of food from each food group rather than amounts in cups or ounces of food. Refer to the chart below for a summary of what counts as a serving.

Daily DASH Recommendations

Grains

DASH recommends eating six to eight servings of grains per day. Some examples of a serving size from this group include the following:

• 1 slice of bread
• 1 ounce of ready-to-eat cereal
• ½ cup of cooked cereal, cooked rice, or cooked pasta

Grains are divided into two subgroups: whole grains and refined grains (Oldways Whole Grains Council n.d.). The DASH eating plan recommends choosing mostly whole grains (NHLBI 2021b). Whole grains contain the entire grain kernel, including the bran, germ, and endosperm. Examples of whole grains include oatmeal, brown rice, whole wheat flour, whole wheat pasta, and quinoa. Whole grains are good sources of fiber and important nutrients.

On the other hand, refined grains have been milled, a process that removes the bran and germ from the grain kernel. Doing so also removes dietary fiber, iron, and many B vitamins. Some examples of refined grain products are white flour, degermed cornmeal, white bread, and white rice.

Vegetables and Fruits

The DASH eating plan (NHLBI 2021b) also recommends eating four to five servings per day each of vegetables and fruits. A serving is considered one of the following:

• 1 cup of raw leafy vegetables
• ½ cup of cut raw or cooked vegetables
• 1 medium whole fruit
• ¼ cup of dried fruit (unsweetened)
• ½ cup of fresh, frozen, or canned fruit
• ½ cup of 100% juice (vegetable or fruit)

Fruits and vegetables are great sources of the mineral potassium, which may help lower blood pressure. Fresh, frozen, canned, and dried fruits and vegetables all count as servings, as do 100% juices. However, if you choose the canned option, buy lower-sodium vegetables and fruits that have been canned in juice.

Fat-Free or Low-Fat Dairy

Regarding the dairy group, choose two to three servings per day of fat-free or low-fat dairy products. One cup of milk or yogurt or 1½ ounces of cheese is a serving size (NHLBI 2019, 2021b). Dairy products contain the mineral calcium, which is important for bone health and is key to regulating blood pressure. Choosing fat-free or low-fat dairy will also lower your intake of saturated fat, one type of fat that should be limited to protect and/or improve your heart health. Milk, buttermilk, cheeses, and yogurt are all available in lower-fat versions. Fat-free and low-fat lactose-free milk products and fortified soy beverage are other choices available within this group.

Lean Meats, Fish, Poultry, and Eggs

The DASH eating plan also recommends eating 6 ounces or less of lean meats, fish, poultry, and eggs each day. Examples include extra-lean ground beef, round or sirloin beef cuts, pork tenderloin, cod, flounder, and skinless chicken and turkey (NHLBI 2019, 2021b). These whole animal proteins do not naturally contain sodium, but sodium is commonly added in the processed versions of these foods. For instance, a plain fish filet is lower in sodium than fish sticks, and a chicken breast contains less sodium than a frozen chicken patty. In addition, limit your intake of deli meats (which are also high in sodium). If you buy canned tuna or chicken, choose the lowest sodium option available.

Fats and Oils

DASH suggests that we eat no more than two to three daily servings of fats and oils. To do this, select soft margarine, vegetable oils like olive oil and canola oil, and low-fat mayonnaise and salad dressings. A good general guideline is to choose liquid oils (which are healthier) over solid fats. Examples of one serving of fats and oils (NHLBI 2021b) include the following:

• 1 teaspoon of soft margarine
• 1 teaspoon of vegetable oil
• 1 Tablespoon of low-fat mayonnaise
• 2 Tablespoons of light salad dressing

Sodium

The DASH eating plan aims to reduce the amount of sodium in your diet and meets the recommendations of the current Dietary Guidelines for Americans to consume no more than 2,300 milligrams (mg) of sodium per day (NHLBI 2021c; U.S. Department of Agriculture and U.S. Department of Health and Human Services 2020). To further lower blood pressure, the DASH eating plan and the American Heart Association (AHA) recommend no more than 1,500 mg of sodium per day for most adults, especially those with high blood pressure (AHA n.d.-b; NHLBI 2021a). Check with your doctor if you are not sure how much sodium is right for you.

Weekly DASH Recommendations

Nuts, Seeds, and Legumes

Over 1 week, the DASH eating plan recommends eating four to five servings of nuts, seeds, and legumes (beans, peas, and lentils), which are good sources of fiber, protein, and magnesium (NHLBI 2021b). Nuts are also a good source of monounsaturated fats, a type of fat that (when eaten in place of foods high in saturated fats) helps lower your bad cholesterol (LDL) levels. Include foods such as almonds, walnuts, kidney beans, lentils, chickpeas (garbanzo beans), and sunflower seeds in your meals and snacks throughout the week. However, you should choose unsalted, no-salt-added, or low-sodium varieties to reduce your sodium intake.

Sweets and Added Sugars

The DASH eating plan also recommends limiting sugar-sweetened beverages and sweets to five servings or less per week, which is just 5 Tablespoons of added sugars (or the equivalent) per week (NHLBI 2019, 2021b). This is equal to eating or drinking just 2 teaspoons of added sugar per day. Some ideas to satisfy your sweet cravings while reducing added sugar intake include the following:

• Choosing fresh or dried fruits for dessert
• Layering low-fat yogurt with fruit and a little granola for a sweet parfait treat
• Enjoying graham crackers with peanut butter or another nut butter
• Replacing your soda, sweet tea, or lemonade with an unsweetened beverage that you enjoy, such as tea, coffee, low-fat milk, or water. You may even flavor plain water with lemon slices or other fruits for a no-added-sugar option.

Overall, the DASH eating plan guidelines include choosing foods low in saturated fats and added sugars; lower in sodium; and rich in potassium, calcium, magnesium, fiber, and protein (NHLBI 2021b). Remember that these recommendations are based on a 1,800- to 2,000-calorie diet. The number of servings you should consume will depend on your specific daily calorie needs. Your age, sex, height, weight, and physical activity level will determine how many calories you need each day.

Below are additional tips to help you follow the DASH lifestyle.

• Cook with fresh foods or choose frozen or canned foods that contain no added salt. Many canned foods (e.g., soup) and frozen meals have a significant amount of sodium added.
• Consider ways to add more veggies to your meals. Include vegetables at both lunch and dinner. For breakfast, enjoy a vegetable omelet, or add spinach when you blend a smoothie.
• Choose fruit as a snack or as your dessert.
• Use fat-free or low-fat dairy products in your coffee.
• Plan a meatless meal at least one or two times per week. Eat legumes (beans, peas, and lentils) as a protein source.
• Reduce your fat intake by limiting butter, margarine, and salad dressing. Use vegetable oil spray instead of a solid fat (such as butter) in your skillet.
• Consider snacks such as fat-free or low-fat yogurt with a piece of fresh fruit, raw vegetables with hummus, unsalted plain popcorn or whole grain pretzels, homemade trail mix (with whole grain cereal, nuts, seeds, and dried fruits), and whole grain crackers with part-skim mozzarella string cheese.
• Choose more foods in their whole or minimally processed forms. These foods are naturally low in sodium and added sugars and are also usually low in saturated fat.

The DASH eating plan is just one part of living a heart-healthy lifestyle. Combine it with other lifestyle practices, such as getting regular physical activity, managing and coping with stress, getting enough sleep, limiting alcohol intake, maintaining a healthy weight, and—if you smoke—quitting (AHA n.d.-a; NHLBI 2021c).

Daily and Weekly DASH Eating Plan Goals for 1,800–2,000 Calories per day

Sources: Recommendations are based on those outlined in NHLBI (2019, 2021b).

*A maximum intake of 2,300 mg of sodium is recommended each day; however, and intake of 1,500 mg may lower blood pressure even more.

References

American Heart Association. n.d.-a. “How to Manage High Blood Pressure.” 

American Heart Association. n.d.-b. “Shaking the Salt Habit to Lower High Blood Pressure.” 

Challa HJ, Ameer MA, and Uppaluri KR. 2023. “DASH Diet to Stop Hypertension.” NCBI Bookshelf. National Library of Medicine, National Institute of Health.

NHLBI. 2019. “What’s on Your Plate? 1,800—2,000 Calories a Day (PDF).” U.S. Department of Health and Human Services, National Institutes of Health. 

NHLBI. 2021a. “DASH Eating Plan.” U.S. Department of Health and Human Services, National Institutes of Health. 

NHLBI. 2021b. “Following the DASH Eating Plan.” U.S. Department of Health and Human Services, National Institutes of Health. 

NHLBI. 2021c. “Living with the DASH Eating Plan.” U.S. Department of Health and Human Services, National Institutes of Health. 

NHLBI. 2021d. “The Science Behind the DASH Eating Plan.” U.S. Department of Health and Human Services, National Institutes of Health. 

Oldways Whole Grains Council. n.d. “What’s a Whole Grain? A Refined Grain?” 

U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020. Dietary Guidelines for Americans, 2020–2025. (9th ed.). 

Prepared by Dori Owczarzak, extension educator, and Nancy Routch, former extension educator.