The DASH Diet

It is estimated that 1.13 billion people worldwide have high blood pressure. Hypertension, a pathological rise in blood pressure, is one of the risk factors for serious cardiovascular diseases (stroke, myocardial infarction, renal failure, atherosclerosis, etc.).   It is one of the leading causes of premature death worldwide, and it is only controlled in one in five people ⁽¹⁾ .   It is, like diabetes , a sneaky disease, as it is often silent – ​​most people who suffer from it are unaware of it, as it is sometimes (and only seemingly) asymptomatic.

The DASH diet (for Dietary Approaches to Stop Hypertension) is a diet developed to neutralize or even reduce high blood pressure. This diet is based on low salt consumption , since a strong link exists between sodium consumption and the occurrence of hypertension. It also recommends a diversified consumption of little or unprocessed foods, and is very similar to the Mediterranean diet.

THE PRINCIPLES OF THE DIET

Principles

The DASH diet is more of a “healthy” diet than a weight loss diet. But given its principles, it is possible that it generates weight loss. In addition, overweight and obesity being factors favoring the occurrence of hypertension, it is strongly recommended that people with hypertension lose weight. So the DASH diet takes this circumstance into   account.

Reduction and control of salt consumption

Daily sodium intake should not exceed 2300 mg (about 1 teaspoon, ie 5 ml table salt). The data seems abstract, but for information ⁽²⁾  :

• A French man consumes an average of 10.7 g/d of salt, corresponding to 8.7 g from food and 2 g from pure salting.
• A French woman consumes an average of 8.7 g/d of salt, corresponding to 6.7 g from food and 2 g from pure salting.

We are therefore clearly above the recommendations of the WHO.

The DASH diet recommends:

• Favor fresh or frozen vegetables (but not canned, unless the salt content is low) and season them yourself, but using spices and herbs rather than salt.
• Consuming fresh fish and meat rather than pre-packaged or pre-prepared – canned, salted, dried, smoked, marinated…
• Carefully examine the labels and prefer products with no added salt, or even reduced in salt.
• Limit the consumption of charcuterie, marinated or fermented foods (sauerkraut, gherkins, olives), condiments (bouillon cubes, mustard, ketchup, “ready-made” sauces, soy sauce, etc.), overly salty cheeses , aperitif biscuits ( crisps, pretzels, salted nuts…).
• Avoid consuming prepared meals , whether frozen, canned, in cartons, in trays (fresh section), vacuum-packed,   purchased in the supermarket or delivered to your home.
• Do not resalt food at the table. To do this, avoid placing the salt shaker within easy reach.
• In the event of meals away from home, favor dishes low in salt, or even ask beforehand for a specific preparation without added salt.
• Ask your baker for bread without salt.

Recommended foods and portions

• Vegetables  : 4-5 servings per day. One serving is 1 cup of raw vegetables or ½ cup of cooked vegetables.
• Fruit  : 4-5 servings per day. A serving is 1 fruit, ¼ cup of dried fruit or ½ cup of cut fruit (fresh, frozen or canned).
• Grain products  : 6-8 servings per day. This is to prefer them from whole grains. A portion is equivalent to 1 slice of bread or ½ cup of cooked cereals (pasta, rice, bulgur, quinoa, semolina…).
• Lean meat or fish  : 2 servings per day or less. One serving is equivalent to 100g of lean meat (rabbit, veal), skinless poultry or fish.
• Low-fat dairy products  : 2-3 servings per day. A serving is equivalent to 1 cup of milk, 1 cup of yoghurt or 50 g of cheese.
• Fats  : 2-3 servings per day. One serving equals 5ml margarine, 15ml light mayonnaise, 5ml vegetable oil, 30ml light vinaigrette.
• Oilseeds, legumes and seeds  : 4-5 servings per week. One serving is 1/3 cup walnuts, 2 tbsp. at s. peanut butter, 2 tbsp. at s. seed butter, ½ cup cooked lentils.
• Sugar  : less than 5 servings per week. One serving is 1 tbsp. at s. powdered sugar, honey or jam, 1 glass of sweet drink or ½ cup of sorbet.

Recommended foods and portions

In addition to salty foods, the DASH diet invites you not to consume:

• Foods and drinks high in sugar – sweets, sodas , industrial fruit juices, desserts, flavored yogurts…
• Red meat.
• Foods high in saturated fats   – ready meals, fast food, fried foods…
• The alcohol.

Additional recommendations

The DASH diet, in addition to recommending a food plan, is accompanied by lifestyle advice favorable to a reduction in high blood pressure:

• Daily physical activity
• Maintaining a healthy weight
• Avoidance of stress
• Quality sleep
• Pure and simple quitting smoking
• Moderate to no alcohol consumption

ADVANTAGES

• Diet inviting to adopt a varied and balanced diet .
• Home-made diet.
• The DASH Diet can be adopted by everyone, not just hypertensives.
• Possible weight loss.
• Lower blood levels of LDL cholesterol and triglycerides.
• Lower blood sugar levels and, ultimately, the risk of developing type 2 diabetes.
• Health benefits with reduced risk of cancer, sleep disorders , inflammatory diseases, cardiovascular diseases.

DISADVANTAGES

• Possible financial impact – the DASH diet, by promoting the consumption of fresh products, can lead to an increase in the food budget.
• Weighing or measuring your food can be tedious, as can systematically control your sodium intake.
• Low intake of mono- and polyunsaturated fatty acids.
• Possible frustration (sugar, fat).
• Impact on social life.
• Possibility of intestinal disorders (large part of fibers ).
• Possibility of developing eating disorders.

ORIGINS

The DASH diet was created in the mid-1990s by the National Heart, Lung and Blood Institute, a branch of the NIH (National Institutes of Health), an agency dependent on the United States Department of Health.  Back then (and still now), one-third of the American population was affected by high blood pressure. Thus, the government has decided to carry out a study across the whole country, the DASH study. The goal: to study the relationship between blood pressure and cardiovascular disease, but also the effects of eating habits on blood pressure. Rather than relying on specific food classes or nutrients, the study preferred to consider diet as a whole, examining habits (patterns) and establishing correlations between food and hypertension. 

Thus, the DASH diet is designed to provide some flexibility:

• No exclusion of food classes – all macro- and micronutrients are included in the diet.
• A significant portion of foods rich in antioxidants, essential for disease prevention.