DASH DIET

PRESENTED BY : Hassaan Arif

DEFINITION

• The DASH, stands for Dietary Approaches to Stop 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.

• It is a dietary pattern promoted by the U.S.-based National Heart, Lung, and Blood Institute to prevent and control hypertension.

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• DASH is a flexible and balanced eating plan.

• It has been proven to lower blood pressure and cholesterol, and is associated with lower risk of several types of cancer, heart disease, stroke, heart failure, kidney stones, reduced risk of developing diabetes, and can slow the progression of kidney disease.

Patients on DASH diet

• The DASH diet is especially recommended for people with hypertension (high blood pressure) or prehypertension. The DASH diet eating plan has been proven to lower blood pressure in studies sponsored by the National Institutes of Health (Dietary Approaches to Stop Hypertension). In addition to being a low salt (or low sodium) plan, the DASH diet provides additional benefits to reduce blood pressure. It is based on an eating plan rich in fruits and vegetables, and low-fat or non-fat dairy, with whole grains. It is a high fiber, low to moderate fat diet, rich in potassium, calcium, and magnesium.

Blood Pressure• Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure rises and falls during the

• Blood pressure includes systolic and diastolic pressures. "Systolic" refers to blood pressure when the heart beats while pumping blood. "Diastolic" refers to blood pressure when the heart is at rest between beats.

• High blood pressure (also called as hypertension) is dangerous because it makes your heart work too hard. The condition can damage your blood vessels and organs, such as your heart, kidneys, brain, and eyes.

• High blood pressure is a risk factor for coronary heart disease and stroke.

High Blood Pressure

• High blood pressure is the consequence of high cholesterol level in the blood that leads to the formation of lumps (plaque) on its accumulation in the arteries. This causes the artery wall to thicken; hindering the ease of blood flow through it. This cuts down the blood supply to the cells; causes a pressure on heart which in turn pumps with greater force; hence results in hypertension(high B.P).

Blood Pressure levels of Adults

Category Systolic(mmHg)

Diastolic(mmHg)

Result

Normal Less than 120 Less than 80 Good

Prehypertension

120-139 80-89 It can cause problem. Dietary modifications are necessary. Exercise and weight loss strategies are beneficial.

Hypertension 140 or higher 90 or higher High B.P

DASH diet and Sodium Intake

• A key goal of the DASH diet is reducing how much sodium you eat, since sodium can dramatically increase blood pressure in people who are sensitive to its effects. In addition to the standard DASH diet, there is also a lower sodium version of the diet.

• Standard DASH diet. You can consume up to 2,300 milligrams (mg) of sodium a day.

• Lower sodium DASH diet. You can consume up to 1,500 mg of sodium a day.

• One teaspoon of table salt has about 2,300 mg of sodium, and 2/3 teaspoon of table salt has about 1,500 mg of sodium.

• 2 g salt; means no extra salt is added, foods contain only natural sodium content(in case of severe hypertension).

• 4 g salt; means a pinch of salt can be added(for mild cases).

• 8g salt ;means less than a tea spoon can be added to food items( for prehypertensive patients).

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The DASH Diet for Weight Loss

• The DASH Diet Weight Loss Solution has special benefits for people who carry their excess weight around the middle, or who have metabolic syndrome, type 2 diabetes, PCOS, or postmenopausal weight gain.

• It emphasizes more on fruits and vegetables; cutting down extra fats and sweets and also low in sodium content.

Dietary Modifications

• In addition to being a low salt (or low sodium) plan, the DASH diet provides additional benefits to reduce blood pressure. It is based on an eating plan rich in fruits and vegetables, and low-fat or non-fat dairy, with whole grains. It is a high fiber, low to moderate fat diet, rich in potassium, calcium, and magnesium.

• The DASH diet emphasizes portion size, eating a variety of foods and getting the right amount of nutrients.

Grains (6 to 8 servings a day)• Grains include bread, cereal, rice and pasta.

Examples of one serving of grains include 1 slice whole-wheat bread, 1 ounce (oz.) dry cereal, or 1/2 cup cooked cereal, rice or pasta.

• Focus on whole grains because they have more fiber and nutrients than do refined grains. For instance, use brown rice instead of white rice, whole-wheat pasta instead of regular pasta and whole-grain bread instead of white bread. Look for products labeled "100 percent whole grain" or "100 percent whole wheat."

• Grains are naturally low in fat, so avoid spreading on butter or adding cream and cheese sauces.

Vegetables (4 to 5 servings a day)

• Tomatoes, carrots, broccoli, sweet potatoes, greens and other vegetables are full of fiber, vitamins, and such minerals as potassium and magnesium. Examples of one serving include 1 cup raw leafy green vegetables or 1/2 cup cut-up raw or cooked vegetable.

• Read labels before buying canned and frozen vegetables.

Fruits (4 to 5 servings a day)

•Many fruits need little preparation to become a healthy part of a meal or snack. Like vegetables, they're packed with fiber, potassium and magnesium and are typically low in fat — exceptions include avocados and coconuts. Examples of one serving include 1 medium fruit or 1/2 cup fresh, frozen or canned fruit.

Dairy (2 to 3 servings a day)

•Milk, yogurt, cheese and other dairy products are major sources of calcium, vitamin D and protein. But the key is to make sure that you choose dairy products that are low-fat or fat-free because otherwise they can be a major source of fat. Examples of one serving include 1 cup skim or 1% milk, 1 cup yogurt or 1 1/2 oz. cheese. 

Lean meat, poultry and fish (6 or fewer servings a day)• Meat can be a rich source of protein, B vitamins,

iron and zinc. But because even lean varieties contain fat and cholesterol, don't make them a mainstay of your diet — cut back typical meat portions by one-third or one-half and pile on the vegetables instead. Examples of one serving include 1 oz. cooked skinless poultry, seafood or lean meat, 1 egg, or 1 oz. water-packed, no-salt-added canned tuna.

•  Trim away skin and fat from meat and then broil, grill, roast or poach instead of frying.

• Eat heart-healthy fish, such as salmon, herring and tuna. These types of fish are high in omega-3 fatty acids, which can help lower your total cholesterol.

Nuts, seeds and legumes (4 to 5 servings a week)

• Almonds, sunflower seeds, kidney beans, peas, lentils and other foods in this family are good sources of magnesium, potassium and protein. They're also full of fiber and phytochemicals, which are plant compounds that may protect against some cancers and cardiovascular disease. Serving sizes are small and are intended to be consumed weekly because these foods are high in calories. Examples of one serving include 1/3 cup (1 1/2 oz.) nuts, 2 tablespoons seeds or 1/2 cup cooked beans or peas.

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• Nuts contain healthy types of fat — monounsaturated fat and omega-3 fatty acids. They're high in calories, however, so eat them in moderation. Try adding them to stir-fries, salads or cereals.

• Soybean-based products, such as tofu and tempeh, can be a good alternative to meat because they contain all of the amino acids your body needs to make a complete protein, just like meat. They also contain is flavones, a type of natural plant compound (phytochemical) that has been shown to have some health benefits.

Fats and oils (2 to 3 servings a day)

• Fat helps your body absorb essential vitamins and helps your body's immune system. But too much fat increases your risk of heart disease, diabetes and obesity. The DASH diet strives for a healthy balance by providing 30 percent or less of daily calories from fat, with a focus on the healthier unsaturated fats. Examples of one serving include 1 teaspoon soft margarine, 1 tablespoon low-fat mayonnaise or 2 tablespoons light salad dressing.

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• Avoid trans fat, commonly found in such processed foods as crackers, baked goods and fried items.

• Read food labels on margarine and salad dressing so that you can choose those that are lowest in saturated fat and free of trans fat.

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• Saturated fat and trans fat are the main dietary culprits in raising your blood cholesterol and increasing your risk of coronary artery disease. DASH helps keep your daily saturated fat to less than 10 percent of your total calories by limiting use of meat, butter, cheese, whole milk, cream and eggs in your diet, along with foods made from lard, solid shortenings, and palm and coconut oils.

Sweets (5 or fewer a week)

• Examples of one serving include 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet or 1 cup (8 oz.) lemonade.

•  When you eat sweets, choose those that are fat-free or low-fat, such as sorbets, fruit ices, jelly beans, hard candy, graham crackers or low-fat cookies.

• Artificial sweeteners such as aspartame (NutraSweet, Equal) and sucralose (Splenda) may help satisfy your sweet tooth while sparing the sugar. But remember that you still must use them sensibly. It's OK to swap a diet cola for a regular cola, but not in place of a more nutritious beverage such as low-fat milk or even plain water.

• Cut back on added sugar, which has no nutritional value but can pack on calories.

Alcohol and Caffeine

•  Drinking too much alcohol can increase blood pressure. The DASH diet recommends that men limit alcohol to two or fewer drinks a day and women one or less.

FIBER

• Getting the recommended daily amount—22 to 34 grams for adults—helps you feel full and promotes good digestion. DASH provides more than enough.

MINERALSPotassium:

A sufficient amount of this important nutrient, according to the 2010 Dietary Guidelines, counters salt’s ability to raise blood pressure, decreases bone loss, and reduces the risk of developing kidney stones. It’s not that easy to get the recommended daily 4,700 mg. from food. (Bananas are high in potassium, yet you’d have to eat 11 a day.) Most Americans take in far too little. At about 4,900 mg., DASH more than meets the government’s recommendation—one of few diets that manages to do so.

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Calcium:

This mineral is essential not only to build and maintain bones but to make blood vessels and muscles function properly. Many Americans don’t get enough. Women and anyone older than 50 should try especially hard to meet the government’s recommendation of 1,000 mg. to 1,300 mg. You shouldn’t have trouble on DASH.

VITAMINS

• Vitamin B-12: Adults should shoot for 2.4 micrograms of this nutrient, which is critical for proper cell metabolism. DASH provides more than enough.

• Vitamin D: Adults who don’t get enough sunlight need to meet the government’s 15 microgram recommendation with food or a supplement to lower the risk of bone fractures. DASH comes up a little short, but choosing a vitamin-D fortified cereal can help. Also, just 3 ounces of sockeye salmon, which packs almost 20 micrograms of vitamin D, will satisfy the requirement.

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Fullness:

• Nutrition experts stress the importance of satiety, the satisfied feeling that you’ve had enough. DASH emphasizes lean protein and fiber-filled fruits and veggies, which should keep you feeling full—even if you’ve reduced your calorie level slightly to support weight loss.

 Taste:

• Although you may miss salty popcorn and potato chips, your taste buds should eventually adjust. Avoid blandness by getting friendly with herbs and spices.

Daily Nutrient Goals Used in the DASH Studies

(for a 2,000-Calorie Eating Plan)

•  Total fat27% of calories

• Saturated fat 6% of calories

• Protein 18% of calories

• Carbohydrate 55% of calories

• Cholesterol 150 mg

• Sodium 2,300 mg*

• Potassium 4,700 mg

• Calcium 1,250 mg

• Magnesium 500 mg

• Fiber 30 g

• * 1,500 mg of sodium was a lower goal tested and found to be even better for lowering blood pressure. It worked very well for people who already had high blood pressure, middle-aged and older adults.

SAMPLE MENU

Breakfast

Amount/Serving provided

Calories(kcal)

CHO(g) Proteins(g)

Fats(g)

Banana (small)

1 60 15 0 0

Egg(boiled)

1 75 0 7 5

Bread 2 slices 80+80=160

15+15=30

3+3=6 1+1=2

Margarine

1 tsp 45 0 0 5

Green tea (with 1 tsp sugar)

1 cup 20+17.5=37.5

5+5=10 0 0

Milk low fat

½ cup 60 6 4 2.5

Total 437.5 61 17 14.5

Lunch Amount/Serving provided

Calories(kcal)

CHO (g) Proteins (g)

Fats (g)

Chicken(lean)soup

(1 ounce+ 1 pinch spices) ½ cup

55+10=65 5 7 3

Vegetable (carrot+peas+potatoes) curry

½ cup + 1 pinch spices & 2 tsp oil

12.5+40+40+10+12.5+90=205

2.5+7.5+7.5+2.5+5=30

1+3+3+1=8

1+1+10=12

Chapatti(medium)

2 160+160=320

15+15=30 3+3=6 2+2=4

Yogurt plain

¾ cup 120 12 8 5

Green salad

½ cup 12.5+12.5+12.5+12.5+10=60

2.5+2.5+2.5+2.5+5=15

1+1+1+1=4

0

Total 770 92 33 24

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CONTINUE…Dinner Amount/

Serving provided

Calories(kcal)

CHO (g) Proteins (g)

Fats (g)

Baked fish (3 ounce ½ cup+2 tsp oil

55*3+10+90=265

5 7*3=21 5+5=10

Fresh fries(spices)

1 potato+2tsp

80+90+10=180

15+5=20 3 5+5=10

Rice(boiled)

½ cup 120 15+7.5=22.5

3+1.5=4.5 0

Green salad

½ cup 12.5+12.5+12.5+12.5+10=60

5*4=20 2 0

Banana custard

½ cup(milk )

30+60=90 7.5+6=13.5

4 2.5

Total 715 81 34.5 22.5

Total calories =437.5+770+715=1922.5 Kcal