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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Get on track to lower your blood pressure in just two weeks! Almost half of all adults in the United States have high blood pressure--but many of us are not aware of it. High blood pressure, also known as hypertension, has serious health implications. It is classified as a leading cause of premature death by the World Health Organization, contributing to strokes, heart attacks, heart failure, kidney failure, and even dementia. While medications are often necessary to keep blood pressure in the safe zone, a judicious dietary and lifestyle overhaul will greatly help manage your blood pressure and your overall heart health. Written in an easy-to-follow, friendly style by three heart and nutrition experts, DASH Diet For Dummies shows you how increasing fiber, vitamins, and minerals, along with reducing your sodium intake when needed, can lower your blood pressure in just two weeks! Ranked the #1 Best Diet for Healthy Eating as well as #2 Best Diets Overall by U.S. News & World Report, the DASH Diet is specifically aimed at relieving hypertension and is endorsed by the American Heart Association, The National Heart, Blood, and Lung Institute, and the Mayo Clinic--and is also proven to be effective against conditions such as Type 2 diabetes, metabolic syndrome, PCOS, and more. * Improve heart health with lower blood pressure * Reduce cholesterol * Lose weight * Follow simple, tasty recipes So, don't let hypertension scare you. Along with good medical care, the DASH diet makes lowering your blood pressure achievable - and tasty! By following the straightforward meal plans and trying out our favorite recipes in DASH Diet for Dummies, you'll set yourself on the fast, proven journey to better blood pressure - and be on your way to a healthy and heart-smart future!
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Veröffentlichungsjahr: 2020
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DASH Diet For Dummies®, 2nd Edition
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Published simultaneously in Canada
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Library of Congress Control Number: 2020947088
ISBN 978-1-119-74079-7 (pbk); ISBN 978-1-119-74080-3 (ebk); ISBN 978-1-119-74081-0 (ebk)
DASH Diet For Dummies®
To view this book's Cheat Sheet, simply go to www.dummies.com and search for “DASH Diet For Dummies Cheat Sheet” in the Search box.
Table of Contents
Cover
Title Page
Copyright
Introduction
About This Book
Foolish Assumptions
Icons Used in This Book
Beyond the Book
Where to Go from Here
Part 1: Getting Started with the DASH Diet
Chapter 1: What Is DASH?
Understanding the DASH Difference
DASH: A Dietary Prescription for a Healthier Lifestyle
Preparing for Success with DASH
A DASH of Caution
Chapter 2: The DASH Diet and Wellness: What Scientists Know
Exploring the Science behind the Diet
Responding to America’s Salt Obsession and Addressing Controversies
Omni-Heart: A Variation on the DASH Theme
DASH: Wellness through Optimal Nutrition
Chapter 3: Improving Your Overall Health
Fighting the Silent Killer: Hypertension
DASH and Cholesterol
Battling the Bulge
Fighting Diabetes
Tackling Cancer
Chapter 4: Gearing Up for a DASH Lifestyle
Setting Yourself Up for a DASHing Success
More of This, Less of That
Creating Goals for Dietary Change
Planning around Obstacles
Chapter 5: Presenting Your DASH Nutrition Primer
Revealing Where Sodium Hides
Figuring Out How Much Sodium You Really Need
Reducing Your Salt Intake by Retraining Your Taste Buds
Examining the DASH Diet Framework
Part 2: DASHing toward Better Health
Chapter 6: Taking Charge of Hypertension
A Crash Course in Cardiology
Zeroing In on Blood Pressure Basics
Distinguishing between Primary and Secondary Hypertension
Examining the Factors That Contribute to Primary Hypertension Risk
Exploring the Medical Treatments for Hypertension
Reducing Your Risk of Hypertension with DASH
Chapter 7: Reducing the Risk of Heart Disease and Stroke
Introducing the Cholesterol Component of Cardiovascular Disease
Getting Acquainted with Matters of the Heart
Stroke, Otherwise Known as a “Brain Attack”
Fighting Heart Disease and Stroke with DASH
Chapter 8: Maintaining a Healthy Weight
Understanding the True Effect of Excess Weight on Your Health
Figuring Out whether You’re Overweight
Who’s at Risk for Obesity?
Eating Your Way to a Healthy Weight with DASH
Chapter 9: Reducing Diabetes Risk
Digging into Diabetes
Examining the Not-So-Obvious Downsides of Diabetes
Determining Your Risk for Diabetes
Watching for the Signs That You Have Diabetes
Treating Diabetes
DASH and Diabetes: A Perfect Prescription
Chapter 10: Keeping Yourself Healthy from Head to Toe
Realizing How Food Affects Your Brain
Maintaining Healthy Kidney Function
Reducing Cancer Risk
Understanding Diet and Healthy Aging
Part 3: Enjoying Life the DASH Way
Chapter 11: Adopting the DASH Diet
Creating a Change-Driven Plan of Attack
Easing Tasty, DASH-Friendly Foods into Your Diet
Surveying Common Obstacles
Presenting a Sample 14-Day Meal Plan
Chapter 12: DASHing Successfully through the Grocery Store
Getting Organized before You Go
Deciphering the Many Details and Claims on Food Packaging
Focusing on the Perimeter of the Store for Wholesome Food Choices
Treading Carefully in the Center Aisles
Heading Home and Storing Your Food with Care
Chapter 13: Setting Up a DASH-Friendly Kitchen
Creating a Healthy Pantry
Arming Yourself with the Right Kitchen Supplies
Infusing More Flavor into Food — without Salt
Making Over Recipes So You Can Indulge without Guilt
Chapter 14: DASH Meal-Planning Strategies
Getting a Grip on How Meal Planning Works
Starting the Day off Right
Packing Your Lunch to Avoid the Takeout Trap
Taking Shortcuts to Dinnertime
Chapter 15: Dining Out and Traveling on DASH
Dining Out with DASH, Generally Speaking
Finding the Healthy Options at Various Types of Restaurants
Planning Ahead to Follow DASH on the Road
Chapter 16: Adopting Everyday Lifestyle Changes
Remembering That the Rat Race Isn’t Really a Race
Coping with Stress
Calling on Your Support System
Sticking to the DASH Plan
Part 4: Smashing DASH Recipes
Chapter 17: Delicious Breakfasts and Brunches
Unscrambling Breakfast, the Most Important Meal of the Day
Getting Creative with the Food Groups
Chapter 18: Quick and Healthy Lunches
Preparing the Big Three: Sandwiches, Salads, and Soups
Chapter 19: Mouth-Watering Entrees
Keeping Protein Portions in Perspective
Building Flavor with Techniques and Seasonings
Chapter 20: Savory Side Dishes
Embracing the Complexity and Tastiness of Whole Grains and Vegetables
Chapter 21: Meatless Main Dishes
The Magic of Plant Food
Chapter 22: One-Pot and Sheet-Pan Meals
Keeping It Simple with One-Dish Wonders
Wrapping Up Dinner Fast with Foil
Chapter 23: Sweet Endings
Part 5: The Part of Tens
Chapter 24: Ten Tips for Following DASH on a Budget
Plan Meals and Snacks for the Week
Include Canned and Frozen Fruits and Vegetables
Purchase in Bulk
Select In-Season Produce and Store It Properly
Buy Store Brands
Skip Convenience Foods
Buy Food from Local Farmers
Grow Your Own Vegetables and Herbs
Cook at Home
Go Meatless Once a Week
Chapter 25: Ten Ways to Add Flavor without Salt
Sauté, Grill, Roast, and Oven-Crisp
Add Herbs and Spices
Squeeze in Some Citrus
Toss in Onions, Peppers, Garlic, and More
Use Fresh Ginger and Horseradish
Cook with Oils and Flavored Oils
Pour in Vinegars, Wine, and Liqueur
Puree and Chop Vegetables
Make Rubs and Marinades
Sprinkle on a Wee Bit of Cheese
Chapter 26: Ten Lifestyle Changes to Curb Hypertension
Lose Weight and Keep It Off
Develop an Exercise Routine
Stick to DASH
Eat Less Salt
Add Good Fats to Your Diet
Avoid Drinking Alcohol Excessively
Don’t Use Tobacco Products
Stress Less
Enlist Your Family and Friends
Follow Your Doctor’s Orders
Appendix: Metric Conversion Guide
Index
About the Authors
Advertisement Page
Connect with Dummies
End User License Agreement
List of Tables
Chapter 1
TABLE 1-1 The DASH Diet (Based on 2,000 Calories/Day)
Chapter 2
TABLE 2-1 Effects of a 1,500-Milligram Sodium DASH Diet on Reducing Both Systoli...
Chapter 4
TABLE 4-1 Serving Sizes of Fruits and Vegetables
TABLE 4-2 Daily Nutrient Goals Used in DASH Diet Studies
TABLE 4-3 Setting Specific Goals
Chapter 5
TABLE 5-1 Comparing Sodium in Foods
TABLE 5-2 Calcium and Calories in Common Foods
TABLE 5-3 Making Lean Beef and Pork Choices
Chapter 6
TABLE 6-1 Prevalence of Hypertension
TABLE 6-2 Common Types of Blood Pressure Medicines
Chapter 9
TABLE 9-1 Looking at the Two Types of Diabetes
Chapter 13
TABLE 13-1 Recipe Substitutions
Chapter 14
TABLE 14-1 DASH Eating Plans
TABLE 14-2 Serving Sizes for Each Food Group
Chapter 15
TABLE 15-1 Comparison of Various Portions of Similar Foods
TABLE 15-2 Calories, Fat, and Sodium in Typical Quick-Stop Breakfast Food
TABLE 15-3 Best Choices at Ethnic Restaurants
Chapter 19
TABLE 19-1 Comparing Chicken, Pork, Beef, and Fish
TABLE 19-2 EPA and DHA Content in Various Types of Seafood
Chapter 21
TABLE 21-1 Food Swaps for Better Heart Health
List of Illustrations
Chapter 4
FIGURE 4-1: Sample goal worksheet.
Chapter 6
FIGURE 6-1: The inner workings of the human heart.
Chapter 7
FIGURE 7-1: A normal artery before and after plaque develops.
FIGURE 7-2: Blood supply to the brain.
Chapter 8
FIGURE 8-1: A BMI chart.
Chapter 10
FIGURE 10-1: The kidneys are bean-shaped organs that play a huge role in your b...
Chapter 12
FIGURE 12-1: A sample Nutrition Facts label.
FIGURE 12-2: The Whole Grain Stamps, basic (left) and 100% (right).
Chapter 13
FIGURE 13-1: A garlic press and a garlic chopper.
FIGURE 13-2: A microplane grater and zester.
FIGURE 13-3: A rotary cheese grater.
Chapter 14
FIGURE 14-1: MyPlate proportions line up with those recommended for the DASH di...
Chapter 18
FIGURE 18-1: How to seed a cucumber.
Chapter 19
FIGURE 19-1: How to mince garlic.
Chapter 20
FIGURE 20-1: How to core and seed a pepper.
Chapter 21
FIGURE 21-1: How to extract excess liquid from tofu.
Chapter 22
FIGURE 22-1: It’s easy to create a foil pouch for cooking.
Guide
Cover
Title Page
Copyright
Table of Contents
Begin Reading
Metric Conversion Guide
Index
About the Authors
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Introduction
Hypertension, or high blood pressure, is a serious health concern affecting about 45 percent of the world population. According to the Million Hearts Initiative, nearly one out of every two adults in the United States has hypertension. More concerning, only one in four have their blood pressure under control. Because hypertension often has no symptoms, it may go undetected for years, damaging the heart, blood vessels, and kidneys.
Fortunately, in the 1990s, researchers discovered two amazing things: that diet can lower blood pressure without medication and that certain foods seem to play an important role in this. And thus, the Dietary Approaches to Stop Hypertension (DASH) diet was born. Of course, it’s not a diet in the traditional sense, because it neither deprives nor restricts you. Instead, it enlightens you to find new ways to add healthful foods to your plate and helps you plan and cook flavorful meals. Experts around the world agree: DASH really works. It’s no wonder that in 2013, the American Heart Association and the American College of Cardiology issued a joint statement urging a DASH-style diet to help achieve a healthy blood pressure and improve heart health.
This book fills you in on the DASH diet, how your heart works, and the lifestyle changes that support lowering blood pressure and better health. We begin by filling you in on how DASH was created (so you can understand the science behind why it works), how it can help with numerous health conditions, and how to apply DASH eating principles in your everyday life. To that end, we provide a variety of recipes to get you started. We also include valuable information about making lifestyle changes, such as becoming more physically active and managing stress. Making these sorts of healthy lifestyle changes is easier than you may think, and we’re here to show you how. By following the DASH diet and setting simple goals that will improve your life and long-term health, you will lower your blood pressure and become healthier to boot. Have no fear — living a healthier life feels good, and the food tastes delicious!
About This Book
This book is your personal reference guide to the DASH diet and heart health. Don’t read it from cover to cover (unless that’s your style), and don’t feel like you have to read the sidebars (they’re interesting but not essential). Do, however, flip to the topics or recipes that interest you.
Speaking of recipes, all of our recipes adhere to DASH guidelines and provide a foundation for a heart-healthy, blood-pressure-lowering diet. Some of them may seem slightly higher in sodium and/or saturated fat; when you make them, simply try to balance them out with lower-sodium meals and more fruits and vegetables the rest of the day. It’s all good food. And yes, fruits, vegetables, and low-fat dairy are just as important in the DASH diet as reducing sodium — if not more so — and we show you plenty of ways to incorporate more of them into your day-to-day living.
Here are a few ground rules relating to the recipes:
All oven and cooking temperatures are measured in degrees Fahrenheit; flip to the appendix for information on converting temperatures to Celsius.
All eggs are large.
All onions are yellow (unless otherwise noted), but feel free to use Vidalia or white.
For measuring purposes, dry ingredients are lightly spooned into a standard U.S. measuring cup or spoon and then leveled with a knife. Liquids are measured in glass, standard U.S. measuring cups. Check out the appendix if you need help converting to metric measurements.
All sugar is granulated.
All flour is all-purpose.
The term
lightly browned
indicates when the food just begins to change color.
All herbs are dried unless specified as fresh.
Lemon and lime juice are freshly squeezed.
All ground pepper is freshly ground black pepper.
Some higher-sodium ingredients (kalamata olives, capers, and Parmesan cheese, for example) are used in very small quantities to enhance the flavor of a recipe. Measure these ingredients carefully to avoid increasing sodium levels significantly.
References to
percent daily values
or limits on nutrients are based on a daily intake of 2,000 calories.
Recipes marked with the tomato icon () are vegetarian.
One final word: This book isn’t intended to be a substitute for medical care. If you have a family history of high blood pressure or have it yourself, you may still need medication. We recommend you see your doctor to determine your personal medical needs and have your blood pressure monitored regularly.
Foolish Assumptions
We wrote this book assuming that you, our dear reader, already have hypertension or are at risk for developing it. We also took for granted that you want to improve your lifestyle and health, meaning you’re willing to make a few informed changes in your habits. You’re ready to get a deeper understanding of how diet and lifestyle affect blood pressure, and you’re willing to spend a little time in the kitchen whipping up tasty, healthy foods. We’re not assuming you’re a master chef, which is why we share helpful cooking preparation and technique tips in as simple a way as possible.
Icons Used in This Book
Like any For Dummies book, DASH Diet For Dummies features some helpful icons, which are like little guideposts that point out useful information as you read:
Keep your eyes peeled for paragraphs marked with this icon, which highlights the most important actions you can take and facts to keep in mind to beat hypertension.
This icon indicates information that’s interesting but not essential to your basic understanding of reducing high blood pressure with the DASH diet.
Want a tip? Read information with this icon to get helpful hints on how to easily make the DASH lifestyle fit within your life.
Halt! Stop! Whoa, Nelly! When we place this icon next to a paragraph, it means we want you to pay attention so you don’t make a mistake that could impact your health or your recipe.
Beyond the Book
We could only include so much information in the book, which is why we’ve put up some additional goodies online:
Check out
www.dummies.com/cheatsheet/dashdiet
for an at-a-glance breakdown of DASH nutrition guidelines and advice for making positive lifestyle changes.
Visit
www.dummies.com/extras/dashdiet
to discover how the low-fat dairy promoted in DASH helps out your bones, which items are the most DASH-friendly at the grocery store, no-cook meal ideas, and more.
Where to Go from Here
You’re welcome to head straight to Chapter 1 for an overview of what you’ll find in this book, but you certainly aren’t required to. If you want to get cooking, start browsing the recipes in Part 4. Wondering what the blood pressure numbers are all about and how your heart works? Head to Chapter 6. Want some help convincing a family member of all the ways eating the DASH way can benefit your health and blood pressure? Head to the chapters in Part 2. You get the idea. Where you go next — both in this book and in your heart-health journey — is up to you!
Part 1
Getting Started with the DASH Diet
IN THIS PART …
Get your feet wet with an overview of the DASH diet — including its basic dietary guidelines and the lifestyle changes that help promote normal blood pressure and support a healthy heart — before diving into DASH completely to improve your chances of making DASH a way of life.
Discover the core science behind the diet. That’s right: DASH isn’t one of the numerous fad diets out there; it’s a well-researched approach to eating that has been benefiting people with high blood pressure for more than 20 years.
Recognize all the ways DASH can have a positive effect on your health, from the obvious (lowering blood pressure and reducing the risk of stroke and heart attack) to the not-so-obvious (fighting diabetes and decreasing cancer risk).
Understand that adopting DASH is a lifestyle change and figure out how to ease into the DASH way of eating. Trust us, setting realistic goals really helps!
Know which foods you can eat on the DASH diet — there are loads of them, particularly fruits and vegetables, nuts, whole grains, lean protein, and low-fat dairy served up in delicious ways.
Chapter 1
What Is DASH?
IN THIS CHAPTER
Explaining the history of DASH and what sets it apart from other diets
Understanding the fundamental dietary and lifestyle guidelines of DASH
Taking a proactive approach to DASH so that it sticks
Adapting DASH to individual circumstances
Hypertension, or high blood pressure, affects one in three of the world’s adult citizens, including nearly half of all U.S. adults, and contributes to millions of deaths from heart disease, stroke, and kidney failure every year. Although medication is usually very effective, in many cases hypertension can be prevented or lessened simply by choosing a diet and lifestyle that promote good health. The Dietary Approaches to Stop Hypertension (DASH) diet was developed as a holistic, yet medically sound, method to lower blood pressure safely while also promoting wellness and vitality of the whole body. In short: The DASH diet uses food as part of the medical treatment.
This chapter shines a spotlight on what makes DASH so powerful for heart health — and good health in general — and what makes it different from all the other diets out there. It also explains how to find true success with DASH: by making a commitment to changing your current lifestyle for a healthier one that incorporates DASH dietary guidelines and increased activity. Change may seem intimidating, but DASH makes it easy and accessible, incorporating foods you already know and love to help you achieve your goals and live your life to the fullest. There’s no time like the present to throw on some sneakers, grab a healthy snack, and jump right in!
Understanding the DASH Difference
Twenty-five years ago, if you were diagnosed with hypertension, your doctor may have simply sent you on your way with a prescription and advice to cut back on salt. However, over the past two decades, the medical community’s understanding of the effects that diet, body weight, and lifestyle have on blood pressure has expanded tremendously. Studies by physicians, scientists, dietitians, and others have concluded that controlling blood pressure is about far more than just the salt. The following sections trace the history of DASH and explain why DASH is more than just another trendy diet.
Exploring the origins of DASH
The acronym DASH comes from a landmark 1997 clinical trial (a well-controlled human research study) that tested the effects of specific types of food on blood pressure. Instead of just telling people with hypertension what to avoid, the study sought to gauge the effects on blood pressure of a variety of readily available, inexpensive whole foods known to support good health.
Study participants following the DASH diet experienced impressive results: By eating a diet rich in fruits, vegetables, whole grains, and low-fat dairy foods and low in saturated fat, they reduced their blood pressure just as much as if they had taken a single prescription drug. The drop in blood pressure was evident within two weeks, even though the participants were on the DASH diet plan for eight weeks. DASH researchers estimated that the improvement in blood pressure could mean a 15 percent drop in heart attack risk and as much as a 27 percent reduction in stroke risk.
It’s worth noting that study participants who followed the DASH diet minus the dairy also reduced their blood pressure, but the decrease was less. That’s why including low-fat dairy is recommended for maximum effectiveness.
Having confirmed that healthy and delicious food could lower blood pressure just as effectively as a pharmaceutical drug, the DASH researchers next turned their attention to salt. The study, known as DASH-Sodium, found that by cutting salt to about 1,500 milligrams daily, blood pressure improved even more than with DASH alone. In fact, even a little reduction in salt made an important difference in blood pressure. The effect was seen in people with borderline high blood pressure, as well as in those with true hypertension.
For a deeper dive into the science behind the DASH study, see Chapter 2. Less interested in the science than in finding advice on how to create a healthy diet plan that works for you? We help you out in Chapter 4.
CONVINCING REASONS TO TRY THE DASH DIET
Hypertension, or high blood pressure, is an incredibly widespread problem, affecting people of all ages, shapes, sizes, colors, and nationalities. If you don’t have hypertension, chances are your parents, siblings, or friends do. And you may too one day because the prevalence of hypertension increases with age. If you live long enough, you have a 90 percent probability of hypertension.
Although some cases of hypertension are due purely to genetics (as we explain in Chapter 6), many times the problem can be prevented or lessened by simple lifestyle changes. That means you may have more control than you realize. Around the world, access to fast food, processed food, and convenience food, along with an increasingly sedentary way of life, means that more people are becoming hypertensive every year. In fact, it’s estimated that if things keep going along the way they are, a jaw-dropping 60 percent of adults around the world will be hypertensive.
Many medications exist that are effective at treating hypertension, and the average person with hypertension requires at least two to three of these medications to really get the problem under control. But due to costs, side effects, and complications, many people never achieve normal blood pressure numbers. Why not save yourself some hassle and prevent hypertension in the first place by following the DASH diet?
Recognizing why DASH isn’t just another trendy diet
It seems like every year a new diet book comes out, full of promises and complete with enthusiastic endorsements from the celebrity-du-jour. Is the DASH diet really any different? Absolutely, 100 percent. No doubt about it.
DASH is science-based. It was developed based on reams of scientific research that identified certain foods as being especially beneficial for blood pressure. The DASH team put their highly educated heads together and came up with a diet that incorporated those foods into an easy-to-follow, inexpensive program that they believed would really make a difference. And make a difference it does. Not only can DASH help lower blood pressure, but it can also help with weight loss (thanks to eating more fiber-rich whole grains, fruits, and vegetables), reduce diabetes risk (thanks to complex carbohydrates), and more. Head to Part 2 for an in-depth look at all the benefits DASH provides for your health.
A HEALTHY EATING PLAN FOR THE WHOLE FAMILY
DASH isn’t just for adults who have or are at risk for hypertension. It’s an approach to eating that’s healthy for most children as well. Why talk about DASH and kids? Consider the fact that since the 1970s, American children between the ages of 6 and 11 are now consuming
Triple the amount of salty snacksNearly double the amount of candyMore than 40 percent fewer vegetablesHalf the amount of milkTwice the amount of sodaIt’s no wonder that more than one-third of U.S. kids are overweight or obese and are at risk for developing a condition known as the metabolic syndrome (the result of a cluster of risk factors including obesity, high blood pressure, abnormal blood lipid levels, and elevated blood sugar), which substantially raises the risk of heart disease, stroke, and diabetes. The good news is that the DASH diet has the potential to help kids who are heading down this road. For instance, a British study of girls with metabolic syndrome found that after spending just six weeks on DASH, blood pressure and insulin levels were improved compared to those who weren’t assigned to DASH. Another study that simply tracked the diets of young girls over the course of ten years reported that those whose diets simply included two or more servings of dairy and at least three servings of fruits and vegetables daily were one-third less likely to have high blood pressure by the time they hit their late teens.
When it comes to kids, it’s up to parents to provide healthy food options and keep unhealthy snacks to a minimum. DASH keeps it simple by giving you a structure that you can follow to put together nutritious meals for your family. And of course, in Part 4 of this book, we share loads of great recipes that can help you get started. As always, get your pediatrician’s or family doctor’s approval before jumping right in.
Scientists know that sometimes an idea can make perfect sense on paper and fail miserably when put to the test. Without a scientific study that randomly assigns individuals to one diet or another, with as many variables as possible controlled by the research team (what scientists call a randomized, controlled trial), you’re just going on an assumption. You also need to set your goals ahead of time and then conduct the study in such a way that it’s as unbiased as possible. Next, when it’s all said and done, you need to do a detailed statistical analysis and then tidy up the whole mess into a neat and obsessively thorough report. Finally, you submit your work for review by other well-respected and uninvolved scientists (what’s known as peer review). This meticulous attention to detail and strict scientific method are what set DASH apart from so many other diet plans.
DASH: A Dietary Prescription for a Healthier Lifestyle
Unlike some medical prescriptions, DASH works for just about anyone. It includes enough variety and room for modification so that most people, even those with dietary restrictions, can make it their own. You just have to follow some simple dietary guidelines and commit to making positive lifestyle changes, as we explain in the next sections.
The basic dietary guidelines
Every type of food included in DASH has a purpose, as you can see from the following list:
Whole grains give you plenty of fiber, potassium, magnesium, and antioxidants, all of which help support the health of your cardiovascular system and lower your blood pressure. A world of difference exists between refined flour and whole-grain flour because after the rough part of the grain is stripped away, most of the nutrients are gone as well.
If you need to steer clear of gluten (a protein abundant in wheat, barley, and rye products), you have a variety of interesting whole-grain options to choose from, including quinoa, millet, rice, and oats.
Fruits and vegetables offer blood pressure–friendly nutrients galore, including a wide range of vitamins and antioxidants, plus potassium and fiber.
Although whole grains also provide a similar list of healthy elements, the variety supplied by fruits and vegetables is very different. Your body is an incredibly complex system, so you can’t rely on just one category of food to give you everything you need.
Low-fat dairy foods have been strongly linked to a lower risk for hypertension because they’re rich in vitamin D, calcium, magnesium, and potassium; high in protein; and low in saturated fat and calories. There’s also good evidence that dairy foods may reduce the likelihood of stroke, a common complication of high blood pressure.
If you’re lactose intolerant, check with your doctor and see whether a lactase supplement may help you enjoy these healthy foods. We provide more pointers on how dairy can fit into your DASH diet in Chapter 11.
Lean meats, fish, and poultry provide plenty of protein to build a healthy and strong body, while limiting your exposure to saturated fats and calories.
Although DASH hasn’t been specifically tested in vegetarians, it’s easily adaptable, especially because animal protein is a proportionately smaller part of the plan than it is in a typical Western diet. If you’re a vegetarian, try substituting soy products or other high-protein, vegetable-based options. Of course, nuts and seeds (see the next bullet) also supply some protein. In
Chapter 21
, we whip up some terrific meat-free recipes to help get you started.
Nuts, seeds, and legumes provide heart-friendly, plant-based protein, along with healthy fats, fiber, and magnesium.
Peanuts and soy nuts are, technically speaking, members of the legume family, which also includes beans, chickpeas (found in hummus), and lentils. Although the calories can add up quickly, especially if you’re a nut lover, they come from healthy fats and are a much better choice than typical snack-food fare.
DASH is important not only for the foods it includes but also for those it limits:
Fats and oils are limited but not out of bounds in the DASH diet.
Since the time that DASH was developed in the 1990s, more recent research has confirmed the benefit of foods rich in omega-3 fats, such as oily fish, as well as monounsaturated fats like olive oil. A second set of studies known as
Omni-Heart
confirmed that switching out a small portion (about 10 percent) of carb-based calories and replacing them with healthy monounsaturated fats can make DASH even more effective, as long as the calories remain the same.
Sugary and high-fat treats aren’t forbidden on DASH, but they’re kept to a minimum.
If you’re like us, you probably need a little indulgence from time to time. Severely restrictive diets aren’t always realistic and may even cause you to jump ship, giving up on a healthy eating plan altogether. DASH allows you a little leeway to enjoy the foods you love, but don’t be surprised if you find that, after a few days on DASH, you feel so good that snack foods no longer hold the same appeal.
Table 1-1 shows the quantities you should eat of different food groups when following DASH and examples from each group. If what you see here looks a bit basic or maybe kind of daunting, don’t despair. We share more than 40 great-tasting recipes in Part 4 that really make the DASH diet come alive. (Note: The servings listed in Table 1-1 are based on a 2,000-calorie diet. Some people need more calories than that; others need fewer calories.)
TABLE 1-1 The DASH Diet (Based on 2,000 Calories/Day)
Type of Food
Number of Servings for a 2,000-Calorie Diet
Example Serving Sizes
Grains and grain products
6–8 per day
1 slice bread, 1 cup dry cereal, ½ cup cooked cereal, rice, or pasta
Fruits
4–5 per day
10 grapes, ½ grapefruit, 1 small banana, 2 tablespoons raisins, 1 medium apple
Vegetables
4–5 per day
1 cup raw, ½ cup cooked
Low-fat or nonfat dairy products
2–3 per day
1 cup milk or yogurt, 1 ounce cheese
Lean meats, fish, poultry
2 or fewer per day
3–4 ounces cooked per day
Nuts, seeds, legumes
4–5 per week
1/3 cup nuts, 2 tablespoons nut butter, 2 tablespoons seeds
Fats and oils
3–4 per day
1 teaspoon margarine, butter, or oil; 2 tablespoons salad dressing
High-fat/high-sugar extras
5 or fewer per week
½ cup sorbet or frozen yogurt, 1 “fun-size” candy bar, 8 pieces of gummy-type candy, 1 tablespoon jam; 1 ounce dark chocolate (70 percent to 85 percent cocoa)
That’s the DASH diet in a nutshell; for a deeper look at DASH nutrition, see Chapter 5.
By choosing DASH, you’ll achieve better blood pressure deliciously. And with such a wide range of foods to choose from, it’s easy to see how you can tailor DASH to your personal taste.
The most powerful lifestyle changes
Just as you need a balanced blend of healthy foods to achieve good health and better blood pressure, your body also requires balance in other areas. Throughout this book, we help you cultivate healthy habits to support the vitality, energy, and overall well-being that you’re craving. Although making changes to your daily routine may seem intimidating at first, it’s surprisingly simple. You just have to take it one step at a time.
We tell you much more about the way lifestyle impacts your health in Chapter 16, but to get started, check out the following sections to get a feel for the simple things you can do or change that may help reduce your risk for hypertension, heart disease, stroke, and a wide array of other conditions.
Moving more
Being active daily is essential for a healthy lifestyle. Before you start calculating the cost of a gym membership and fancy workout clothes, it’s important to understand that getting more daily activity can be as simple as putting on your sneakers and walking out the door. Combat the modern sedentary lifestyle by looking for simple ways to add daily activity: taking a ten-minute walk break, choosing to use the stairs, walking where you may normally drive, sweeping the porch more often, or committing to housework or yard maintenance.
While you’re busy getting more active, why not add in some exercise? It’s nearly impossible to be healthy without regular exercise. By exercising two and a half hours each week, you’ll lower your blood pressure, reduce your stress level, burn some calories, and cut your risk of heart disease, stroke, and dementia a well-worth-it 30 percent. If hitting the gym’s your thing, go for it! If you’re a weight lifter, just make sure you get a good balance of aerobic exercise along with the resistance training. Yoga and Pilates are also terrific ways to take care of your body and encourage serenity of mind, but adding in some walking, running, biking, or swimming to your weekly routine helps keep your heart even stronger.
Exercise isn’t just for the young and fit. Just about anyone can do it, and you can usually find something that works with any limitations you may have. Remember, though, that anytime you’re beginning a new exercise regimen or bumping up the intensity of a current routine, you need to check in with your doctor to be sure your plan makes good health sense for you.
Because exercise can lower blood pressure, blood sugar, and cholesterol, you want to keep track of your numbers when you get started. If you have hypertension, high cholesterol, or diabetes, don’t be surprised if, eventually, you don’t require as much medication to keep the problem under control.
Cutting back on caffeine, alcohol, and smoking
DASH doesn’t put caffeine off-limits, and for many people, a cup or two of tea or coffee is a great way to take a break and recharge. It turns out that these plant-based drinks actually offer a boost of healthy antioxidants along with the caffeine, but don’t go overboard. (Caffeinated sodas and energy drinks may give you a similar jolt, but they don’t have the same health benefits.) Doctors used to shake their fingers at people with a coffee habit, but the research on coffee and tea strongly suggests that they have health benefits when consumed in moderation — generally considered 3 cups or fewer per day.
Although coffee can cause a temporary bump in blood pressure, it doesn’t appear to cause hypertension. Of course, some people can’t take a sip of tea or coffee without experiencing heart flutters or heartburn, and if that’s you we’re talking about, then it’s best to avoid a cup of brew or switch to decaf.
Whether or not to drink alcohol is a personal decision. Any form of alcohol enjoyed in moderation appears to offer health benefits for the heart and brain, although red wine is especially beneficial. “Moderation” means one drink for women and one to two for men. More than that and you’re more likely to develop high blood pressure, especially if you binge drink. Additional downsides of overindulging in alcohol include alcoholism, a higher risk of cancer, poor decisions made under the influence (perhaps including extra calories from junk food), and of course weight gain from the extra calories.
We’d be remiss if we didn’t touch on smoking. If you don’t already know that smoking is bad for your health, we have to assume that you’ve been in hibernation for the past 50 years. Not only does it raise your risk for numerous particularly nasty forms of cancer, but it also drastically raises your chances of developing heart attacks, aneurysms, blocked leg arteries, and strokes. It may not affect your blood pressure much, but it can hurt you in just about every other way. Quitting isn’t easy, but it’s well worth the effort.
Reducing stress
Not all stress is created equal. There’s good stress, which you have control over, and then there’s the bad kind, which leaves you feeling overwhelmed and powerless. Guess which form of stress is harmful? Of course, it’s the second type. Sometimes you can get away from this sort of stress, but sometimes it’s just a part of your work or family life.
Stress can seem like so much a part of everyday life that it becomes hard to recognize, but the truth is that it can affect your health. Perhaps you don’t realize it, but when you’re stressed you may be more apt to reach for a cookie or a soda rather than an apple or a handful of nuts. Sometimes these cravings mean that you’re searching for an instant energy boost, but processed foods only serve to cause a vicious cycle of craving and hunger. Keep these foods out of reach and you may find that you’re better able to manage the stress that comes your way.
Not surprisingly, stress can also have a direct influence on your blood pressure. By leaving an unhappy job or a difficult relationship, you may suddenly find that your blood pressure is much easier to manage. Of course, sometimes you can’t, or don’t want to, get away from the situation that’s causing the problem, but many times there’s something about it that you can change for the better. Don’t give up on yourself just because it seems difficult. Your health depends on you taking good care of yourself.
Stress can also cause poor sleep, which itself may lead to high blood pressure and cravings for unhealthy food. Getting to the root of the problem may help you sleep better.
When dealing with stress above and beyond the daily annoyances, it often helps to enlist the services of a well-qualified counselor. By doing so, you’ll find it much easier to get your life back on track, and the healthier choices may begin to come more naturally.
Preparing for Success with DASH
By choosing DASH, you’re affirming a commitment to good health and vitality. Unlike many other diet plans, DASH doesn’t explicitly tell you what to do; there are no gimmicks, supplements, or products that you need to make it work. Instead, DASH offers a range of options that you can use to build a diet that works specifically for you. Though this framework may seem a little intimidating at first, you’ll find that such flexibility is exactly what makes DASH so useful and so doable. Choices abound in the real world, and DASH gives you a structure that helps you make healthy sense of the options.
Choosing foods that support your health
Does the word diet make you think of dreary, boring meals; deprivation with nothing to look forward to; and miserable nights spent alone avoiding social situations where food may appear? We promise that’s not the life you’ll be living when you adopt DASH. Although the word diet is often used in conjunction with DASH, we’re here to show you how DASH is different and how it can be part of a healthy, vibrant, and delicious way of eating and living.
One of the really wonderful things about DASH is that it gives you such broad leeway to make your own personal choices about the foods that you eat. Studies of DASH have incorporated the plan into menus all over the world, including the United States, Asia, Europe, South America, and the Middle East. The thing really works!
For many people, the number of servings of fruits and vegetables is an eye-opener. If you follow DASH, you’ll naturally start to peruse the produce aisles with more curiosity, and you’ll probably begin to take some chances, bringing home unfamiliar produce to try at home. You can think of it as a great adventure!
The DASH diet is lower in sodium than a typical Western diet, which may take some adjustment for you. Be patient with your taste buds as you cut back on the salt because it may take them several weeks to adapt. If you cut back slowly, it won’t seem like you’re giving something up, and you’ll probably find that you’re enjoying the natural flavors of foods so much more than ever before.
Sweets and other simple carbs may be a bit harder to renounce, but, just like salt, you’ll eventually realize that, first of all, many packaged sweets usually don’t taste as good as advertised, and second, you’ll actually feel better if you limit portions to just a small taste of something homemade and really good. Plus, as you cut back on sweets, you’ll crave them less often.
We share additional guidance on adopting a DASH way of life in Chapter 11, as well as a 14-day meal plan you can follow. For help setting up your kitchen for your new cooking adventures, see Chapter 13. Or for advice on following DASH when dining out or traveling, see Chapter 15.
PUTTING FOOD BEFORE SUPPLEMENTS
It’s tempting to think that rather than having to bother with healthy eating, you may be able to get your nutrition from a pill or a powder. It often seems all Willy Wonka and the Chocolate Factory, but like those hapless kiddos who fell victim to the magical “three-course meal in a stick of gum,” it just doesn’t work out the way you’d think it should. You may be surprised to know that the world of supplements is largely unregulated, so manufacturers face little accountability.
Over the years, trends have come and gone for a wide variety of supplements, including vitamin E, high dose folic acid, selenium, L-arginine, and others. When put to the scientific test, these supplements and their counter-mates have often had unintended consequences, including a greater risk for certain cancers, diabetes, and heart disease. Other supplements used for weight loss and energy may put you at risk for heart rhythm disturbances, heart attacks, and strokes. And while a multivitamin probably won’t hurt you, there’s little evidence that it will do you much good, either.
Whole foods are very different from supplements. Their natural goodness is balanced in a neat package created by Mother Nature, with literally dozens of nutrients in a single bite. Your body was designed to use foods in their natural form. By overwhelming your system with massive doses of a single substance, you may be setting yourself up for unintended consequences.
Of course, there are exceptions. For instance, many people are deficient in vitamin D, and in these cases, a supplement can be helpful. The same may apply to iron and certain B-vitamins. Your doctor can test you to see whether your levels are low. Other supplements, like fiber, can help with constipation and even lower cholesterol. And sometimes a protein shake can be a reasonable replacement for a single meal. But before you take a product’s claim on faith, check in with your doctor or a registered dietitian.
Creating lifestyle changes that stick
Hypertension, diabetes, heart disease, obesity. All these conditions, and more, can be impacted by your lifestyle, and they can weigh you down if you allow them to. Fortunately, you don’t have to. Making positive changes in the way you eat and the way you choose to spend your time can have a lasting impact on your health and the overall quality of your life. No matter what challenges you may have in your life, never give up or give in. Life is too precious.
Don’t think of DASH as “going on a diet.” That implies a temporary situation. What you’re after here is making a lifestyle change that you can live with — one that doesn’t make you feel deprived or drained, but rather, one that you can celebrate! Our recipes and tips throughout this book will help you accomplish this, and you’ll find lots of tips in Chapters 4, 11, and 16.
By following the DASH diet, you’ll be able to create a plan that will support your health and empower you with more energy. Consequently, exercise will seem less daunting, and you’ll find it easier to change other habits that have been keeping you back.
Track your successes and forgive your slip-ups. Reach out for support from professionals or a friend when you need encouragement or focus. Making healthy changes may seem difficult at first, but by taking it one step at a time, you’ll find that you can accomplish a great deal.
A DASH of Caution
Although DASH is a fabulous plan that promotes better health and well-being for most people, it’s not for everyone.
One advantage of DASH is the fact that it’s high in potassium. For most people, that helps their kidneys regulate blood pressure more efficiently. However, people with advanced kidney disease may need to limit the potassium in their diet.
If you have a chronic medical condition or take prescription potassium, it’s important to discuss any major changes in the foods you choose with your doctor. In some cases, you may need more careful monitoring of blood work, and in other situations, it may be possible to cut back on the potassium pills when you switch to DASH.
Of course, if you have high blood pressure, DASH may lower it enough that your medications will need to be adjusted. That’s a really good side effect, but not one that you want to overlook. When you commit to DASH, it’s important to monitor your blood pressure closely, especially in the first one to two months and whenever you find yourself losing weight. Let your doctor know of any changes. Doctors love it when patients can ditch a pill or two.
It goes without saying that if you’re gluten intolerant, you need to modify a bit, but there are plenty of tantalizing, gluten-free, healthy grains, including buckwheat, quinoa, millet, and wild rice.
If you’re lactose intolerant, yogurt and other dairy products may not be right for you (although kefir, a cultured milk product low in lactose and high in healthy probiotics, may be an option). Consider calcium-fortified soy milk, almond milk, and other such products.
If you have a disease or disorder that requires medical nutrition therapy (MNT), you need to consult with a registered dietitian/nutritionist (RDN) for individual nutrition counseling prior to starting the DASH diet. Talk to your doctor about a referral or find an RDN near you by checking out “Find a Registered Dietitian” at www.eatright.org.
Finally, despite the fact that some people eat way too much salt, others need more salt, and not everyone needs to cut back. Competitive athletes and people working outdoors in the heat are the obvious examples. A small minority of people suffer from low blood pressure, and in those cases, extra salt is often the treatment of choice.
The great thing about DASH is that it can be easily adapted for a wide variety of tastes and conditions. Because everybody is different, check with your doctor before jumping in with both feet, and let her be a partner in your path to wellness.
Chapter 2
The DASH Diet and Wellness: What Scientists Know
IN THIS CHAPTER
Tracing the origins of DASH to its original study
Examining the relationship between DASH and sodium intake
Looking at other diets similar to DASH
Seeing some of the positive potential effects of DASH
Despite its catchy name, the DASH diet is based on hard science. It was created to help fight and reverse high blood pressure. It also has some remarkable benefits for the body as a whole. Incorporating decades of medical and nutritional research, the DASH diet is a delicious way to boost your health and keep your taste buds happy all at the same time. By choosing to eat the DASH way, you’re making a commitment to a healthier, happier, and more vibrant you. In this chapter, we fill you in on the science behind the DASH diet to help you better understand why it was created and how it works.
You may want to skip ahead so you can get started on the DASH diet and dig in to all the great recipes right away, and there’s nothing wrong with that. But knowing the hows and whys can help keep that motivation going.
Exploring the Science behind the Diet
Hypertension (or high blood pressure) is more common than the common cold — and a lot more deadly. All told, in the U.S., hypertension affects upwards of 1 out of every 13 people in the under-40 set and more than 30 percent of folks in their 40s and 50s. By age 60, nearly two-thirds of individuals have full-on hypertension. And if you make it to 90, you’re nearly guaranteed full membership in the hypertension club. That adds up to more than 100 million Americans and over one billion people worldwide potentially popping a lot of pills every single day, and though that may make the drug companies happy, it’s not so good for everyone else.
More than just a number, high blood pressure affects the health of your heart, brain, and kidneys. Most research suggests that an ideal natural blood pressure is around 115/75. Those numbers may vary depending on your age and other health conditions, a topic we delve into in Part 2 of the book. For a typical adult age 40 through 70, it’s been estimated that for every 20-point elevation in systolic blood pressure (the top number) or 10-point rise in diastolic pressure (the bottom number) above these ideal numbers, your risk for heart attack or stroke doubles.
Although the link between diet and blood pressure had long been suspected, for years, no one had scientifically put a healthier diet to the test in average Americans with borderline to high blood pressure. In the 1990s, a group of physicians, nutritionists, nurses, and other medical researchers from five medical centers across the United States, along with scientists from the National Heart, Lung, and Blood Institute, set out on a mission to find out whether straightforward changes in diet could have an important impact in blood pressure. They wanted to create a plan that was easy to follow, accessible, and would work well for a variety of individual tastes. Auspiciously, the researchers called themselves the DASH group, for Dietary Approaches to Stop Hypertension. Who says scientists don’t know how to have fun?
Setting up the study
The scientists set up their research as a randomized, controlled trial, which means they followed strict scientific principles to limit any deviation from the study, provided all the meals, and monitored the research subjects very closely.
For their first experiment, the DASHers recruited 459 brave men and women, all of whom had borderline to high blood pressure. To be included, the participants’ baseline systolic pressure couldn’t be higher than 160, and the diastolic readings could range from 80 to 95. No one was on blood pressure medication.
