From time to time, I get to recommend to a motivated new patient with mildly elevated blood pressure that he or she try the “DASH” diet prior to considering medication.  The DASH diet, which stands for “Dietary Approaches to Stop Hypertension,” and has been recommended by the National Institutes for Health, the National Heart, Lung, and Blood Institute, and the American Heart Association, lowers blood pressure within 2 weeks.  You can check it out yourself at dashdiet.org.

The DASH diet is based on 1) increasing fruits and vegetables, whole grains, nuts, and dairy; and 2) decreasing fat and sugar.  Specifically recommended for lowering blood pressure, it also lowers weight, and the risk of stroke and heart disease.  Combined with exercise, it improves insulin resistance, which decreases your risk of developing diabetes.  The benefits have been seen in people of all ages, from teens to the elderly.

You can see that there is significant crossover between my 4 recommendations and the DASH diet, although we do part company on the amount of grain it recommends and the preference for low-fat dairy.  Let’s just say I respect the fact that everyone is different, and that some folks seem to tolerate grain (whole-grain only) better than others.  If the low-fat dairy recommendation confuses you, I recommend that you do your own little experiment:  Follow the DASH diet as written for a month or two, and then switch to full-fat dairy.  If your pants get tight or your weight (or blood pressure) rises, then you’ll have your answer.  But just for the record, I don’t believe that will happen.  I don’t believe that the fat in dairy and meats is unhealthy.  In fact, I believe those fats are nutritious.  It’s the fats in fast food, snack foods, and commercial baked goods that are the big problem.  All fats are not the same (see “Butter is better.”)

A new study shows that the DASH diet plus regular exercise improves not only blood pressure, but brain power as well.  In a March 2010 study published in Hypertension: Journal of the American Heart Association, 124 men and women were divided into 3 groups.  Over 4 months, one group followed the DASH diet and exercised for 30 minutes three times a week, a second group followed the DASH diet without exercise, and a third group changed neither their eating patterns nor their level of activity. 

At the beginning and end of the study, participants underwent a series of tests that assessed mental skills such as manipulation of ideas, concepts, and planning.  The people who combined aerobic exercise with the DASH diet experienced a 30% improvement in brain function, improved their cardiovascular fitness, lost 19 pounds on average, and lowered their systolic blood pressure (top number) by 16 points and diastolic blood pressure (bottom number) by 10 points.  Wow.  That’s the group I want to be in.

High blood pressure is a huge problem in our country.  It affects at least one-half of adults aged 60 and older and increases the risk of heart attacks, strokes, kidney disease, and dementia.  So why don’t we all eat the DASH diet?  Why don’t all newly diagnosed hypertension patients get referred to a nutritionist to learn to eat this way?  Come to think of it, why should you have to wait until you’re diagnosed with high blood pressure?  Why aren’t school lunch programs based on the DASH diet?  And why don’t children learn these basics in their science and nutrition classes?  I am more than ready to spend my days teaching people how not to become hypertensive and diabetic.  Any takers?
 
How to start improving your nutrition?  Since the average American gets only 2-3 servings of fruits and vegetables each day in total, the DASH diet involves a significant increase in the amount of produce consumed.  As usual, I don’t recommend jumping in all at once.  Instead, pick something from the list below.  In a few weeks, add another choice, and then another a few weeks later.  At some point, you will notice that you feel a lot better.  Then, if you’re like most people, you’ll go back to your old habits.  Don’t worry, it’s temporary.  You just need to see if it’s really the dietary changes that are responsible for the fact that you feel better.  That’s human nature, and it’s how we convince ourselves which investments are worth it.  Don’t take my word for it — take all the time you need, and figure it out for yourself. 

Here are some ways to get started:  
 .Add a serving of vegetables to lunch and dinner. 
 .Bring a piece of fresh fruit to work for midday snack. 
 .Switch to butter, and make your own salad dressing (see “What’s in that salad dressing?”).
 .Use vinegar, herbs, and spices instead of salt. 
 .Have a glass of milk or a piece of cheese or a serving of yogurt three times a day. 
 .Limit meat to 6 ounces a day.  Be aware of portion size; we all need to know what an appropriate serving size looks like. 
 .Change from white rice and conventional pasta to brown rice and whole-grain pasta. 
 .Eat more beans (see “The Lovely but Lowly Bean“).  
 .Choose cheese sticks, nuts and nut butters, raisins and other dried fruits, yogurt (see “Everything You Always Wanted to Know About Yogurt But Were Afraid to Ask“), fresh fruits and vegetables for snacks.

Bon appetit!