F A C T S A B O U T
`
`The DASH Diet
`FEATURINGNEWFINDINGS
`ABOUTREDUCINGSODIUM—
`ANDNEWLOWER-SODIUM
`RECIPESANDMENUS.
`
`Research has found that diet
`affects the development of high
`blood pressure, or hypertension
`(the medical term). Recently, two studies
`showed that following a particular eating
`plan—called the DASH diet—and reducing
`the amount of sodium consumed lowers
`blood pressure.
`
`While each step alone lowers blood pres-
`sure, the combination of the eating plan
`and a reduced sodium intake gives the
`biggest benefit and may help prevent the
`development of high blood pressure.
`
`This fact sheet, based on the DASH
`research findings, tells about high blood
`pressure, and how to follow the DASH
`diet and reduce the amount of sodium
`you consume. It offers tips on how to
`start and stay on the eating plan, as well
`as a week of menus and some recipes.
`The menus and recipes are given for
`two levels of daily sodium consumption
`—2,400 milligrams (the upper limit of
`current recommendations by the Federal
`
`Government’s National High Blood
`Pressure Education Program, or NHBPEP,
`and the amount used to figure food
`labels’ Nutrition Facts Daily Value) and
`1,500 milligrams.
`
`Those with high blood pressure may
`especially benefit from following the
`eating plan and reducing their sodium
`intake. But the combination is a heart-
`healthy recipe that all adults can follow.
`
`WHAT IS HIGH BLOOD
`PRESSURE?
`
`Blood pressure is the force of blood
`against artery walls. It is measured in
`millimeters of mercury (mm Hg) and
`recorded as two numbers—systolic pres-
`sure (as the heart beats) over diastolic
`pressure (as the heart relaxes between
`beats). Both numbers are important
`(see Box 1 on page 2).
`
`Blood pressure rises and falls during the
`day. But when it stays elevated over
`
`I N S T I T U T E S O F H E A L T H
`N A T I O N A L
`N A T I O N A L H E A R T ,
` L U N G ,
` A N D B L O O D
`I N S T I T U T E
`
`Human Power of N Company
`EX1055
`Page 1 of 20
`
`

`

`F A C T S A B O U T
`
`The DASH Diet
`FEATURING NEW FINDINGS
`ABOUT REDUCING SODIUM—
`AND NEW LOWER-SODIUM
`RECIPES AND MENUS.
`
`Research has found that diet
`affects the development of high
`blood pressure, or hypertension
`(the medical term). Recently, two studies
`showed that following a particular eating
`plan—called the DASH diet—and reducing
`the amount of sodium consumed lowers
`blood pressure.
`
`While each step alone lowers blood pres-
`sure, the combination of the eating plan
`and a reduced sodium intake gives the
`biggest benefit and may help prevent the
`development of high blood pressure.
`
`This fact sheet, based on the DASH
`research findings, tells about high blood
`pressure, and how to follow the DASH
`diet and reduce the amount of sodium
`you consume. It offers tips on how to
`start and stay on the eating plan, as well
`as a week of menus and some recipes.
`The menus and recipes are given for
`two levels of daily sodium consumption
`—2,400 milligrams (the upper limit of
`current recommendations by the Federal
`
`Government’s National High Blood
`Pressure Education Program, or NHBPEP,
`and the amount used to figure food
`labels’ Nutrition Facts Daily Value) and
`1,500 milligrams.
`
`Those with high blood pressure may
`especially benefit from following the
`eating plan and reducing their sodium
`intake. But the combination is a heart-
`healthy recipe that all adults can follow.
`
`WHAT IS HIGH BLOOD
`PRESSURE?
`
`Blood pressure is the force of blood
`against artery walls. It is measured in
`millimeters of mercury (mm Hg) and
`recorded as two numbers—systolic pres-
`sure (as the heart beats) over diastolic
`pressure (as the heart relaxes between
`beats). Both numbers are important
`(see Box 1 on page 2).
`
`Blood pressure rises and falls during the
`day. But when it stays elevated over
`
`I N S T I T U T E S O F H E A L T H
`N A T I O N A L
`N A T I O N A L H E A R T ,
` L U N G ,
` A N D B L O O D
`I N S T I T U T E
`
`Page 1 of 20
`
`

`

`BOX 1
`
`B L O O D P R E S S U R E C A T E G O R I E S F O R A D U L T S *
`B L O O D P R E S S U R E C A T E G O R I E S F O R A D U L T S *
`
`Optimal
`
`Normal
`
`Systolic**
`
`<120 mm Hg
`
`<130 mm Hg
`
`High-Normal
`
`130–139 mm Hg
`
`High
`
`Stage 1
`Stage 2
`Stage 3
`
`140–159 mm Hg
`160–179 mm Hg
`>180 mm Hg
`
`and
`
`and
`
`or
`
`or
`or
`or
`
`Diastolic**
`
`<80 mm Hg
`
`<85 mm Hg
`
`85–89 mm Hg
`
`90–99 mm Hg
`100–109 mm Hg
`>110 mm Hg
`
`* Categories are for those age 18 and older and come from the NHBPEP.
`The categories are for those not on a high blood pressure medication and
`who have no short-term serious illness.
`
`** If your systolic and diastolic pressures fall into different
`categories, your overall status is the higher category.
`
`< means less than; > means greater than or equal to.
`
`time, then it’s called high blood
`pressure. High blood pressure is
`dangerous because it makes the
`heart work too hard, and the force
`of its blood flow can harm arter-
`ies. High blood pressure often has
`no warning signs or symptoms.
`Once it occurs, it usually lasts a
`lifetime. If uncontrolled, it can
`lead to heart and kidney disease,
`and stroke.
`
`High blood pressure affects about
`50 million—or 1 in 4—adult
`Americans. High blood pressure is
`especially common among African
`Americans, who tend to develop
`it at an earlier age and more often
`than whites. It also is common
`among older Americans—about
`60 percent of those age 60 and
`
`2
`
`older have high blood pressure.
`
`High blood pressure can be
`controlled if you take these steps:
`maintain a healthy weight; be
`physically active; follow a healthy
`eating plan, which includes foods
`lower in salt and sodium; if you
`drink alcoholic beverages, do so
`in moderation; and, if you have
`high blood pressure and are
`prescribed medication, take it as
`directed. All steps but the last
`also help to prevent high blood
`pressure.
`
`WHAT IS THE DASH DIET?
`
`Blood pressure can be unhealthy
`even if it stays only slightly above
`the optimal level of less than
`120/80 mm Hg. The higher blood
`
`pressure rises above optimal,
`the greater the health risk.
`
`In the past, researchers tried to
`find clues about what in the diet
`affects blood pressure by testing
`various single nutrients, such as
`calcium and magnesium. These
`studies were done mostly with
`dietary supplements and their
`findings were not conclusive.
`
`Then, scientists supported by the
`National Heart, Lung, and Blood
`Institute (NHLBI) conducted two
`key studies. The first was called
`“DASH,” for Dietary Approaches
`to Stop Hypertension, and it tested
`nutrients as they occur together
`in food. Its findings showed that
`blood pressures were reduced with
`an eating plan that is low in satu-
`rated fat, cholesterol, and total fat,
`and that emphasizes fruits, vegeta-
`bles, and lowfat dairy foods. This
`eating plan—known as the DASH
`diet—also includes whole grain
`products, fish, poultry, and nuts.
`It is reduced in red meat, sweets,
`and sugar-containing beverages.
`It is rich in magnesium, potassium,
`and calcium, as well as protein
`and fiber.
`
`The DASH study involved 459
`adults with systolic blood pressures
`of less than 160 mm Hg and diastolic
`pressures of 80–95 mm Hg. About
`
`Page 2 of 20
`
`

`

`BOX 2
`
`F O L L O W I N G T H E D A S H D I E T
`
`The DASH eating plan shown below is based on 2,000 calories a day. The number of daily servings in a food group may
`vary from those listed depending on your caloric needs. Use this chart to help you plan your menus or take it with you
`when you go to the store.
`
`F O O D
`G R O U P
`
`D A I L Y
`S E R V I N G S
`(except as noted)
`
`S E R V I N G
`S I Z E S
`
`E X A M P L E S
`A N D N O T E S
`
`S I G N I F I C A N C E
`O F E A C H F O O D
`G R O U P T O T H E
`D A S H E A T I N G
`P L A N
`
`major sources of
`energy and fiber
`
`Grains & grain
`products
`
`7–8
`
`Vegetables
`
`4–5
`
`Fruits
`
`4–5
`
`1 slice bread
`1 oz dry cereal*
`1/2 cup cooked rice,
`pasta, or cereal
`
`whole wheat bread, English
`muffin, pita bread, bagel,
`cereals, grits, oatmeal, crackers,
`unsalted pretzels and popcorn
`
`1 cup raw leafy vegetable
`1/2 cup cooked vegetable
`6 oz vegetable juice
`
`tomatoes, potatoes, carrots, green
`peas, squash, broccoli, turnip
`greens, collards, kale, spinach,
`artichokes, green beans, lima
`beans, sweet potatoes
`
`rich sources
`of potassium,
`magnesium,
`and fiber
`
`6 oz fruit juice
`1 medium fruit
`1/4 cup dried fruit
`1/2 cup fresh, frozen,
`or canned fruit
`
`apricots, bananas, dates, grapes,
`oranges, orange juice, grapefruit,
`grapefruit juice, mangoes, melons,
`peaches, pineapples, prunes,
`raisins, strawberries, tangerines
`
`important sources
`of potassium,
`magnesium, and
`fiber
`
`Lowfat or
`fat free dairy
`foods
`
`2–3
`
`8 oz milk
`1 cup yogurt
`11/2 oz cheese
`
`Meats, poultry,
`and fish
`
`2 or less
`
`3 oz cooked meats,
`poultry, or fish
`
`fat free (skim) or lowfat (1%) milk,
`fat free or lowfat buttermilk, fat free
`or lowfat regular or frozen yogurt,
`lowfat and fat free cheese
`
`major sources
`of calcium and
`protein
`
`select only lean; trim away visible
`fats; broil, roast, or boil, instead
`of frying; remove skin from
`poultry
`
`rich sources
`of protein and
`magnesium
`
`Nuts, seeds,
`and dry beans
`
`4–5 per week
`
`1/3 cup or 11/2 oz nuts
`2 Tbsp or 1/2 oz seeds
`1/2 cup cooked dry beans
`
`almonds, filberts, mixed nuts,
`peanuts, walnuts, sunflower
`seeds, kidney beans, lentils,
`peas
`
`Fats & oils**
`
`2–3
`
`1 tsp soft margarine
`1 Tbsp lowfat
`mayonnaise
`2 Tbsp light salad dressing
`1 tsp vegetable oil
`
`soft margarine, lowfat
`mayonnaise, light salad
`dressing, vegetable oil
`(such as olive, corn, canola,
`or safflower)
`
`rich sources
`of energy,
`magnesium,
`potassium,
`protein, and fiber
`
`DASH has 27 percent
`of calories as fat,
`including that in or
`added to foods
`
`Sweets
`
`5 per week
`
`1 Tbsp sugar
`1 Tbsp jelly or jam
`1/2 oz jelly beans
`8 oz lemonade
`
`maple syrup, sugar, jelly,
`jam, fruit-flavored gelatin, jelly
`beans, hard candy, fruit punch,
`sorbet, ices
`
`sweets should be
`low in fat
`
`* Equals 1/2 -11/4 cup, depending on cereal type. Check the product’s nutrition label.
`** Fat content changes serving counts for fats and oils: For example, 1 Tbsp of regular salad dressing equals
`1 serving; 1 Tbsp of a lowfat dressing equals 1/2 serving; 1 Tbsp of a fat free dressing equals 0 servings.
`
`3
`
`Page 3 of 20
`
`

`

`BOX 3
`
`HOW TO LOWER CALORIES ON THE DASH EATING PLAN
`
`The DASH eating plan was not designed to promote weight loss. But it is rich
`in lower-calorie foods, such as fruits and vegetables. You can make it lower
`in calories by replacing higher-calorie foods with more fruits and vegetables—
`and that also will make it easier for you to reach your DASH goals. Here are
`some examples:
`
`To increase fruits—
`I Eat a medium apple instead of four shortbread cookies. You’ll save
`
`80 calories.
`
`I Eat 1/4 cup of dried apricots instead of a 2-ounce bag of pork rinds.
`
`You’ll save 230 calories.
`
`To increase vegetables—
`I Have a hamburger that’s 3 ounces of meat instead of 6 ounces. Add 1/2
`cup serving of carrots and 1/2 cup serving of spinach. You’ll save more
`
`than 200 calories.
`
`I Instead of 5 ounces of chicken, have a stir-fry with 2 ounces of chicken
`
`and 11/2 cups of raw vegetables. Use a small amount of vegetable oil.
`
`You’ll save 50 calories.
`
`To increase lowfat or fat free dairy products—
`I Have a 1/2 cup serving of lowfat frozen yogurt instead of a 11/2-ounce
`
`milk chocolate bar. You'll save about 110 calories.
`
`And don’t forget these calorie-saving tips—
`I Use lowfat or fat free condiments.
`
`I Use half as much vegetable oil, soft or liquid margarine, or salad
`
`dressing, or choose fat free versions.
`
`I Eat smaller portions—cut back gradually.
`
`I Choose lowfat or fat free dairy products to reduce total fat intake.
`
`I Check the food labels to compare fat content in packaged foods—
`
`items marked lowfat or fat free are not always lower in calories than
`
`their regular versions.
`
`I Limit foods with lots of added sugar, such as pies, flavored
`
`yogurts, candy bars, ice cream, sherbet, regular soft
`
`drinks, and fruit drinks.
`
`I Eat fruits canned in their own juice.
`
`I Add fruit to plain yogurt.
`
`I Snack on fruit, vegetable sticks, unbuttered and
`
`unsalted popcorn, or bread sticks.
`
`I Drink water or club soda.
`
`4
`
`27 percent of the participants had
`hypertension. About 50 percent
`were women and 60 percent were
`African Americans.
`
`DASH compared three eating
`plans: A plan similar in nutrients
`to what many Americans consume;
`a plan similar to what Americans
`consume but higher in fruits and
`vegetables; and the DASH diet.
`All three plans used about 3,000
`milligrams of sodium daily. None
`of the plans were vegetarian or
`used specialty foods.
`
`Results were dramatic: Both the
`fruits and vegetables plan and the
`DASH diet reduced blood pressure.
`But the DASH diet had the greatest
`effect, especially for those with high
`blood pressure. Further, the blood
`pressure reductions came fast—
`within 2 weeks of starting the plan.
`
`The second study was called
`“DASH-Sodium,” and it looked
`at the effect on blood pressure of
`a reduced dietary sodium intake
`as participants followed either
`the DASH diet or an eating plan
`typical of what many Americans
`consume. DASH-Sodium involved
`412 participants. Their systolic
`blood pressures were 120–159 mm
`Hg and their diastolic blood pres-
`sures were 80–95 mm Hg. About
`41 percent of them had high blood
`
`Page 4 of 20
`
`

`

`pressure. About 57 percent were
`women and about 57 percent were
`African Americans.
`
`Participants were randomly
`assigned to one of the two eating
`plans and then followed for a month
`at each of three sodium levels. The
`three sodium levels were: a higher
`intake of about 3,300 milligrams
`per day (the level consumed by
`many Americans); an intermediate
`intake of about 2,400 milligrams
`per day; and a lower intake of
`about 1,500 milligrams per day.
`
`Results showed that reducing dietary
`sodium lowered blood pressure for
`both eating plans. At each sodium
`level, blood pressure was lower on
`the DASH diet than on the other
`eating plan. The biggest blood
`pressure reductions were for the
`DASH diet at the sodium intake of
`1,500 milligrams per day. Those
`with hypertension saw the biggest
`reductions, but those without it
`also had large decreases.
`
`Those on the 1,500-milligram
`sodium intake, as well as those
`on the DASH diet, had fewer
`headaches. Other than that and
`blood pressure levels, there were
`no significant effects caused by
`the two eating plans or different
`sodium levels.
`
`BOX 4
`
`D A S H E A T I N G P L A N N U M B E R O F S E R V I N G S
`F O R O T H E R C A L O R I E L E V E L S
`
`Food Group
`
`Grains and grain products
`Vegetables
`Fruits
`Lowfat or fat free dairy foods
`Meats, poultry, and fish
`Nuts, seeds, and dry beans
`Fat and oils
`Sweets
`
`Servings/Day
`1,600 calories/day
`3,100 calories/day
`6
`12-13
`3-4
`6
`4
`6
`2-3
`3-4
`1-2
`2-3
`3/week
`1
`2
`4
`0
`2
`
`
`
`BOX 5BOX 5
`
`W H E R E ’ S T H E S O D I U M ?
`
`Only a small amount of sodium occurs naturally in foods. Most sodium is
`added during processing. The Table below gives examples of varying
`amounts of sodium that occur in foods before and after processing.
`
`Food Groups
`
`Sodium (mg)
`
`Grains and grain products
`Cooked cereal, rice, pasta, unsalted, 1/2 cup
`Ready-to-eat-cereal, 1 cup
`Bread, 1 slice
`
`Vegetables
`Fresh or frozen, cooked without salt, 1/2 cup
`Canned or frozen with sauce, 1/2 cup
`Tomato juice, canned 3/4 cup
`
`Fruit
`Fresh, frozen, canned, 1/2 cup
`
`Lowfat or fat free dairy foods
`Milk, 1 cup
`Yogurt, 8 oz
`Natural cheeses, 11/2 oz
`Processed cheeses, 11/2 oz
`
`Nuts, seeds, and dry beans
`Peanuts, salted, 1/3 cup
`Peanuts, unsalted, 1/3 cup
`Beans, cooked from dried
`or frozen, without salt, 1/2 cup
`Beans, canned, 1/2 cup
`
`Meats, fish, and poultry
`Fresh meat, fish, poultry, 3 oz
`Tuna canned, water pack, no salt added, 3 oz
`Tuna canned, water pack, 3 oz
`Ham, lean, roasted, 3 oz
`
`0–5
`100–360
`110–175
`
`1–70
`140–460
`820
`
`0–5
`
`120
`160
`110–450
`600
`
`120
`0–5
`0–5
`
`400
`
`30–90
`35–45
`250–350
`1,020
`
`5
`
`Page 5 of 20
`
`

`

`BOX 6
`
`BOX 7
`
`TIPS TO REDUCE SALT
`AND SODIUM
`
`I Use reduced sodium or no-salt-
`added products. For example,
`choose low- or reduced-sodium,
`or no-salt-added versions of
`foods and condiments when
`available.
`I Buy fresh, plain frozen, or canned
`with “no-salt-added” vegetables.
`I Use fresh poultry, fish, and lean
`meat, rather than canned, smoked,
`or processed types.
`I Choose ready-to-eat breakfast
`cereals that are lower in sodium.
`I Limit cured foods (such as bacon
`and ham), foods packed in brine
`(such as pickles, pickled veg-
`etables, olives, and sauerkraut),
`and condiments (such as MSG,
`mustard, horseradish, catsup,
`and barbecue sauce). Limit even
`lower sodium versions of soy
`sauce and teriyaki sauce—treat
`these condiments as you do
`table salt.
`I Be spicy instead of salty. In
`cooking and at the table, flavor
`foods with herbs, spices, lemon,
`lime, vinegar, or salt-free
`seasoning blends. Start by
`cutting salt in half.
`I Cook rice, pasta, and hot
`cereals without salt. Cut back on
`instant or flavored rice, pasta,
`and cereal mixes, which usually
`have added salt.
`I Choose “convenience” foods that
`are lower in sodium. Cut back on
`frozen dinners, mixed dishes
`such as pizza, packaged mixes,
`canned soups or broths, and
`salad dressings—these often
`have a lot of sodium.
`I Rinse canned foods, such as
`tuna, to remove some sodium.
`
`6
`
`R E D U C I N G S O D I U M W H E N E A T I N G O U T
`
`I Ask how foods are prepared. Ask that they be prepared without added
`salt, MSG, or salt-containing ingredients. Most restaurants are willing to
`accommodate requests.
`I Know the terms that indicate high sodium content: pickled, cured, soy
`sauce, broth.
`I Move the salt shaker away.
`I Limit condiments, such as mustard, catsup, pickles, and sauces with
`salt-containing ingredients.
`I Choose fruit or vegetables, instead of salty
`snack foods.
`
`DASH-Sodium shows the impor-
`tance of lowering sodium intake
`—whatever your eating plan. But
`for a true winning combination,
`follow the DASH diet and lower
`your intake of salt.
`
`HOW DO I MAKE
`THE DASH?
`
`The DASH diet used in the studies
`calls for a certain number of
`servings daily from various food
`groups. These are given in Box 2
`on page 3 for 2,000 calories per
`day. The number of servings you
`require may vary, depending on
`your caloric need—Box 4 gives
`the servings for 1,600 and 3,100
`calories. If you’re trying to lose
`weight, check Box 3 for tips on
`how to make the DASH eating
`plan lower in calories.
`
`You should be aware that the DASH
`diet has more daily servings of
`fruits, vegetables, and whole grain
`
`foods than you may be used to
`eating. This makes it high in fiber,
`which can cause bloating and
`diarrhea in some persons. To
`avoid these problems, gradually
`increase your intake of fruit, veg-
`etables, and whole grain foods.
`
`This fact sheet gives menus and
`recipes for both 2,400 and 1,500
`milligrams of daily sodium intake.
`Twenty-four hundred milligrams
`of sodium equals about 6 grams,
`or 1 teaspoon, of table salt
`(sodium chloride); 1,500 milligrams
`of sodium equals about 4 grams,
`or 2/3 teaspoon, of table salt. These
`amounts include all salt consumed—
`that in food products, used in cook-
`ing, and added at the table. Only
`small amounts of sodium occur
`naturally in food. Processed foods
`account for most of the salt and
`sodium Americans consume. So,
`be sure to read food labels to
`choose products lower in sodium.
`
`Page 6 of 20
`
`

`

`You may be surprised at many of
`the foods that have sodium. They
`include soy sauce, seasoned salts,
`monosodium glutamate (MSG),
`baking soda, and some antacids—
`the range is wide.
`
`Since it is rich in fruits and veg-
`etables, which are naturally lower
`in sodium than many other foods,
`the DASH diet makes it easier
`to consume less salt and sodium.
`Still, you may want to begin by
`adopting the DASH diet at the
`level of 2,400 milligrams of sodi-
`um per day and then further lower
`your sodium intake to 1,500 mil-
`ligrams per day.
`
`Boxes 6, 7, and 8 offer tips on
`how to reduce the salt and sodium
`content in your diet, and how
`to use food labels to find lower
`sodium products.
`
`How can you get started on the
`DASH diet? It’s easy. The DASH
`diet requires no special foods and
`has no hard-to-follow recipes.
`One way to begin is by seeing
`how DASH compares with your
`current food habits. Use the
`“What’s On Your Plate?” form
`on page 9. Fill it in for 1–2 days
`and see how it compares with
`the DASH plan. This will help
`you see what changes you need
`to make in your food choices.
`
`BOX 8
`
`C O M P A R E F O O D L A B E L S
`
`Read the Nutrition Facts on food labels to compare the amount of sodium
`in products. Look for the sodium content in milligrams and the % Daily
`Value. Aim for foods that are less than 5 percent of the Daily Value of
`sodium.
`Compare the food labels of these two versions of canned tomatoes:*
`
`CANNED DICED TOMATOES,
`NO SALT ADDED
`Nutrition Facts
`Serving Size 1/2 cup
`Servings Per Container approx. 31/2
`
`Amount Per Serving
`0
`Calories from Fat
`Calories 25
`% Daily Value*
`0%
`0%
`0%
`1%
`2%
`8%
`
`Total Fat 0 g
`Saturated Fat 0 g
`Cholesterol 0 mg
`Sodium 20 mg
`Total Carbohydrate 6 g
`Dietary Fiber 2 g
`Sugars 4 g
`Protein 1 g
`
`CANNED DICED TOMATOES
`
`Nutrition Facts
`Serving Size 1/2 cup
`Servings Per Container approx. 31/2
`
`Amount Per Serving
`0
`Calories from Fat
`Calories 25
`% Daily Value*
`0%
`0%
`0%
`8%
`2%
`8%
`
`Total Fat 0 g
`Saturated Fat 0 g
`Cholesterol 0 mg
`Sodium 200 mg
`Total Carbohydrate 6 g
`Dietary Fiber 2 g
`Sugars 4 g
`Protein 1 g
`
`Vitamin A 10% • Vitamin C 15%
`Calcium 2% • Iron 2%
`*Percent Daily Values are based on a
`2,000 calorie diet
`
`Vitamin A 10% • Vitamin C 15%
`Calcium 2% • Iron 2%
`*Percent Daily Values are based on a
`2,000 calorie diet
`
`*The regular canned tomatoes have 10 times as much sodium as the unsalted canned tomatoes.
`
`BOX 9
`
`L A B E L L A N G U A G E
`
`Food labels can help you choose items lower in sodium and saturated and
`total fat. Look for the following labels on cans, boxes, bottles, bags, and
`other packaging:
`
`Phrase
`Sodium
`Sodium free or salt free
`Very low sodium
`Low sodium
`Low sodium meal
`Reduced or less sodium
`
`Light in sodium
`
`Unsalted or no salt added
`
`What it means
`
`Less than 5 mg per serving
`35 mg or less of sodium per serving
`140 mg or less of sodium per serving
`140 mg or less of sodium per 31/2 oz (100 g)
`At least 25 percent less sodium than the
`regular version
`50 percent less sodium than the regular
`version
`No salt added to the product during
`processing
`
`Fat
`Fat free
`Low-saturated fat
`Lowfat
`Reduced fat
`
`Light in fat
`
`Less than 0.5 g per serving
`1 g or less per serving
`3 g or less per serving
`At least 25 percent less fat than the
`regular version
`Half the fat than the regular version
`
`7
`
`Page 7 of 20
`
`

`

`Remember that some days the
`foods you eat may add up to more
`than the recommended servings
`from one food group and less
`from another. Similarly, you may
`have too much sodium on a partic-
`ular day. But don’t worry. Just
`be sure that the average of several
`days or a week comes close to
`what’s recommended for the food
`groups and for your chosen daily
`sodium level.
`
`Next, read the “Getting Started”
`suggestions in the box on this page.
`
`Finally, use the menus that begin
`on page 10—or make up your own.
`
`One note: If you take medication
`to control high blood pressure,
`you should not stop using it.
`Follow the DASH diet and talk
`with your doctor about your drug
`treatment.
`
`BOX 10
`
`G E T T I N G S T A R T E D
`
`It’s easy to adopt the DASH eating plan. Here are some ways to get started:
`
`Change gradually.
`I If you now eat one or two vegetables a day, add a serving at lunch and
`another at dinner.
`I If you don't eat fruit now or have only juice at breakfast, add a serving to
`your meals or have it as a snack.
`I Gradually increase your use of fat free and lowfat dairy products to three
`servings a day. For example, drink milk with lunch or dinner, instead of
`soda, sugar-sweetened tea, or alcohol. Choose lowfat (1 percent) or fat
`free (skim) dairy products to reduce your intake of saturated fat, total fat,
`cholesterol, and calories.
`I Read food labels on margarines and salad dressings to choose those
`lowest in unsaturated fat. Some margarines are now trans-fat free.
`
`Treat meat as one part of the whole meal, instead of the focus.
`I Limit meat to 6 ounces a day (2 servings)—all that’s needed. Three to
`four ounces is about the size of a deck of cards.
`I If you now eat large portions of meat, cut them back gradually—by a half
`or a third at each meal.
`I Include two or more vegetarian-style (meatless) meals each week.
`I Increase servings of vegetables, rice, pasta, and dry beans in meals. Try
`casseroles and pasta, and stir-fry dishes, which have less meat and more
`vegetables, grains, and dry beans.
`
`Use fruits or other foods low in saturated fat, cholesterol, and calories
`as desserts and snacks.
`I Fruits and other lowfat foods offer great taste and variety. Use fruits canned
`in their own juice. Fresh fruits require little or no preparation. Dried fruits
`are a good choice to carry with you or to have ready in the car.
`I Try these snacks ideas: unsalted pretzels or nuts mixed with raisins;
`graham crackers; lowfat and fat free yogurt and frozen yogurt;
`popcorn with no salt or butter added; and raw vegetables.
`
`Try these other tips:
`I Choose whole grain foods to get added nutrients, such as minerals and
`fiber. For example, choose whole wheat bread or whole grain cereals.
`I If you have trouble digesting dairy products, try taking lactase enzyme
`pills or drops (available at drugstores and groceries) with the dairy foods.
`Or, buy lactose-free milk or milk with lactase enzyme added to it.
`I Use fresh, frozen, or no-salt-added canned vegetables.
`
`8
`
`Page 8 of 20
`
`

`

`BOX 11
`
`W H A T ’ S O N Y O U R P L A T E ?
`
`Use this form to track your food habits before you start on the DASH eating plan or to see how you’re doing after a few weeks. To record
`more than 1 day, just copy the form. Total each day’s food groups and compare what you ate with the DASH plan. To see how the form
`looks completed, check the menus that start on page 10.
`
`Food
`
`Amount
`(serving size)
`
`Number of servings by DASH food group
`
`Sweets
`
`Fats and oils
`
`2
`
`& dry beans
`Nuts, seeds,
`
`& fish
`Meat, poultry,
`
`Dairy foods
`
`Fruits
`
`Vegetables
`
`2
`
`Grains
`
`Sodium (mg)
`
`299
`102
`
`Breakfast
`
`Example: whole wheat bread
`& soft margarine
`
`2 slices
`2 tsp
`
`Lunch
`
`Dinner
`
`Snacks
`
`D A Y ’ S T O T A L
`
`Compare yours with the DASH plan
`
`2,400 mg
`or
`1,500 mg
`
`7–8
`
`4–5
`
`4–5
`
`2–3
`
`2
`or less
`
`4–5
`a week
`
`2–3
`
`5
`a week
`
`* Read food labels to compare the sodium content of foods. See page 7 to learn how to find sodium information on food labels.
`
`9
`
`Page 9 of 20
`
`

`

`A W E E K W I T H T H E D A S H D I E T
`
`Here is a week of menus from the DASH eating plan. The menus allow you to have a daily sodium level of either 2,400 mg or, by making the noted
`changes, 1,500 mg. You'll also find that the menus sometimes call for you to use lower sodium, or reduced fat or fat free, versions of products.
`
`The menus are based on 2,000 calories a day—serving sizes should be increased or decreased for other calorie levels. To ease the calculations,
`some of the serving sizes have been rounded off. Also, some items may be in too small a quantity to have a listed food group serving.
`
`Recipes for starred items are given on the later pages. Some of these recipes give changes that can be used to lower their sodium level. Use the
`changes if you want to follow the DASH diet at 1,500 milligrams of sodium per day.
`
`Abbreviations: oz=ounce, tsp=teaspoon, Tbsp=tablespoon, g=gram, mg=milligram
`Number of DASH Food Group Servings
`
`Sodium (mg)
`
`161
`149
`1
`53
`
`126
`5
`
`201
`299
`372
`
`8
`1
`306
`5
`
`52
`163
`
`12
`
`7
`28
`86
`
`1
`148
`51
`0
`126
`
`5
`2
`2
`
`DAY 1
`
`2,400 mg Sodium Menu
`
`Breakfast
`2/3 cup bran cereal
`1 slice whole wheat bread
`1 medium banana
`1 cup fruit yogurt, fat free, no
`sugar added
`1 cup fat free milk
`2 tsp jelly
`
`Lunch
`3/4 cup chicken salad*
`2 slices whole wheat bread
`1 Tbsp Dijon mustard
`salad:
`1/2 cup fresh cucumber slices
`1/2 cup tomato wedges
`2 Tbsp ranch dressing, fat free
`1/2 cup fruit cocktail, juice pack
`
`Dinner
`3 oz beef, eye of round
`2 Tbsp beef gravy, lowfat
`
`1 cup green beans, cooked
`from frozen
`1 small baked potato:
`2 Tbsp sour cream, fat free
`2 Tbsp grated cheddar
`cheese, natural, reduced fat
`1 Tbsp chopped scallions
`1 small whole wheat roll
`1 tsp soft margarine
`1 small apple
`1 cup fat free milk
`
`Snack
`1/3 cup almonds, unsalted
`1/4 cup raisins
`1 cup orange juice
`
`Totals
`
`Nutrients Per Day
`Calories
`Total fat
`Percent calories from fat
`Saturated fat
`Percent calories from saturated fat
`Cholesterol
`10
`
`Sodium Level
`2,400 mg
`1,500 mg
`2,024
`1,998
`51 g
`50 g
`23 %
`23 %
`9 g
`9 g
`4 %
`4 %
`164 mg
`164 mg
`
`5
`
`5
`
`Nutrients Per Day
`Sodium
`Calcium
`Magnesium
`Potassium
`Fiber
`
`Fruits
`
`1
`
`1
`
`1
`1
`
`2
`
`1
`
`Vegetables
`
`Grains
`
`Sodium (mg)
`
`Substitutions to Reduce
`Sodium to 1,500 mg
`
`2/3 cup shedded wheat cereal
`
`3
`
`remove salt from recipe
`
`1 Tbsp regular mustard
`
`127
`
`196
`
`2 Tbsp yogurt salad dressing*
`
`84
`
`2 Tbsp beef gravy, lowfat,
`unsalted
`
`2 Tbsp cheddar cheese, natural,
`reduced fat, low sodium
`
`1 tsp soft margarine, unsalted
`
`5
`
`1
`
`1
`
`1
`1
`
`2
`
`1
`
`1/4
`
`1
`
`31/4
`
`1
`
`1
`11/3
`
`51/3
`
`Sweets
`
`2/3
`
`Fats & oils
`
`& dry beans
`Nuts, seeds,
`
`& fish
`Meat, poultry,
`
`Dairy foods
`
`1
`
`1
`
`1
`
`1
`
`1
`
`1
`
`1
`
`2
`
`2/3
`
`2
`1
`Sodium Level
`2,400 mg
`1,500 mg
`2,363 mg
`1,320 mg
`1,257 mg
`1,338 mg
`572 mg
`589 mg
`4,780 mg
`4,745 mg
`34 g
`34 g
`
`*recipe on page 17
`
`Page 10 of 20
`
`

`

`Sodium (mg)
`
`104
`
`84
`1
`126
`75
`
`65
`
`299
`328
`
`1
`4
`90
`0
`7
`
`DAY 2
`
`2,400 mg Sodium Menu
`
`Breakfast
`1/2 cup instant oatmeal,
`flavored
`1 mini whole wheat bagel
`1 medium banana
`1 cup fat free milk
`1 Tbsp cream cheese, fat free
`
`Lunch
`chicken breast sandwich:
`2 slices (3 oz) chicken breast,
`skinless
`2 slices whole wheat bread
`1 slice (3/4 oz) American
`cheese, reduced fat
`1 large leaf romaine lettuce
`2 slices tomato
`1 Tbsp mayonnaise, lowfat
`1 medium peach
`1 cup apple juice
`
`Dinner
`3/4 cup vegetarian spaghetti sauce* 459
`
`1 cup spaghetti
`3 Tbsp Parmesan cheese
`spinach salad:
`1 cup fresh spinach leaves
`1/4 cup fresh carrots, grated
`1/4 cup fresh mushrooms, sliced
`2 Tbsp vinaigrette dressing*
`1/2 cup corn, cooked from frozen
`1/2 cup canned pears, juice pack
`
`Snack
`1/3 cup almonds
`1/4 cup dried apricots
`1 cup fruit yogurt, fat free,
`no sugar added
`
`Totals
`
`1
`349
`
`24
`10
`1
`0
`4
`4
`
`5
`3
`107
`
`1/2
`1/2
`
`1
`
`1
`
`1
`
`1
`
`6
`
`51/4
`
`51/3
`
`Nutrients Per Day
`Sodium
`Calcium
`Magnesium
`Potassium
`Fiber
`
`Nutrients Per Day
`Calories
`Total fat
`Percent calories from fat
`Saturated fat
`Percent calories from saturated fat
`Cholesterol
`
`Sodium Level
`2,400 mg
`1,500 mg
`1,977
`1,967
`60 g
`59 g
`27 %
`27 %
`12 g
`13 g
`6 %
`6 %
`107 mg
`112 mg
`
`*recipe on page 17
`
`11
`
`Number of DASH Food Group Servings
`
`Dairy foods
`
`1
`
`Fruits
`
`1
`
`Vegetables
`
`Grains
`
`1
`
`1
`
`2
`
`Sodium (mg)
`
`1
`
`Substitutions to Reduce
`Sodium to 1,500 mg
`
`1/2 cup regular oatmeal,
`with 1 tsp cinnamon
`
`1 slice (3/4 oz) Swiss
`cheese, natural
`
`54
`
`1/4
`1/2
`
`1
`11/3
`
`Substitute no-salt-added
`tomato paste (6 oz)*
`
`260
`
`11/2
`
`2
`
`Sweets
`
`Fats and oils
`
`& dry beans
`Nuts, seeds,
`
`& fish
`Meat, poultry,
`
`1
`
`1
`
`3/4
`
`1
`
`1
`
`1
`
`13/4
`
`0
`
`Sodium Level
`2,400 mg
`1,500 mg
`2,152 mg
`1,577 mg
`1,351 mg
`1,494 mg
`502 mg
`509 mg
`4,513 mg
`4,440 mg
`32 g
`34 g
`
`1/2
`
`1/2
`
`1
`
`3
`
`Page 11 of 20
`
`

`

`Sweets
`
`Fats and oils
`
`& dry beans
`Nuts, seeds,
`
`& fish
`Meat, poultry,
`
`Dairy foods
`
`2/3
`
`1
`
`1
`
`1
`
`1
`
`1
`
`1
`
`Fruits
`
`1
`
`11/3
`
`1
`
`1
`
`1
`1
`
`1
`
`1
`
`1
`
`1
`
`1/4
`1/2
`
`2
`
`1
`
`6
`
`33/4
`
`41/3
`
`3
`
`12/3
`
`1/2
`
`1/2
`
`2
`
`0
`
`2 cups puffed wheat cereal
`
`1 tsp soft margarine, unsalted
`
`2 slices (11/2 oz) Swiss
`cheese, natural
`
`1 small white dinner roll
`1 tsp soft margarine,
`unsalted
`
`1 Tbsp peanut butter,
`unsalted
`
`1
`
`1
`
`109
`
`146
`1
`
`3
`
`Sodium (mg)
`
`199
`149
`1
`126
`5
`51
`
`35
`156
`260
`
`319
`1
`22
`12
`0
`
`89
`1
`5
`88
`
`363
`51
`
`107
`
`6
`156
`
`101
`
`DAY 3
`
`2,400 mg Sodium Menu
`
`Breakfast
`3/4 cup wheat flakes cereal
`1 slice whole wheat bread
`1 medium banana
`1 cup fat free milk
`1 cup orange juice
`1 tsp soft margarine
`
`Lunch
`beef barbeque sandwich:
`2 oz beef, eye of round
`1 Tbsp barbeque sauce
`2 slices (11/2 oz) cheddar
`cheese, reduced fat
`1 sesame roll
`1 large leaf romaine lettuce
`2 slices tomato
`1 cup new potato salad*
`1 medium orange
`
`Dinner
`3 oz cod:
`1 tsp lemon juice
`1/2 cup brown rice, long grain
`1/2 cup spinach, cooked
`from frozen
`1 small corn bread muffin
`1 tsp soft margarine
`
`Snack
`1 cup fruit yogurt, fat free,
`no added sugar
`1/4 cup dried fruit
`2 large graham cracker
`rectangles
`1 Tbsp peanut butter,
`reduced fat
`
`Totals
`
`Number of DASH Food Group Servings
`
`Vegetables
`
`Grains
`
`Sodium (mg)
`
`Substitutions to Reduce
`Sodium to 1,500 mg
`
`Nutrients Per Day
`Calories
`Total fat
`Percent calories from fat
`Saturated fat
`Percent calories from saturated fat
`Cholesterol
`
`Sodium Level
`2,400 mg
`1,500 mg
`1,984
`1,958
`44 g
`46 g
`20 %
`21 %
`12 g
`13 g
`5 %
`6 %
`146 mg
`137 mg
`
`Nutrients Per Day
`Sodium
`Calcium
`Magnesium
`Potassium
`Fiber
`
`Sodium Level
`2,400 mg
`1,500 mg
`2,303 mg
`1,519 mg
`1,490 mg
`1,50