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Guide to Life: DASH diet proves effective and sustainable

This diet doesn’t forbid certain food groups.

It isn’t built on the premise that humans were meant to eat raw food only — or no grains or
no provolone.

The DASH diet encompasses a variety of foods, including plenty of plants — and, therefore,
many experts in healthful eating cite it or something similar when people want a sustainable eating
plan that protects them from illnesses and, in many cases, helps them shed pounds.

DASH stands for Dietary Approaches To Stop Hypertension.

It is traced to the late 1990s, when researchers backed by the federal government were
seeking a diet to lower blood pressure.

They found that a combination of fruits, vegetables, whole grains, lean proteins, low-fat
dairy plus nuts and seeds worked remarkably well.

They had formulated the plan with a vegetarian diet in mind but wanted something that more
people would be willing to adopt — one that didn’t eschew chicken or salmon with dinner.

In the intervening years, many dietitians and doctors have recommended DASH and not only to
people with high blood pressure. More evidence has emerged that the approach yields other benefits,
including working against diabetes and some cancers.

And, in January, a panel of experts who evaluate diet plans for U.S. News World Report
named DASH tops among diets for the fifth straight year.

There are many ways to approach more-healthful eating, but, if you’re looking for something
backed by science and years of proven results, dietitians say DASH offers a good starting point.

Daily and weekly serving recommendations vary depending on a person’s age and level of

A 55-year-old moderately active woman, for example, should eat six servings of grains
(preferably whole grains); four to five servings of both fruits and vegetables; two to three
low-fat or fat-free dairy servings; and six or fewer servings of lean meats, poultry and fish.

She should also have four servings a week of nuts, seeds and legumes; two to three servings
of fats and oils; five or fewer servings of sweets and added sugar; and no more than 2,300
milligrams a day of sodium. (Additional details — and links to recipes — are available through the
National Institutes of Health.)

Though not new, DASH remains relatively undiscovered, said Marla Heller, a California
dietitian and author of three books on the diet.

“The first research was done at the end of 1997, and this is still something that few people
know about,” she said. “The premise behind the DASH diet was to take the benefits of a vegetarian
diet and create a plan that was flexible enough to appeal to the average American.”

Some experts, including those involved in the initial research, worried about being able to
translate the diet to the masses, Heller said. But once you stop nitpicking about daily servings
and start focusing on what those servings look like in real food, she said, DASH can be easily

“Fill your plate half with vegetables; add some lean protein-rich foods to quench your
hunger,” she said. “Have three meals and two to three snacks every day, some low-fat or nonfat
dairy to boost protein.”

Fruits can satisfy the sweet tooth while adding nutrients and fiber; and nuts and seeds make
good snacks that, in moderation, aid heart health, Heller said.

Science has evolved since the 1990s to place less emphasis on cutting out fat and meat
proteins, and upping starch intake, she said, because newer research has highlighted the importance
of proteins and fats, and the dangers of eating too many refined carbohydrates.


“In the mid-1990s, it was high carbs, low protein, low fat — and everyone got fatter, and we
ended up with this epidemic of diabetes and obesity based on this premise.”

Carbohydrates play an important role in the human diet, Heller said, but we are better-served
by eating whole, unprocessed vegetables and grains than white pasta and bread.

Growing up, Heller said, she was “the queen vegetable hater,” but she now knows firsthand
that experimenting with cooking and eating vegetables in new ways (roasting, for instance) can make
converts out of cauliflower haters.

Others agree.

DASH “is just such a great, no-nonsense, solid program that works,” said Amy
Jamieson-Petonic, a Cleveland dietitian who has recommended DASH for 15 years. “The research and
the science support it, and it just makes sense for so many reasons.

“This is a really, really healthy way to live for the whole family. It really helps people
get to a point where they can get into this type of a lifestyle and stay there. Sustainability is a
real issue for many, many people with regard to eating healthy.”

The first step she would take if she were embarking on a DASH program, Jamieson-Petonic said,
is to try to meet the vegetable and fruit goals.

“I’m not about taking away everything,” she said. “Filling up on dietary fiber will hopefully
displace some unhealthy choices. That’s kind of a back-door benefit.”

Part of the reason that DASH proves effective in controlling blood pressure, said Emily
Lisciandro, a dietitian at Ohio State University’s Wexner Medical Center, is its focus on
nutrient-rich foods that contain plenty of blood-pressure-reducing magnesium, calcium and

People who follow the recommended servings of those foods, Lisciandro said, will fill up on
the healthful choices and won’t have as much room for “empty” calories from, say, sweets and
processed foods.

“It’s so structured. That’s maybe why it works so well,” she said.

A person looking to overhaul a not-so-stellar diet, many experts say, should make changes

“People say, ‘I don’t eat most vegetables, but I eat green beans.’ Think about incorporating
green beans into a lot of dishes. Maybe peas in a soup or a casserole? Try that,” Lisciandro said. “
Incorporate one new veggie at a time. And don’t just put a pile of peas on your plate. Make it as
a nice dish where you’re going to enjoy it.”

She sees many patients who have just survived a major cardiac crisis, and she often talks to
them about significant changes.

“It’s kind of daunting because a lot of patients tell me: ‘I eat whatever I want. I know what
I should eat, but I just love food. I love my burgers.’

“It seems overwhelming,” she said. “It seems like ‘Oh, man, I’m not going to have anything
good. My whole life is going to be taken away.’

“I say: Start slow.”

The key to developing a fondness for new foods, Jamieson-Petonic said, is to plan ahead and
look for recipes that appeal to your taste buds. In many cases, she said, people grew up with
mediocre (or worse) vegetable preparation and can’t get that bad memory out of their heads.

“I didn’t know that broccoli was not army olive-drab green until I moved out of the house,”
she said, adding that her mother has since become a talented vegetable chef.

With planning, too, you will be able to make grocery lists specific to your meals for the
week rather than just grabbing a bunch of vegetables that are likely to wilt in the fridge before
you eat them.

As with eating a lot of vegetables, Jamieson-Petonic said, a switch to whole grains can seem
like a big jump, but they’re increasingly available and worth the effort because they help with
blood sugar, promote weight loss and reduce belly fat.

“It’s challenging because it’s so different from what most Americans eat,” said Jackie
Haskins, a dietitian at Mount Carmel West hospital.

“I recommend it in steps because a lot of Americans don’t eat very many fruits and

Sometimes, Haskins starts by suggesting an apple a day — which most people view as pretty
benign, she said. Adding another vegetable or fruit a day the next week and the week after, she
said, can make the transition seem less extreme.

Some patients at the hospital tell Haskins they’re concerned about the cost of fruits and
vegetables. She encourages them to buy items that are in season (usually cheaper) and watch grocery
fliers for sales.

“Many of the snack foods that people are buying are expensive, too,” she said.

As are the diseases, she noted, that better eating might help you avoid: heart disease,
cancer and diabetes.

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