For more information, visit http://www.nhlbi.nih.gov/health/health-topics/topics/dash/

What Is the DASH Eating Plan?

Dietary Approaches to Stop Hypertension (DASH) is a flexible and balanced eating plan. DASH was one of three eating plans that were compared in research studies sponsored by the National Heart, Lung, and Blood Institute (NHLBI).

The goal of this research was to study the effects of diet on high blood pressure. The results showed that the DASH eating plan lowers blood pressure. The plan:

Is low in saturated fat, cholesterol, and total fat
Focuses on fruits, vegetables, and fat-free or low-fat dairy products
Is rich in whole grains, fish, poultry, beans, seeds, and nuts
Contains fewer sweets, added sugars and sugary beverages, and red meats than the typical American diet

The DASH eating plan also is lower in sodium (salt) than the typical American diet. The DASH research showed that an eating plan containing 2,300 milligrams (mg) of sodium per day lowered blood pressure. An eating plan containing only 1,500 mg of sodium per day even further lowered blood pressure.

The "Dietary Guidelines for Americans, 2010" advise people in the following groups to aim for no more than 1,500 mg of sodium per day:

People who already have high blood pressure
People who have diabetes or chronic kidney disease
African Americans
Middle-aged and older adults

The DASH eating plan also includes foods rich in potassium, such as fruits and vegetables. In general, potassium should come from food sources only, not supplements. For a list of the potassium content of selected foods, visit http://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/SR22/ nutrlist/sr22w306.pdf.

Reduced-sodium products and salt substitutes likely contain potassium chloride as a main ingredient. This substance may harm people who have certain medical conditions, such as diabetes and kidney disease. Check with your doctor before trying reduced-sodium products and salt substitutes that contain potassium chloride.

You can limit salt intake without using salt substitutes. For example, use herbs and spices to add flavor to foods. For examples of how to season foods without using salt, visit the NHLBI's Flavor That Food Web page.

Below is a table that shows the daily nutrient goals, including potassium, used in the DASH studies.

Daily Nutrient Goals Used in the DASH Studies (for a 2,000-Calorie Eating Plan)

Total fat	27% of calories
Saturated fat	6% of calories
Protein	18% of calories
Carbohydrate	55% of calories
Cholesterol	150 mg
Sodium	2,300 mg*
Potassium	4,700 mg
Calcium	1,250 mg
Magnesium	500 mg
Fiber	30 g

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

g = grams; mg = milligrams

For more detailed information about the DASH eating plan, go to the NHLBI's "Your Guide to Lowering Your Blood Pressure With DASH."

What Is High Blood Pressure?

Your doctor may recommend the DASH eating plan if you have high blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure rises and falls during the day.

If blood pressure rises and stays high over time (high blood pressure), it can damage the body in many ways. High blood pressure also is called hypertension (HI-per-TEN-shun).

Blood pressure includes systolic (sis-TOL-ik) and diastolic (di-ah-STOL-ik) pressures. "Systolic" refers to blood pressure when the heart beats while pumping blood. "Diastolic" refers to blood pressure when the heart is at rest between beats.

You'll most often see blood pressure numbers written with the systolic number above or before the diastolic number, such as 120/80 mmHg. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)

Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. A diagnosis of high blood pressure is based on an average of two or more properly measured, seated blood pressure readings done during two or more office visits.

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

High blood pressure is a risk factor for coronary heart disease and stroke, two of the leading causes of death among Americans. High blood pressure also can put you at risk for other medical conditions, such as heart failure, kidney disease, and blindness.

For more information about high blood pressure, go to the Health Topics High Blood Pressure article.

What Are the Benefits of the DASH Eating Plan?

Following the DASH eating plan and eating less sodium (salt) can lower high blood pressure or your risk for the condition.

Results from the DASH research showed that following a DASH plan containing 2,300 milligrams (mg) of sodium per day lowered blood pressure. Following a DASH plan containing 1,500 mg of sodium lowered blood pressure even more (systolic blood pressure was lowered by about 7 to 12 mmHg).

One important note: If you take medicine to control high blood pressure, you should keep taking it. However, you should tell your doctor that you're now following the DASH eating plan.

Following the DASH Eating Plan

The DASH eating plan is easy to follow using common foods available in your grocery store. The plan includes daily servings from different food groups. The number of servings you should have depends on your daily calorie (energy) needs.

To figure out your calorie needs, you need to consider your age and physical activity level. If you want to maintain your current weight, you should eat only as many calories as you burn by being physically active. This is called energy balance. (For more information about energy balance, go to the Health Topics Overweight and Obesity article.)

If you need to lose weight, you should eat fewer calories than you burn or increase your activity level to burn more calories than you eat.

Consider your physical activity level. Are you sedentary, moderately active, or active?

Sedentary means that you do only light physical activity as part of your typical daily routine.
Moderately active means that you do physical activity equal to walking about 1.5 to 3 miles a day at 3 to 4 miles per hour, plus light physical activity.
Active means that you do physical activity equal to walking more than 3 miles per day at 3 to 4 miles per hour, plus light physical activity.

Use the chart below to estimate your daily calorie needs.

Daily Calorie Needs for Women

Age (years)	Calories Needed for Sedentary Activity Level	Calories Needed for Moderately Active Activity Level	Calories Needed for Active Activity Level
19–30	2,000	2,000–2,200	2,400
31–50	1,800	2,000	2,200
51+	1,600	1,800	2,000–2,200

Daily Calorie Needs for Men

Age (years)	Calories Needed for Sedentary Activity Level	Calories Needed for Moderately Active Activity Level	Calories Needed for Active Activity Level
19–30	2,400	2,600–2,800	3,000
31–50	2,200	2,400–2,600	2,800–3,000
51+	2,000	2,200–2,400	2,400–2,800

After figuring out your daily calorie needs, go to the table below and find the closest calorie level to yours. This table estimates the number of servings from each food group that you should have. Serving quantities are per day, unless otherwise noted.

DASH Eating Plan—Number of Food Servings by Calorie Level

Food Group	1,200 Cal.	1,400 Cal.	1,600 Cal.	1,800 Cal.	2,000 Cal.	2,600 Cal.	3,100 Cal.
Grains^a	4–5	5–6	6	6	6–8	10–11	12–13
Vegetables	3–4	3–4	3–4	4–5	4–5	5–6	6
Fruits	3–4	4	4	4–5	4–5	5–6	6
Fat-free or low-fat dairy products^b	2–3	2–3	2–3	2–3	2–3	3	3–4
Lean meats, poultry, and fish	3 or less	3–4 or less	3–4 or less	6 or less	6 or less	6 or less	6–9
Nuts, seeds, and legumes	3 per week	3 per week	3–4 per week	4 per week	4–5 per week	1	1
Fats and oils^c	1	1	2	2–3	2–3	3	4
Sweets and added sugars	3 or less per week	3 or less per week	3 or less per week	5 or less per week	5 or less per week	≤2	≤2
Maximum sodium limit^d	2,300 mg/day	2,300 mg/day	2,300 mg/day	2,300 mg/day	2,300 mg/day	2,300 mg/day	2,300 mg/day

^a Whole grains are recommended for most grain servings as a good source of fiber and nutrients.

^b For lactose intolerance, try either lactase enzyme pills with dairy products or lactose-free or lactose-reduced milk.

^c Fat content changes the serving amount for fats and oils. For example, 1 Tbsp regular salad dressing = one serving; 1 Tbsp low-fat dressing = one-half serving; 1 Tbsp fat-free dressing = zero servings.

^d The DASH eating plan has a sodium limit of either 2,300 mg or 1,500 mg per day.

DASH Eating Plan—Serving Sizes, Examples, and Significance

Food Group	Serving Sizes	Examples and Notes	Significance of Each Food Group to the DASH Eating Plan
Grains^a	1 slice bread 1 oz dry cereal^b ½ cup cooked rice, pasta, or cereal^b	Whole-wheat bread and rolls, whole-wheat pasta, English muffin, pita bread, bagel, cereals, grits, oatmeal, brown rice, unsalted pretzels and popcorn	Major sources of energy and fiber
Vegetables	1 cup raw leafy vegetable ½ cup cut-up raw or cooked vegetable ½ cup vegetable juice	Broccoli, carrots, collards, green beans, green peas, kale, lima beans, potatoes, spinach, squash, sweet potatoes, tomatoes	Rich sources of potassium, magnesium, and fiber
Fruits	1 medium fruit ¼ cup dried fruit ½ cup fresh, frozen, or canned fruit ½ cup fruit juice	Apples, apricots, bananas, dates, grapes, oranges, grapefruit, grapefruit juice, mangoes, melons, peaches, pineapples, raisins, strawberries, tangerines	Important sources of potassium, magnesium, and fiber
Fat-free or low-fat dairy products^c	1 cup milk or yogurt 1½ oz cheese	Fat-free milk or buttermilk; fat-free, low-fat, or reduced-fat cheese; fat-free/low-fat regular or frozen yogurt	Major sources of calcium and protein
Lean meats, poultry, and fish	1 oz cooked meats, poultry, or fish 1 egg^d	Select only lean; trim away visible fats; broil, roast, or poach; remove skin from poultry	Rich sources of protein and magnesium
Nuts, seeds, and legumes	⅓ cup or 1½ oz nuts 2 Tbsp peanut butter 2 Tbsp or ½ oz seeds ½ cup cooked legumes (dried beans, peas)	Almonds, filberts, mixed nuts, peanuts, walnuts, sunflower seeds, peanut butter, kidney beans, lentils, split peas	Rich sources of energy, magnesium, protein, and fiber
Fats and oils^e	1 tsp soft margarine 1 tsp vegetable oil 1 Tbsp mayonnaise 2 Tbsp salad dressing	Soft margarine, vegetable oil (canola, corn, olive, safflower), low-fat mayonnaise, light salad dressing	The DASH study had 27% of calories as fat, including fat in or added to foods
Sweets and added sugars	1 Tbsp sugar 1 Tbsp jelly or jam ½ cup sorbet, gelatin dessert 1 cup lemonade	Fruit-flavored gelatin, fruit punch, hard candy, jelly, maple syrup, sorbet and ices, sugar	Sweets should be low in fat

^a Whole grains are recommended for most grain servings as a good source of fiber and nutrients.

^b Serving sizes vary between ½ cup and 1¼ cups, depending on cereal type. Check the product's Nutrition Facts label.

^c For lactose intolerance, try either lactase enzyme pills with dairy products or lactose-free or lactose-reduced milk.

^d Because eggs are high in cholesterol, limit egg yolk intake to no more than four per week; two egg whites have the same protein content as 1 oz of meat.

^e Fat content changes the serving amount for fats and oils. For example, 1 Tbsp regular salad dressing = one serving; 1 Tbsp low-fat dressing = one-half serving; 1 Tbsp fat-free dressing = zero servings.

The DASH Eating Plan as Part of a Heart Healthy Lifestyle

Making other heart healthy lifestyle changes while following the DASH eating plan is the best way to prevent or control high blood pressure. For example, try to maintain a healthy weight, be physically active, make healthy eating choices, and don't smoke.

Maintain a Healthy Weight

Maintaining a healthy weight is an important part of a heart healthy lifestyle. If you're overweight or obese, you can lose weight while following the DASH eating plan. By reducing your daily calorie intake by 500 to 1,000 calories, you can slowly lose weight.

A weight loss of 1 to 2 pounds a week is do-able, safe, and will help you keep off the weight. To create a weight-loss or weight-maintenance plan that's right for you, talk with your doctor or a registered dietitian.

For more information about maintaining a healthy weight or losing weight, go to the Health Topics Overweight and Obesity article.

Be Physically Active

Physical activity also is an important part of a heart healthy lifestyle. You can gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. Walking is an excellent heart healthy activity. The more active you are, the more you'll benefit.

To get started and stay active, make physical activity part of your daily routine, keep track of your progress, and be active and safe.

If you have a heart problem or chronic disease—such as high blood pressure, heart disease, or diabetes—ask your doctor what types of physical activity are safe for you.

You also should ask your doctor about safe physical activities if you have symptoms such as chest pain or dizziness.

For more information about physical activity, go to the Health Topics Physical Activity and Your Heart article.

Make Healthy Eating Choices

While following the DASH eating plan, choose and prepare foods with less sodium (salt). Be creative—try herbs, spices, lemon, lime, vinegar, and salt-free seasoning blends while cooking and at the table. For examples of how to season foods without using salt, visit the National Heart, Lung, and Blood Institute’s (NHLBI’s) Flavor That Food Web page.

Most of the sodium that people eat comes from processed foods. So, make sure you read the Nutrition Facts label on prepared foods to check the amount of sodium in each item.

For more information about how to read a Nutrition Facts label, see boxes 10 and 11 in the NHLBI’s "Your Guide to Lowering Your Blood Pressure With DASH."

Buy low-sodium, reduced-sodium, or no salt added versions of foods when they're available. Rinse all canned vegetables and beans before cooking and eating them.

Reduced-sodium products and salt substitutes likely contain potassium chloride as a main ingredient. This substance may harm people who have certain medical conditions, such as kidney disease and diabetes. Check with your doctor before trying reduced-sodium products and salt substitutes that contain potassium chloride.

If you drink alcoholic beverages, do so in moderation.

Don't Smoke

If you smoke or use tobacco, quit. Smoking harms nearly every organ in the body, including the heart, blood vessels, lungs, eyes, mouth, reproductive organs, bones, and digestive organs. Also, try to avoid secondhand smoke.

Talk with your doctor about programs and products that can help you quit. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Ask your family and friends to support you in your efforts to quit.

For more information about how to quit smoking, go to the Health Topics Smoking and Your Heart article and the NHLBI’s "Your Guide to a Healthy Heart."

Getting Started on the DASH Eating Plan

To get started on the DASH eating plan, make the following changes over a few days or weeks. This will give you a chance to adjust to the changes and make them part of your daily routine:

If you now eat one or two servings of vegetables a day, add a serving at lunch and another at dinner. Add a serving of fruit at one meal a day or as a snack.
Choose whole-grain foods for most of your grain servings to get added nutrients, such as minerals and fiber. For example, choose whole-wheat bread or whole-grain cereals.
Include three servings of fat-free or low-fat dairy products a day.
Limit lean meats to 6 ounces a day. Have only 3 ounces of lean meat (about the size of a deck of cards) at a meal. If you usually eat large portions of meat, cut back over a couple of days—by half or a third at each meal.
Include two or more vegetarian-style, or meatless, meals each week.
Read the Nutrition Facts label on foods to compare the amount of sodium (salt) in products. Look for the sodium content in milligrams (mg) and the Percent Daily Value. Aim for foods that have less than 5 percent of the daily value of sodium. Foods with 20 percent or more of the daily value of sodium are considered high-sodium foods.

For more information and tips on how to adopt the DASH eating plan, including a week of DASH menus, go to the National Heart, Lung, and Blood Institute's "Your Guide to Lowering Your Blood Pressure With DASH."

More Helpful DASH Tips

The DASH eating plan might have more servings of fruits, vegetables, and whole-grain foods than you’re used to eating. Slowly increase your servings of these foods over several weeks.

If you have trouble digesting dairy products, try taking lactase enzyme pills with these foods. These pills are available at drug stores and grocery stores. You also can buy lactose-free or lactose-reduced milk at the grocery store.

If you don't like nuts or are allergic to them, use seeds or legumes (cooked dried beans or peas) as part of your eating plan.

If you take medicines to control your high blood pressure, keep taking them. However, you should tell your doctor that you're now following the DASH eating plan.

How To Deal With Challenges and Setbacks

You may stray from the DASH eating plan or your other lifestyle changes. If so, don't let it keep you from reaching your health goals. Get back on track. Below are some ideas that may help you:

Ask yourself why you got off track. Find out what triggered your setback, and start following the DASH eating plan again. Remember that changing your lifestyle is a long-term process.
Make small changes. Trying to change too much at once can be overwhelming. Make one or two small changes at a time. This prevents you from trying to do too much at once and keeps the changes simpler.
Write it down. Write down what you eat and the amount of physical activity you do each day. This can help pinpoint problems and ensure that you're getting the proper nutrition and enough physical activity. Use the form in box 14 of "Your Guide to Lowering Your Blood Pressure With DASH" to record your food and physical activity habits.
Celebrate success. Reward yourself for meeting your goals with something you like to do, not with food. Choose rewards that you'll enjoy, such as a movie, music CD, an afternoon off from work, a massage, or personal time.

Links to Other Information About the DASH Eating Plan

NHLBI Resources

Non-NHLBI Resources

ChooseMyPlate.gov (U.S. Department of Agriculture, U.S. Department of Health and Human Services)
DASH (MedlinePlus)
"Dietary Guidelines for Americans, 2010" (U.S. Department of Agriculture, U.S. Department of Health and Human Services)
High Blood Pressure (MedlinePlus)

Clinical Trials

Children and Clinical Studies
Clinical Trials (Health Topics)
NHLBI Clinical Trials
NIH Clinical Research Trials and You (National Institutes of Health)
ResearchMatch (funded by the National Institutes of Health)