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Health Information for the Public

Your Guide to Lowering Your Blood Pressure With DASH —
How Can I Get Started on the DASH Eating Plan?

"There's a history of cardiovascular disease in my family and I also know that good habits can start when the children are very young. In my family, we are physically active, we drink water and low-fat or fat-free milk, and we rarely keep sugary snacks in the house. I'm also very aware of portion sizes and how many calories are in the portions we eat. We are teaching them good eating habits right now." — JEANETTE GUYTON-KRISHNAN AND FAMILY

It's easy. Reading the "Getting Started" suggestions in box 13 should help you along the way. The DASH eating plan 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. (See box 14.) 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.

Remember that on 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 particular day. But don't worry. Try your best to keep the average of several days close to the DASH eating plan and the sodium level recommended for you.

Use the menus if you want to follow the menus similar to those used in the DASH trial—or make up your own using your favorite foods. In fact, your entire family can eat meals using the DASH eating plan. Use box 3 to choose your favorite foods from each food group based on your calorie needs as described in the 2005 "U.S. Dietary Guidelines for Americans."

The Dietary Guidelines determined that the DASH eating plan is an example of a healthy eating plan and recommends it as a plan that not only meets your nutritional needs but can accommodate varied types of cuisines and special needs.

Remember that the DASH eating plan used along with other lifestyle changes can help you prevent and control your blood pressure. Important lifestyle recommendations for you include: achieve and maintain a healthy weight, participate in your favorite regular physical activity, and, if you drink, use moderation in alcohol consumption (defined as up to one drink per day for women and up to two drinks per day for men).

One important note: If you take medication to control high blood pressure, you should not stop using it. Follow the DASH eating plan and talk with your doctor about your medication treatment. The tips in box 15 can help you continue to follow the DASH eating plan and make other healthy lifestyle changes for a lifetime.

Box 13: Getting Started

It's easy to adopt the DASH eating plan. Here are some ways to get started:

Change gradually

  • If you now eat one or two vegetables a day, add a serving at lunch and another at dinner.
  • If you don't eat fruit now or have juice only at breakfast, add a serving to your meals or have it as a snack.
  • Gradually increase your use of fat-free and low-fat milk and milk products to three servings a day. For example, drink milk with lunch or dinner, instead of soda, sugar—sweetened tea, or alcohol. Choose fat-free (skim) or low-fat (1 percent) milk and milk products to reduce your intake of saturated fat, total fat, cholesterol, and calories and to increase your calcium.
  • Read the Nutrition Facts label on margarines and salad dressings to choose those lowest in saturated fat and trans fat.

Treat meats as one part of the whole meal, instead of the focus

  • Limit lean meats to 6 ounces a day—all that's needed. Have only 3 ounces at a meal, which is about the size of a deck of cards.
  • If you now eat large portions of meats, cut them back gradually— by a half or a third at each meal.
  • Include two or more vegetarian-style (meatless) meals each week.
  • Increase servings of vegetables, brown rice, whole wheat pasta, and cooked dry beans in meals. Try casseroles, whole wheat 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, trans fat, cholesterol, sodium, sugar, and calories as desserts and snacks

  • Fruits and other lower fat foods offer great taste and variety. Use fruits canned in their own juice or packed in water. Fresh fruits require little or no preparation. Dried fruits are a good choice to carry with you or to have ready in the car.
  • Try these snacks ideas: unsalted rice cakes; nuts mixed with raisins; graham crackers; fat-free and low-fat yogurt and frozen yogurt; popcorn with no salt or butter added; raw vegetables.

Try these other tips

  • Choose whole grain foods for most grain servings to get added nutrients, such as minerals and fiber. For example, choose whole wheat bread or whole grain cereals.
  • If you have trouble digesting milk and milk products, try taking lactase enzyme pills (available at drugstores and groceries) with the milk products. Or, buy lactose-free milk, which has the lactase enzyme already added to it.
  • If you are allergic to nuts, use seeds or legumes (cooked dried beans or peas).
  • Use fresh, frozen, or low-sodium canned vegetables and fruits.

Use the form in box 14 to track your food and physical activities 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 eating plan. To see how the form looks completed, check the menus that start on page 30.

Box 14: What's on Your Plate? How Much Are You Moving?


What's on Your Plate?
Food Amount (serving size) Sodium (mg) Number of Servings by DASH Food Group
Grains Vegetables Fruits Milk Products Meats, fish, and poultry Nuts, seeds, and legumes Fish oils and oils Sweets and added sugars
Example: whole wheat bread, with soft (tub) margarine 2 slices
2 tsp
2 2




Day's Totals
Compare yours with the DASH eating plan at 2,000 calories. 2,300 or 1,500 mg per day 6-8 per day 4-5 per day 4-5 per day 2-3 per day 6 or less per day 4-5 per week 2-3 per day 5 or less per week

Record your minutes per day for each activity. Aim for at least 30 minutes of moderate-intensity physical activity on most days of the week.

Physical Activity Log
Physical Activity Time Notes

Box 15: Making the DASH to Good Health

The DASH plan is a new way of eating—for a lifetime. If you slip from the eating plan for a few days, don't let it keep you from reaching your health goals. Get back on track. Here's how:

Ask yourself why you got off-track.
Was it at a party? Were you feeling stress at home or work? Find out what triggered your sidetrack and start again with the DASH plan.

Don't worry about a slip.
Everyone slips—especially when learning something new. Remember that changing your lifestyle is a long-term process.

See if you tried to do too much at once.
Often, those starting a new lifestyle try to change too much at once. Instead, change one or two things at a time. Slowly but surely is the best way to succeed.

Break the process down into small steps.
This not only keeps you from trying to do too much at once, but also keeps the changes simpler. Break complex goals into smaller, simpler steps, each of which is attainable.

Write it down.
Use the table in box 14 to keep track of what you eat and what you're doing. This can help you find the problem. Keep track for several days. You may find, for instance, that you eat high-fat foods while watching television. If so, you could start keeping a substitute snack on hand to eat instead of the high-fat foods. This record also helps you be sure you're getting enough of each food group and physical activity each day.

Celebrate success.
Treat yourself to a nonfood treat for your accomplishments.



What Is High Blood Pressure?

What Is the DASH Eating Plan?
- How Do I Make the DASH?
- How Can I Get Started on the DASH Eating Plan?

A Week With the DASH Eating Plan

Recipes for Heart Health

To Learn More

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