Contents

Introduction

What Is High Blood Pressure?

Blood Pressure Levels for Adults

What Is the DASH Eating Plan?

Daily Nutrient Goals Used in the DASH Studies (for a 2,100 Calorie Eating Plan)

Who Helped With DASH?

How Do I Make the DASH?

Following the DASH Eating Plan

DASH Eating Plan—Number of Daily Servings for Other Calorie Levels

How to Lower Calories on the DASH Eating Plan

Make a Dash for DASH

Where’s the Sodium?

Tips To Reduce Salt and Sodium

Reducing Salt and Sodium When Eating Out

Compare Nutrition Facts Labels on Foods

Label Language

Where’s the Potassium?

How Can I Get Started on the DASH Eating Plan?

Getting Started

What’s on Your Plate? How Much Are You Moving?

Making the DASH to Good Health

A Week With the DASH Eating Plan

Recipes for Heart Health

To Learn More

“My doctor noticed my blood pressure was a little high. I try to be more aware of the foods I eat. I limit alcohol, and watch my portions. I also work out 5–7 days a week. My son is learning from me and is doing the same things I do.”

— Ricardo Eley

Introduction

What you choose to eat affects your chances of developing high blood pressure, or hypertension (the medical term). Recent studies show that blood pressure can be lowered by following the Dietary Approaches to Stop Hypertension (DASH) eating plan—and by eating less salt, also called sodium.

While each step alone lowers blood pressure, 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 booklet, based on the DASH research findings, tells how to follow the DASH eating plan 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—2,300 and 1,500 milligrams per day. Twenty-three hundred milligrams is the highest level considered acceptable by the National High Blood Pressure Education Program. It is also the highest amount recommended for healthy Americans by the 2005 “U.S. Dietary Guidelines for Americans.” The 1,500 milligram level can lower blood pressure further and more recently is the amount recommended by the Institute of Medicine as an adequate intake level and one that most people should try to achieve.

The lower your salt intake is, the lower your blood pressure. Studies have found that the DASH menus containing 2,300 milligrams of sodium can lower blood pressure and that an even lower level of sodium, 1,500 milligrams, can further reduce blood pressure. All the menus are lower in sodium than what adults in the United States currently eat—about 4,200 milligrams per day in men and 3,300 milligrams per day in women.

Those with high blood pressure and prehypertension may benefit especially from following the DASH eating plan and reducing their sodium intake.

“My family’s food choices have always been pretty good. We eat a lot of fruit, vegetables, and low-fat yogurt.”

— Lilly Kramer

What Is High Blood Pressure?

Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mmHg) and recorded as two numbers—systolic pressure (when the heart beats) over diastolic pressure (when the heart relaxes between beats). Both numbers are important. (See “Blood Pressure Levels for Adults.”)

Blood pressure rises and falls during the day. But when it stays elevated over time, then it’s called high blood pressure. High blood pressure is dangerous because it makes the heart work too hard, and the high force of the blood flow can harm arteries and organs such as the heart, kidneys, brain, and eyes. 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, stroke, and blindness.

High blood pressure affects more than 65 million—or 1 in 3—American adults. About 28 percent of American adults ages 18 and older, or about 59 million people, have prehypertension, a condition that also increases the chance of heart disease and stroke. High blood pressure is especially common among African Americans, who tend to develop it at an earlier age and more often than Whites. It is also common among older Americans—individuals with normal blood pressure at age 55 have a 90 percent lifetime risk for developing high blood pressure.

High blood pressure can be controlled if you take these steps:

• Maintain a healthy weight.

• Be moderately physically active on most days of the week.

• Follow a healthy eating plan, which includes foods lower in sodium.

• If you drink alcoholic beverages, do so in moderation.

• 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.

Blood Pressure Levels for Adults*

Category

Systolic† (mmHg)‡

Diastolic†

(mmHg)‡

Result

Normal

Less than 120

and

Less than 80

Good for you!

Prehypertension

120–139

or

80–89

Your blood pressure could be a problem. Make changes in what you eat and drink, be physically active, and lose extra weight. If you also have diabetes, see your doctor.

Hypertension

140 or higher

or

90 or higher

You have high blood pressure. Ask your doctor

or nurse how to control it.

* For adults ages 18 and older who are not on medicine for high blood pressure and do not have a short-term serious illness. Source: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; NIH Publication No. 03-5230, National High Blood Pressure Education Program, May 2003.

† If systolic and diastolic pressures fall into different categories, overall status is the higher category.

‡ Millimeters of mercury.

What Is the DASH Eating Plan?

Blood pressure can be unhealthy even if it stays only slightly above the normal level of less than 120/80 mmHg. The more your blood pressure rises above normal, the greater the health risk.

Scientists supported by the National Heart, Lung, and Blood Institute (NHLBI) conducted two key studies. Their findings showed that blood pressures were reduced with an eating plan that is low in saturated fat, cholesterol, and total fat and that emphasizes fruits, vegetables, and fat-free or low-fat milk and milk products. This eating plan—known as the DASH eating plan—also includes whole grain products, fish, poultry, and nuts. It is reduced in lean red meat, sweets, added sugars, and sugar-containing beverages compared to the typical American diet. It is rich in potassium, magnesium, and calcium, as well as protein and fiber. (See “Daily Nutrient Goals Used in the DASH Studies” for the DASH studies’ daily nutrient goals.)

Daily Nutrient Goals Used in the DASH Studies (for a 2,100 Calorie Eating Plan)

Total fat

27% of calories

Sodium

2,300 mg*

Saturated fat

6% of calories

Potassium

4,700 mg

Protein

18% of calories

Calcium

1,250 mg

Carbohydrate

55% of calories

Magnesium

500 mg

Cholesterol

150 mg

Fiber

30 g

* 1,500 mg sodium was a lower goal tested and found to be even better for lowering blood pressure. It was particularly effective for middle-aged and older individuals, African Americans, and those who already had high blood pressure. g = grams; mg = milligrams

The DASH eating plan follows heart healthy guidelines to limit saturated fat and cholesterol. It focuses on increasing intake of foods rich in nutrients that are expected to lower blood pressure, mainly inerals (like potassium, calcium, and magnesium), protein, and fiber. It includes nutrient-rich foods so that it meets other nutrient requirements as recommended by the Institute of Medicine.

The first DASH study involved 459 adults with systolic blood pressures of less than 160 mmHg and diastolic pressures of 80–95 mmHg. About 27 percent of the participants had high blood pressure. About 50 percent were women and 60 percent were African Americans. It compared three eating plans: a plan that includes foods similar to what many Americans regularly eat; a plan that includes foods similar to what many Americans regularly eat plus more fruits and vegetables; and the DASH eating lan. All three plans included about 3,000 milligrams of sodium daily. None of the plans was vegetarian or used specialty foods.

Results were dramatic. Participants who followed both the plan that included more fruits and vegetables and the DASH eating plan had reduced blood pressure. But the DASH eating plan had the greatest effect, especially for those with high blood pressure. Furthermore, the blood pressure reductions came fast—within 2 weeks of starting the plan.

The second DASH study looked at the effect on blood pressure of a reduced dietary sodium intake as participants followed either the DASH eating plan or an eating plan typical of what many Americans consume. This second study involved 412 participants. Participants were randomly assigned to one of the two eating plans and then followed for a month at each of the 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 2,300 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 eating plan than on the other eating plan. The greatest blood pressure reductions were for the DASH eating plan at the sodium intake of 1,500 milligrams per day. Those with high blood pressure saw the greatest reductions, but those with prehypertension also had large decreases.

Together these studies show the importance of lowering sodium intake—whatever your eating plan. For a true winning combination, follow the DASH eating plan and lower your intake of salt and sodium.

Who Helped With DASH?

The DASH studies were sponsored by the NHLBI and conducted at four medical centers. There was also a central coordinating center at Kaiser Permanente Center for Health Research in Portland, OR. The four medical centers were: Brigham and Women’s Hospital, Boston, MA; Duke Hypertension Center and the Sarah W. Stedman Nutrition and Metabolism Center, Durham, NC; Johns Hopkins Medical Institutions, Baltimore, MD; and Pennington Biomedical Research Center, Baton Rouge, LA.

How Do I Make the DASH?

The DASH eating plan used in the studies calls for a certain number of daily servings from various food groups. These are given in “Following the DASH Eating Plan” for 2,000 calories per day. The number of servings you require may vary, depending on your caloric need. The “DASH Eating Plan—Number of Daily Servings for Other Calorie Levels” gives the number of servings for 1,600, 2,600, and 3,100 calories.

The DASH eating plan used along with other lifestyle changes can help you prevent and control blood pressure. If your blood pressure is not too high, you may be able to control it entirely by changing your eating habits, losing weight if you are overweight, getting regular physical activity, and cutting down on alcohol. The DASH eating plan also has other benefits, such as lowering LDL (“bad”) cholesterol, which, along with lowering blood pressure, can reduce your risk for getting heart disease.

Following the DASH Eating Plan

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.

Food Group

Daily Servings

Serving Sizes

Examples and Notes

Significance of Each Food Group to the DASH Eating Pattern

Grains*

6–8

1 slice bread

1 oz dry cereal†

1/2 cup cooked rice, pasta, or cereal

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

4–5

1 cup raw leafy vegetable

1/2 cup cut-up raw or cooked vegetable

1/2 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

4–5

1 medium fruit

1/4 cup dried fruit

1/2 cup fresh, frozen, or canned fruit

1/2 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 milk and milk products

2–3

1 cup milk or yogurt

1 1/2 oz cheese

Fat-free (skim) or low-fat (1%) milk or buttermilk, fat-free, low-fat, or reduced-fat cheese, fat-free or low-fat regular or frozen yogurt

Major sources of calcium and protein

Lean meats, poultry, and fish

6 or less

1 oz cooked meats, poultry, or fish

1 egg‡

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

4–5 per week

1/3 cup or 1 1/2 oz nuts

2 Tbsp peanut butter

2 Tbsp or 1/2 oz seeds

1/2 cup cooked legumes (dry beans and peas)

Almonds, hazelnuts, mixed nuts, peanuts, walnuts, sunflower seeds, peanut butter, kidney beans, lentils, split peas

Rich sources of energy, magnesium, protein, and fiber

Fats and oils§

2–3

1 tsp soft margarine

1 tsp vegetable oil

1 Tbsp mayonnaise

2 Tbsp salad dressing

Soft margarine, vegetable oil (such as canola, corn, olive, or safflower), low-fat mayonnaise, light salad dressing

The DASH study had 27 percent of calories as fat, including fat in or added to foods

Sweets and added sugars

5 or less per week

1 Tbsp sugar

1 Tbsp jelly or jam

1/2 cup sorbet, gelatin

1 cup lemonade

Fruit-flavored gelatin, fruit punch, hard candy, jelly, maple syrup, sorbet and ices, sugar

Sweets should be low in fat

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

† Serving sizes vary between 1/2 cup and 1 1/4 cups, depending on cereal type. Check the product’s Nutrition Facts label.

‡ Since 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.

§ Fat content changes serving amount for fats and oils. For example, 1 Tbsp of regular salad dressing equals one serving; 1 Tbsp of a low-fat dressing equals one-half serving; 1 Tbsp of a fat-free dressing equals zero servings.

DASH Eating Plan—Number of Daily Servings for Other Calorie Levels

Servings/Day

Food Groups

1,600 calories/day

2,600 calories/day

3,100 calories/day

Grains*

6

10–11

12–13

Vegetables

3–4

5–6

6

Fruits

4

5–6

6

Fat-free or low-fat milk and milk products

2–3

3

3–4

Lean meats, poultry, and fish

3–6

6

6–9

Nuts, seeds, and legumes

3/week

1

1

Fats and oils

2

3

4

Sweets and added sugars

0

≤2

≤2

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

If you need to lose weight, even a small weight loss will help to lower your risks of developing high blood pressure and other serious health conditions. At the very least, you should not gain weight. A recent study showed that people can lose weight while following the DASH eating plan and lowering their sodium intake. In a study of 810 participants, one-third were taught how to lower their sodium intake and follow the DASH eating plan on their own. Most of them needed to lose weight as well. They followed the DASH eating plan at lower calorie levels and they increased their physical activity. Over the course of 18 months, participants lost weight and improved their blood pressure control.

“I was overweight. I was told by my doctor that if I kept it up I was going to develop high blood pressure and high blood cholesterol. The doctor sent me to a dietitian. She is the one who taught me the things that I had to do in order to eat right. It was hard at the beginning because once you have bad habits they are hard to break. Once I realized it was for my own good and no one was going to take care of me except me, I decided to start eating better. At home, we keep stuff like fruits, vegetables, and low-fat or fat-free milk in the house. My three daughters are beginning to learn how to eat right, and my little one loves vegetables like I do.”

— Jose Henriquez

If you’re trying to lose weight, use the foods and serving guidelines in “Following the DASH Eating Plan” and “DASH Eating Plan—Number of Daily Servings for Other Calorie Levels.” Aim for a caloric level that is lower than what you usually consume. In addition, you can make your diet lower in calories by using the tips in “How to Lower Calories on the DASH Eating Plan.” The best way to take off pounds is to do so gradually, get more physical activity, and eat a balanced diet that is lower in calories and fat. For some people at very high risk for heart disease or stroke, medication will be necessary. To develop a weight-loss or weight-maintenance program that works well for you, consult with your doctor or registered dietitian.

Combining the DASH eating plan with a regular physical activity program, such as walking or swimming, will help you both shed pounds and stay trim for the long term. You can do an activity for 30 minutes at one time, or choose shorter periods of at least 10 minutes each. (See “Make a Dash for DASH.”) The important thing is to total about 30 minutes of activity each day. (To avoid weight gain, try to total about 60 minutes per day.)

You should be aware that the DASH eating plan has more daily servings of fruits, vegetables, and whole grain foods than you may be used to eating. Because the plan is high in fiber, it can cause bloating and diarrhea in some persons. To avoid these problems, gradually increase your intake of fruit, vegetables, and whole grain foods.

This booklet gives menus and recipes from the DASH studies for both 2,300 and 1,500 milligrams of daily sodium intake. Twenty-three 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.

The key to reducing salt intake is making wise food choices. Only a small amount of salt that we consume comes from the salt added at the table, and 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. You may be surprised to find which foods have sodium. They include baked goods, certain cereals, soy sauce, seasoned salts, monosodium glutamate (MSG), baking soda, and some antacids—the range is wide.

Because it is rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH eating plan makes it easier to consume less salt and sodium. Still, you may want to begin by adopting the DASH eating plan at the level of 2,300 milligrams of sodium per day and then further lower your sodium intake to 1,500 milligrams per day.

“Where’s the Sodium?” “Tips To Reduce Salt and Sodium,” and “Reducing Salt and Sodium When Eating Out” offer tips on how to reduce the salt and sodium content in your diet, and “Compare Nutrition Facts Labels on Foods” and “Label Language” show how to use food labels to find lower sodium products.

The DASH eating plan also emphasizes potassium from food, especially fruits and vegetables, to help keep blood pressure levels healthy. A potassium-rich diet may help to reduce elevated or high blood pressure, but be sure to get your potassium from food sources, not from supplements. Many fruits and vegetables, some milk products, and fish are rich sources of potassium. (See “Where’s the Potassium?”) However, fruits and vegetables are rich in the form of potassium (potassium with bicarbonate precursors) that favorably affects acid-base metabolism. This form of potassium may help to reduce risk of kidney stones and bone loss. While salt substitutes containing potassium are sometimes needed by persons on drug therapy for high blood pressure, these supplements can be harmful to people with certain medical conditions. Ask your doctor before trying salt substitutes or supplements.

Start the DASH eating plan today—it can help you prevent and control high blood pressure, has other health benefits for your heart, can be used to lose weight, and meets your nutritional needs.

How to Lower Calories on the DASH Eating Plan

The DASH eating plan can be adopted to promote weight loss. It is rich in lower-calorie foods, such as fruits and vegetables. You can make it lower in calories by replacing higher calorie foods such as sweets 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—

• Eat a medium apple instead of four shortbread cookies. You’ll save 80 calories.

• Eat 1/4 cup of dried apricots instead of a 2-ounce bag of pork rinds. You’ll save 230 calories.

To increase vegetables—

• Have a hamburger that’s 3 ounces of meat instead of 6 ounces. Add a 1/2-cup serving of carrots and a 1/2-cup serving of spinach. You’ll save more than 200 calories.

• Instead of 5 ounces of chicken, have a stir fry with 2 ounces of chicken and 1 1/2 cups of raw vegetables. Use a small amount of vegetable oil. You’ll save 50 calories.

To increase fat-free or low-fat milk products—

• Have a 1/2-cup serving of low-fat frozen yogurt instead of a 1/2-cup serving of full-fat ice cream. You’ll save about 70 calories.

And don’t forget these calorie-saving tips:

• Use fat-free or low-fat condiments.

• Use half as much vegetable oil, soft or liquid margarine, mayonnaise, or salad dressing, or choose available low-fat or fat-free versions.

• Eat smaller portions––cut back gradually.

• Choose fat-free or low-fat milk and milk products.

• Check the food labels to compare fat content in packaged foods––items marked fat-free or low-fat are not always lower in calories than their regular versions.

• Limit foods with lots of added sugar, such as pies, flavored yogurts, candy bars, ice cream, sherbet, regular soft drinks, and fruit drinks.

• Eat fruits canned in their own juice or in water.

• Add fruit to plain fat-free or low-fat yogurt.

• Snack on fruit, vegetable sticks, unbuttered and unsalted popcorn, or rice cakes.

• Drink water or club soda––zest it up with a wedge of lemon or lime.

Make a Dash for DASH

Thirty minutes of moderate-intensity physical activity each day can help.

• If your blood pressure is moderately elevated, 30 minutes of brisk walking on most days a week may be enough to keep you off medication.

• If you take medication for high blood pressure, 30 minutes of moderate physical activity can make your medication work more effectively and make you feel better.

• If you don’t have high blood pressure, being physically active can help keep it that way. If you have normal blood pressure—but are not active—your chances of developing high blood pressure increase, especially as you get older or if you become overweight or obese or develop diabetes.

Getting started: Your physical activity program can be as simple as a 15-minute walk around the block each morning and evening. Gradually build up your program and set new goals to stay motivated. The important thing is to find something you enjoy, and do it safely. And remember––trying too hard at first can lead to injury and cause you to give up. If you have a chronic health problem or a family history of heart disease at an early age, be sure to talk with your doctor before launching a new physical activity program.

1. Set a schedule and try to keep it.

2. Get a friend or family member to join you. Motivate each other to keep it up.

3. Cross-train. Alternate between different activities so you don’t strain one part of your body day after day.

4. Set goals.

5. Reward yourself. At the end of each month that you stay on your exercise program, reward yourself with something new––new clothes, a compact disc, a new book––something that will help keep you committed. But don’t use food as a reward.

Where’s the Sodium?

Only a small amount of sodium occurs naturally in foods. Most sodium is added during processing. The table below gives examples of sodium in some foods.

Food Groups

Sodium (mg)

Whole and other grains and grain products*

Cooked cereal, rice, pasta, unsalted, 1/2 cup

0–5

Ready-to-eat cereal, 1 cup

0–360

Bread, 1 slice

110–175

Vegetables

Fresh or frozen, cooked without salt, 1/2 cup

1–70

Canned or frozen with sauce, 1/2 cup

140–460

Tomato juice, canned, 1/2 cup

330

Fruit

Fresh, frozen, canned, 1/2 cup

0–5

Low-fat or fat-free milk and milk products

Milk, 1 cup

107

Yogurt, 1 cup

175

Natural cheeses, 1 1/2 oz

110–450

Process cheeses, 2 oz

600

Nuts, seeds, and legumes

Peanuts, salted, 1/3 cup

120

Peanuts, unsalted, 1/3 cup

0–5

Beans, cooked from dried or frozen, without salt, 1/2 cup

0–5

Beans, canned, 1/2 cup

400

Lean meats, fish, and poultry

Fresh meat, fish, poultry, 3 oz

30–90

Tuna canned, water pack, no salt added, 3 oz

35–45

Tuna canned, water pack, 3 oz

230–350

Ham, lean, roasted, 3 oz

1,020

* Whole grains are recommended for most grain servings.

Tips To Reduce Salt and Sodium

• Choose low- or reduced-sodium, or no-salt-added versions of foods and condiments when available.

• Choose fresh, frozen, or canned (low-sodium or no-salt-added) vegetables.

• Use fresh poultry, fish, and lean meat, rather than canned, smoked, or processed types.

• Choose ready-to-eat breakfast cereals that are lower in sodium.

• Limit cured foods (such as bacon and ham); foods packed in brine (such as pickles, pickled vegetables, olives, and sauerkraut); and condiments (such as mustard, horseradish, ketchup, and barbecue sauce). Limit even lower sodium versions of soy sauce and teriyaki sauce. Treat these condiments sparingly as you do table salt.

• Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes, which usually have added salt.

• 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.

• Rinse canned foods, such as tuna and canned beans, to remove some of the sodium.

• Use spices instead of salt. 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.

Reducing Salt and Sodium When Eating Out

• 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.

• Know the terms that indicate high sodium content: pickled, cured, smoked, soy sauce, broth.

• Move the salt shaker away.

• Limit condiments, such as mustard, ketchup, pickles, and sauces with salt-containing ingredients.

• Choose fruit or vegetables, instead of salty snack foods.

Compare Nutrition Facts Labels on Foods

Read the Nutrition Facts labels on foods to compare the amount of sodium in products. Look for the sodium content in milligrams and the Percent Daily Value. Aim for foods that are less than 5 percent of the Daily Value of sodium. Foods with 20 percent or more Daily Value of sodium are considered high. You can also check out the amounts of the other DASH goal nutrients.

Compare the food labels of these two versions of canned tomatoes. The regular canned tomatoes (right) have 15 times as much sodium as the low-sodium canned tomatoes.

Low-Sodium Canned Diced Tomatoes

Canned Diced Tomatoes

Label Language

Food labels can help you choose items lower in sodium, saturated fat, trans fat, cholesterol, and calories and higher in potassium and calcium. Look for the following label information on cans, boxes, bottles, bags, and other packaging:

Phrase

What It Means*

Sodium

Sodium free or salt free

Less than 5 mg per serving

Very low sodium

35 mg or less of sodium per serving

Low sodium

140 mg or less of sodium per serving

Low-sodium meal

140 mg or less of sodium per 3 1/2 oz (100 g)

Reduced or less sodium

At least 25 percent less sodium than the regular version

Light in sodium

50 percent less sodium than the regular version

Unsalted or no salt added

No salt added to the product during processing (this is not a sodium-free food)

Fat

Fat-free

Less than 0.5 g per serving

Low saturated fat

1 g or less per serving and 15% or less of calories from saturated fat

Low-fat

3 g or less per serving

Reduced fat

At least 25 percent less fat than the regular version

Light in fat

Half the fat compared to the regular version

* Small serving sizes (50 g) or meals and main dishes are based on various weights in grams versus a serving size.

Where’s the Potassium?

Potassium comes from a variety of food sources. The table below gives examples of potassium in some foods.

Food Groups

Potassium (mg)

Vegetables

Potato, 1 medium

926

Sweet Potato, 1 medium

540

Spinach, cooked, 1/2 cup

290

Zucchini, cooked, 1/2 cup

280

Tomato, fresh, 1/2 cup

210

Kale, cooked, 1/2 cup

150

Romaine lettuce, 1 cup

140

Mushrooms, 1/2 cup

110

Cucumber, 1/2 cup

80

Fruit

Banana, 1 medium

420

Apricots, 1/4 cup

380

Orange, 1 medium

237

Cantaloupe chunks, 1/2 cup

214

Apple, 1 medium

150

Nuts, seeds, and legumes

Cooked soybeans, 1/2 cup

440

Cooked lentils, 1/2 cup

370

Cooked kidney beans, 1/2 cup

360

Cooked split peas, 1/2 cup

360

Almonds, roasted, 1/3 cup

310

Walnuts, roasted, 1/3 cup

190

Sunflower seeds, roasted, 2 Tbsp

124

Peanuts, roasted, 1/3 cup

120

Low-fat or fat-free milk and milk products

Milk, 1 cup

380

Yogurt, 1 cup

370

Lean meats, fish, and poultry

Fish (cod, halibut, rockfish, trout, tuna), 3 oz

200–400

Pork tenderloin, 3 oz

370

Beef tenderloin, chicken, turkey, 3 oz

210

“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

How Can I Get Started on the DASH Eating Plan?

It’s easy. Reading the “Getting Started” suggestions 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 “What’s on Your Plate? How Much Are You Moving?”) 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 “Following the DASH Eating Plan” 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 “Making the DASH to Good Health” can help you continue to follow the DASH eating plan and make other healthy lifestyle changes for a lifetime.

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 “What’s on Your Plate? How Much Are You Moving?” 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.

What’s on Your Plate? How Much Are You Moving?

If you have trouble viewing this table, or would like to print a copy to track your daily food intake and physical activity, see page 26 of the PDF on the NHLBI website at http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf.

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 “What’s on Your Plate? How Much Are You Moving?” 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.

A Week With the DASH Eating Plan

Here is a week of menus from the DASH eating plan. The menus allow you to have a daily sodium level of either 2,300 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, low-fat, fat-free, or reduced fat 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 eating plan at 1,500 milligrams of sodium per day.

This eBook provides menus for a daily sodium level of 2,300 mg; please consult the information in the PDF (starting on page 29) on the NHLBI website at http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf for changes to reduce menus to 1,500 mg and to see food group serving calculations for each menu.

Abbreviations:

oz = ounce

tsp = teaspoon

Tbsp = tablespoon

g = gram

mg = milligram

Day 1

2,300 mg Sodium Menu

Sodium (mg)

Breakfast

3/4 cup bran flakes cereal:

220

1 medium banana

1

1 cup low-fat milk

107

1 slice whole wheat bread:

149

1 tsp soft (tub) margarine

26

1 cup orange juice

5

Lunch

3/4 cup chicken salad:

179

2 slices whole wheat bread

299

1 Tbsp Dijon mustard

373

salad:

1/2 cup fresh cucumber slices

1

1/2 cup tomato wedges

5

1 Tbsp sunflower seeds

0

1 tsp Italian dressing, low calorie

43

1/2 cup fruit cocktail, juice pack

5

Dinner

3 oz beef, eye of the round:

35

2 Tbsp beef gravy, fat-free

165

1 cup green beans, sautéed with:

12

1/2 tsp canola oil

0

1 small baked potato:

14

1 Tbsp sour cream, fat-free

21

1 Tbsp grated natural cheddar cheese, reduced fat

67

1 Tbsp chopped scallions

1

1 small whole wheat roll:

148

1 tsp soft (tub) margarine

26

1 small apple

1

1 cup low-fat milk

107

Snacks

1/3 cup almonds, unsalted

0

1/4 cup raisins

4

1/2 cup fruit yogurt, fat-free, no sugar added

86

Totals

2,101

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Calories

2,062

2,037

Total fat

63 g

59 g

Calories from fat

28%

26 %

Saturated fat

13 g

12 g

Calories from saturated fat

6 %

5 %

Cholesterol

155 mg

155 mg

Sodium

2,101 mg

1,507 mg

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Carbohydrate

284 g

284 g

Protein

114 g

115 g

Calcium

1,220 mg

1,218 mg

Magnesium

594 mg

580 mg

Potassium

4,909 mg

4,855 mg

Fiber

37 g

36 g

Day 2

2,300 mg Sodium Menu

Sodium (mg)

Breakfast

1/2 cup instant oatmeal

54

1 mini whole wheat bagel:

84

1 Tbsp peanut butter

81

1 medium banana

1

1 cup low-fat milk

107

Lunch

chicken breast sandwich:

3 oz chicken breast, skinless

65

2 slices whole wheat bread

299

1 slice (3/4 oz) natural cheddar cheese, reduced fat

202

1 large leaf romaine lettuce

1

2 slices tomato

2

1 Tbsp mayonnaise, low-fat

101

1 cup cantaloupe chunks

26

1 cup apple juice

21

Dinner

1 cup spaghetti:

1

3/4 cup vegetarian spaghetti sauce

479

3 Tbsp Parmesan cheese

287

spinach salad:

1 cup fresh spinach leaves

24

1/4 cup fresh carrots, grated

19

1/4 cup fresh mushrooms, sliced

1

1 Tbsp vinaigrette dressing†

1

1/2 cup corn, cooked from frozen

1

1/2 cup canned pears, juice pack

5

Snacks

1/3 cup almonds, unsalted

0

1/4 cup dried apricots

3

1 cup fruit yogurt, fat-free, no sugar added

173

Totals

2,035

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Calories

2,027

2,078

Total fat

64 g

68 g

Calories from fat

28%

30%

Saturated fat

13 g

16 g

Calories from saturated fat

6%

7%

Cholesterol

114 mg

129 mg

Sodium

2,035 mg

1,560 mg

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Carbohydrate

288 g

290 g

Protein

99 g

100 g

Calcium

1,370 mg

1,334 mg

Magnesium

535 mg

542 mg

Potassium

4,715 mg

4,721 mg

Fiber

34 g

34 g

Day 3

2,300 mg Sodium Menu

Sodium (mg)

Breakfast

3/4 cup bran flakes cereal:

220

1 medium banana

1

1 cup low-fat milk

107

1 slice whole wheat bread:

149

1 tsp soft (tub) margarine

26

1 cup orange juice

6

Lunch

beef barbeque sandwich:

2 oz beef, eye of round

26

1 Tbsp barbeque sauce

156

2 slices (1 1/2 oz) natural cheddar cheese, reduced fat

405

1 hamburger bun

183

1 large leaf romaine lettuce

1

2 slices tomato

2

1 cup new potato salad

17

1 medium orange

0

Dinner

3 oz cod:

70

1 tsp lemon juice

1

1/2 cup brown rice

5

1 cup spinach, cooked from frozen, sautéed with:

184

1 tsp canola oil

0

1 Tbsp almonds, slivered

0

1 small cornbread muffin, made with oil:

119

1 tsp soft (tub) margarine

26

Snacks

1 cup fruit yogurt, fat-free,

173

no added sugar:

1 Tbsp sunflower seeds, unsalted

0

2 large graham cracker rectangles:

156

1 Tbsp peanut butter

81

Totals

2,114

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Calories

1,997

1,995

Total fat

56 g

52 g

Calories from fat

25%

24%

Saturated fat

12 g

11 g

Calories from saturated fat

6%

5%

Cholesterol

140 mg

140 mg

Sodium

2,114 mg

1,447 mg

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Carbohydrate

289 g

283 g

Protein

103 g

104 g

Calcium

1,537 mg

1,524 mg

Magnesium

630 mg

598 mg

Potassium

4,676 mg

4,580 mg

Fiber

34 g

31 g

Day 4

2,300 mg Sodium Menu

Sodium (mg)

Breakfast

1 slice whole wheat bread:

149

1 tsp soft (tub) margarine

26

1 cup fruit yogurt, fat-free, no added sugar

173

1 medium peach

0

1/2 cup grape juice

4

Lunch

ham and cheese sandwich:

2 oz ham, low-fat, low sodium

549

1 slice (3/4 oz) natural cheddar cheese, reduced fat

202

2 slices whole wheat bread

299

1 large leaf romaine lettuce

1

2 slices tomato

2

1 Tbsp mayonnaise, low-fat

101

1 cup carrot sticks

84

Dinner

chicken and Spanish rice

341

1 cup green peas, sautéed with:

115

1 tsp canola oil

0

1 cup cantaloupe chunks

26

1 cup low-fat milk

107

Snacks

1/3 cup almonds, unsalted

0

1 cup apple juice

21

1/4 cup apricots

3

1 cup low-fat milk

107

Totals

2,312

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Calories

2,024

2,045

Total fat

59 g

59 g

Calories from fat

26%

26%

Saturated fat

12 g

12 g

Calories from saturated fat

5%

5%

Cholesterol

148 mg

150 mg

Sodium

2,312 mg

1,436 mg

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Carbohydrate

279 g

278 g

Protein

110 g

116 g

Calcium

1,417 mg

1,415 mg

Magnesium

538 mg

541 mg

Potassium

4,575 mg

4,559 mg

Fiber

35 g

35 g

Day 5

2,300 mg Sodium Menu

Sodium (mg)

Breakfast

1 cup whole grain oat rings cereal:

273

1 medium banana

1

1 cup low-fat milk

107

1 medium raisin bagel:

272

1 Tbsp peanut butter

81

1 cup orange juice

5

Lunch

tuna salad plate:

1/2 cup tuna salad

171

1 large leaf romaine lettuce

1

1 slice whole wheat bread

149

cucumber salad:

1 cup fresh cucumber slices

2

1/2 cup tomato wedges

5

1 Tbsp vinaigrette dressing

133

1/2 cup cottage cheese, low-fat:

459

1/2 cup canned pineapple, juice pack

1

1 Tbsp almonds, unsalted

0

Dinner

3 oz turkey meatloaf

205

1 small baked potato:

14

1 Tbsp sour cream, fat-free

21

1 Tbsp natural cheddar cheese, reduced fat, grated

67

1 scallion stalk, chopped

1

1 cup collard greens, sautéed with:

85

1 tsp canola oil

0

1 small whole wheat roll

148

1 medium peach

0

Snacks

1 cup fruit yogurt, fat-free, no added sugar

173

2 Tbsp sunflower seeds, unsalted

0

Totals

2,373

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Calories

1,976

2,100

Total fat

57 g

52 g

Calories from fat

26 %

22%

Saturated fat

11 g

11 g

Calories from saturated fat

5 %

5%

Cholesterol

158 mg

158 mg

Sodium

2,373 mg

1,519 mg

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Carbohydrate

275 g

314 g

Protein

111 g

114 g

Calcium

1,470 mg

1,412 mg

Magnesium

495 mg

491 mg

Potassium

4,769 mg

4,903 mg

Fiber

30 g

31 g

Day 6

2,300 mg Sodium Menu

Sodium (mg)

Breakfast

1 low-fat granola bar

81

1 medium banana

1

1/2 cup fruit yogurt, fat-free, no sugar added

86

1 cup orange juice

5

1 cup low-fat milk

107

Lunch

turkey breast sandwich:

3 oz turkey breast

48

2 slices whole wheat bread

299

1 large leaf romaine lettuce

1

2 slices tomato

2

2 tsp mayonnaise, low-fat

67

1 Tbsp Dijon mustard

373

1 cup steamed broccoli, cooked from frozen

11

1 medium orange

0

Dinner

3 oz spicy baked fish

50

1 cup scallion rice

18

spinach sauté:

1/2 cup spinach, cooked from frozen, sautéed with:

92

2 tsp canola oil

0

1 Tbsp almonds, slivered, unsalted

0

1 cup carrots, cooked from frozen

84

1 small whole wheat roll:

148

1 tsp soft (tub) margarine

26

1 small cookie

60

Snacks

2 Tbsp peanuts, unsalted

1

1 cup low-fat milk

107

1/4 cup dried apricots

3

Totals

1,671

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Calories

1,939

1,935

Total fat

58 g

57 g

Calories from fat

27%

27%

Saturated fat

12 g

12 g

Calories from saturated fat

6 %

6 %

Cholesterol

171 mg

171 mg

Sodium

1,671 mg

1,472 mg

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Carbohydrate

268 g

268 g

Protein

105 g

105 g

Calcium

1,210 mg

1,214 mg

Magnesium

548 mg

545 mg

Potassium

4,710 mg

4,710 mg

Fiber

36 g

36 g

Day 7

2,300 mg Sodium Menu

Sodium (mg)

Breakfast

1 cup whole grain oat rings:

273

1 medium banana

1

1 cup low-fat milk

107

1 cup fruit yogurt, fat-free, no sugar added

173

Lunch

tuna salad sandwich:

1/2 cup tuna, drained, rinsed

39

1 Tbsp mayonnaise, low-fat

101

1 large leaf romaine lettuce

1

2 slices tomato

2

2 slices whole wheat bread

299

1 medium apple

1

1 cup low-fat milk

107

Dinner

1/6 recipe zucchini lasagna:

368

salad:

1 cup fresh spinach leaves

24

1 cup tomato wedges

9

2 Tbsp croutons, seasoned

62

1 Tbsp vinaigrette dressing, reduced calorie

133

1 Tbsp sunflower seeds

0

1 small whole wheat roll:

148

1 tsp soft (tub) margarine

45

1 cup grape juice

8

Snacks

1/3 cup almonds, unsalted

0

1/4 cup dry apricots

3

6 whole wheat crackers

166

Totals

2,069

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Calories

1,993

1,988

Total fat

64 g

60 g

Calories from fat

29%

27%

Saturated fat

13 g

13 g

Calories from saturated fat

6%

6%

Cholesterol

71 mg

72 mg

Sodium

2,069 mg

1,421 mg

Sodium Level

Nutrients Per Day

2,300 mg

1,500 mg

Carbohydrate

283 g

285 g

Protein

93 g

97 g

Calcium

1,616 mg

1,447 mg

Magnesium

537 mg

553 mg

Potassium

4,693 mg

4,695 mg

Fiber

32 g

33 g

Recipes for Heart Health

Here are some recipes to help you cook up a week of tasty, heart healthy meals. If you’re following the DASH eating plan at 1,500 milligrams of sodium per day or just want to reduce your sodium intake, use the suggested recipe changes.

Day 1

Chicken Salad

3 1/4

cups

chicken breast, cooked, cubed, and skinless

1/4

cup

celery, chopped

1

Tbsp

lemon juice

1/2

tsp

onion powder

1/8

tsp

salt*

3

Tbsp

mayonnaise, low-fat

1. Bake chicken, cut into cubes, and refrigerate.

2. In a large bowl combine rest of ingredients, add chilled chicken and mix well.

Makes 5 servings

Serving Size: 3/4 cup

Per Serving:

Calories

176

Total Fat

6 g

Saturated Fat

2 g

Cholesterol

77 mg

Sodium

179 mg

Protein

27 g

Carbohydrate

2 g

Calcium

16 mg

Magnesium

25 mg

Potassium

236 mg

Fiber

0 g

* To reduce sodium, omit the 1/8 tsp of added salt. New sodium content for each serving is 120 mg.

Day 2

Vegetarian Spaghetti Sauce

2

Tbsp

olive oil

2

small

onions, chopped

3

cloves

garlic, chopped

1 1/4

cups

zucchini, sliced

1

Tbsp

oregano, dried

1

Tbsp

basil, dried

1

8 oz can

tomato sauce

1

6 oz can

tomato paste*

2

medium

tomatoes, chopped

1

cup

water

1. In a medium skillet, heat oil. Sauté onions, garlic, and zucchini in oil for 5 minutes on medium heat.

2. Add remaining ingredients and simmer covered for 45 minutes. Serve over spaghetti.

Makes 6 servings

Serving Size: 3/4 cup

Per Serving:

Calories

105

Total Fat

5 g

Saturated Fat

1 g

Cholesterol

0 mg

Sodium

479 mg

Protein

3 g

Carbohydrate

15 g

Calcium

49 mg

Magnesium

35 mg

Potassium

686 mg

Fiber

4 g

* To reduce sodium, use a 6-oz can of low-sodium tomato paste. New sodium content for each serving is 253 mg.

Day 2

Vinaigrette Salad Dressing

1

bulb

garlic, separated and peeled

1/2

cup

water

1

Tbsp

red wine vinegar

1/4

tsp

honey

1

Tbsp

virgin olive oil

1/4

tsp

black pepper

1. Place the garlic cloves into a small saucepan and pour enough water (about 1/2 cup) to cover them.

2. Bring water to a boil, then reduce heat and simmer until garlic is tender, about 15 minutes.

3. Reduce the liquid to 2 Tbsp and increase the heat for 3 minutes.

4. Pour the contents into a small sieve over a bowl, and with a wooden spoon, mash the garlic through the sieve into the bowl.

5. Whisk the vinegar into the garlic mixture; incorporate the oil and seasoning.

Makes 4 servings

Serving Size: 2 Tbsp

Per Serving:

Calories

33

Total Fat

3 g

Saturated Fat

1 g

Cholesterol

0 mg

Sodium

1 mg

Protein

0 g

Carbohydrate

1 g

Calcium

3 mg

Magnesium

1 mg

Potassium

6 mg

Fiber

0 g

Day 3

New Potato Salad

16

small

new potatoes (5 cups)

2

Tbsp

olive oil

1/4

cup

green onions, chopped

1/4

tsp

black pepper

1

tsp

dill weed, dried

1. Thoroughly clean potatoes with vegetable brush and water.

2. Boil potatoes for 20 minutes or until tender.

3. Drain and cool potatoes for 20 minutes.

4. Cut potatoes into quarters and mix with olive oil, onions, and spices.

5. Refrigerate until ready to serve.

Makes 5 servings

Serving Size: 1 cup

Per Serving:

Calories

196

Total Fat

6 g

Saturated Fat

1 g

Cholesterol

0 mg

Sodium

17 mg

Protein

4 g

Carbohydrate

34 g

Calcium

31 mg

Magnesium

46 mg

Potassium

861 mg

Fiber

4 g

Day 4

Chicken and Spanish Rice

1

cup

onions, chopped

3/4

cup

green peppers

2

tsp

vegetable oil

1

8 oz can

tomato sauce*

1

tsp

parsley, chopped

1/2

tsp

black pepper

1 1/4

tsp

garlic, minced

5

cups

cooked brown rice (cooked in unsalted water)

3 1/4

cups

chicken breasts, cooked, skin and bone removed, and diced

1. In a large skillet, sauté onions and green peppers in oil for 5 minutes on medium heat.

2. Add tomato sauce and spices. Heat through.

3. Add cooked rice and chicken. Heat through.

Makes 5 servings

Serving Size: 1 1/2 cup

Per Serving:

Calories

428

Total Fat

8 g

Saturated Fat

2 g

Cholesterol

80 mg

Sodium

341 mg

Protein

35 g

Carbohydrate

52 g

Calcium

50 mg

Magnesium

122 mg

Potassium

545 mg

Fiber

8 g

* To reduce sodium, use one 4-oz can of low-sodium tomato sauce and one 4-oz can of regular tomato sauce. New sodium content for each serving is 215 mg.

Day 5

Tuna Salad

2

6 oz cans

tuna, water pack

1/2

cup

raw celery, chopped

1/3

cup

green onions, chopped

6 1/2

Tbsp

mayonnaise, low-fat

1. Rinse and drain tuna for 5 minutes. Break apart with a fork.

2. Add celery, onion, and mayonnaise and mix well.

Makes 5 servings

Serving Size:  1/2 cup

Per Serving:

Calories

138

Total Fat

7 g

Saturated Fat

1 g

Cholesterol

25 mg

Sodium

171 mg

Protein

16 g

Carbohydrate

2 g

Calcium

17 mg

Magnesium

19 mg

Potassium

198 mg

Fiber

0 g

Day 5

Turkey Meatloaf

1

pound

lean ground turkey

1/2

cup

regular oats, dry

1

large

egg, whole

1

Tbsp

onion, dehydrated flakes

1/4

cup

ketchup*

1. Combine all ingredients and mix well.

2. Bake in a loaf pan at 350 ˚F for 25 minutes or to an internal temperature of 165 ˚F.

3. Cut into five slices and serve.

Makes 5 servings

Serving Size: 1 slice (3 oz)

Per Serving:

Calories

191

Total Fat

7 g

Saturated Fat

2 g

Cholesterol

103 mg

Sodium

205 mg

Protein

23 g

Carbohydrate

9 g

Calcium

24 mg

Magnesium

33 mg

Potassium

268 mg

Fiber

1 g

* To reduce sodium, use low-sodium ketchup. New sodium content for each serving is 74 mg.

Day 5

Yogurt Salad Dressing

8

oz

plain yogurt, fat-free

1/4

cup

mayonnaise, low-fat

2

Tbsp

chives, dried

2

Tbsp

dill, dried

2

Tbsp

lemon juice

Mix all ingredients in bowl and refrigerate.

Makes 5 servings

Serving Size: 2 Tbsp

Per Serving:

Calories

39

Total Fat

2 g

Saturated Fat

0 g

Cholesterol

3 mg

Sodium

66 mg

Protein

2 g

Carbohydrate

4 g

Calcium

76 mg

Magnesium

10 mg

Potassium

110 mg

Fiber

0 g

Day 6

Spicy Baked Fish

1

pound

salmon (or other fish) fillet

1

Tbsp

olive oil

1

tsp

spicy seasoning, salt-free

1. Preheat oven to 350 ˚F. Spray a casserole dish with cooking oil spray.

2. Wash and dry fish. Place in dish. Mix oil and seasoning and drizzle over fish.

3. Bake uncovered for 15 minutes or until fish flakes with fork. Cut into 4 pieces. Serve with rice.

Makes 4 servings

Serving Size: 1 piece (3 oz)

Per Serving:

Calories

192

Total Fat

11 g

Saturated Fat

2 g

Cholesterol

63 mg

Sodium

50 mg

Protein

23 g

Carbohydrate

<1 g

Calcium

18 mg

Magnesium

34 mg

Potassium

560 mg

Fiber

0 g

Day 6

Scallion Rice

4 1/2

cups

cooked brown rice (cooked in unsalted water)

1 1/2

tsp

bouillon granules, low sodium

1/4

cup

scallions (green onions), chopped

1. Cook rice according to directions on the package.

2. Combine the cooked rice, scallions, and bouillon granules and mix well.

3. Measure 1-cup portions and serve.

Makes 5 servings

Serving Size: 1 cup

Per Serving:

Calories

200

Total Fat

2 g

Saturated Fat

0 g

Cholesterol

0 mg

Sodium

18 mg

Protein

5 g

Carbohydrate

41 g

Calcium

23 mg

Magnesium

77 mg

Potassium

92 mg

Fiber

6 g

Day 7

Zucchini Lasagna

1/2

pound

cooked lasagna noodles, cooked in unsalted water

3/4

cup

part-skim mozzarella cheese, grated

1 1/2

cups

cottage cheese,* fat-free

1/4

cup

Parmesan cheese, grated

1 1/2

cups

raw zucchini, sliced

2 1/2

cups

low-sodium tomato sauce

2

tsp

basil, dried

2

tsp

oregano, dried

1/4

cup

onion, chopped

1

clove

garlic

1/8

tsp

black pepper

1. Preheat oven to 350 °F. Lightly spray a 9- by 13-inch baking dish with vegetable oil spray.

2. In a small bowl, combine 1/8 cup mozzarella and 1 Tbsp Parmesan cheese. Set aside.

3. In a medium bowl, combine remaining mozzarella and Parmesan cheese with all the cottage cheese. Mix well and set aside.

4. Combine tomato sauce with remaining ingredients. Spread a thin layer of tomato sauce in the bottom of the baking dish. Add a third of the noodles in a single layer. Spread half of the cottage cheese mixture on top. Add a layer of zucchini.

5. Repeat layering. Add a thin coating of sauce. Top with noodles, sauce, and reserved cheese mixture. Cover with aluminum foil.

6. Bake 30 to 40 minutes. Cool for 10 to 15 minutes. Cut into 6 portions.

Makes 6 servings

Serving Size: 1 piece

Per Serving:

Calories

200

Total Fat

5 g

Saturated Fat

3 g

Cholesterol

12 mg

Sodium

368 mg

Protein

15 g

Carbohydrate

24 g

Calcium

310 mg

Magnesium

46 mg

Potassium

593 mg

Fiber

3 g

* To reduce sodium, use low-sodium cottage cheese. New sodium content for each serving is 165 mg

To Learn More

NHLBI Health Information Center

P.O. Box 30105

Bethesda, MD 20824–0105

Telephone: 301–592–8573 (or dial 7–1–1 for access to free Telecommunications Relay Services (TRS))

E-mail: nhlbiinfo@nhlbi.nih.gov

Provides information on the prevention and treatment of heart disease and offers publications on heart health and heart disease.

Also, check out these online resources:

General Health Information

NHLBI Web site: www.nhlbi.nih.gov

HHS Web site: www.healthfinder.gov

Health Topics A–Z Index : http://www.nhlbi.nih.gov/health/health-topics/by-alpha/

Your Guide To Better Health Series

Your Guide to Lowering High Blood Pressure With DASH: www.nhlbi.nih.gov/health/public/heart/hbp/dash/index.htm

Your Guide to Lowering Your Cholesterol With TLC: www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.htm

Your Guide to Physical Activity and Your Heart: www.nhlbi.nih.gov/health/public/heart/obesity/phy_active.htm

Nutrition

Dietary Guidelines for Americans: http://www.health.gov/DietaryGuidelines/

How to Understand and Use the Nutrition Facts Label: http://www.fda.gov/Food/IngredientsPackagingLabeling/LabelingNutrition/ucm274593.htm

USDA Food Guidance System and other nutrition information: http://www.choosemyplate.gov/ and http://fnic.nal.usda.gov/dietary-guidance/myplatefood-pyramid-resources

Physical Activity

The President’s Council on Physical Fitness and Sports: www.fitness.gov

Exercise and Physical Activity: A Guide from NIA: http://www.nia.nih.gov/health/publication/exercise-physical-activity-your-everyday-guide-national-institute-aging-1

Weight

Aim for a Healthy Weight: http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/index.htm

Menus and recipes were analyzed using the Minnesota Nutrition Data System software—Food Data Base version NDS-R 2005—developed by the Nutrition Coordinating Center, University of Minnesota, Minneapolis, MN.

Discrimination Prohibited: Under provisions of applicable public laws enacted by Congress since 1964, no person in the United States shall, on the grounds of race, color, national origin, handicap, or age, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity (or, on the basis of sex, with respect to any education program or activity) receiving Federal financial assistance. In addition, Executive Order 11141 prohibits discrimination on the basis of age by contractors and subcontractors in the performance of Federal contracts, and Executive Order 11246 states that no federally funded contractor may discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. Therefore, the National Heart, Lung, and Blood Institute must be operated in compliance with these laws and Executive Orders.

NIH Publication No. 06-4082

Originally Printed 1998

Revised April 2006

Reprinted May 2013