DASHing to Drop Blood Pressure, Maybe Lose a Few Pounds

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Pam Linn

That old saw makes perfect sense: What matters more than what you know is what you do with what you know. Sometimes advice has been around so long that while we once paid attention, now we say, “Oh, I know all about that.” 

But are we doing anything about it? Maybe not so much.

So when the March issue of Nutrition Action Healthletter featured the DASH diet in its cover story, I almost gave it a miss. But wait. This is exactly the information I’ve been looking for, neatly focused in an interview with Frank M. Sacks, whose credentials in cardiovascular health are deemed impeccable.

The interviewer, Bonnie Liebman, asked all the right questions. We first heard about DASH (Dietary Approaches to Stop Hypertension) in a 1997 study showing that the regimen lowered blood pressure as much as drug treatment, more if salt is also restricted. It was followed in 2001 by a study called DASH-Sodium and later OmniHeart, which lowered carbs, replacing them with unsaturated fat or more plant protein. Results were better than good.

We’ve heard a lot about eating more fruits and vegetables. DASH combines that with low-fat dairy products, fewer sweets, and less saturated fat and cholesterol, so it’s rich in potassium, magnesium, calcium, fiber and protein.

It’s important to note that this isn’t just another fad diet that flourishes then fades (think paleo, the current rage). Yes, one is likely to lose some weight, which of itself lowers blood pressure, but lowering risk of heart attacks and strokes will likely change eating patterns for a lifetime.

DASH, like its cousin, the Mediterranean diet, protects both hearts and minds, and as we live longer and more people experience dementia, that “mind” part resonates.

The OmniHeart study maps targets for a day’s worth of food based on a 2,100-calorie diet.

– Vegetables and fruit: 11 servings (1/2 cup raw or cooked or one piece of fruit)

– Grains: four servings (one slice of bread, 1/2 cup cereal, pasta or rice)

– Low-fat dairy (one cup milk or yogurt, 1 1/2 oz. cheese)

– Legumes & nuts: two servings (1/4 cup nuts, 1/2 cup cooked beans or 4 oz. tofu)

– Fish, Poultry, Meat: one four oz. serving

– Oils and fats: two one tbsp. servings (includes mayo)

– Sweets: two servings (one small cookie or one tsp. sugar)

Good luck figuring out how much sugar is added to processed foods. First of all, labels rate sugar in grams and sodium in mgs. For instance: Newman’s Own estimates two cookies (their version of wheat and dairy free Oreo-type) at 27 grams. You do the math. 

Center for Science in the Public Interest, which publishes Nutrition Action, has long pressed for clearer labeling that would help people limit sugar and salt intake, such as listing teaspoons instead of grams. 

Which brings us to an issue mentioned in Nutrition Action Executive Director Michael F. Jacobson’s column: the intense pressure of food industry lobbyists against anything that might limit government approval of their products.

Every five years, our government updates its official nutrition policy, the Dietary Guidelines for Americans. The next version is due later this year, but an advisory committee leaked a preview in December that has the beef and sugar industries crying foul. For the first time ever, the report addresses the consequences of damage to the environment caused by different types of agriculture.

And, of course, Congress has warned the government that the Dietary Guidelines should not discuss the “sustainability” of the food supply. “Producing beef requires more energy and pollutes the environment more than any other food, so it’s not hard to guess who was behind that directive,” Jacobson writes. 

The guidelines are important, as they affect almost all government programs involving food subsidies, including school lunch programs, food stamps and Women, Infants, and Children (WIC), etc.

Meanwhile, individuals can consult the DASH recommendations once more to accomplish what government and food industry lobbyists just don’t seem to get. We all pay for poor food choices that raise medical costs astronomically. 

In the interest of full disclosure, I have tried to stick to a vegetarian diet for a couple of decades. It’s not hard if you include fish, eggs and some dairy, though traveling can be a challenge.