Origin of DASH | How Does DASH Work | DASH Diet Foods | Unsupported Foods | Health Benefits | DASH Weight Loss | Experts Say | Bottom Line
Hypertension, otherwise known as high blood pressure, is a surprisingly common affliction in the United States. Almost 50% of adult Americans have hypertension, which is defined as a systolic blood pressure of greater than 130 mmHg. It’s also a potentially serious medical condition that is linked with numerous negative health outcomes; in fact, in 2021 hypertension was the primary or contributing cause of nearly 700,000 deaths in the country. Sadly, though, only about a quarter of U.S. adults are actually participating in a medical intervention that could control their blood pressure.
This trend of high blood pressure among American adults isn’t a new problem, however, and it even prompted the National Heart, Lung, and Blood Institute (NHIBI) to develop a special diet that could hopefully make a difference. The diet they developed is called the DASH diet, which stands for Dietary Approaches to Stop Hypertension. Yet while the DASH diet was originally designed specifically to control hypertension, it has been used by some in recent years as a weight loss method. But can a diet that is designed for a particular medical purpose actually work for weight loss?
Up until the 1990s, research on the treatment for hypertension had primarily revolved around the use of various blood pressure medications in combination with some select lifestyle changes. Yet because these treatment options weren’t having the intended impact, in 1992 the NHIBI, a division of the National Institutes of Health (NIH), began a multi-year research project to look at how dietary patterns affect blood pressure. This project, known as the DASH study, was eventually published in the New England Journal of Medicine in 1997.
The DASH study randomly assigned different diets to its 456 participants in order to test each diet’s effectiveness at lowering blood pressure. They used an average American diet as the control group and compared it to a similar diet with additional fruits and vegetables and a combination diet that included a mix of fruits, vegetables, whole grains, and low-fat dairy products. All three diets included 3000 mg of sodium per day, which is higher than the recommended amount for adults but lower than the average intake for Americans.
The two diets being tested next to the control were also designed to be richer in nutrients that have been linked to lower blood pressure like potassium, calcium, magnesium, protein, and fiber. After eight weeks, the researchers found that the combination diet with a mix of foods was substantially more effective at lowering blood pressure than the control diet and the diet with added fruits and vegetables. Moreover, the decreases in blood pressure were even more pronounced for participants in the study who already had hypertension.
The DASH study was quickly embraced by many healthcare professionals in the years that followed, and the principle of using healthy eating as a way to control hypertension became a standard practice. In fact, the Dietary Guidelines for Americans, a series of principles of healthy eating published by the U.S. Department of Agriculture every five years, has been partly based on data from the DASH study ever since. The DASH diet in its current form is based on the original study and is now recommended by medical organizations like the American Heart Association and journalistic publications like U.S. News & World Report.
The DASH diet is similar to the Mediterranean diet in its emphasis on consuming heart-healthy foods while limiting saturated fats and trans fats. It is also similar to the Mediterranean diet because it is ultimately not meant as a weight loss method. It was designed specifically as a treatment for hypertension, but the nature of the diet makes it additionally beneficial for other reasons. Below is the basic outline of the DASH eating plan and how much of each food group you can eat based on a 2000-calorie-per-day diet plan:
In order to bring down blood pressure, the DASH diet centers on healthy foods that are either naturally low sodium or have been known to lower blood pressure. Foods that are high in the minerals potassium, magnesium, and calcium, for example, have a beneficial impact on the vasoconstriction that affects blood vessels. Also, recent research has shown that foods high in dietary fiber have a similarly beneficial effect on blood pressure. Below is a sample menu for a typical day on the DASH diet:
It’s important to note that since the DASH diet was not developed with weight loss in mind, calorie counts are somewhat irrelevant. The food choices each day are primarily selected based on overall sodium intake (which shouldn’t exceed 2300 mg per day) and their likelihood of decreasing blood pressure. And while not officially part of the program, the developers of the diet also strongly recommend additional lifestyle changes like being more physically active, limiting alcohol use, and getting plenty of sleep each night.
Most fad diets and meal plans tend to fixate on lists of what you can and can’t eat each day, and that can inadvertently make the diet an exercise in withholding foods you enjoy. The DASH diet doesn’t really prohibit any foods; rather, it presents recommendations for each food group so you can make healthier choices. However, there are some foods that are best to limit because of their potential negative impact on health:
As the initial DASH study back in the 90s demonstrated, the DASH diet is clearly effective at achieving its main goal of lowering blood pressure. This has been further borne out by subsequent studies that have been done in the years since the first research project. A meta analysis from 2014, for instance, looked at 17 different randomized controlled trials and found that the diet does indeed work as intended for reducing both systolic and diastolic blood pressure by a significant amount.
However, because of how the DASH diet is structured and what types of food are emphasized, it does also have efficacy for other aspects of health. This is why it is recommended for good overall health by various medical organizations like the American Heart Association and the National Kidney Foundation. But beyond being good for general health, research has shown that the DASH diet is also associated with a number of other health benefits:
The DASH diet truly should be considered more of an eating style than a “diet” in the popular sense of the word. It may be recommended for people with hypertension, but the full range of health benefits linked to the diet make it ideal for almost anyone. But unlike many fad diets that come with potentially unhealthy restrictions, the DASH diet doesn’t have any substantial risks that need to be weighed against its benefits.
For anyone who doesn’t have hypertension severe enough to need treatment from a doctor, the DASH diet may not seem appealing on the surface. Most people automatically associate “diet” with “weight loss” and may not care about a program that is merely ‘healthy.’ Yet even though DASH isn’t designed for weight loss, there are many elements of the diet that make it a great companion for a weight loss plan. An important caveat is that there’s nothing unique to the diet that makes it better than any other weight loss method.
One of the main reasons DASH can potentially help you lose weight, though, is because of the recommendation to limit saturated fats and added sugars, two food components that have long been connected to obesity. By eschewing those foods in favor of fruits, vegetables, and whole grains, a person looking to lose weight would be off to a great start. The nutrient content, fiber, and anti-inflammatory properties of the foods recommended in the diet all can have a positive impact on metabolism, blood sugar, insulin, and fat storage—all factors that can make weight loss more achievable.
Virtually all of the research on the DASH diet has naturally been about its effectiveness at reducing hypertension, but some of those studies also looked at the question of weight loss. In one clinical trial from 2003, for instance, 810 participants were split into three groups, one of which involved a combination of weight loss counseling and adherence to the DASH diet. The researchers found that this group that followed the DASH diet had a greater reduction in blood pressure and greater weight loss than the groups that were only given dieting advice and established weight loss treatments.
It’s also important to mention that, even in cases where people have lost weight with the DASH diet, it only happened in the context of a specific weight loss program. In other words, anyone attempting to lose weight via the DASH diet alone won’t necessarily find success. As with any diet, the crucial element is being in a calorie deficit by consuming fewer calories than the body needs to function. It would be easy to technically follow the parameters of DASH and still be eating too many calories to actually lose weight.
Darius Cammon, MS, RD, LDN, a registered dietitian at True You Weight Loss, offers some insight into commonly asked questions about the DASH diet:
What are the pros of the DASH diet?
What are the cons of the DASH diet?
What have you found people are generally unaware of when considering the DASH diet?
Do you have firsthand experience with the DASH diet, whether it's something that you've personally tried, or have seen others be successful or unsuccessful with?
How much weight do people typically lose with the DASH diet?
For someone that might be considering the DASH diet, what alternative options should they consider and why?
Most of the time it’s really hard to evaluate a diet because there isn’t always sufficient research to come up with solid scientific answers. The lack of research is partly because not all diets are considered worthy to be researched and partly because tracking eating habits is notoriously inconsistent and difficult to track. The DASH diet is one of the rare examples of a diet plan that has been the subject of many studies over nearly 30 years. And that research has shown unequivocally that it is effective at reducing hypertension.
But as noted earlier, many people are primarily interested in a diet that can help them lose weight. The bottom line on the DASH diet for weight loss: it can be a useful eating pattern to adopt when you’re trying to lose weight. The truth is, though, that it can really only work for weight loss if you specifically set out to lose weight by using many of the traditional approaches like calorie tracking and increasing your physical activity level. In this regard, the DASH diet isn’t any more effective for weight loss than any other science-based approach.
If you’re like most Americans, you’ve tried tons of diets in the past with mixed results. The traditional path to weight loss that involves a restrictive diet and/or a punishing exercise regimen just isn’t sustainable for most people. It has become incredibly commonplace to hear about a new diet and launch yourself into it for a few weeks or months. Maybe at first you feel good and optimistic, but then you lose interest or hit a weight loss plateau and you slip back into old habits. So even if you do manage to lose some weight, it goes right back on in a few months.
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