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By: Jean Johnson for Heart1
We’ve covered all the lifestyle change bases related to hypertension except diet and activity. While most of us have a general idea of what we need to eat and how to stay moving, actually going from wherever we are to getting blood-pressure friendly meals on the table – and getting up for the walk afterward, can be a challenge. So join us as we explore the DASH Eating Plan, a guide to healthful eating and staying active produced by the National Heart, Lung, and Blood Institute (NHLBI), a division of the National Institutes of Health.
A Matter of Choice
DASH is the acronym for Dietary Approaches to Stop Hypertension and the NHLBI is upfront about its point: “What you choose to eat affects your chances of developing high blood pressure.”
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Controlling High Blood Pressure in a Nutshell from the National High Blood Pressure Education Program:
Maintain a healthy weight
Be moderately physically active on most days of the week
Follow a healthy eating plan, which includes foods low 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
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Clearly the NHLBI is putting the burden of responsibility on the shoulders of the individual. That said, the DASH Eating Plan offers tips on how to get started and, more significantly, how to make sensible, healthful eating and activity a permanent habit.
A Word on Salt
While the National High Blood Pressure Education Program encourages Americans to eat a range of fresh vegetables and fruits, whole grains, legumes, and low-fat dairy, fish, poultry, and meats, it brings the issue of salt consumption to the forefront of the discussion.
Most Americans get between 4,200 milligrams (mg) and 3,300 mg of salt in their diets daily, figures that are outlandish, according to national experts associated with DASH. Rather, they want people to shoot for a streamlined 1,500 mg with a high ceiling of 2,300 mg.
While 2,300 mg is considered acceptable, DASH notes that “The 1,500 mg 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.”
No too hip on your milligrams? Us either, but we went searching. A single teaspoon of salt is equal to 2,300 mg, and the preferred 1,500 mg is the equivalent of a carefully measured ¾ teaspoon.
While it’s fairly easy to get your salt intake down to this level when you are cooking from scratch and using splashes of great vinegars to help bring out the flavors in food eaten at its height of seasonal freshness, when you schlep into the realm of processed foods, the chore of figuring out sodium content is quite the conundrum.
“Only a small amount of salt we consume is added at the table, and only small amounts of sodium naturally occur in food,” state the good people behind the DASH effort. “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. They include baked goods, certain cereals, soy sauce, seasoned salts, monosodium glutamate (MSG), baking soda, and some antacids – the range is wide.”
The DASH Eating Plan
In two key studies conducted at four centers scientists working in conjunction with the NHLBI found 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.”
“Results were dramatic” in the studies, say experts involved with DASH. “Furthermore, the blood pressure reductions came fast – within two weeks of starting the plan.”
Convinced? Ready to DASH? If so, here’s a summary of the program.
Try:
6-8 half cup servings of whole grains, 4-5 half cup servings of vegetables, 4-5 half cup servings of fruits, 2-3 cup servings of fat-free or low-fat milk or milk products, 6 or less 1-ounce servings of fish, poultry, or meat (or 1 egg), 4-5 2-tablespoon servings of nuts or half cup servings of legumes, 2-3 1-teaspoon servings of fats or oils daily.
If you think you can live with that, you’re good to go, say the DASH folks. Plus that, they even allow a small dabble into the sugar for those that must have the white crystal. Recommended are 5 or less servings of sweets and added sugars at the rate of 1 tablespoon each per week.
Creators of the 2,300 plan, of course, realize that most of us could stand to shed a few pounds. Consequently they’ve also provided guidelines for a 1,600 calorie a day plan. For this approach use the following serving guides: 6 grains, 3-4 vegetables, 4 fruits, 2-3 milk, 3-6 lean protein, 3/week nuts and legumes, 2 fats and oils, skipping sugars altogether.
Getting Started
Changing the habits of a lifetime is difficult, especially when it comes to one’s groceries. “Don’t mess with my _______,” we all tend to say, filling in the blank with any number of oh-so-delectable foods dear to our hearts.
What DASH wants to convey, though, is that their food plan is a satisfying one that people can grown accustomed to if they are willing to try a few simple techniques. For one, don’t put it off.
“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.”
DASH also points out that the plan requires no special foods or hard-to-follow recipes. More, experts suggest that “One way to being is by seeing how DASH compares with your current food habits.” Keep track of what you eat for a couple days and then compare to the DASH plan. From there see what changes you might make to get started.
Gradually easing into DASH is a key suggestion. “If you now eat one or two vegetables a day, add a serving at lunch and another at dinner… Read the labels on margarines and salad dressings to choose those lowest in saturated fats and trans fats.”
DASH also takes aim at Americans’ traditional approach to meat. “Treat meat as one part of the whole meal, instead of the focus.” To do this, start cutting back on portion sizes and including “two or more vegetarian-style (meatless) meals each week.”
And, if you must have a snack, DASH highlights the benefits of turning to things like fruit, unsalted rice cakes, nuts mixed with raisins, graham crackers, fat-free and low-fat yogurt, and raw vegetables.
Making a Dash for DASH
You knew, of course, that once DASH dispatched our food, it would get around to activity. Here they offer four helpful tips.
Find a pal. Sharing “war stories” as well as the physical and emotional well being that eating well and staying active brings can help keep participants motivated as they learn to trust the DASH system and experience the benefits it brings.
Cross-train. Mix your activity so it stays interesting and so no particular part of you body becomes strained. Try walking, biking, going to the gym for a swim, stretching, strength training, or just some plain old-fashioned sit-ups and push-ups.
Set goals. Not to put too fine a point on it, but working toward a goal can inspire many to keep going even during those times when the mood doesn’t strike. Goals can be in terms of times, distances, numbers of repetitions, or better yet, your blood pressure reading.
Lastly, DASH recommends rewarding 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.”
Indeed, building healthy behaviors into our lifestyles takes a significant commitment and is not a feat to be underestimated. Persistence and determination are required, particularly at the beginning when we tend to feel as though we are in unchartered waters.
Clearly Americans have not come to the current overweight and obesity crisis that is leading to type 2 diabetes and high blood pressure problems because they wanted to. No one means to treat their body poorly or carry extra weight, and bad habits have seemingly snuck up out of nowhere.
Thus, the problem is that once a counterproductive lifestyle gets rooted, it takes real gumption to get it reversed. So, if you’re one of those willing to put your head down and go for it, definitely take DASH up on your monthly reward. You will earn it and you will deserve it.
