Chapter 1

What Is DASH?

IN THIS CHAPTER

Explaining the history of DASH and what sets it apart from other diets

Understanding the fundamental dietary and lifestyle guidelines of DASH

Taking a proactive approach to DASH so that it sticks

Adapting DASH to individual circumstances

Hypertension, or high blood pressure, affects one in three of the world's adult citizens, including nearly half of all U.S. adults, and contributes to millions of deaths from heart disease, stroke, and kidney failure every year. Although medication is usually very effective, in many cases hypertension can be prevented or lessened simply by choosing a diet and lifestyle that promote good health. The Dietary Approaches to Stop Hypertension (DASH) diet was developed as a holistic, yet medically sound, method to lower blood pressure safely while also promoting wellness and vitality of the whole body. In short: The DASH diet uses food as part of the medical treatment.

This chapter shines a spotlight on what makes DASH so powerful for heart health - and good health in general - and what makes it different from all the other diets out there. It also explains how to find true success with DASH: by making a commitment to changing your current lifestyle for a healthier one that incorporates DASH dietary guidelines and increased activity. Change may seem intimidating, but DASH makes it easy and accessible, incorporating foods you already know and love to help you achieve your goals and live your life to the fullest. There's no time like the present to throw on some sneakers, grab a healthy snack, and jump right in!

Understanding the DASH Difference

Twenty-five years ago, if you were diagnosed with hypertension, your doctor may have simply sent you on your way with a prescription and advice to cut back on salt. However, over the past two decades, the medical community's understanding of the effects that diet, body weight, and lifestyle have on blood pressure has expanded tremendously. Studies by physicians, scientists, dietitians, and others have concluded that controlling blood pressure is about far more than just the salt. The following sections trace the history of DASH and explain why DASH is more than just another trendy diet.

Exploring the origins of DASH

The acronym DASH comes from a landmark 1997 clinical trial (a well-controlled human research study) that tested the effects of specific types of food on blood pressure. Instead of just telling people with hypertension what to avoid, the study sought to gauge the effects on blood pressure of a variety of readily available, inexpensive whole foods known to support good health.

Study participants following the DASH diet experienced impressive results: By eating a diet rich in fruits, vegetables, whole grains, and low-fat dairy foods and low in saturated fat, they reduced their blood pressure just as much as if they had taken a single prescription drug. The drop in blood pressure was evident within two weeks, even though the participants were on the DASH diet plan for eight weeks. DASH researchers estimated that the improvement in blood pressure could mean a 15 percent drop in heart attack risk and as much as a 27 percent reduction in stroke risk.

It's worth noting that study participants who followed the DASH diet minus the dairy also reduced their blood pressure, but the decrease was less. That's why including low-fat dairy is recommended for maximum effectiveness.

Having confirmed that healthy and delicious food could lower blood pressure just as effectively as a pharmaceutical drug, the DASH researchers next turned their attention to salt. The study, known as DASH-Sodium, found that by cutting salt to about 1,500 milligrams daily, blood pressure improved even more than with DASH alone. In fact, even a little reduction in salt made an important difference in blood pressure. The effect was seen in people with borderline high blood pressure, as well as in those with true hypertension.

For a deeper dive into the science behind the DASH study, see Chapter 2. Less interested in the science than in finding advice on how to create a healthy diet plan that works for you? We help you out in Chapter 4.

CONVINCING REASONS TO TRY THE DASH DIET

Hypertension, or high blood pressure, is an incredibly widespread problem, affecting people of all ages, shapes, sizes, colors, and nationalities. If you don't have hypertension, chances are your parents, siblings, or friends do. And you may too one day because the prevalence of hypertension increases with age. If you live long enough, you have a 90 percent probability of hypertension.

Although some cases of hypertension are due purely to genetics (as we explain in Chapter 6), many times the problem can be prevented or lessened by simple lifestyle changes. That means you may have more control than you realize. Around the world, access to fast food, processed food, and convenience food, along with an increasingly sedentary way of life, means that more people are becoming hypertensive every year. In fact, it's estimated that if things keep going along the way they are, a jaw-dropping 60 percent of adults around the world will be hypertensive.

Many medications exist that are effective at treating hypertension, and the average person with hypertension requires at least two to three of these medications to really get the problem under control. But due to costs, side effects, and complications, many people never achieve normal blood pressure numbers. Why not save yourself some hassle and prevent hypertension in the first place by following the DASH diet?

Recognizing why DASH isn't just another trendy diet

It seems like every year a new diet book comes out, full of promises and complete with enthusiastic endorsements from the celebrity-du-jour. Is the DASH diet really any different? Absolutely, 100 percent. No doubt about it.

DASH is science-based. It was developed based on reams of scientific research that identified certain foods as being especially beneficial for blood pressure. The DASH team put their highly educated heads together and came up with a diet that incorporated those foods into an easy-to-follow, inexpensive program that they believed would really make a difference. And make a difference it does. Not only can DASH help lower blood pressure, but it can also help with weight loss (thanks to eating more fiber-rich whole grains, fruits, and vegetables), reduce diabetes risk (thanks to complex carbohydrates), and more. Head to Part 2 for an in-depth look at all the benefits DASH provides for your health.

A HEALTHY EATING PLAN FOR THE WHOLE FAMILY

DASH isn't just for adults who have or are at risk for hypertension. It's an approach to eating that's healthy for most children as well. Why talk about DASH and kids? Consider the fact that since the 1970s, American children between the ages of 6 and 11 are now consuming

• Triple the amount of salty snacks
• Nearly double the amount of candy
• More than 40 percent fewer vegetables
• Half the amount of milk
• Twice the amount of soda

It's no wonder that more than one-third of U.S. kids are overweight or obese and are at risk for developing a condition known as the metabolic syndrome (the result of a cluster of risk factors including obesity, high blood pressure, abnormal blood lipid levels, and elevated blood sugar), which substantially raises the risk of heart disease, stroke, and diabetes. The good news is that the DASH diet has the potential to help kids who are heading down this road. For instance, a British study of girls with metabolic syndrome found that after spending just six weeks on DASH, blood pressure and insulin levels were improved compared to those who weren't assigned to DASH. Another study that simply tracked the diets of young girls over the course of ten years reported that those whose diets simply included two or more servings of dairy and at least three servings of fruits and vegetables daily were one-third less likely to have high blood pressure by the time they hit their late teens.

When it comes to kids, it's up to parents to provide healthy food options and keep unhealthy snacks to a minimum. DASH keeps it simple by giving you a structure that you can follow to put together nutritious meals for your family. And of course, in Part 4 of this book, we share loads of great recipes that can help you get started. As always, get your pediatrician's or family doctor's approval before jumping right in.

Scientists know that sometimes an idea can make perfect sense on paper and fail miserably when put to the test. Without a scientific study that randomly assigns individuals to one diet or another, with as many variables as possible controlled by the research team (what scientists call a randomized, controlled trial), you're just going on an assumption. You also need to set your goals ahead of time and then conduct the study in such a way that it's as unbiased as possible. Next, when it's all said and done, you need to do a detailed statistical analysis and then tidy up the whole mess into a neat and obsessively thorough report. Finally, you submit your work for review by other well-respected and uninvolved scientists (what's known as peer review). This meticulous attention to detail and strict...