The dietary approaches to stop hypertension (DASH) diet is an eating plan that was originally developed to help people with hypertension (high blood pressure). The recommendations from the DASH diet focus on high-fiber, antioxidant-rich foods with minimal salt, sugar, and saturated fats.^[1] The included foods are fruit and vegetables, whole grains, nuts, legumes, poultry, fish, and low-fat dairy products. This leads to a diet with a high fiber content, a moderate protein content, and a low saturated fat content.

Importantly, DASH is also low in sodium, which may contribute to the blood-pressure-lowering effects. Originally, an intake of 2,300 mg of sodium daily was recommended, but more recently a daily sodium intake of 1,500 mg was shown to be more effective for lowering blood pressure.^[2]

The DASH diet is low in saturated fat and therefore can benefit people with high cholesterol and other cardiovascular disease risk factors. Minerals are also important factors in the DASH diet; in particular, potassium, magnesium, and calcium intakes are increased through the eating plan.^[3]

The dietary approaches to stop hypertension (DASH) diet was originally designed as a tool for managing high blood pressure. In the DASH trial, following a DASH diet reduced both systolic and diastolic blood pressures significantly, and results were seen within 2 weeks.^[4] The DASH diet’s ability to reduce blood pressure is supported by multiple reviews, meta-analyses, and clinical trials.^{[3][5][6][7][8][9]} Outside of controlled clinical environments, the DASH diet can be more difficult for people to adhere to; however, the ENCORE study showed that if weight loss and exercise tools (such as cognitive behavioral therapy (CBT) and group support sessions) were used in conjunction with the DASH diet, blood pressure improvements were greater.^[10]

The dietary approaches to stop hypertension (DASH) diet has been shown to be effective in multiple clinical trials, but adhering to any diet in the long term can be difficult. There are several studies that show that adherence to the DASH diet over periods longer than 12 weeks is poor. Finding ways to help people sustain the diet plan is crucial to maintaining the positive changes it might produce on blood pressure, body weight, and type 2 diabetes.^[11][12][13]

The DASH diet might not be appropriate for people with certain health conditions. In people with kidney disease, the DASH diet could lead to dangerously high levels of potassium in the blood. This risk is also increased in people who use diuretic medications, such as hydrochlorothiazide (HCTZ), which increase potassium levels. The same is true for people with chronic liver disease.^[14]

In people with type 2 diabetes (T2D), the DASH diet might be a good option to control blood pressure and assist with weight loss, but it may be too high in carbohydrates to recommend to all people with T2D. Close glucose monitoring is necessary, and in some cases following a modified DASH diet with a lower carbohydrate intake may be more appropriate.^[14]

The dietary approaches to stop hypertension (DASH) diet includes a simple-to-follow list of foods to include in your diet, as well as a short list of items to limit or avoid. Adhering to these recommendations creates a diet that is high in fiber, moderate in protein, lower in sodium, lower in saturated fats, and higher in important minerals.^[3]

The initial DASH diet did not restrict sodium intake specifically, but following the dietary recommendations brought down sodium intake naturally. This, combined with an increased potassium intake, could influence fluid balance, the ability of blood vessels to relax, and the response of blood vessels to pressure receptors, and these would all result in lower blood pressure.^[3] The increased intake in magnesium and calcium could also reduce blood pressure by relaxing the smooth muscles in the blood vessels.^[8]

Magnesium is a part of the process that moves glucose from the bloodstream into the cells, and an increased magnesium intake as part of the DASH diet could play a positive role in type 2 diabetes and insulin resistance. The increased fiber intake can decrease cholesterol levels, improve digestion, and increase satiety, resulting in a lower calorie intake, weight loss, and a potential improvement in blood sugar levels.^[8]

The DASH diet often results in an increased intake of plant-based foods, and some of these might exert an anti-inflammatory effect because they contain flavonoids and antioxidants.^[8]