Best known for its proven effect in controlling blood pressure, the DASH (Dietary Approaches to Stop Hypertension) eating plan also lowers LDL (“bad”) cholesterol and can improve other cardiovascular risk factors. Similar to the Mediterranean diet in many respects (though DASH specifies low-fat or nonfat dairy foods), DASH is not a weight-loss diet by design; but it can help with weight control since it emphasizes moderate portions of filling, lower-calorie foods. No wonder U.S. News & World Report ranked it the No.1 “best diet overall” of 38 popular plans.
Even though DASH offers a wide variety of foods, some people still find it limiting. That’s one reason why researchers have been testing variations of the diet to see if adding certain foods will keep it just as beneficial—or perhaps make it even more so. Here are some examples:
Adding full-fat dairy foods. In a study in the American Journal of Clinical Nutrition (AJCN), researchers tested three diets in people with prehypertension: standard DASH diet; higher-fat, lower-carbohydrate DASH; and a typical U.S. diet. In the higher-fat DASH, people consumed full-fat dairy (mostly milk, cheese, and yogurt) instead of low-fat or nonfat. To compensate for the extra calories, they consumed less sugar than in standard DASH, mostly by drinking less fruit juice. Each diet was followed for three weeks. The higher-fat DASH was found to lower blood pressure as much as standard DASH; it lowered LDL cholesterol as well, despite its higher saturated fat content. As a bonus, it modestly reduced triglycerides (fats in the blood) compared to the other two diets, presumably because of the reduction in sugar. The study was partly funded by the dairy industry.
More pork. DASH allows up to 6 ounces a day of lean meat, poultry, and fish, but the emphasis has always been on the latter two. In another AJCN study, researchers found that when people with prehypertension substituted lean pork in a DASH diet, their blood pressure dropped as much as when they ate poultry and fish. The study was partly funded by the pork industry.
More protein or fat. Going back a decade, the NIH-funded OmniHeart trial found that when people with hypertension or prehypertension replaced one-sixth of the carbohydrates in DASH (primarily by consuming less fruit juice and sweets) with either additional protein (primarily from poultry, legumes, and eggs) or unsaturated fats (primarily olive oil), they had further reductions in blood pressure and improvements in cholesterol and triglycerides.
Bottom line: All of these findings “provide evidence that aspects of the DASH diet can be modified without compromising its benefits on blood pressure or LDL-cholesterol-lowering, offering flexibility in food choices,” according to the first AJCN study. The key is the focus on vegetables, fruits, whole grains, and dairy (of any fat content). The rest of the diet may not matter much, as long as you limit sugar and keep your calorie intake moderate.
For more on DASH, see this brief from the National Heart, Lung, and Blood Institute.