Here's How to Overcome Hypertension with the DASH Diet, What is the DASH Diet?

Hypertension or high blood pressure is a condition when the systolic blood pressure rises by more than 140 mmHg and the diastolic blood pressure rises by more than 90 mmHg on 2 different measurements in a clinic or hospital, under restful conditions. Hypertension puts people at greater risk of heart disease, kidney failure and stroke. Based on the Basic Health Research (Riskesdas) of the Republic of Indonesia in 2018, the incidence of hypertension in Indonesia reached 34.1%. One of the therapies for hypertension is lifestyle changes including diet and physical activity. A diet that can be applied to hypertensive patients is the DASH diet. 

DASH diet, what kind of diet?

The Dietary Approaches to Stop Hypertension (DASH) diet was first developed in the 1990s. Research by the National Institute of Health (NIH) found that dietary intervention alone can reduce systolic blood pressure by about 6-11 mmHg. This effect was seen in patients with hypertension as well as normal blood pressure. 

The DASH diet prioritizes the consumption of vegetables and fruits, lean meat and dairy products, and micronutrients in the daily diet. The DASH diet also recommends reducing sodium intake to 1500 mg/day or the equivalent of ¾ teaspoon of salt. There is strong evidence of an association between high salt/sodium intake and increased blood pressure. Avoid consumption of high-salt foods, such as soy sauce, prepared foods, and processed foods, such as high-salt breads and cereals, and reduce the addition of salt when preparing food or during meals. The DASH diet emphasizes the consumption of fresh and minimally processed foods.
 
Let's take a closer look at the nutrient recommendations based on the DASH diet: 

Carbohydrates in the DASH diet include green leafy vegetables (kale, broccoli, spinach, mustard greens), whole grains (oats, wheat), fruits with a low glycemic index, and nuts. Fats are divided into good fats and bad fats. Good fats prevent inflammation, are a source of essential fatty acids, and promote overall health. Good fats can raise HDL and lower LDL when consumed in moderation. Sources of good fats include olive oil, avocados, nuts, flax seeds, fish rich in omega-3 fatty acids (e.g. mackerel, salmon). Bad fat sources include margarine, vegetable butter, partially hydrogenated vegetable oils, commonly found in ultra-processed foods (biscuits, ice cream, packaged foods), which can increase LDL levels that trigger plaque formation in arteries. Fats recommended in the DASH diet are good fats. Proteins in the DASH diet include plant-based proteins such as beans, soy products, and whole grains, and animal-based proteins including lean meats, low-fat dairy products, eggs, and fish. Processed or cured meats are not recommended as they can cause hypertension and also contain carcinogens. 

The DASH diet also includes certain foods rich in potassium, calcium and magnesium as these nutrients prevent endothelial dysfunction and promote relaxation of vascular smooth muscle. Potassium source foods include bananas, oranges, avocados and spinach. Calcium can be found in dairy products and green leafy vegetables. Magnesium is obtained from whole grains, leafy vegetables, nuts and seeds. 

Serving/portioning guidelines on the DASH diet are as follows: 
1. Vegetables: about 5 servings per day 
2. Fruit: about 5 servings per day 
3. Carbohydrates: about 7 servings per day 
4. Low-fat dairy products: about 2 servings per day
5. Lean meat products: about 2 servings or less per day
6. Nuts and seeds 2-3 times per week 7. 

The DASH diet is a nutrition-based approach to prevent and control hypertension. However, it is not limited to people with hypertension, the DASH diet has also been studied to have benefits in helping reduce blood sugar, triglycerides, LDL, and insulin resistance. The DASH diet is also associated with the prevention and management of chronic heart failure. The most important thing about the DASH diet is that it requires lifestyle changes and adopting a healthy diet. Implementation of the DASH diet needs to be monitored by a health professional to optimize the benefits of this diet.