You may have heard time and again about the benefits of dietary modification for cardiovascular health. The key components of a heart-healthy diet include complex carbohydrates, healthy unsaturated fats, reduced salt and refined sugar consumption, and fresh fruits and vegetables. These significantly reduce your risk of long-term cardiovascular diseases (CVDs) and adverse cardiovascular events like heart attacks.

Along the lines of healthy diets, you may have been bombarded with an onslaught of information about fad diets and ‘miracle’ concoctions that claim to keep you healthy in the long run. It may be overwhelming to deal with this information overload and decide what would work best for you or your family. However, there is one type of diet you can definitely trust to do the job of protecting your heart — the DASH diet (Dietary Approaches to Stop Hypertension).

Hypertension, or high blood pressure, is one of the major culprits behind the high burden of heart disease in India. Research has also shown that salt intake in India is about 11 grams per day, far above the World Health Organization’s daily recommendation of 5 grams. Thus, tackling hypertension by promoting healthy levels of salt intake is essential to ensure India is a heart-healthy nation, and the DASH diet can help in this. The DASH diet is scientifically backed and encourages low sodium consumption to reduce the risk of heart disease. Numerous research studies have demonstrated that the DASH diet not only helps in lowering blood pressure, but also in regulating blood cholesterol levels, reducing the risk of diabetes, and reducing the risk of cardiac-related deaths. Unlike other diet regimens, the DASH does not need drastic changes in what you eat on a daily basis — it’s about making smarter food choices to maximize your and your family’s heart health.

Benefits of the DASH diet

The DASH diet is endorsed by leading health organizations like the ‘American Heart Association’ and ‘Mayo Clinic’. Numerous research studies have shown the health benefits linked with the DASH diet:

• 2 weeks to reduce blood pressure: The original DASH research study from 1997 showed that the DASH diet reduced systolic blood pressure of the participants by 5.5 mmHg and diastolic blood pressure by 3.0 mmHg. Reductions in blood pressure readings were observed as early as two weeks from the start of the study. The benefits on blood pressure were even more pronounced in participants who had borderline hypertension.

• Reduced risk of heart failure: A recent study involving 4,478 participants found that in those aged 75 and below, adhering to the DASH diet was linked with a 60% lower risk of heart failure.

• Effective against diabetes: The DASH diet can also be protective against other CVD risk factors like diabetes. One study showed that adhering to the DASH diet is likely to reduce the risk of diabetes by up to 20%. This is because of the DASH diet’s limitations on refined carbohydrates, refined sugar, and processed meat.

The DASH diet — what does it include?

Contrary to what you may think, the DASH diet does not feature expensive, hard-to-find foods or ingredients. The objective of the DASH diet is to control your blood pressure and thus, it emphasizes foods rich in blood pressure-friendly protein, fibre, potassium, magnesium, and calcium. These are present in commonly eaten foods like fresh fruits and vegetables, whole grains, beans, nuts, seeds, lean meat, and low fat dairy. Typically, if you are on the DASH diet, you should aim to consume less than 2.3 grams of sodium per day. Below is a typical serving guide of each component of the DASH diet:

Why?

Complex carbohydrates rich in fibre that keep you full for longer and prevent you from overeating. They also provide protective micronutrients like magnesium and potassium.

What?

Green leafy vegetables like spinach, broccoli, and kale.

Whole grains like whole wheat bread, brown rice, millets, and oats.

Legumes and beans like rajma, peas, and dahl.

How much?

About seven servings per day. For example, one slice of bread is one serving, and 1/2 cup of cooked rice is one serving.

Why?

Although fat may have a bad reputation, foods rich in healthy fats like omega-3 fatty acids, monounsaturated fats, and unsaturated fats actually increase ‘good’ cholesterol levels and reduce ‘bad’ cholesterol levels in the blood. However, moderation of fat intake is key.

What?

Olive oil, avocados, nuts, fish rich in omega-3 fatty acids like salmon.

How much?

2-3 servings per day. For example, 1 teaspoon of vegetable oil is one serving, and 1/3 cup of unsalted nuts is one serving.

Why?

There are several ways by which protein can help reduce the risk of hypertension. Protein may help improve how the cells respond to insulin, and thereby improving blood pressure. Amino acids present in proteins can help relax the blood vessels, allowing blood to flow through easily.

What?

Plant-based protein like soy products, nuts, and seeds. Animal-based protein sources like lean meats (poultry), eggs, fish, and low-fat dairy products. You should avoid processed and cured meats like salami, sausages, or nuggets as they tend to raise blood pressure.

How much?

About 6 servings or less per day. Each serving is about 28 grams of protein.

Why?

Fruits and vegetables are undoubtedly rich sources of fibre, vitamins, complex carbohydrates, and minerals like potassium and magnesium. With the exception of coconut, they are also low in fat.

What?

Fresh fruits and vegetables, frozen and canned fruits and vegetables low in or without added sugar and sodium, fresh juices without added sugar.

How much?

About 4-5 servings per day. For example, 1 cup of raw leafy vegetables is one serving, and 1 medium fruit is one serving.

Why?

Calcium-rich dairy products promote the proper functioning of the cells lining the blood vessel walls. Dairy products are also good sources of protein.

What?

Low-fat or fat free milk and yoghurt. Limit the consumption of cheese, even fat-free alternatives as they tend to be high in sodium.

How much?

2-3 servings a day. For example, 1 cup of skim milk or low-fat yoghurt is one serving.

Fortunately for those with a sweet tooth, the DASH diet does not forbid the consumption of sweets. Instead, it recommends limiting the consumption to less than five servings per week. For example, 1 tablespoon of sugar, jelly, or jam is one serving.

Transitioning to a DASH diet

If you’re convinced by the scientifically backed benefits of the DASH diet, it is easy to make the switch. Drastic changes are not needed, it’s all about making healthy swaps and embracing heart-friendly foods you are already familiar with and love. Below are a few tips to help you start including elements of the DASH diet into your daily meals:

• Have more fruits and vegetables with your first meal of the day. For example, you could whip up an egg white omelette loaded with different vegetables, or make a smoothie with various berries and low-fat yoghurt or milk.

• Make healthier swaps while you prepare your meals. Use olive oil, soybean oil, or canola oil while cooking. Switch to low-fat milk or yoghurt. Have whole wheat bread, brown rice, or whole grains like quinoa with your meals instead.

• Snack smarter. When those pangs of hunger strike, have nuts without added salt, fresh fruits and vegetables, or seeds instead of packaged snacks.

In the beginning, it may be challenging to adapt to the new food swaps. But do remember that slip-ups happen while changing your dietary practices — you should treat these slip-ups as learning opportunities and remain committed to leading a heart-healthy diet. It is also important to remember that dietary intervention for your and your family’s heart health is just one element. To maximize the protective effect of the DASH diet on blood pressure and cardiovascular function, engaging in other heart-healthy behaviors like physical activity and quitting smoking is also necessary.

Key take-home messages:

• The DASH diet is a heart-friendly dietary intervention that is recommended by leading health organizations.
• It emphasizes on fruits and vegetables, healthy carbohydrates like whole grains, healthy fats, protein from lean meat, and low-fat dairy products. These elements are rich in fibre, vitamins, and minerals which promote good cardiovascular function.
• In addition to lowering blood pressure and preventing hypertension, the DASH diet has been scientifically proven to reduce the risk of CVDs like heart failure and CVD risk factors like diabetes and high ‘bad’ cholesterol levels.
• Gradual and easy changes can be made in your daily food habits to include elements of the DASH diet. This can be an effective part of a holistic approach to protect your and your family’s heart health.

For a more detailed explanation of diet and exercise, you can refer to our earlier blogs. Find out how you can eat a heart-healthy diet, and how exercise can benefit you and become a part of your routine.

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