The DASH diet: the blood pressure drug you eat with a fork.
It has the most boring name in nutrition and some of the best results. Scientists designed it to lower blood pressure, tested it with real meals, and it worked. No supplements, no app, no guru.
The short version
- What it is
- Lots of vegetables, fruit, beans, nuts and whole grains, some low-fat dairy, less red meat, sugar and salt.
- Good for
- Blood pressure. Clearly, quickly, in controlled feeding trials.
- Bad at
- Being exciting. And it still allows a few sweets a week, which we don't.
- Evidence
- Strong for blood pressure. Observational for heart attacks and strokes.
- Our take
- We borrow its salt rule and its love of vegetables. The rest is already in your plan.
What the DASH diet actually is
DASH stands for Dietary Approaches to Stop Hypertension. Hypertension is the medical word for high blood pressure. In the 1990s, the US National Institutes of Health paid for a trial with one plain question: can food alone bring blood pressure down?
So researchers cooked every meal for hundreds of people and tested three menus: a typical American diet, the same diet with more fruit and vegetables, and a "combination" diet. That last one became DASH: rich in vegetables, fruit and low-fat dairy, with whole grains, fish, poultry, beans and nuts, and less red meat, sugar, sweet drinks and saturated fat.1
Later, a second trial added the salt part. Today's official DASH plan from the US government caps sodium at 2,300 mg a day, with a stricter version at 1,500 mg.3 For comparison: the World Health Organization recommends under 2,000 mg of sodium (5 g of salt) a day, and the average adult eats more than double that.4
How it works in your body
Blood pressure is the force of your blood pushing against your artery walls. Too high for too long and it damages your heart, brain, kidneys and eyes, quietly, for years, without symptoms.
DASH pulls several levers at once. Vegetables, fruit, beans and nuts are full of potassium, magnesium and fibre. Potassium helps your kidneys get rid of sodium, and sodium is what makes your body hold on to water and push the pressure up. Low-fat dairy adds calcium. Less sugar and fewer processed foods mean less salt sneaking in, because most of the salt we eat is already inside bread, processed meat and snacks before it reaches the table.4
The surprise: in the original trial, salt was kept the same in all groups, and DASH still lowered blood pressure.1 The food pattern did that on its own. Cutting salt on top made it work even better.
What you eat, what you don't
Eat
- Vegetables, lots of them, at every meal
- Fruit: whole, not juiced
- Beans, lentils, nuts and seeds, several times a week
- Whole grains: oats, brown rice, wholegrain bread
- Plain yoghurt, milk, cheese in modest amounts
- Fish, chicken, eggs
- Herbs, spices, lemon, garlic instead of salt
Forget it
- Salty processed food: ham, salami, sausages, instant noodles, ready meals
- Crisps, salted nuts, stock cubes, soy sauce by the splash
- Soft drinks and sweetened drinks
- Sweets and pastries (DASH allows a few a week; we don't)
- Fatty red meat more than now and then
- Adding salt before you've even tasted the food
Alcohol on the DASH diet
OK, now and then
- One glass of dry wine with a meal
- A spirit with soda water and lime
- Alcohol-free beer, if it isn't sugary
Pushes the pressure up
- Several drinks in one evening
- Daily drinking "to relax"
- Cocktails, sweet mixers, liqueurs
- Salty bar snacks with your drink
50 Club: one glass of wine or a small beer, on the weekend, with food.
The World Health Organization says no safe level of alcohol has been shown.5 If your blood pressure is the reason you're here, less is better, and none is best. All the details are in our alcohol guide.
What it's good for, with proof
Lower blood pressure, fast
In the original DASH trial, 459 adults ate prepared meals for eight weeks. Compared with a typical American diet, DASH lowered the top blood pressure number by 5.5 points on average. In people who already had high blood pressure, the drop was 11.4 points.1 That's in the same range as a blood pressure pill, achieved with lunch.
Even better with less salt
The follow-up DASH-Sodium trial tested DASH at three salt levels. The combination of DASH and the lowest salt level beat a typical diet with high salt by 11.5 points in people with high blood pressure, and 7.1 points in people without.2 Food pattern and less salt add up. You don't have to pick one. If salt is a medical issue for you, our low sodium article goes deeper.
Fewer heart attacks and strokes, probably
A review of reviews pooled the long-term studies. People whose eating looked most like DASH had about 20% less heart disease, stroke and type 2 diabetes.6 Honest caveat: those numbers come from observational studies, which watch what people eat rather than assigning a diet. People who eat like this also tend to smoke less and move more. Strong hint, not proof.
A little weight loss on the side
DASH wasn't built for weight loss. Still, a meta-analysis of trials found people on DASH lost about 1.4 kg more than control groups over two to six months.7 Nice bonus, not a reason to start.
The uncomfortable truth
"DASH is just a low-salt diet." Wrong, and that's the interesting part. The original trial didn't change salt at all and blood pressure still dropped.1 If you only swap your salt for "sea salt" or "pink salt" and keep eating crisps, you've done neither. Fancy salt is still salt.
"Feeding trials prove it works in real life." The big DASH results came from studies where researchers cooked every meal and weight was held steady. That's the cleanest possible test of the food. It also means the real-life effect depends on whether you actually eat that way, at home, for years. Most people drift back.
The risks
- Kidney disease. DASH is rich in potassium and phosphorus. If your kidneys don't work properly, too much potassium can be dangerous for your heart rhythm. The US National Kidney Foundation says DASH should not be used by people on dialysis, and people with kidney disease should check with their kidney doctor first.8 See our renal diet article.
- Blood pressure drugs. Some heart and blood pressure medicines affect your potassium levels. If you take any, ask your doctor before loading up on potassium or switching to a potassium salt substitute. Don't stop or change your medication on your own because your readings improve.
- Too low too fast. If you're already on blood pressure pills and DASH works well, your pressure can drop too far. Dizzy when you stand up? Tell your doctor.
- Carb load. Fruit, grains and dairy add up. People with type 2 diabetes may need to adjust portions.
Allergies: watch the staples
| Staple | Allergen (EU list of 14)9 | Swap |
|---|---|---|
| Milk, yoghurt, cheese | Milk | Calcium-fortified soy or oat drink, tofu set with calcium, sardines with bones |
| Almonds, walnuts, cashews | Tree nuts | Pumpkin and sunflower seeds |
| Peanuts, peanut butter | Peanuts | Sunflower seed butter |
| Wholegrain bread, oats, barley | Cereals containing gluten | Brown rice, quinoa, buckwheat, certified gluten-free oats |
| Salmon, mackerel, tuna | Fish | Beans, lentils, chicken, eggs |
| Tofu, soy drink | Soy | Beans, lentils, dairy |
| Sesame seeds, tahini | Sesame | Pumpkin seeds |
Don't do the DASH diet if you…
- are on dialysis or have advanced kidney disease
- take medicines that raise potassium, unless your doctor knows
- have been told to restrict potassium or phosphorus for any reason
- plan to use potassium salt substitutes without checking with your doctor first
Healthen me asks about all of these and gives you a different plan if any apply.
How we use the DASH diet in your plan
DASH is a building block. Every plan gets its spirit: vegetables at every meal, beans and nuts instead of processed snacks, almost no salty packaged food. That overlaps a lot with the Mediterranean diet, our food-quality backbone.
If you tell us in Healthen me that your blood pressure is high, or a doctor has mentioned it, the engine turns the DASH rules up: we lower the salt in your recipes, add more potassium-rich vegetables and beans, and flag the saltiest foods in your region (looking at you, soy sauce and Wurst).
We skip DASH's allowance for sweets. Natural sugar from fruit is fine. Sweets are on our red list.
This article is general information, not medical advice. If you have a medical condition or take medication, talk to your doctor before changing how you eat.
Sources
- Appel LJ et al. A clinical trial of the effects of dietary patterns on blood pressure. New England Journal of Medicine 1997;336(16):1117–1124. doi.org/10.1056/NEJM199704173361601
- Sacks FM et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. New England Journal of Medicine 2001;344(1):3–10. doi.org/10.1056/NEJM200101043440101
- National Heart, Lung, and Blood Institute (NIH). Description of the DASH eating plan. nhlbi.nih.gov/education/dash-eating-plan
- World Health Organization. Sodium reduction. Fact sheet. who.int/news-room/fact-sheets/detail/sodium-reduction
- WHO Regional Office for Europe. No level of alcohol consumption is safe for our health. News release, 4 January 2023. who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health
- Chiavaroli L et al. DASH dietary pattern and cardiometabolic outcomes: an umbrella review of systematic reviews and meta-analyses. Nutrients 2019;11(2):338. doi.org/10.3390/nu11020338
- Soltani S et al. The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Obesity Reviews 2016;17(5):442–454. pubmed.ncbi.nlm.nih.gov/26990451
- National Kidney Foundation. Tips to tackling the DASH diet. kidney.org/kidney-topics/tips-to-tackling-dash-diet
- Regulation (EU) No 1169/2011 on food information to consumers, Annex II (the 14 allergens). eur-lex.europa.eu/eli/reg/2011/1169/oj