The Dash Diet for hypertension

MANILA, Philippines - Food has a great impact on health; in fact, new research investigations have shown that foods exert a powerful effect on our well-being. How many times have we heard that excessive alcohol consumption can lead to liver disease and that low fiber intake may predispose one to colon cancer?

Together with advancements in therapeutics, understanding the relationship between food and disease may help medical doctors develop appropriate strategies in disease prevention and therapy.

Certain allergies, food intolerances, heart disease, and cancer may respond to diet modification. This specialty area is called medical nutrition therapy, and the most popular ones are the Elimination Diet (for food allergies), G.E.R.D Diet (to help reduce esophageal reflux disease), MyPyramid Plan (an individualized diet based on activity levels), and the DASH Diet, which will be discussed in detail.

The DASH Diet (Dietary Approaches to Stop Hypertension) is a well-known intervention to treat high blood pressure, and is included in evidence- based medical nutrition therapy in most hospital settings. The Dash Diet requires the person to eat four to five servings of fruit, four to five servings of vegetables, and two to three servings of low-fat dairy (fat is limited to less than 25 percent total per serving).

The Dash eating plan, together with lifestyle changes like exercise, can help and prevent the onset of high blood pressure, and may be achieved by means of maintaining a healthy weight, participating in exercise programs, and moderation in alcohol consumption.

Unlike other diets, the Dash eating plan requires no special food and has no hard-to-follow recipes. It involves the intake of   high-fiber foods such as vegetables, cooked dried peas and beans (legumes), whole-grain foods, bran, cereals, pasta, rice, and fresh fruits. The high-fiber content of this diet can lower the levels of bad cholesterol and prevent the onset of other illnesses like diabetes mellitus.

With regard to meat, certain adjustments are needed since the Filipino diet is meat-based. Meat should be treated as part of a meal rather than the focus. Suggested meat sources should come from roasted seafood, skinless poultry or lean meats.

Sodium is the most important mineral in controlling blood pressure because it helps keep normal fluids balanced in the body. Most people eat foods containing excessive amounts of sodium as some foods may not taste salty but can be high in sodium. Too much sodium intake causes the body to retain too much water.

Switching from a high-sodium diet to a low-sodium diet can modestly reduce blood pressure in people who have normal blood pressure. When the sodium intake is lowered from 4,000mg to 2,000mg per day, blood pressure falls by 2 to 3mmHg. This reduction may be as great as 10mmHg over several years and can substantially lower the risk of heart disease.

A key goal of the Dash Diet is to reduce the sodium you eat, since sodium can dramatically increase blood pressure in people who are sensitive to its effects. According to the Mayo Clinic website, there are two versions of the Dash Diet — Standard Dash Diet, where one can consume up to 2,300 milligrams (mg) of sodium a day, and Lower Sodium Dash Diet, where one can consume up to 1,500mg of sodium a day.

Both versions of the Dash Diet aim to reduce the amount of sodium in the diet compared with what one might get in a more traditional diet, which can be more than 5,000mg in the Filipino diet.

Studies show that the lower sodium version of the Dash Diet is especially helpful in lowering blood pressure for adults who are middle-aged or older.

Sodium requirement may be an obstacle for some Filipinos because our diet is inherently salty and decreasing the amount of salt can make food less palatable. However, replacing salt with monosodium glutamate reduces the sodium content of the recipe by up to 40 percent without loss in palatability, as MSG contains one third the amount of sodium (gram per gram). In comparison, 1 tsp. of table salt contains 2,400mg sodium while the same amount of MSG only contains 480mg sodium, which is even less than the amount recommended by the Dash Diet. Umami, the fifth taste — completely different yet complementary to a human’s four basic tastes of sweet, sour, bitter, and salty — is naturally occurring in food such as tomatoes, mushrooms, and cheese such as Parmesan. The Umami taste is abundant in monosodium glutamate, which enhances the meaty or savory taste in food while reducing the body’s consumption of sodium.

Proponents of the Dash Diet believe that its success can be traced to its overall approach of focusing on foods that can be consumed, rather than on dietary restrictions.

In summary, one can never go wrong with the Dash Diet because it is recommended by most health professionals. Hunger need not be a problem, the Dash Diet is particularly useful in managing heart health, lowering excessive cholesterol, and preventing diabetes. It is not a weight loss plan, but it can be an effective tool for most overweight people.