HANDI
Making non-drug
interventions easier
to nd and use
www.racgp.org.au/handi
First published: October 2015 Reprinted with permission from The Royal Australian College of General Practitioners.
Intervention
A change in overall diet pattern that emphasises fruits, vegetables and low-fat dairy
products, and which includes whole grains, sh, poultry and nuts but limits saturated
fat, red meat, sweets and sugar-containing beverages.
The dietary changes result in a reduced consumption of sodium and an increased
consumption of potassium, calcium and magnesium compared with a typical
Australiandiet.
There are strong similarities between the DASH diet and the Mediterranean diet.
However, the DASH diet does not emphasise olive oil and sh and does not include
wine: http://www.racgp.org.au/your-practice/guidelines/handi/interventions/nutrition/
the-mediterranean-diet-for-reducing-cardiovascular-disease-risk/
Indication
The DASH diet has been
ratedthe best diet for overall
health and wellness for the
past5 years in a row.
Reduction of blood pressure. The DASH diet has been shown to reduce
bloodpressurewithin 2 to 4 weeks (by 6 mmHg systolic and 3 mmHg diastolic).
Afterthisinitial reduction the blood pressure is maintained rather than reduced further.
Effects are more pronounced in people who are hypertensive rather than normotensive.
The DASH diet may further reduce cardiovascular disease (CVD) risk through reduction
in total cholesterol, low density lipoproteins (LDLs) and body mass index (BMI).
Changes achieved with the DASH diet predict a reduction of CVD of approximately
13%using the 10-year Framingham risk score.
Availability
The DASH diet consists of foods that are readily available in Australia.
Description
The DASH diet plan includes the following:
Type of food Servings Serving size
Fruits 4–5 a day 1 medium fruit
1/4 cup dried fruit
1/2 cup fresh, frozen,
orcanned fruit
Vegetables 4–5 a day 1 cup raw leafy vegetable
1/2 cup cooked vegetable
Low-fat or non-fat dairy
foods
2–4 a day 250 mL milk
1 cup yogurt
50 g cheese
Grains and grain products
(include at least 3 whole-
grain foods each day)
6–8 a day 1 slice bread
1 cup cereal
1/2 cup cooked rice
orpasta
Lean meats, poultry and
sh
2 or fewer a day 90 g cooked lean meat,
skinless poultry or sh
DASH (Dietary Approaches to Stop Hypertension)
dietto prevent and control hypertension
HANDI
Making non-drug
interventions easier
to nd and use
www.racgp.org.au/handi
First published: October 2015 Reprinted with permission from The Royal Australian College of General Practitioners.
Description
(continued)
Nuts, seeds and legumes 4–5 per week 1/3 cup nuts
1 tablespoon seeds 1/2
cup cooked dry beans
Fats and oils 2–3 a day 1 teaspoon margarine
1 tablespoon low-fat
mayonnaise
2 tablespoons light
saladdressing
1 teaspoon vegetable oil
Sweets 5 or fewer per week 1 tablespoon sugar
1 tablespoon jam
15 g jelly beans
250 mL lemonade
Tips and Challenges
Referral to a dietitian is recommended for tailored advice and ongoing follow-up.
Referto Dietitians Association of Australia.
Grading
NHMRC Level 2 evidence.
References
Salehi-Abargouei A, Maghsoudi Z, Shirani F. Effects of Dietary Approaches to
StopHypertension (DASH)-style diet on fatal or nonfatal cardiovascular diseases –
incidence: a systematic review and meta-analysis on observational prospective studies.
Nutrition 2013; 29:611–618.
Siervo M, Lara J, Chowdhury S et al. Effects of the Dietary Approach to Stop
Hypertension (DASH) diet on cardiovascular risk factors: a systematic review
andmeta-analysis. British Journal of Nutrition 2015;113: 1–15.
Consumer Resources
There are numerous books about the DASH diet (e.g. The DASH diet, The DASH
diet for beginners, The DASH diet action plan The DASH diet for weight loss).
Most consumer resources for the DASH diet have been developed in the United
States (US). The National Heart, Lung and Blood Institute (part of the US Department
of Health and Human Services) promotes the DASH diet as a well-balanced diet
for the general public as well as those with hypertension. Some call it the American
version of the Mediterranean diet.
• The US Department of Health and Human Services has produced a brief guide
to lowering blood pressure with the DASH diet http://www.nhlbi.nih.gov/les/
docs/public/heart/dash_brief.pdf and a more general guide to lowering blood
pressure http://www.nhlbi.nih.gov/les/docs/public/heart/hbp_low.pdf
• WebMD offers some tips to starting and staying on the DASH diet:
http://www.webmd.com/hypertension-high-blood-pressure/guide/dash-diet
It also has an action set for using the DASH diet: http://www.webmd.com/
hypertension-high-blood-pressure/tips-for-following-the-dietary-approaches-
to-stop-hypertension-dash-diet
• DASH Diet Oregon provides some useful information and resources about the
DASH diet. While this is a free site, it is paid for by the Oregon Dairy Council.
www.dashdietoregon
• A US-based paid site offers online DASH diet programs (including education,
support, meal plans, tracking tools and recipes). http://www.dashforhealth.com