1. Dietary Approaches to Stop Hypertension (DASH) Eating Plan

2. Why DASH? 1/3 of Americans have hypertension 1/3 of Americans have hypertension DASH may prevent or help control high blood pressure DASH may prevent or help control high blood pressure Clinically proven Clinically proven

3. Who should try it? Those with prehypertension Those with prehypertension –Systolic 120-139 mmHg –Diastolic 80-89 mmHg Those with Stage 1 hypertension Those with Stage 1 hypertension –Systolic 140-159 mmHg –Diastolic 90-99 mmHg

4. What is DASH? High in potassium, calcium, High in potassium, calcium, magnesium, fiber, protein Lower in fat and cholesterol Lower in fat and cholesterol

6. Plenty of Grains and Produce Food GroupServings/Day for 1600 2000 calories Serving Size Grains6 7-81 slice bread, 1 oz cereal, ½ cup cooked rice/pasta, ½ small bagel Vegetables4 4-51 cup leafy vegs, ½ cup raw/cooked vegs Fruit4 4-56 oz juice, 1 medium fruit, ¼ cup dried fruit, ½ cup fresh/frozen/canned fruit

7. Good Protein Sources Food GroupServings/Day for 1600 2000 calories calories Serving Size Low-fat or fat free dairy 2-3 8 oz milk, 1 cup yogurt, 1-1/2 oz cheese Meats, poultry and fish 1-2 2 or less3 oz Nuts, seeds, and dry beans 2/wk 5/wk1/3 cup nuts, 2 Tbl seeds, ½ cup cooked dry beans

8. Minimal Fat and Sugar Food GroupServings/Day 1600 2000 calories calories Serving Size Fats and oils2 2-31 tsp margarine, 1 Tbl mayo, 2 Tbl salad dressing, 1 tsp oil Sweets2/wk 5/wk1 Tbl sugar, 1 Tbl jelly

9. Side Benefits Somewhat similar to Dietary Guideline recommendations Somewhat similar to Dietary Guideline recommendations May help prevent cancer May help prevent cancer Anyone can choose to follow it (NOT a diet) Anyone can choose to follow it (NOT a diet)

10. Getting Started Small steps Small steps –Focus on 1-2 changes –Add 1 more serving at a time –Think food, not nutrients Increase fluid intake Increase fluid intake

11. Getting started Plan ahead Plan ahead –Have produce at each meal/snack –Include vegetarian entrees Keep a food record Keep a food record

12. Read food labels

14. Winning at DASH Be flexible Be flexible Aim for 6 months of dietary change Aim for 6 months of dietary change

15. Moving toward DASH - breakfast TYPICAL Frosted Flakes Frosted Flakes 1% milk 1% milk toast with butter toast with butter coffee coffeeMODIFIED whole grain cereal with almonds, raisins & berries whole grain cereal with almonds, raisins & berries skim milk skim milk whole wheat toast with reduced-fat pb whole wheat toast with reduced-fat pb

16. Moving toward DASH - snacks TYPICAL candy bar or potato chips candy bar or potato chips pop popMODIFIED Banana or grapes with yogurt Banana or grapes with yogurt Water or 100% fruit juice Water or 100% fruit juice

17. Moving toward DASH – sack lunch TYPICAL turkey & cheddar sandwich on white bread with mayo turkey & cheddar sandwich on white bread with mayo apple apple pop pop Fritos FritosMODIFIED add lettuce and tomato, choose whole wheat bread, use reduced-fat mayo add lettuce and tomato, choose whole wheat bread, use reduced-fat mayo skim milk skim milk baked tortilla chips baked tortilla chips add baby carrots or mandarin oranges add baby carrots or mandarin oranges

19. Moving toward DASH - dinner TYPICAL spaghetti with Italian sausage spaghetti with Italian sausage green beans green beans garlic bread garlic breadMODIFIED Add salad with chopped broccoli, mushrooms, tomato, sunflower seeds Add salad with chopped broccoli, mushrooms, tomato, sunflower seeds Use turkey sausage or eat ½ sausage Use turkey sausage or eat ½ sausage

20. Moving toward DASH - dessert TYPICAL Ice cream Ice creamMODIFIED Max ½ cup ice cream or choose frozen yogurt Max ½ cup ice cream or choose frozen yogurt Add frozen or chopped fresh peaches Add frozen or chopped fresh peaches

21. DASH Resources Your Guide to Lowering Blood Pressure With DASH Your Guide to Lowering Blood Pressure With DASH –http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/index.htm http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/ihttp://www.nhlbi.nih.gov/health/public/heart/hbp/dash/i The DASH Diet Action Plan, by Marla Heller, MS, RD The DASH Diet Action Plan, by Marla Heller, MS, RD –http://dashdiet.org

22. Next phase – Sodium reduction Guidelines General population: maximum 2300 milligrams sodium/day (1 tsp. salt) General population: maximum 2300 milligrams sodium/day (1 tsp. salt) People with high blood pressure or adults 40 years and older: maximum 1500 milligrams sodium/day People with high blood pressure or adults 40 years and older: maximum 1500 milligrams sodium/day

23. Major Dietary Sodium Sources - Processed foods - Restaurant foods

24. How to reduce sodium Choose fewer packaged, processed foods Choose fewer packaged, processed foods Buy reduced-sodium soup and canned vegetables Buy reduced-sodium soup and canned vegetables Use less salt in cooking Use less salt in cooking Minimal use of condiments like Worcestershire sauce, steak sauce, pickles, and salad dressing Minimal use of condiments like Worcestershire sauce, steak sauce, pickles, and salad dressing

25. Add flavor instead of salt Use citrus peel (zest) Use citrus peel (zest) Add hot peppers Add hot peppers Use wine or specialty vinegars instead of high-sodium marinades Use wine or specialty vinegars instead of high-sodium marinades Add espresso powder or dry granulated coffee and use less salt Add espresso powder or dry granulated coffee and use less salt Use fresh herbs Use fresh herbs

26. Sodium label terms Sodium/Salt Free less than 5 mg per serving less than 5 mg per serving Very low sodium 35 mg or less per serving 35 mg or less per serving Low sodium 140 mg or less per serving 140 mg or less per serving Reduced Sodium/Less Sodium 25% less per serving than regular product 25% less per serving than regular product Light in sodium 50% less per serving than regular product 50% less per serving than regular product

27. Need help? Ask for dietitian referral Ask for dietitian referral Involve your family/co-workers Involve your family/co-workers

29. Questions?