The DASH diet (Dietary Approaches to Stop Hypertension) has been consistently cited as one of the best overall diets. The lifelong eating plan focuses on consuming fruits, vegetables, lean proteins, and whole grains. Foods that are high in sodium or added sugar are reduced.
The DASH program was developed by a panel of experts at the National Institutes of Health to help Americans lower their blood pressure. But as it turns out, it can also promote healthy weight loss and may provide other health benefits, as well.
However, there is no diet that is perfect for everyone. Consider the pros and cons of this eating plan before you begin the diet.
Evidence-based health benefits
Accessible
Flexible
Nutritional balance
Designed for lifelong wellness
Backed by major health organizations
Hard to maintain
No convenience foods
No organized support
Requires substantial food tracking
Not designed for weight loss
May not be appropriate for everyone
Pros
Evidence-Based Health Benefits
The DASH diet has been studied extensively. The original study which introduced the eating plan was published in 1997 and showed that the diet helped to reduce high blood pressure in people with normal blood pressure and reduced it even more in those with hypertension.
Since that original study was introduced, more recent research has confirmed the findings. In fact, authors of a 2016 analysis concluded that "the DASH dietary approach might be the most effective dietary measure to reduce blood pressure among hypertensive and pre-hypertensive patients based on high-quality evidence."
And those who follow the eating plan can expect other health benefits. Further research has found that the DASH diet helps to reduce LDL cholesterol, and may improve other cardiovascular risk factors, as well. The DASH diet has been shown to be an effective management strategy for diabetes and research has even shown that the DASH diet may reduce the risk of gout in men.
In addition to studies supporting the DASH diet specifically, research has consistently found that reducing your sugar intake, eliminating heavily processed, sodium-rich foods, and increasing your intake of fruits and vegetables leads to a wide range of health benefits.
Accessible
The food recommended on the DASH diet can be easily found in almost any supermarket. There are no hard-to-find ingredients, required foods, supplements, or subscriptions required to follow the program.
Additionally, unlike commercial diet plans, everything you need to learn the program is available online free-of-charge. The National Institutes of Health provides a wide range of resources, including a complete guide to recommended servings, meal plans, sodium intake recommendations, calorie guides, tip sheets, and recipes.
There are also countless cookbooks, websites, and smartphone apps dedicated to this eating style. And, because it has been well researched and widely promoted in the medical community , this is a diet that your healthcare provider is likely to be familiar with. So, if you have questions about whether or not to follow the plan, they may be well-equipped to provide advice.
Flexible
DASH diet plans are available for various calorie levels to accommodate men and women with different activity levels. It is easy to determine the right energy intake based on the online charts provided by NIH.
Additionally, those who follow special diets can follow the DASH eating plan. Vegetarians and vegans will find the plan easy to follow because grains, fruits, and vegetables are strongly encouraged. Those who eat a gluten-free diet can maintain their eating program by choosing safe grains such as buckwheat and quinoa. And those who eat a kosher or Halal diet can choose foods that conform to those dietary standards and still follow the plan.
Nutritional Balance
While many diets require consumers to drastically shift their macronutrient balance (including low-carb diets or low-fat diets) or severely restrict calories, the DASH diet stays within nutritional guidelines provided by the USDA.
For example, on the DASH diet, you'll consume about 55% of your calories from carbohydrate. The USDA recommends that 45% to 65% of your calories come from carbs.
According to the USDA, 20% to 35% of your calories should come from fat and less than 10% of those calories should be saturated fat. On the DASH diet, no more than 27% of your calories will come from fat and up to six percent of those calories will be saturated fat.
By following the program, you should also be able to reach your recommended intake of other important nutrients such as protein, fiber, and calcium.
Lifelong Wellness
The DASH diet is not a short-term program. The eating plan is designed to be a lifestyle that you maintain for life.
Tips are provided to help those who consume a typical American diet gradually adjust to eating less red meat, fewer processed foods, and more fruits and vegetables. Changes are introduced gradually to promote adherence.
For example, DASH experts recommend that you cut your sodium intake to 2,300 milligrams per day before attempting to reduce it to 1,500 milligrams —a level that may provide greater health benefits to some. Additionally, there is no difficult introductory phase where calories or daily carbs are drastically cut.
Backed By Major Health Organizations
The DASH diet has been promoted by the National Institutes of Health, National Heart, Lung, and Blood Institute, the American Heart Association, the American Diabetes Association, the USDA and medical institutions including the Mayo Clinic and the Cleveland Clinic. The DASH diet is also ranked as the second-best diet overall by U.S. News and World Report.
Cons
Hard to Maintain
Those who eat a typical American diet may have a hard time adjusting to the DASH plan. The program recommends that you cut your salt intake to 2,300 milligrams of sodium per day and potentially to 1,500 milligrams per day.
According to the Centers for Disease Control, the average American consumes 3,400 milligrams of sodium per day. Much of our salt intake comes from heavily processed foods—which are restricted on the DASH diet.
And even if you don't eat processed foods, letting go of the salt-shaker habit is hard for many.
For this reason and for several others, the DASH diet can be challenging to stick to. A study investigating DASH diet compliance found that people have a hard time sticking to the program and need more than just counseling to stick with it for the long term.
Researchers have also investigated the dietary fat intake on the DASH diet, theorizing that allowing more fat in the diet might help people stick with the plan.
In one study, participants followed a higher fat version of the diet and consumed full-fat dairy products instead of low-fat or nonfat dairy and also reduced their sugar intake by limiting consumption of fruit juice. Researchers found that the higher fat version of the DASH diet lowered blood pressure to the same extent as the traditional DASH diet without significantly increasing LDL cholesterol.
No Convenience Foods
Part of the appeal of programs like Weight Watchers, South Beach, or Jenny Craig is that you can subscribe to a service and get all of your meals conveniently delivered to your door. Portions sizes are pre-measured, and most meals and snacks are ready-to-eat or can be easily heated in the microwave.
Because the DASH is not a commercial diet, you won't be able to get pre-packaged foods delivered to your door. You also can't go to the freezer section of your local market and get meals that are already cooked. There are no easy-to-grab smoothies or snack bars. This diet takes more work.
No Organized Support
Another popular feature of some diet plans is group support. Some programs offer face-to-face counseling, group meetings, or peer-to-peer coaching. These features help people get through rough patches when motivation wanes, allows them to ask questions, and learn insightful tips and insider tricks.
While you'll find plenty of DASH diet resources available, there is no organized support platform for the plan. However, if you are considering the eating program, don't let this "con" derail you. Any good registered dietitian is familiar with the plan and they can help you to develop meal plans, or provide coaching and support when you need it.
Requires Food Tracking
There is no calorie counting required on the DASH diet. However, there are recommended calorie goals that determine the number of servings you are allowed for each food group. So you'll have to choose the right level and adjust periodically as your age changes or if you increase or decrease your activity level. Still, you do not have to track or count calories.
But to follow the DASH diet properly, you need to measure portions and count servings of foods that fall into different categories. This process can be just as tedious, if not more so, than calorie counting.
The DASH diet guide provided by the National Institutes of Health includes several downloadable forms that can be printed out to help you manage and track your servings of food. With practice, the process may become easier. But initially, this part of the program may be overwhelming for some people.
Not Specifically Designed for Weight Loss
While you can follow a lower-calorie target plan on the DASH diet, the primary emphasis is not on weight loss. Furthermore, studies investigating the DASH diet don't focus on weight loss, but rather on other health outcomes. So it can be hard to tell how the DASH diet compares to other diets when you're trying to lose weight.
The DASH diet doesn't include a quick weight loss phase (offered by many other weight loss programs) in which consumers are able to slim down quickly to boost motivation and adherence to the plan. Instead, you are likely to see gradual weight loss.
Not Appropriate for Everyone
While there are many people who can benefit from the DASH diet, researchers have identified certain groups who should exercise caution before changing their eating habits to adopt this plan.
A published study investigated the DASH diet in special populations. While study authors note that the diet is healthy for most people, they advise that patients with chronic kidney disease, chronic liver disease, and those who are prescribed renin-angiotensin-aldosterone system antagonist should exercise caution. They also suggest that modifications to the DASH diet may be necessary for patients with chronic heart failure, uncontrolled diabetes mellitus type II, lactose intolerance, and celiac disease.
The report underscores the importance of working together with your healthcare provider before making substantial changes to your diet or exercise program. They can not only provide guidance regarding the potential health benefits you may gain, but they may be able to refer you to a registered dietitian or another professional who can provide support and related services.