DASH Diet

USAGE AND EFFECTIVENESS

Usage	Effectiveness
High Blood Pressure	Gold Standard (Reduce blood pressure) Several studies have shown that compared to other structured diet, DASH diet lowers the systolic blood pressure (pressure when the heart contracts) by 5 to 11mm Hg and diastolic pressure (pressure when the heart relaxes) by 3 - 6mm Hg. Blood pressure lowering effect is synergistic when combined with salt lowering diet, weight management programme and prescription medicines. Taking the DASH diet is a part of lifestyle recommendations by American College of Cardiology and American Heart Association Guidelines. Usage of DASH diet may be useful for some subtypes of high blood pressure such as isolated systolic hypertension where only the pressure when the heart contracts is higher than normal.
Diabetes	Effective (Reduce chance of developing non-insulin dependent diabetes and pregnancy-related diabetes American Association of Clinical Endocrinologists and American College of Endocrinology advise the use of DASH diet for non-insulin dependent diabetes patients with no kidney issue to use DASH diet to manage blood pressure. A population study found that subjects who carried out DASH diet strictly were 69% less likely to have non-insulin dependent diabetes. An analysis of clinical studies found that test subjects had lower blood sugar than another structured diet (mean of 6mg/dl) Other research showed that use of DASH diet may reduce the probability of having diabetes or the need to use insulin during pregnancy.
Heart & Blood Vessel Diseases	Effective (Reduce likelihood of heart & blood vessel diseases) A long populaton study showed that subjects who ate DASH diet dutifully were 20% less likely to have heart attack, 19% less likely to have stroke and 29% less likely to have heart failure. There is also an observation study on DASH diet's protection against abdominal aortic aneurism (a condition where the main artery swells up and is prone to life-threatening breakage); while it claimed 40% protection against its development, more studies of robust design is needed.
Colorectal Cancer	Mild Effectiveness (Reduce likelihood of developing colorectal cancer) Observation studies showed that subjects were 20% less likely to develop colorectal cancer However, females seemed to benefit less from DASH diet in these studies. More evidence is needed (e.g. robust population study is needed)
Depression	Mild Effectveness (Reduce development of depression) Population studies showed that eating DASH diet might be helpful in reducing the chance of developing depression particularly in high blood pressure patients and teenage girls More clinical studies will be needed to support its claim of effectiveness.
High Blood Pressure During Pregnancy	Mild Effectiveness (Reduce probability of developing high blood pressure) An analysis of small clinical studies showed that eating DASH diet lowered probability of high blood pressure in pregnant mothers by 33% An observation study also found that a stricter practice of DASH diet was also found to reduce the chance of having high blood pressure in pregnancy. More clinical studies of robust design are needed to support its claim of effectiveness.
High Cholesterol	Mild Effectiveness (Reduce bad cholesterol) Some studies showed that usage of DASH diet decreased both good and bad cholesterol; more studies are needed to confirm its claim of effectiveness
Metabolic Syndrome	Mild Effectiveness (Improve health test results) A study showed that DASH diet contributed to the decrease of blood pressure, blood sugar, triglycerides and increase of good cholesterol More studies are needed to confirm its claim of effectiveness
Obesity	Mild Effectiveness (Reduce weight) An analysis of clinical studies showed that subjects who were on DASH diet, were 3 pounds lighter than those who were on another structured diet. However, this analysis was hampered by the fact that the component studies did not separate the effect on normal weight and obese individuals and there were actually some obese patients who gained weight after taking DASH diet. There was a clinical study which looked at the effect of DASH diet and exercise on obese pregnant mothers. While it was shown that undesirable weight gain was mitigated, it is uncertain if DASH diet exerts any effect or the effect was entirely due to exercise. More supporting evidence is needed.
Overall Mortality	Mild Effectiveness (Reduce all-cause death rate) An analysis of observation studies showed that healthy subjects using the DASH diet have lower death rate; a population study found that subjects using DASH diet had a 6% to 11% lower death rate More clinical studies of robust design are needed to support its claim of effectiveness.
Stroke	Mild Effectiveness (Reduce development of stroke) A population study showed that test subjects on DASH diet were 12% less likely to have stroke. More evidence is needed to support claim of effectiveness.
Kidney Stones	Unclear Effectiveness (Reduce risk factor of development of kidney stones) Observational study linked the use of DASH diet to lower calcium and uric acid level in the blood (component and risk factors for kidney stones). However, there was no supporting evidence of DASH diet preventing actual kidney stones; more enidence is needed.
Nonalcoholic Fatty Liver Disease	Unclear Effectiveness (Reduce weight and improve liver function test) A small clinical study showed that usage of DASH diet observed lower weight and better liver function test results as compared to those who ate other structured diet. More clinical evidence is needed to support the claim of effectiveness.
Prostate Cancer	Unclear Effectiveness (Reduce incidence of prostate) A observational study showed that DASH diet lowered probability of prostate cancer by 35%. More clinical evidence is needed to support claim of effectiveness.

General Safety

• DASH diet is safe when used appropriately.

Pregnant/Breastfeeding

• DASH diet has been used in clinical studies on pregnant mothers. It can be used safety for a short duration of 12 weeks. Modified DASH diet (which is known as MAMA-DASH and accounts for nutritional requirement to support pregnancy) can be used for 20 weeks.

Children

• Due to lack of specific research and given that any diet modification must be balanced with children's growth needs, patients are advised to see their doctor to assess the benefit of implementing such a diet

Elderly

• While there is no specific report on elderly, given the safety profile and the widespread use of DASH diet, it is likely safe. Nevertheless, it is best to consult your doctor to assess if DASH diet is suitable for you.

Special to Note

• None known.

Contraindications

• There is no specific medical condition that will necessitate avoidance of DASH diet.

Side Effects

• DASH diet has a very good safety record. In most clinical trials, there has been no report of any side effect.

• Medicines
  None known
• Supplements
  None known
• Food
  None known
• Lab Tests
  None known

• Adult:
  To be taken daily, ensuring a limit of 2000 calories per day and comprising of 7 to 8 servings of grains, 4 to 5 servings of fruits, 4 to 5 servings of vegetables, 2 to 3 servings of milk-related food (low fat or non-fat), 0 to 2 servings of lean meat. |Salt should be limited to 2.3g per day which is roughly 1 tablespoon while sugar should be reduced to not more than 5 servings per week (e.g. 1 serving of sugar is 1 tablespoon of sugar or jam).

• General Information
  • DASH is an acronym that stands for Dietary Approach to Stop Hypertension (High blood pressure) and has been popularly used to manage high blood pressure and its harmful effect.
• How does it work?
  • Compared to other diets, it focuses on what can be taken instead of what cannot be taken. DASH diet is high in potassium, calcium and magnesium, while it is low on bad cholesterol; this profile are excellent for heart health.