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Healthy Heart Reports

Dash Plus Low-salt Diet

The DASH study shows that a diet based on fruits, vegetables, whole grains, beans, seeds and nuts and low fat dairy products helps to lower high blood pressure more effectively than drugs or a low salt diet does.

To determine whether a low-salt diet is more important than a fruits, vegetables, whole grains, beans, seeds and nuts diet, researchers at Harvard Medical School set up a study in which they put people on the DASH diet and then rotated them through additional changes of 30 days each on high, moderate and low salt intake. For people with normal blood pressure, a severely restricted low-salt diet lowered systolic blood pressure by 6.7 mm Hg in people on the normal North American diet and by 3 mm Hg on the DASH diet. DASH plus low salt diet reduced systolic blood pressure 7.1 mm hg in normal blood pressure and 11.5 in people with high blood pressure. Their conclusion is that DASH diet lowers high blood pressure and that eating a DASH diet and restricting salt lowers high blood pressure even more.

You should be very critical of these results. The changes are minimal. They show that people on the DASH diet reduce their blood pressure only 3 mm of Hg with an extremely low-salt diet and this type of salt restriction is so severe that the only way you could to it is to order special low-salt dairy products and avoid most foods.

You cannot exercise effectively on a low-salt diet. I know the principal investigator because he ran marathons many years ago, and he has to know that a restricted salt diet prevents vigorous exercise.

My advice is to go on the DASH diet of fruits, vegetables, whole grains, beans, seeds and nuts, whether you have high blood pressure or not; start an exercise program; and add enough salt to your food to make it taste good to you. If you avoid most processed foods, as the DASH diet recommends, you will probably be taking in far less salt than you were before you started the diet even if you use reasonable amounts of salt when you prepare your vegetables, whole grains and beans. Severe salt restriction is not healthy, it prevents you from exercising and it may even raise blood pressure in some people.

The New England Journal of Medicine -- January 4, 2001 -- Vol. 344, No. 1, 3-10. Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet. Frank M. Sacks, Laura P. Svetkey, William M. Vollmer, Lawrence J. Appel, George A. Bray, David Harsha, Eva Obarzanek, Paul R. Conlin, Edgar R. Miller III, Denise G. Simons-Morton, Njeri Karanja, Pao-Hwa Lin, Mikel Aickin, Marlene M. Most-Windhauser, Thomas J. Moore, Michael A. Proschan, Jeffrey A. Cutler, for the DASH-Sodium Collaborative Research Group.

Copyright 2003
Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.

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