Breaking Down the DASH Diet with Julia Zumpano, RD

John Horton:

Hey there, and welcome to another episode of Nutrition Essentials, a chewier version of our long-running Health Essentials Podcast. I'm John Horton, your co-host, with registered dietitian Julia Zumpano. How's life treating you today, Julia?

Julia Zumpano:

Feeling great. I'm loving to see the sun shine, so it's nice to see that.

So today we're going to be talking about the DASH diet, a very well-known, science-backed diet that's been around for a couple decades now.

John Horton:

Yeah. And, Julia, I feel like the DASH diet is one of those things that we bring up on the podcast again and again and again. And that's the reason why we wanted to set aside a little bit of time to kind of break it down for folks and really get into what it means to be on the DASH diet.

Julia Zumpano:

Yeah. The DASH diet has a lot of great science to support its use and a lot of great resources. It's a stricter plan, but it's very effective, and we'll find out some of the nuances that come with it.

John Horton:

Well, and we always bring in an expert on these sorts of things to kind of walk us through it. And luckily, we have that expert in-house, and that would be you. So we're really looking forward to kind of picking your brain and finding out what we should know if we're going to try the DASH diet to just improve our health.

Julia Zumpano:

So happy to be here and talk through the details of the DASH diet.

John Horton:

Well, let's get to it.

So, Julia, we always introduce you as a “registered dietitian,” but that title is pretty broad. Your actual specialty is working the nutritional angles within preventive cardiology. That kind of goes hand in hand with what we're going to talk about today with the DASH diet, right?

Julia Zumpano:

Absolutely. I utilize the DASH diet frequently. The DASH diet is a diet that is used commonly for the treatment of hypertension. So I see that all the time in cardiology.

John Horton:

Well, and that's ... the heart and what we eat is so tied together. I know we bring up the DASH diet a lot during our discussions and when they touch on heart issues and things like that, so we really did want to spend a little more time on it today. So I guess we should just start with the basics, which is: What is the DASH diet? Because I'm assuming it's not just eating really, really quickly.

Julia Zumpano:

No, it does not include eating quickly, but I could see where you thought that. So DASH is an acronym. It stands for “Dietary Approaches to Stop Hypertension.”

John Horton:

That sounds a little more formal.

Julia Zumpano:

Yeah. It is designed to help lower blood pressure. And it is a flexible, balanced eating plan, and it is based on the concept of eating more plant-based foods, eating lower-fat foods, more dairy and restricting sodium to attain that goal.

John Horton:

Yeah, it has a really neat history. When I started doing a little research on it, 1) I was surprised that it was as young as what it is. Because I think, if my memory's right, it goes back to 1997, but it was just like ... I think it was 160 scientists or medical professionals kind of got together and just came up with this plan to deal with high blood pressure that they were routinely seeing in people.

Julia Zumpano:

Right. Yeah, it does date back quite a ways. And the best, other part is that there are a ton of great resources if you're going to follow the DASH diet — meal plans, recipes, tons of resources, grocery lists, et cetera. And then, there's also a great amount of research on this diet supporting its use. So that's one of the founding … the best foundation of this diet is that it's so well clinically supported.

John Horton:

Yeah. And it seems like, I mean, just with the whole formation of it and everything after that, it really just seems to hit the nail on the head when you're trying to address that very specific issue, which is high blood pressure.

Julia Zumpano:

Right, right. And I mean, it can help with other issues as well. I mean, it was designed for the treatment of hypertension, but it has been shown to reduce cardiovascular disease risk even with ... it's very diabetic-friendly. It's overall anti-inflammatory, which I'm sure we're going to get into a little bit more deeper. So it was designed initially for the treatment of hypertension, but it can be used for other disease states or to try to prevent other non-cardiac-related health concerns.

John Horton:

Yeah. Because I mean, as you started to kind of share a little bit, it's very plant-based, and it seems to hit on a lot of those common themes that we see in all these really healthy diet plans that are sustainable for people if they're just trying to be healthy.

Julia Zumpano:

Absolutely. The plan recommends specifically four main topics. So first of all, eating vegetables, fruits, and whole grains. Not surprising there.

John Horton:

Yeah.

Julia Zumpano:

Right?

John Horton:

Always seem to be the recommended things.

Julia Zumpano:

Exactly. Eating dairy is a big foundation of this plan. So eating low-fat and fat-free dairy products; fish, poultry, nuts and beans as our main sources of protein. And then, limiting those foods that we all know we should limit that are high in saturated fat, like fatty processed meats.

It does limit full-fat dairy and then some tropical oils, so it is way more of a lower-fat diet when compared to some of more of the traditional guidelines that we're instilling now, such as the Mediterranean diet.

And then, it suggests lowering sugar-sweetened beverages and sweets.

John Horton:

Those seem like really, I mean, basic things that we see in a lot of these healthy eating plans, so-

Julia Zumpano:

…right. I mean, it's very similar to the Mediterranean style of eating or pretty much any basic diet recommendations we have regardless of the plan you're following.

John Horton:

So kind of just to run through the rules of the DASH diet — we kind of just did a little bit there, but just to really break it down — so it looks like, 1), you want to make sure you're hitting whole grains. How are those going to help with blood pressure to maybe bring those numbers down a little bit?

Julia Zumpano:

Sure. So whole grains are usually one-ingredient food. So when you think of a whole grain, you think of quinoa or brown rice or wild rice or oats or even a whole grain pasta. So any of those things really do only have one ingredient. And they're minimally, or very little processing, in it at all, so they tend to not have any added sodium, which is very helpful for the reduction of blood pressure.

So the more we process foods — and we have things like white bread or bakery items that are not whole grain — we have more of a likelihood of a chance for those foods to have more sodium and some of those higher fat or vegetable-based oils that then start to become more of a processed food. So I mean, that's one aspect of it.

The other aspect of whole grains is that they provide more fiber, dietary fiber, and they provide more protein than refined grains. And we know that those two things can lead to better blood sugar control, lead to better appetite control, and then, ultimately, better weight control. And we do know blood pressure is related to your weight most of the time. So small and moderate amounts of weight loss can positively impact blood pressure control.

John Horton:

Yeah, I was going to say, you mentioned fiber in there, too. And I know the two other big groups that are within that DASH diet are fruits and vegetables. Pretty much it looks like everything you find in the produce aisle.

Julia Zumpano:

Sure.

John Horton:

Those are all things that are usually pretty heavy in fiber content, too, correct?

Julia Zumpano:

Right, right. Absolutely. Those are primary sources of fiber. They're also, again, very low in sodium, if any at all. I always say you don't want to be concerned with the amount of sodium that's naturally found in celery. That's not what we're worried about here, right?

John Horton:

That's not your biggest issue when people come in like, "Hey, you got to cut back on the celery a little bit."

Julia Zumpano:

Right. And you have to think about more fluid-based vegetables like that, I mean, they're providing you hydration and fluid, and they're also providing you potassium, which are found in fruits and vegetables. And the potassium helps balance sodium. Potassium helps promote the excretion of sodium. So that's also another backend way of how high intake of fruits and vegetables support blood pressure control and the reduction of blood pressure.

John Horton:

You know, that was such a cool thing that you just brought up with potassium and how it works with sodium. And that's something I don't think a lot of people necessarily know off the top of their head. But it does sound like if you eat a little more potassium, what does it do to cut the sodium levels down in your body?

Julia Zumpano:

Well, it helps promote the excretion of sodium. So if you're having a little more potassium, it helps you get rid of that sodium that you might be carrying and holding onto. So sodium pulls fluid into the cells. Potassium pulls fluid out of your cells. So it really helps that promotion of excretion. So if you are going to follow, let's say, a little bit of a higher sodium diet, the higher potassium diet can help offset or get rid of some of that extra sodium. So that's potentially how it works. They work synergistically.

John Horton:

Yeah. So a few more bananas, which I know everyone talks about with sodium, but then I know there's a lot of other fruits and vegetables that kind of hit that mark, too.

Julia Zumpano:

Yeah. Bananas are a good source of potassium. Potatoes are a good source, leafy greens, beans, tomatoes. Avocado is an excellent source of potassium, nuts. So there's a long list of fruits and vegetables and plant-based foods that are high sources of potassium.

John Horton:

Now, you did just bring up nuts. And I know nuts are ... I know they check the box for what you want here, but the key is you want to make sure you're getting those unsalted nuts-

Julia Zumpano:

…right.

John Horton:

...and all that stuff, which I don't think a lot of people naturally lean toward.

Julia Zumpano:

Right. You definitely want to get unsalted or lightly salted, depending on your sodium intake and how much those nuts are contributing to your daily intake. The other thing you want to be mindful of is, the DASH diet does not allow a lot of added fats. It's a lower-fat diet, so serving sizes are very important when it comes to things like nuts and seeds.

John Horton:

And with those fats, too, I take it that's why you're talking with dairy. You're looking at fat-free or low-fat milks and-

Julia Zumpano:

…correct.

John Horton:

...cheeses and yogurts and all that sort of stuff.

Julia Zumpano:

And it does really promote dairy in the DASH diet, two to three servings of dairy a day, low-fat or fat-free — so milk, yogurt, cottage cheese. So cheese is going to be a little higher in fat and sodium, so not recommending a lot of cheese, more of the lower-sodium, lower-fat dairy sources. Still, can have some cheese, but just be really mindful of the sodium that's in the cheese.

John Horton:

I say cheese is one of those things … I think we all like cheese way more than we should for our health. I know I've tried to cut back on it by using even just the shredded cheese every once in a while instead of the whole slice because you figure you're getting a little less in there, but you still get a little bit of the taste.

Julia Zumpano:

That's a good option, too. They do have those thin-sliced cheeses now. So they're very, very thinly sliced pieces of cheeses. So about three slices is equivalent to one traditional cheese slice. So really, when you're using one of those ultra-thin slices, it's a third of a typical slice. So that's very helpful, too. I'll recommend those often. Or if you get your cheese from the deli, having them sliced as thin as possible.

Another option would be even looking outside of the dairy world for replacements to cheese. So I'll use avocado on sandwiches or salads instead of shredded cheese or chopped nuts instead of shredded cheese. So looking for something else that's going to take the place of that but still add some more flavor and even add some protein and healthy fats.

John Horton:

Now, we've talked mostly plant-based foods so far, which always seems to be really heavy in any of these healthy diets, but the DASH diet does have a spot for lean meats and poultry and fish and things like that. So people will still be able to get their burger in there, right?

Julia Zumpano:

Right. Absolutely. So the serving sizes for ... and one thing to note is that the DASH diet is specific, very specific. It provides a specific number of serving sizes per the appropriate caloric value. So the DASH diet is based on a 2,000-calorie diet, and then it gives you the recommended amounts of servings in each food group based on that calorie level. So for meats, including poultry and fish, it's six servings or less a day, which is 6 ounces. So it's not very much. It's very little protein compared to the current dietary guidelines for Americans. And even when you're calculating protein needs, it most likely will be a little bit less than what's advised.

John Horton:

Yeah. Now, I have to say, going through that list, everything we went over, the whole grains and all the stuff that's in there, fruits and vegetables, you get some meat in there, the low-fat dairy, nuts, seeds, I mean, that's pretty good eating. I mean, I hear that list, and I don't go, "Man, I'm missing out on a lot of stuff." It does seem like a diet that includes foods that we naturally gravitate to and want.

Julia Zumpano:

Yeah. I would say that the standard American diet does not gravitate to this amount of fruits and vegetables. So just to give you a picture: On the 2,000-calorie diet, it's recommending four to five servings of vegetables and four to five servings of fruit. So that's eight to 10 servings a day. Most Americans are nowhere near that. It's suggesting six to eight servings of grains. Again, most Americans are not eating grains, whole grains, and not in that quantity. And then, six or less servings of meat, poultry and fish. Again, Americans are eating about double that. And then fats and oils, only two to three servings, which is very little. A serving size is about a teaspoon of oil. So a tablespoon of oil is three servings of fat. That is the very upper limit of the allotted fat. So if you want nuts, seeds, peanut butter, et cetera, it's already taken. It's been used already. So you have to wait till the next day to get your fat allotment from that source.

So I do feel that when you look at the food groups, it looks phenomenal, and it's great for someone who more adheres to the style of a plant-based diet. But you just do have to be aware that the portions and the serving sizes are very specific to the caloric value. And if you do want to follow the diet strictly the way it is, you really want to practice portion control and be aware of what those serving sizes are.

John Horton:

Yeah. And that's where I think we get into a little bit of maybe some of the trickiness of the DASH diet. Because you see that list, you go, "Oh, this seems pretty good." I know we've talked and kind of laughed a little bit — you're not the biggest fan of the DASH diet, and it sounds like a big reason for that is just some of the restrictions that are in place and some of the rules and things like that. It can get a little more complicated than maybe what it seems on the surface.

Julia Zumpano:

So as I mentioned, I think it's a very solid diet, very science-backed. Although, when you go to put it in practices, which is my job — I'm meeting the patient where they're at — I may have a 65-year-old African-American male with high blood pressure. So when I present this 2,000-calorie diet to him, it's very opposite of the way he's used to eating. And it would be very challenging for him to follow this diet coming from where he's at.

So my goal is to be able to provide the plan that's going to get him to lower his blood pressure and still enjoy his diet, is attainable, sustainable, and culturally appropriate, financially appropriate, whatever will be sustainable for him long term. Because really, this hypertension is likely not going to go away. So we're trying to manage it. We're trying to minimize it. We're trying to control it.

John Horton:

So how do we do that? How do we take the tenets of the DASH diet and then maybe adjust them a little bit, massage them, and make them fit into your lifestyle?

Julia Zumpano:

Well, just for this example, what I would use for this type of patient is I would give them a sodium-restricted diet. So I would use the time that I have with them to educate them on where sodium is found and educate them on how to read labels and educate good alternatives to some of the foods they may be choosing, what the label should read in regard to sodium, what our targets are for sodium, how much sodium you should have in a day. So that's where I tend to spend more time.

And then I, of course, just naturally encourage the low-sodium foods that are very nutrient-dense, like fresh fruits and vegetables and whole grains. But this diet is great for someone maybe who doctors may suggest try the DASH diet because it's already set up for them. The caloric value's set up. The serving size is set up. There's grocery lists. There's meal plans. There's everything you need to follow it maybe without a dietitian or a nutritionist there to guide you through every step.

So that is really the best part of the diet, is it's a standalone diet. It can be followed without necessarily needing to meet with a dietitian because you have all the resources and steps there mapped out for you.

But if you are meeting with a dietitian, that's where I will dig in deeper and say, "Well, let's really see where your sodium is coming from. Let's try to target those sources and come up with better choices so we can make a bigger impact." And if they're willing to follow, and would like to follow, this specific strategic plan, I'm very supportive of that. But most people don't have the time to measure and weigh out their foods and track all their serving sizes. And to be honest, most people would prefer to eat a little bit more in the protein area, a little bit more in the fat area. And then, with the lower-carb trends, most people like to have a little less carbs. They might feel better on that type of plan, or their activity may not be able to support that high intake of carbohydrate. So it's just that fine dance of a balance of where the patient is at, where they want to be and how much work they want to put into getting to that point.

John Horton:

And I know, we've talked often on this podcast about looking at reading labels and looking closely. I know I've started looking a lot more closely since we've been talking for two-plus years now in doing this. And it's amazing how much sodium is in things that you wouldn't think. Condiments, they're huge. If you get those prepared rice packs, those are just sodium bombs. I'm always shocked when you look and you go, "Oh, this sounds great, this rice bag where you heat it up,” whatever. And then, you look at the back, and it's like 50% of your sodium for the day is in this one little pouch of rice. And that's bonkers.

Julia Zumpano:

Right. So yeah, you can make a lot of headway just through label reading and being more educated on what food you're purchasing and putting in your mouth.

So you mentioned some of the big hitters, like condiments and prepared foods. So ready-prepared rice or noodle dishes, anything-

John Horton:

…soup.

Julia Zumpano:

...in a can.

John Horton:

Soup is still-

Julia Zumpano:

…soup. Soups are very high.

But processed meats — Americans eat a lot of processed meats and deli meats. So that's one of the biggest contributors. Processed cheese is another huge contributor. Bread products, the whole bakery bread aisle, especially if it has a long shelf life, those are very, very large sources of sodium. And not maybe individually. Maybe a slice of bread has 200 milligrams of sodium. Doesn't sound like a lot. But if you're eating a sandwich twice a day or having toast in the morning, maybe you're having four slices of bread a day, that adds up to 800, and that's pushing into 50% of your needs. The DASH diet is based on a fairly low-sodium diet. It's 1,500 milligrams to 2,300 milligrams of sodium for the day based on the caloric intake.

John Horton:

That's a big dropdown. So you can see where, 1), it would make a big difference, but 2), where it would also be very difficult at times to stay under that bar.

Julia Zumpano:

Yeah, absolutely.

John Horton:

Now, you mentioned a little bit ago the Mediterranean diet, which I know anybody who's listened to this podcast has heard again and again and again. It seems like the Mediterranean diet and the DASH diet are often kind of thrown out there as two really good options.

Julia Zumpano:

Right.

John Horton:

How do they compare? If somebody's looking at these, what's the main difference you're going to have if you go with one versus the other?

Julia Zumpano:

Sure. So the primary goal of the DASH diet is to lower blood pressure, hypertension. The Mediterranean diet really promotes overall longevity and prevents chronic disease. So we're looking at two different specific goals. Now, we do know that the Mediterranean diet does reduce cardiovascular disease risk, as does the DASH diet. So they do kind of crossover there.

The sodium limits are different. I just mentioned the sodium restriction for DASH, between 1,500 to 2,300 milligrams. There is no sodium restriction for Mediterranean. It really just does focus on whole foods that, therefore, would support a naturally lower-sodium diet because it eliminates a lot of processed foods.

The other piece we've talked about again is the dairy, two to three servings of dairy for the DASH diet. And there's very little dairy on the Mediterranean diet. Most of the dairy in the Med diet is yogurt and a little bit of sprinkling in cheese here and there, but not daily. They're … again, in moderation.

John Horton:

Yeah. Do you find that people can almost blend the two together maybe and find the parts that work best for them and make their own Med-DASH diet or something like that?

Julia Zumpano:

Yeah. So there is a diet called the MIND Diet, and it is kind of a blend of the two, the Mediterranean and the DASH, and it has been shown to support cognition and mental health and cognitive decline. So it helps support that. So it does kind of mend those two diets together. So you certainly can mend those together.

What I often do in clinic when I see patients is that I give them a sodium-restricted diet, and then I give them the Mediterranean diet. So we kind of mend them together in that sense by restricting the sodium, but providing the facets of the Mediterranean diet that is a little bit more loose, not so strict.

John Horton:

I was going to ask that: Is the DASH diet something that's effective? If your blood pressure is really high and you need to see some instant results, do you have times where maybe a patient will start on the DASH diet, bring it down a little bit, and then maybe you can start loosening it up a little bit, maybe go more to the Mediterranean one, something where that sodium comes up a bit, still isn't at peak levels, which I think a lot of people are way too high, but just you kind of bring it down and then you can adjust afterward?

Julia Zumpano:

Well, so usually I try to keep the sodium pretty stable, between 1,500 and 2,300. I try to keep it within that range. But what I do is maybe adjust the foods a little bit. So instead of adjusting the sodium, I may be a little more lenient.

We didn't talk about fats, but fats are a big difference between the Mediterranean and DASH. I think I mentioned that the DASH diet only allows two to three fat servings a day. And so it really does limit total and saturated fat and plant-based fats. It just limits all fats, and the Mediterranean diet emphasizes fats. There's an emphasis on the use of extra virgin olive oil. There's an emphasis on the use of nuts and seeds. So that's vastly different because the fat can be almost double when you compare the diets together or against each other.

So instead of looking at sodium, what I do is keep sodium the same, but I start to add maybe a little bit more of the fats and maybe a little bit more of the protein in the diet to allow for more variability and flexibility.

John Horton:

Yeah. And that's where it seems like there is a little bit of a build-your-own-component if you do it right.

How do people know where to go with that and how to make those adjustments? Is this a matter of, you experiment a little bit on your own or you just talk it through with your healthcare provider, a registered dietitian? What steps should people take?

Julia Zumpano:

Well, the best would be if you do have a registered dietitian to be able to meet with to navigate through this. If you just choose to start on the DASH diet, which is, again, a very highly structured, very strict, exact daily targeted plan, you just decide to start that way and you're doing great on it, there's no harm in continuing. But if you're looking to expand a bit, venture out and provide more flexibility, I think meeting with a dietitian is ideal if you have that option. If not, you can discuss it with your healthcare provider.

Or another great option is just to kind of do your research on a Mediterranean diet and start to incorporate a little bit more of the facets of that diet. So naturally starting to maybe increase intakes of protein slightly, adding a little bit of Greek yogurt in the diet, and then also increasing fats slightly, plant-based, healthy fats like extra virgin olive oil, nuts, and seeds.

John Horton:

Yeah. Do you usually recommend that somebody just jump right into a DASH diet if they're going to do it? Or, I mean, you kind of slowly work your way in? Maybe cut out some of those highly processed foods that we talk about, those fried foods, things like that, sub in a few extra fruits and vegetables, and then just slowly bring it down to more to where the plan is?

Julia Zumpano:

It depends. It depends. Some people do better with an all-or-nothing plan. Some people like to transition slowly. But I think the first step should always be looking at what you're eating and what are your biggest sources of sodium. I think that's definitely the first step. That's what I do. I take an umbrella look at the whole diet history and really see where the sodium's coming from. And then I try to target that. Because that's that low-hanging fruit, right? That's going to make the biggest impact. So deli meats, processed meats, fast foods, eating out, snack foods, we really target those foods first.

John Horton:

Yeah. It is shocking. Like I said, if you spend a little bit of time looking at the labels and really zero in on that sodium line, it can be shocking when you see what the numbers are for things that you think might actually be good for you. Like I said, some of those rice packages or things like that, "Oh, it's rice. It's got to be OK." And then you look, and you go, "Holy smokes. This is most of my sodium for the day."

Julia Zumpano:

Yeah. Any convenient food, you're going to get in trouble with there. I'm just being mindful of serving sizes and sodium, like you mentioned. Even things that are healthy, as you mentioned, like canned beans, trying to get more beans in the diet and you're using canned beans or salad dressings, even if they're made with olive oil, can still contain a lot of sodium. A lot of people use olives or pickles or pickled vegetables. Those can contain a lot of sodium. So just being mindful of those intakes.

And eating out is so high in sodium. I mean, most of us are very busy. A lot of people don't have the time to prepare a meal from scratch. So you might be grabbing really quick, easy, pre-prepared items that when you put them all together, can equate to a very high-sodium meal. Or you could be grabbing some takeout, ordering in or going to a restaurant, and that's going to be very high in sodium. So just being mindful of that.

John Horton:

So kind of bottom line here, to wrap everything up, because we've covered an immense amount, if somebody's looking to ... they have high blood pressure, they want to make some dietary changes. And they look at the DASH diet and go, "All right. Maybe this is the solution." What would your recommendation be to them when they're considering what to do and whether they should just jump in and eat that way?

Julia Zumpano:

I don't think there's any harm in starting it. I'd say if you have the resources available to you, go ahead and get started. I usually tell people, take it in two-week increments. Just say, "I'm going to follow this diet for two weeks and see how I feel." And then, make note of your blood pressure. Of course. That's why we're following it. So it's really important to have a baseline blood pressure, understanding where your baseline blood pressure values are, and then measuring your blood pressure as you go along through the diet and seeing the change. And that's a huge incentive for people to change, right?

May also see the scale moving a little bit toward the right direction. Am I tipping the scale, losing a little bit of weight? That is making me feel better. And as these two things come down, then most of the time we can move a little more. Activity is a little easier to do. Your blood pressure is better controlled. You're feeling better when you're exercising, you're losing a little bit of weight, you're moving a little bit easier. That is going to support your blood pressure coming down even further. So we're kind of utilizing many aspects here into the control of blood pressure.

And then, you get to a good point where you have some flexibility. You're exercising regularly. You've lost some weight. You're limiting your sodium. Your blood pressure readings have come down significantly. And then, you can even start to play around with that, add a little more healthy fats, add a little bit more fish, whatever you want to get a little bit more flexible with. But that's where you can play around with it and be educated on the DASH diet, as well as the Mediterranean diet or, even better yet, meeting with a registered dietitian to help you navigate through the next steps.

John Horton:

How quickly do people typically see results? I mean, we're very much in a results-oriented world, and I think people want to see it instantly.

Julia Zumpano:

Yeah. I think that one to two weeks, if you do follow this for one to two weeks and you do check your blood pressure, I am pretty guaranteed you'll see some results.

John Horton:

Wow.

Julia Zumpano:

Yeah.

John Horton:

I mean, but then, you got to stay on. I take it then if you revert back to the way you were eating, it's going to go right back into that trouble zone.

Julia Zumpano:

Exactly. It's like your weight. Yeah. You follow a plan for a couple weeks, you lose a couple pounds, you go back to your normal eating habits. You're just going to regain it back. So it's consistency.

John Horton:

Yeah, I think we've all been there a few times. All right. So I guess final thoughts to wrap everything up here with the DASH diet. If people are looking at it, yes, no, or what should they know going into it?

Julia Zumpano:

So biggest thing is knowing how ... it is a very controlled diet. So it has strict targets, specific serving sizes. I think I mentioned the 2,000-calorie plan, but there are other plans available based on your caloric value. So it starts at 1,200 calories, allows for a 14 to 1,600-calorie plan, 18 to 2,000. And then for those who have greater needs, 2,600 calories. So it does provide a lot of great plans, so just figuring out what the appropriate caloric value is for you is the first step. So doing an estimated needs, trying to find out what your calorie needs are, and then following the appropriate caloric plan for you.

John Horton:

And then, just work through it, take your blood pressure, see if you're getting results. And then, it sounds like there's always some room to maneuver within it and you can make some adjustments. You don't necessarily have to feel like you got to follow the plan step by step exactly. You can make some adjustments to fit your lifestyle also.

Julia Zumpano:

You can. It may be best off if you follow it strictly for the first couple weeks, just so you really understand the reasoning behind it, so you understand the low sodium, the higher potassium, the higher plant-based, the lower protein. The reasoning behind all of that is to produce this benefit, this outcome of lowering your blood pressure.

So if you are following it without supervision of a registered dietitian or a healthcare provider, it would be great if you could at least commit to two weeks of following it strictly as associated with the caloric value.

So you have to look at the serving sizes and try to keep track of that. So I do recommend logging your food — whether you use an app or just in a notebook — keeping a food diary that will help keep you on track. Utilizing serving sizes — so looking at measuring cups and spoons and teaspoons, and even a food scale if you have that available, to really look at how much you're eating volume-wise. And try to follow it as strictly as you can for a couple weeks, and then kind of see what you like about the diet, what you find restricting with the diet, what you wish you could have more of, and then start to play around there.

John Horton:

Well, I think that's a really good way to sum up what the DASH diet is, kind of the dash version of learning the DASH diet. And sounds like just look at the plan, get it in place, and do your best and see what kind of results you get.

Julia Zumpano:

Absolutely.

John Horton:

All right. Well, Julia, it's always great talking to you, and it was really nice just being able to talk with you on this program and kind of work through a diet that I know we mention all the time.

Julia Zumpano:

Yeah, it was great chatting about it.

John Horton:

Well, if you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Until next time, eat well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.