DASH Works Better with Exercise and Weight Loss

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Written By Judy Doherty, MPS, PCII

 Salt reduction is essential for preventing and lowering elevated blood pressure (BP) and reducing CVD risk it. However, weight loss and a healthier DASH-diet are also important for lowering elevated BP. A study of 144 free-living overweight and obese subjects with elevated BP compared the impact of the DASH diet alone (DASH-A) or combined with exercise and weight loss (DASH-WM) with a control group that were advised not to change their diet or lose weight (UC). The subjects had an initial systolic BP = 130-159mmHg and a diastolic BP = 85-99mmHg but none were taking or started on BP-drugs during the 4 month study period. The DASH diet used in this study only reduced sodium to about 1.2mg sodium/kcal and the urinary sodium excretion data indicated dietary sodium intake was only reduced about 14% in the DASHA group and 21% in the DASH -WM group compared to the UC group that maintained their normal diet. The DASH-WM group was instructed to reduce their energy intake by about 500kcal/day. DASH-WM lowered BP significantly by 16.1/9.9mmHg over 4 months while the DASH-A group also experienced a significant BP reduction of 11.2/7.5mmHg on average. By contrast, the UC group experienced an average BP reduction of only 3.4/3.8mmHg after 4 months. 1 In addition to significant reductions in BP in the two DASH diet groups compared to the UC group this study also demonstrated that left ventricular hypertrophy (LVH) was significantly reduced in both DASH groups albeit more in the DASH-WH than the DASH-A. This is important as LVH is the single greatest risk factor for heart disease. LVH develops in part due to stiffened arteries. Pulse wave velocity (a measure of artery stiffness) was reduced significantly in both DASH diet groups compared to the control group albeit more so in the DASH-WM. The reduction in BP seen in this study was comparable to that seen with a high dose of the best antihypertensive drugs. This study demonstrates that dietary counseling and exercise classes are as effective for lowering BP and reducing artery stiffness and LVH as drugs.

The authors note that despite the effectiveness of the diet and lifestyle interventions might be difficult to implement in clinical settings. True enough but is this not so in part because few health insurance (public and private) currently pay for even a single dietary consult or even group classes for people who are overweight and have hypertension? Nor will most health insurance pay for exercise classes or a personal trainer. There is something fundamentally wrong with a healthcare system that pays billions for medical doctor office visits and billions more dollars for drugs to treat hypertension but pays next to nothing for dietary counseling or exercise classes so patients can learn how to reverse their own disease with a healthy diet and exercise program.
By James J. Kenney, PhD, RD, FACN?
1. Blumenthal J. et al. Arch Intern Med 2010;170:126-35
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Judy Doherty, MPS, PCII

Judy’s passion for cooking began with helping her grandmother make raisin oatmeal for breakfast. From there, she earned her first food service job at 15, was accepted to the world-famous Culinary Institute of America at 18 (where she graduated second in her class), and went on to the Fachschule Richemont in Switzerland, where she focused on pastry arts and baking. After a decade in food service for Hyatt Hotels, Judy launched Food and Health Communications to focus on flavor and health. She graduated with Summa Cum Laude distinction from Johnson and Wales University with a BS in Culinary Arts, holds a master’s degree in Food Business from the Culinary Institute of America, two art certificates from UC Berkeley Extension, and runs a food photography & motion studio where her love is creating fun recipes and content.

Judy received The Culinary Institute of America’s Pro Chef II certification, the American Culinary Federation Bronze Medal, Gold Medal, and ACF Chef of the Year. Her enthusiasm for eating nutritiously and deliciously leads her to constantly innovate and use the latest nutritional science and Dietary Guidelines to guide her creativity, from putting new twists on fajitas to adapting Italian brownies to include ingredients like toasted nuts and cooked honey. Judy’s publishing company, Food and Health Communications, is dedicated to her vision that everyone can make food that tastes as good as it is for you.

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