Is the DASH diet the best diet for heart health?

VALLEY — The DASH (Dietary Approaches to Stop Hypertension) diet was developed by scientists at the National Institutes of Health specifically to reduce blood pressure, and has been extensively studied. Many physicians and experts recommend the DASH diet for reducing blood pressure and improving heart health. It emphasizes vegetables, fruits, and whole grains; it is low in saturated and trans fats; low in sodium; and rich in potassium, calcium, magnesium, fiber, and protein. While the DASH diet does help to reduce blood pressure, there is much room for improvement to make it a truly heart-healthy diet.

DASH diet guidelines:

* 4-5 servings/day of vegetables

* 4-5 servings/day of fruit

* Up to 6 ounces/day of meat, fish or poultry

* 2-3 servings/day of low-fat dairy

* 2-3 tablespoons/day of oil

* 4-5 servings/week of nuts, seeds and beans

* Up to 5 servings/week of sweets

The DASH diet is typically recommended to patients with heart disease or who have risk factors for heart disease. There is evidence from randomized controlled dietary intervention trials that the DASH diet helps to reduce blood pressure and LDL cholesterol. But are these reductions enough to offer significant protection against cardiovascular death? Compare the results of studies on the DASH diet to those in a recent study, which documented survey data and case histories the dramatic weight loss and cardiovascular benefits possible with a nutrient-dense, plant rich (Nutritarian) diet.

The DASH diet alone produced a weight loss of less than one pound in a four-month study; combined with calorie restriction and exercise, the average weight loss was 19 pounds. On a Nutritarian diet, after two years, respondents who started out obese had maintained an average weight loss of more than 50 pounds.

In people with high blood pressure, the DASH diet reduced systolic (top number) blood pressure by 6.82 mmHg and diastolic (bottom number) pressure by 3.59 mmHg. A lower sodium version of the DASH diet (1500 mg/day sodium) reduced systolic blood pressure by 11.5 mm Hg. Respondents with high blood pressure who followed a Nutritarian diet reduced systolic blood pressure by an average of 26 mm Hg  and 14.7 mmHg in diastolic blood pressure. These improvements in blood pressure on a Nutritarian diet led to 60 percent reduction in the use of blood pressure medications.

The DASH diet reduced total cholesterol by up to 14 mg/dl, and LDL by about 11 mg/dl, with no decrease in triglyceride levels. In comparison, on a Nutritarian diet, the average decrease in LDL cholesterol was 42 mg/dl, and there was an average 79.5 mg/dl decrease in triglycerides.

The DASH diet is an improvement for most Americans: more vegetables and fruits, fewer sweets, more whole grains, and a smaller amount of oil. However, the DASH diet does not emphasize nuts, seeds, and beans, which have profound and extensively researched benefits for cardiovascular health. In addition, it encourages consumption of too much animal products, including up to three servings of dairy daily. Nor does the DASH encourage eating leafy greens and cruciferous vegetables.

The DASH diet was designed to be acceptable to the average American, and this usually results in an overreliance on animal foods for a protein and fat source. The problem is – if you want big changes in health, you have to make sufficient changes in your diet. The Nutritarian diet is designed to maximize results and therefore utilizes green vegetables, beans, nuts, and other foods with documented protective effects making the Nutritarian diet the most effective, safest and healthiest way to eat.

There is now a significant amount of research documenting that heart disease is almost completely preventable (and reversible) with a diet rich in whole plant foods and low in processed foods and animal products.

In my book The End of Heart Disease, I devote an entire chapter to comparing my high-nutrient (Nutritarian) dietary guidelines to a number of diet plans, including the DASH diet, that are typically recommended for improving heart health. For those who desire reversal of high blood pressure, high cholesterol and dramatic reduction in plaque burden and protection from premature death—there is no equal. 

Dr. Fuhrman is a #1 New York Times best-selling author and a board certified family physician specializing in lifestyle and nutritional medicine. The Eat To Live Cookbook offers over 200 unique disease-fighting delicious recipes and his newest book, The End of Heart Disease, offers a detailed plan to prevent and reverse heart disease using a nutrient-dense, plant-rich eating style. Visit his informative website at Submit your questions and comments about this column directly to