DASH diet

• Lower blood pressure in people with elevated readings or hypertension, with or without medication.
• Prevent high blood pressure in people whose readings are creeping up.
• Reduce the long-term risk of heart attack, stroke and kidney disease that comes with high blood pressure.
• Improve LDL cholesterol, insulin sensitivity and weight as secondary effects.
• Give a flexible, family-friendly pattern of common foods rather than a restrictive diet.

The plan came out of a set of feeding trials funded by the US National Heart, Lung, and Blood Institute (NHLBI). In the first, published in 1997, researchers cooked every meal for 459 adults and kept salt and body weight constant, so that only the food pattern changed [1]. The pattern that won was called the combination diet. It became the DASH diet.

Three things make DASH different from most diets people search for:

• It was designed in a trial, not a kitchen. Its rules are servings per day at a given calorie level, tested against a typical American diet [18].
• It targets blood pressure first. Weight loss, cholesterol and blood sugar are secondary effects, and smaller ones.
• It needs no special foods. NHLBI describes it as daily and weekly goals for food groups, not a list of banned items [18].

Who is the DASH diet for? It was tested in adults with blood pressure above optimal or stage 1 hypertension, both with and without medication [1] [12]. Current US guidance names DASH-style eating as one of the first-line treatments for high blood pressure, alongside weight management, sodium restriction, activity and less alcohol [19]. It is also a reasonable everyday pattern for people without high blood pressure, though the effect on their readings is smaller.

What it is not. DASH is not a weight loss diet, although it can be eaten at a lower calorie level. It is not low carbohydrate: the original menus were high in grains and fruit. And the first trial did not cut sodium at all; the low sodium version came later [20].

NHLBI publishes servings for seven calorie levels. The table shows four of them. A serving is small: 1 slice of bread, half a cup of cooked rice or pasta, 1 cup of raw leafy greens, 1 medium fruit, 1 cup of milk or yogurt, 1 ounce of cooked meat or fish, or 1 egg [18].

Foods to favor

• Whole grain bread, oatmeal, brown rice, unsalted popcorn.
• Broccoli, carrots, leafy greens, tomatoes, potatoes, sweet potatoes, beans and peas.
• Bananas, oranges, berries, melon, dried apricots and other fruit.
• Fat-free or low-fat milk, yogurt and reduced-fat cheese.
• Fish, skinless poultry and lean meat, broiled, roasted or poached.
• Almonds, walnuts, peanuts, sunflower seeds, lentils and kidney beans.
• Vegetable oils such as canola, olive and corn oil.

Foods to limit on the DASH diet

NHLBI asks people to limit fatty meats, full-fat dairy, coconut, palm and palm kernel oils, sugar-sweetened drinks and sweets, and to keep sodium to 2,300 mg a day, or 1,500 mg for a larger drop in blood pressure [18]. Most sodium comes from packaged and restaurant food such as bread, cold cuts, pizza, soups, sandwiches and cheese, not the salt shaker [21].

What AumniVIDA scores

The AumniVIDA DASH protocol scores three daily targets from logged meals: sodium at most 2,300 mg, potassium at least 3,500 mg and at least 500 g of fruit, berries and vegetables. It pairs them with home blood pressure readings, because the readings show whether the pattern is working for you.

The original DASH trial. After 8 weeks with sodium (about 3,000 mg a day) and weight held constant, the DASH diet lowered systolic and diastolic pressure by 5.5 and 3.0 mm Hg more than the control diet. A diet with extra fruit and vegetables alone did about half as much: 2.8 mm Hg systolic. In the 133 participants with hypertension the DASH effect was 11.4/5.5 mm Hg; in the 326 without, 3.5/2.1 mm Hg [1] [20].

DASH-Sodium. The next trial fed 412 adults either DASH or a control diet at three sodium levels for 30 days each: about 3,300, 2,300 and 1,500 mg a day [20]. Each step down in sodium lowered pressure on both diets. DASH at the low sodium level gave a systolic pressure 7.1 mm Hg lower in people without hypertension and 11.5 mm Hg lower in people with hypertension than the control diet at the high level [2].

Bigger effects at higher starting pressure. A reanalysis by baseline systolic pressure found that low sodium plus DASH lowered systolic pressure by 5.3 mm Hg in people starting under 130 mm Hg, 7.5 at 130 to 139, 9.7 at 140 to 149 and 20.8 at 150 mm Hg or higher [3]. That last figure is similar to what a blood pressure drug can do, but it comes from a small subgroup on fully provided meals.

Outside the feeding lab. When people buy and cook their own food, effects shrink. A meta-analysis of 30 trials with 5,545 adults found average reductions of 3.2 mm Hg systolic and 2.5 mm Hg diastolic [4]. An umbrella review put the systolic effect at 5.2 mm Hg [5].

How long before the DASH diet works?

Weeks, not months. In the DASH4D crossover trial, most of the blood pressure drop on each diet happened in the first 3 weeks [12]. Measure at home over several weeks and compare averages, not single readings.

• Sodium excretion. In DASH-Sodium participants, the DASH diet roughly doubled the slope of the pressure-natriuresis curve (from 29.5 to 64.9 mmol a day per mm Hg). The kidneys cleared sodium at a lower pressure, a natriuretic effect much like a mild diuretic [22].
• Potassium. Trials of extra potassium lower systolic pressure by 3.49 mm Hg on average and by 7.16 mm Hg when intake reaches 90 to 120 mmol a day, about 3,500 to 4,700 mg [23]. NHLBI designs DASH menus around 4,700 mg of potassium [21].
• The whole pattern. Fruit and vegetables alone produced about half the effect of full DASH in the first trial, so low-fat dairy, nuts and less saturated fat seem to add something [1].
• Heart strain. In DASH-Sodium, DASH lowered high-sensitivity troponin, a marker of heart muscle injury, by 18%, and sodium reduction lowered NT-proBNP, a marker of strain, by 19% [16].

One rat study is worth knowing about because it did not work: DASH-style nutrient profiles did not change blood pressure in normal or hypertensive rats over 8 weeks [24]. The human feeding trials, not animal work, are what the evidence rests on.

Sodium. The DASH-Sodium trial showed a dose response: 3,300 to 2,300 to 1,500 mg a day lowered pressure at each step [2] [20]. NHLBI therefore gives two limits, 2,300 mg and 1,500 mg [18]. Meta-analysis suggests DASH lowers systolic pressure more in people whose sodium stays above 2,400 mg, so the diet partly offsets a salty background [4].

Potassium. NHLBI menus aim for 4,700 mg of potassium a day [21]. Few people reach that. AumniVIDA's 3,500 mg target matches the lower end of the 90 to 120 mmol a day range where potassium trials found the largest drop [23]. Potatoes, yogurt, sweet potatoes, beans, bananas, oranges, tomato sauce and fish are rich sources [21].

Is there a debate about sodium?

Yes, about how low to go, not about whether DASH lowers blood pressure.

• The PURE cohort estimated sodium from a single morning urine sample in 101,945 people. Compared with 4.00 to 5.99 g of sodium a day, both more than 7 g and less than 3 g were linked to more deaths and cardiovascular events [25]. Critics of PURE note that one spot urine sample measures individual intake poorly, and sick people may eat less.
• James DiNicolantonio and colleagues argue that sodium restriction has not been shown to reduce cardiovascular events and that the body regulates sodium tightly enough to leave it alone [26].
• On the other side, a cluster-randomized trial in 20,995 older adults in rural China found that a salt substitute with 25% potassium chloride cut stroke by 14% and death by 12% [27]. The 2025 US guideline now includes potassium-based salt substitutes, with caution in severe kidney disease [19].

The randomized evidence favors less sodium and more potassium for blood pressure. Whether going below about 1,500 mg adds hard-outcome benefit is not settled.

Cholesterol. In the original trial, DASH lowered LDL cholesterol by 10.7 mg/dL (0.28 mmol/L)0.28 mmol/L (10.7 mg/dL) and total cholesterol by 13.7 mg/dL, but also lowered HDL by 3.7 mg/dL, with no change in triglycerides [8]. The 2025 Cochrane review found little to no effect on LDL cholesterol in longer trials [7]. In the OmniHeart trial, swapping about 10% of calories from carbohydrate to protein lowered LDL by a further 3.3 mg/dL [28]. For more on targets, see LDL cholesterol and triglycerides.

A higher-fat DASH. Swapping low-fat for full-fat dairy and cutting sugar lowered blood pressure as much as standard DASH and lowered triglycerides more, without a significant rise in LDL cholesterol, in a 36-person crossover trial [9].

Diabetes and blood sugar. DASH lowers fasting insulin, but in a meta-analysis its effects on fasting glucose and HOMA-IR were not significant [11]. An umbrella review found an HbA1c reduction of 0.53%, from only 2 small trials [5]. In adults with type 2 diabetes, a lower carbohydrate DASH4D diet with less sodium lowered systolic pressure by 4.6 mm Hg, mostly through sodium [12]. See HbA1c and fasting insulin.

Weight loss. A meta-analysis found 1.42 kg more weight loss over 8 to 24 weeks than control diets, more when DASH was eaten at a calorie deficit [13]. Combining DASH with exercise and weight loss lowered clinic blood pressure by 16.1/9.9 mm Hg, versus 11.2/7.5 mm Hg for DASH alone [14].

Uric acid and gout. DASH lowered serum uric acid by 0.35 mg/dL, and by 1.29 mg/dL in the few participants with high levels [17].

Cohorts. Among 88,517 US nurses followed for 24 years, women with the highest DASH-style scores had 24% lower coronary heart disease risk and 18% lower stroke risk than those with the lowest [6]. Pooled cohorts link DASH with 20% less cardiovascular disease, 21% less coronary disease and 19% less stroke, on low certainty evidence [5]. Each 5-point rise on a 40-point adherence score tracks with 5% lower all-cause mortality [10]. Cohorts cannot rule out that people who eat this way also exercise more and smoke less.

Trials. The 2025 Cochrane review found only 5 eligible trials, all in people without heart disease, lasting 16 weeks to 12 months. They recorded almost no heart attacks, strokes or deaths, so the effect on these outcomes remains unknown [7]. The closest proof of hard outcomes comes from salt substitution, not DASH itself [27].

The adherence problem. Only 19.4% of US adults with hypertension ate in line with DASH in 1999 to 2004, fewer than a decade earlier [29]. Even with free groceries and a dietitian, the blood pressure benefit in the GoFresh trial disappeared within 3 months of deliveries stopping [30]. DASH works while people eat it; staying on it is the hard part.

Read the Mediterranean diet page for its outcome trials, and the MIND diet page for the brain-focused hybrid of the two. The ketogenic diet page covers the low carbohydrate end. DASH and Mediterranean are close enough that you can combine them: the OmniHeart trial showed that a DASH-type diet with more unsaturated fat, mostly monounsaturated, lowered blood pressure a little more than the original [28].

What critics say about the DASH diet

• Low-fat dairy is not essential. Ronald Krauss's group found that full-fat dairy in a DASH diet lowered blood pressure just as well [9].
• Sodium targets may be too low. PURE investigators and James DiNicolantonio argue that very low sodium targets are not proven to cut events [25] [26].
• Hard outcomes are missing. Cochrane rates the trial evidence for events low to very low [7].
• Glycemic index adds little. Within a DASH-like diet, the OmniCarb trial found low glycemic index foods did not improve blood pressure or insulin resistance [20].

Supporters such as Lawrence Appel point out that cardiovascular and kidney risk rise steadily with blood pressure across its usual range, and that diet change can be the first treatment for stage 1 hypertension [31].

• Adding fruit and vegetables without cutting sodium, which leaves much of the blood pressure benefit on the table.
• Counting the salt shaker but missing sodium in bread, cheese, deli meat, soup, pizza and restaurant food.
• Judging the diet on one or two readings instead of weekly averages over a month or more.
• Assuming DASH alone will cause large weight loss without attention to calories.
• Stopping or changing blood pressure medication on your own after readings improve.
• Going straight from a low-fiber diet to 10 servings of produce and beans, which causes bloating.

• You have chronic kidney disease or take drugs that raise potassium, such as ACE inhibitors, ARBs, spironolactone or potassium-sparing diuretics: ask your clinician before raising potassium or using potassium-based salt substitutes.
• You take blood pressure medication: readings can fall within weeks, so measure at home and talk to your clinician about any dizziness or low readings.
• You have heart failure or another condition with a prescribed fluid or sodium target: follow that target.
• You take warfarin: a large rise in leafy green vegetables changes vitamin K intake, so keep it steady and tell your prescriber.
• You are pregnant, have an eating disorder or are on insulin or sulfonylureas: set up changes with your clinician or dietitian.

• Gas and bloating as fiber rises; build up fruit, vegetables and beans over a few weeks.
• Digestive upset from dairy in people with lactose intolerance; lactose-free milk or yogurt works.
• Light-headedness if blood pressure falls on top of medication.
• A small fall in HDL cholesterol in some people on the low-fat version.