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The DASH Eating Plan: The DASH Eating Plan: Moving Beyond Moving Beyond HypertensionHypertension

Natalie Webb, MS, RD, LDNatalie Webb, MS, RD, LD

nawebb@erols.comnawebb@erols.com

301301--704704--17561756

DASH Diet 101

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DASH Eating Plan• Emphasizes nutrient-rich low-fat dairy products, fruits and

vegetables

• Consistent with the 2005 Dietary Guidelines

• Provides nutrients of concern: calcium, potassium, fiber and magnesium, as well as vitamins A, C and E.

• Positive approach - focused on what to include, not what to avoid

33U.S. Department of Health and Human Services. Your Guide to Lowering Your Blood Pressure with DASH. 2nd Edition, April 2006

DASH Eating PlanDASH Eating Planbased on a 2,000 calorie dietbased on a 2,000 calorie diet

U.S. Department of Health and Human Services. Your Guide to Lowering Your Blood Pressure with DASH. 2nd Edition, April 2006

Food GroupFood Group Daily ServingsDaily Servings

GrainsGrains 66--88

VegetablesVegetables 44--55

FruitsFruits 44--55

LowLow--fat or fatfat or fat--free dairy products 2free dairy products 2--33

Meats, poultry, fishMeats, poultry, fish 6 or less6 or less

Nuts, seeds, dry beans Nuts, seeds, dry beans and peasand peas 44--5/week5/week

Fats and oilsFats and oils 22--33

SweetsSweets 5 or less/week5 or less/week

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How Are Americans Doing?How Are Americans Doing?

What We Eat in America, NHANES 2001-2002, 2005-2006: Usual Nutrient Intakes from Food Compared to Dietary Reference Intakes;http://www.ars.usda.gov/foodsurvey

Fruits/Vegetables:Fruits/Vegetables:

DASH recommendation DASH recommendation 88--1010 daily daily

servingsservings

American average American average 3.043.04 daily servingsdaily servings

Milk Group FoodsMilk Group Foods

DASH recommendationDASH recommendation 3.003.00 daily servingsdaily servings

American average American average 1.71.7 daily servingsdaily servings

Calcium IntakeCalcium Intake

DASH trial DASH trial 1250mg1250mgdailydaily

American average American average 970mg 970mg dailydaily 55

Dietitian Dietitian DASHesDASHes to Good Healthto Good Health

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PUTTING DASH INTO PUTTING DASH INTO PRACTICEPRACTICE

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DC Fire and EMSDC Fire and EMS

�� CardiacCardiac related* fatalities are related* fatalities are typically the #1 cause of death in typically the #1 cause of death in the line of dutythe line of duty

*Source: National Fire Protection Association Statistics

2006 Fitness Testing 2006 Fitness Testing Body Mass IndexBody Mass Index

24

25

26

27

28

29

30

31

32

20-29 30-39 40-49 50-59 All

Male

Female

< 25Normal Weight

25-30Overweight

> 30 Obese

2006 Fitness Testing 2006 Fitness Testing Systolic Blood PressureSystolic Blood Pressure

110

115

120

125

130

135

140

20-29 30-39 40-49 50-59 All

Male

Female

563 participants: 499 males, 64 females

2006 Fitness Testing 2006 Fitness Testing Diastolic Blood PressureDiastolic Blood Pressure

65

70

75

80

85

90

95

20-29 30-39 40-49 50-59 All

Male

Female

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Fanning the Flames of Fanning the Flames of Food and FitnessFood and Fitness

�� Personal and Group Personal and Group fitness trainingfitness training

Fire House Culture Fire House Culture

�� BrotherhoodBrotherhood

–– Often male Often male dominateddominated

–– Eat together and Eat together and live as a familylive as a family

Fanning the Flames of Fanning the Flames of Food and FitnessFood and Fitness

�� NutritionNutrition

–– Training TableTraining Table

��Menu Planning: Menu Planning:

–– Taste goodTaste good

–– ConvenientConvenient

–– EconomicalEconomical

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DASH Tip

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Mix it up

Make pizza with reduced-fat cheese and vegetables.

Create a baked potato bar withvegetables for topping, beans,salsa, and cheese.

Sprinkle cheese on top of chili, soups and casseroles

DASH Tip

Prepare soups with low-fat milk instead of water.

Add extra fresh, canned or frozen

vegetables to prepared soups.

Super soups

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DC Fire and EMSDC Fire and EMS

�� Next StepsNext Steps

–– FirehousesFirehouses

�� Training TablesTraining Tables

�� Supermarket ToursSupermarket Tours

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The mission of AAHP is to eliminate health disparities and improve the number and quality of years of life for African Americans and people of African descent in Montgomery County Maryland.

African Americans make up 17% of Montgomery County’s population but over 40% of hospital discharges related to diabetes and cardiovascular disease.

CURRENT PROGRAMS AND SERVICES INCLUDE:

•Diabetes self-management classes

•Diabetes dining club

Diabetes SelfDiabetes Self--Management classesManagement classes

�� Four class seriesFour class series

��Tips and tools to Tips and tools to manage diabetesmanage diabetes

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Diabetes SelfDiabetes Self--Management classesManagement classes

�� ScreeningScreening

��Hemoglobin A1CHemoglobin A1C

��Blood pressureBlood pressure

Diabetes SelfDiabetes Self--Management classesManagement classes

�� Healthy meals and recipes providedHealthy meals and recipes provided

�� Chef/RD recipe reviewChef/RD recipe review

DASH Tip

Get VeggiesTry new vegetables by serving them raw with low-fat yogurt dip, topping them with cheese or adding them to recipes.

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DASH Tip

Use lowUse low--fat milk in place of fat milk in place of water when cooking, especially water when cooking, especially with oatmeal, brown rice and with oatmeal, brown rice and wholewhole--grain pasta dishes.grain pasta dishes.

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Make substitutions

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The Diabetes Dining Club…

Monthly follow-up to classes

•Meal

•Education

•Physical Activity

MEAL FOCUS:

•Promotes diabetes and blood pressure management•Whole grains•Low-fat and fat-free dairy foods•Vegetables and fruit

Issue of LactoseIssue of Lactose

�� Combine dairy foods with Combine dairy foods with other foods other foods

�� Gradually increase Gradually increase amount amount

�� Try nonTry non--milk dairy foodsmilk dairy foods–– Cheeses Cheeses –– YogurtYogurt

�� PrePre--digest lactosedigest lactose–– LactoseLactose--reduced milkreduced milk–– Commercial lactase Commercial lactase

preparations (capsules, preparations (capsules, chewable tablets, solutions) chewable tablets, solutions)

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PGCC PGCC DASHesDASHes to Good to Good HealthHealth

�� Stimulating ClassesStimulating Classes

–– SelfSelf--Assessment ProjectAssessment Project

�� Community OutreachCommunity Outreach

–– Workshops/TVWorkshops/TV

�� TechnologyTechnology

–– Ask the DietitianAsk the Dietitian

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DASH Tip

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Start with BreakfastGet ahead of the game and

start your day with a

whole grain cereal,

fruit and low-fat milk

or yogurt.

DASH Tip

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Rethink your drinkMake low-fat and fat-free milkyour beverage of choice.

Serve low-fat plain or

flavored milk at meals.

Choose a skinny latteor milk steamer.

DASH Tip

Nourish your sweet toothTry low-fat chocolate milk for a nutrient-rich beverage break.

Feed your cravings with fresh or dried fruits or fruit filled gelatin.

Layer low-fat yogurt with granola and/or fruit for a sweet treat.

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Healthy RecipesHealthy Recipes

�� www.3aday.orgwww.3aday.org

�� www.fruitsandveggiesmorematters.orgwww.fruitsandveggiesmorematters.org

�� www.nhlbi.nih.gov/health/public/heartwww.nhlbi.nih.gov/health/public/heart/hbp/dash/recipes.html/hbp/dash/recipes.html

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Additional DASHResources

National Heart, Lung and Blood Institute:

www.nhlbi.nih.gov

American Heart Association:

www.americanheart.org

American Dietetic Association:

www.eatright.org

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Additional DASHResources

The DASH Diet Action Plan

By

Marla Heller, MS, RD

Product Market Place, booth #41

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Questions & AnswersQuestions & Answers