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Fall 2011 Table of Contents

U.S. News & World Report:
DASH Diet Number One

Plan created by MED prof tops magazine’s list

| From Commonwealth | By Rich Barlow

DASH’s key insight is that a nutritional diet can reduce high blood pressure, just as losing weight and cutting your salt intake can.

Want the inside scoop on dieting? Ask BU’s Thomas Moore. The Medical Campus associate provost helped create the best diet plan going, according to U.S. News & World Report.

DASH (Dietary Approaches to Stop Hypertension) topped 19 other diet plans in the magazine’s “Best Diets Overall” category, beating out such popular plans as Atkins, Jenny Craig, and Slim-Fast. The accolade is notable for two reasons: DASH hasn’t been commercially marketed like those other plans—you don’t see it at halftime during football games, notes Moore, a School of Medicine professor. And it wasn’t even designed to shrink waistlines. Rather, it’s a doctor-devised regimen to help people lower high blood pressure.

Several studies have confirmed DASH’s calorie-cutting potential, including one by Boston Medical Center researchers who looked at adolescent girls using the diet. The plan was devised in the 1990s in a multi–medical center trial led by Moore, who was a Brigham and Women’s Hospital researcher at the time. Since then, it has anchored a BU-developed weight reduction regimen offered free to University employees. Moore says several companies, including CVS, offer DASH to workers.

The benefits of DASH, which is similar to the Mediterranean diet, won’t surprise followers of nutrition news. The diet stresses fruits, vegetables, and whole grains and avoids high-fat dairy products and high-sugar foods. Cutting salt intake enhances the diet’s potency. DASH’s key insight is that a nutritional diet can reduce high blood pressure, just as losing weight and cutting your salt intake can. It also recommends exercise as a complement to the menu.

“DASH is really better known to the medical community,” says Moore. “To get it out in the lay press like this is always lots of fun,” not to mention great publicity: the day U.S. News announced its rankings, traffic to the DASH website jumped 20-fold, he says.

You Asked, We Answered
Readers took advantage of our invitation to ask Thomas Moore about the DASH diet. Here are some of those questions, along with Moore’s responses.

QHow does my age (66) and weight (115 lbs.) affect the amount of fiber I need and can handle? Please be as specific as you can about the number of fruit servings and vegetable servings. Second question: How much dairy? Is an 8-ounce milk serving equal to the same amount of Greek-style yogurt? I have been trying this diet for years, but now am wondering if I should cut back on the amount of fiber that I eat. — Alice (SED’68)

A The DASH diet provides around 25-30 grams of fiber per day. This is a good deal more than the average American typically eats. I know of no reason why being 66 years old or weighing 115 pounds would affect how you digest fiber. If you have some specific digestive problem, probably talking to your physician would be the place to start. Yes, in DASH servings, 8 ounces of milk is equivalent to 8 ounces of yogurt. Both are one DASH serving. Depending on whether the milk is nonfat milk or whole milk, the number of calories in a serving of dairy in DASH can vary.

If you are interested in cutting back on your fiber while still meeting the recommended number of DASH servings in each food group, you could do that by selecting lower fiber varieties within each food group. For example, a medium apple contains about 4 grams of fiber, while a similar-sized orange contains about 2 grams.

In terms of specific numbers of servings of fruits and vegetables for you, I would suggest that you go to our website at dashforhealth.com and use our DASH diet calculator to learn the specific DASH recommendations for someone your age and size.

Q The New England Journal of Medicine indicated that there is little good evidence for dairy intake in the diet. As a person with lactose intolerance, can I skip dairy intake in my close adherence to the DASH diet? — A.R. (SED’68)

A We did not test, in our research studies, whether the DASH diet without dairy would offer the same benefits. So I cannot specifically comment on how a dairy-free DASH diet would work.

Many people with lactose intolerance can tolerate the recommended servings of dairy in DASH by using Lactaid or Lactaid-enriched dairy products. I should add that in the original DASH studies, a number of the subjects who volunteered for the study reported that they had lactose intolerance, but they were able to tolerate the dairy foods we gave them without problem.

Q How does DASH compare with the low-carb diet (refer to The Primal Blueprint by Mark Sisson), which says fat is better than carb, and it is the carb that causes the insulin spike? Also animal fat/coconut is good/OK for you and nuts everyday are fine. Look forward to your opinion and a comparison to DASH. — Arun Chaddha

A A formal comparison of the DASH diet to a low-carb diet is beyond the space available here. One of the differences between the DASH diet and a typical American diet in terms of carbohydrate is that the DASH diet recommends emphasizing complex carbohydrates instead of simple sugars. Complex carbohydrates take longer to digest in the intestinal tract and so don’t cause the same kind of spike in blood sugar as foods containing simple sugar. So, although the DASH diet does include carbohydrates, they are a type of carbohydrate that does not cause wide swings in blood sugar.

One of the problems with a very low-carb diet is that people have found it difficult to stick with for a long time because it is quite restrictive. More balanced diets like DASH offer a variety of foods in a variety of food groups, and so that variety alone makes the diet more palatable and easier to adhere to.

Q I have used the Dash diet with much success. Even when I casually watch the fundamentals, I’m OK. However, I do worry about the amount of milk (and other dairy) I’m consuming. A recent Chinese scientist notes the dangers of too much dairy in a recent book. Please comment. — Josephine Fogarty

A There is a lot of debate in the scientific literature about the importance of dairy foods. Some studies have suggested that a dairy-free diet is compatible with good health. However, we did not test the DASH diet without dairy, and so I can’t comment on whether that type of a diet would provide the same benefits.

Q I am a triple Terrier who had a heart attack and stent about five years ago. I am 59 years old, 5'10", 220 pounds, and have high blood pressure. I am interested in learning more about the DASH diet and would like to start on it right away, especially before the holiday season begins. Is there any direction or guidance you can give me, to help me get started on the Dash diet? — Richard A. Pacia (COM’74,’75, LAW’80)

A You can do a Google search on “DASH diet” and get information from the website of the National Heart, Lung, and Blood Institute, which you will find as one of the very first search responses. I have also written a book about the DASH diet. You can learn more about that by going to amazon.com and doing a search on DASH diet. Finally, we offer a formal program to teach people the DASH diet on the internet. Go to dashforhealth.com to learn more about that.

Q I am vegan. Is there an adaptation of the DASH diet for me? Is dairy an integral part? — Carol Sakala (UNI’93)

A The DASH diet is not really consistent with a vegan eating pattern because it includes dairy, eggs, and meat/fish/poultry. An ovo-lacto vegetarian eating pattern can be consistent with DASH. There are ways that one can substitute various other protein sources for the meat/fish/poultry in DASH. We offer formal vegetarian meal plans as part of our online DASH program at dashforhealth.com. We have a new book that will be published by Free Press in May 2012. That book will offer 7-day vegetarian meal plans that are consistent with the DASH diet.

Please note: the question and answer period has now ended.

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On 7 January 2012 at 7:07 PM, Bert E. Mason (MED/BUSM '77) wrote:

Which diet had the greatest weight lost whether the healthiest or not!

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