UNC Health Care

Comparing the DASH and the Mediterranean Diets

According to the CDC, hypertension (high blood pressure) affects 70 million Americans. It’s a condition which can lead to weakening of the arteries, stroke, and heart and kidney disease if is not controlled. High blood pressure is a measured blood pressure reading of 140/90 mm Hg or higher. Shockingly, one out of three American adults has prehypertension, which is blood pressure higher than normal between 120/80 to 140/89 mmHg. Many American do not have this condition under control, increasing their chances of developing hypertension.

The typical American diet of over processed foods and eating on-the-go affects one’s chances of developing hypertension. Research has shown that healthy lifestyle changes such as a low sodium diet high in whole grains, fruits and vegetables, along with moderate physical activity, can lower and prevent the development of these conditions. Here we will compare two of the most proven dietary approaches for preventing hypertension and improving ones dietary health, the DASH and Mediterranean diets.

DASH (Dietary Approaches to Stop Hypertension)

The DASH Diet was developed as a dietary approach to lower blood pressure without the use of medication and has been proven useful for weight loss. It reduces sodium consumption, and promoting an increased intake of fruits and vegetables, whole grains, fish, poultry and nuts. These foods provide an abundant source of nutrients such as potassium, calcium, and magnesium, which have lowering effects on blood pressure.

The Dash Diet plan was developed with everyone in mind, and it is a therapeutic meal plan that can be easily adapted for a lifetime of healthy eating. The overall goal of this dietary approach is to encourage lifestyle changes which promote healthy dietary behaviors. You can choose from two plans based on individual need. Version one allows for 2300 milligrams of sodium per day. The second is for 1500 mg of sodium per day and is promoted by the American Heart Association. It’s the recommended diet for adults 51 years of age or older, African Americans, or for those with hypertension, diabetes or chronic kidney disease.

Mediterranean Diet

In the 1970s, it was concluded in the landmark Seven Country Study that a so called ‘peasant diet’ consumed throughout the Mediterranean had a beneficial effect on heart health and other co-morbidities. It was determined that dietary fats, such as saturated fat, contributed to the development of heart disease. The traditional Mediterranean diet was introduced in 1993 by the Harvard School of Public Health and the World Health Organizations as a lifestyle change to be used as a prevention strategy for heart disease, in addition to hypertension, obesity, diabetes and other chronic diseases.

Like the Dash Diet, although its distinction includes the title of diet, the Mediterranean diet is a lifestyle change, which encompasses healthy eating patterns. It encourages eating more whole foods packed with nutrients and less of heavily processed and refined foods. Due to variations among countries throughout the Mediterranean, recommendations include multiple versions from the traditional plan to the new Mediterranean pyramid.

Side-by-Side Comparison

When looking at a side-by-side comparison of the Mediterranean diet compared to the DASH diet plans they vary slightly in whole grains, fruit and vegetable servings per day. However, the Mediterranean diet differs greatly in the amount of fish, lean meat, and sweets consumed. Red and processed meats come with the lowest serving recommendations per week of two or less, or in some cases, these meats are only recommended at one to two servings per month. In addition, two or more servings of fish, the use of olive oil in food preparation at each meal, and a daily serving of nuts are encouraged on a Mediterranean diet plan.

Benefits of Adherence to Either Diet

  • Reduces hypertension as much as seven to 12 points, over time.
  • Improves weight loss outcomes
  • Reduces hypertension by four points with every 10 pounds of weight loss.
  • Reduces primary and secondary cardiovascular risk
  • Reduces the inflammation response in the body
  • Helps lower risk for osteoporosis, cancer, heart disease, stroke and diabetes.

Take Home Message

Both the DASH and Mediterranean Diets promote healthy lifestyles, which includes both physical and nutritional health. If you have hypertension, talk with your doctor or a dietitian to explore your current diet and lifestyle.

Do your homework! There are many books and online resources for you to learn more about these diets and recipes.

Remember, when making a change to your diet, start with one behavior that you would be willing to change. Change should come gradually to allow for the behavioral modification to take place. For instance, you may have considered switching from white bread to whole grain breads. Give yourself a start date and an end point to reassess your ability to make this change. Ask yourself what barriers kept you from meeting your goal or expectation. More importantly, forgive yourself if and when set-backs occur, but analyze why the setback occurred and then continue where you left off.

For more information or if you are having trouble making dietary changes, make an appointment to talk to a registered dietitian. A dietitian can provide counseling and tips to help guide you on diet strategies and maintaining a healthy diet long-term.