DASH dietary pattern
Vegetables, fruit, whole grains, low-fat dairy, fish and legumes. The most solid non-drug lever on blood pressure.
Order of magnitude
The whole pattern, not single foods; the trials provided or closely supervised the food.
The DASH effect on blood pressure is larger where baseline sodium intake is high, which means part of it overlaps with the sodium lever rather than adding to it.
Effects in detail
Each row is a directed edge from our database, with range, latency, evidence grade and the condition under which it applies at all.
| Marker | Effect | Latency | Mode of action | Outcome | Evidence | Condition | Sources |
|---|---|---|---|---|---|---|---|
| Systolic blood pressure | helps. Lowers -3.20 mmHg confidence interval of the estimate, not the range one person can expect Thirty randomised trials in 5545 adults give a systolic reduction of 3.2 mmHg (95 % CI -4.2 to -2.3) and a diastolic reduction of 2.5 mmHg with the DASH diet, at GRADE moderate certainty. The overlap with sodium reduction is the reason this is not simply additive with the sodium lever. | not specified | chronic | unclear | Evidence grade A | applies regardless of the starting value | |
| Diastolic blood pressure | helps. Lowers -2.50 mmHg confidence interval of the estimate, not the range one person can expect Thirty randomised trials in 5545 adults give a systolic reduction of 3.2 mmHg (95 % CI -4.2 to -2.3) and a diastolic reduction of 2.5 mmHg with the DASH diet, at GRADE moderate certainty. The overlap with sodium reduction is the reason this is not simply additive with the sodium lever. | not specified | chronic | unclear | Evidence grade A | applies regardless of the starting value |
What this measure costs
Counteracting effects of the same measure.
No counteracting effect is on file for this measure. That does not mean there is none, only that we found no defensible edge.
Moves without implying progress
Informational or no established effect: the marker moves or was checked, and that is not progress.
| Marker | Effect | Latency | Mode of action | Outcome | Evidence | Condition | Sources |
|---|---|---|---|---|---|---|---|
| high-sensitivity CRP | checked, nothing happens. No established effect In a meta-analysis of 22 randomised trials of dietary patterns, no substantial effect on inflammatory biomarkers was observed for DASH. A deliberate no-effect row, and a weak one: 'no substantial effect' across a small number of DASH trials is an absence of demonstrated effect, not a demonstration of absence. | not specified | chronic | unclear | Evidence grade C | applies regardless of the starting value | |
| Uric acid | checked, nothing happens. No established effect confidence interval of the estimate, not the range one person can expect In a randomised feeding trial in 55 adults with hypertension, the DASH diet changed serum urate by -0.05 mg/dL (95 % CI -0.39 to +0.28) overall, and by -0.33 mg/dL (95 % CI -0.87 to +0.21) in those with baseline hyperuricaemia, with a significant interaction between the two groups (p = 0.007). Entered as 'none' because that is what the overall estimate says, with the subgroup signal recorded in the summary. | 4–4 weeks | chronic | unclear | Evidence grade C | applies regardless of the starting value |
Sources
Full details of every study the rows above rely on.
Effects of the DASH diet and losartan on serum urate among adults with hypertension: Results of a randomized trial
Castilla-Ojo et al. · Journal of Clinical Hypertension · 2023 · Randomised trial
Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Filippou et al. · Advances in Nutrition · 2020 · Meta-analysis
Effect of dose and duration of reduction in dietary sodium on blood pressure levels: systematic review and meta-analysis of randomised trials
Huang et al. · BMJ · 2020 · Meta-analysis
Effects of Dietary Patterns on Biomarkers of Inflammation and Immune Responses: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Koelman et al. · Advances in Nutrition · 2022 · Meta-analysis