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Is the DASH Diet Safe?
There is a great deal of confusion in the pro/anti-diet debate regarding those diets recommended for medical reasons. While most diets are intended for the user to lose weight or alter their body chemistry in some way, others are genuinely created with the intention of supporting individuals with their medical health. While diets in general encourage deprivation of some sort through limitation of certain foods, each dietary plan must be evaluated objectively to determine how the food and movement choices of that diet impact an individual’s physical and mental well-being.
What is the DASH Diet?
The DASH diet was created approximately 20 years ago with support from the National Institute of Health (NIH)’s National Heart, Lung, and Blood Institute (NHLBI). DASH is an acronym for “Dietary Approaches to Stop Hypertension.” The intention for the diet is to treat high blood pressure.
While we talk often about high or low blood pressure, many do not know what it means until their Doctor begins speaking with them about it. “Blood pressure is the amount of pressure that blood places against the walls of arteries. It will normally vary throughout the day but if it remains too high, this is called high blood pressure or hypertension. Untreated high blood pressure can lead to heart disease, stroke, congestive heart failure, kidney disease, and blindness .”
The DASH diet is a plant-focused diet that recommends:
- “Eating vegetables, fruits, and whole grains.
- Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils.
- Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils.
- Limiting sugar-sweetened beverages and sweets .”
Does the DASH Diet “Work?”
Before getting into the science, it is important to distinguish what we mean when we ask if a diet “works.” As mentioned above, the DASH diet is intended to support improved cardiovascular functioning. If research were to indicate it does this, we would objectively say that it “works.”
The challenge becomes when many people ask if a diet “works” but are asking about different results. Individuals asking if the DASH diet works to promote weight loss or body alteration are already considering using the diet for something other than what it is intended for.
As far as what the DASH diet was created to do, research does indicate it is effective.
The NIH specifically reports that “Compared to a standard diet, adults who follow DASH without altering sodium intake can lower their blood pressure within weeks. Study participants who reduced their sodium intake from 3,450 mg to 2,300 mg or less per day had even greater reductions in blood pressure .”
A study published in the Journal of American College in Cardiology found that “consuming a diet rich in fruits, vegetables, and low-fat dairy products, and reduced in saturated fat and cholesterol lowered systolic blood pressure (SBP) and diastolic blood pressure (DBP) .”
Additionally, “Adherence to the DASH-style pattern may also help prevent the development of diabetes .”
For those engaging in the DASH diet with the intention of weight loss, it does not “work.” According to a review completed by the Harvard School of Public Health, while the DASH diet reduced blood pressure effectively, it did not result in any weight changes .
The key in distinguishing these findings is the recognition that this diet does what it is intended to do yet should not be misused for body alteration purposes. It is when individuals engage in diets purely to lose weight or alter their natural bodies that they become dangerous.
DASH Diet & Eating Disorders
While effective in treating what it was created to treat, it cannot be denied that the DASH diet presents risks for development of eating disorder beliefs and behaviors.
This is true not only of the DASH diet but truly any diet that encourages restriction, which the DASH diet does. Restriction is considered any degree of control or rules being placed around what type of food and what amount an individual should put in their bodies.
Restrictive eating behaviors is present in almost all eating disorder diagnoses and is one of the largest risk factors for eating disorder development.
One study learned that “teenage girls who even moderately dieted had a five times higher risk of developing an eating disorder than those who did not diet; those who dieted at ‘a severe leve’” were 18 times more likely to develop an eating disorder .”
Many professionals do report that, of all the diets, the DASH diet is one of the more well-balanced in allowing all foods groups.
Even so, the question becomes “why is the individual engaging in the diet?” If they are approaching the diet from a disordered place with the intention of altering their bodies, it is dangerous. This is particularly true if the individual has a history of disordered eating.
If you or someone you love is considering exploring the DASH diet, it is best that they do so with consistent support of a medical professional. If this individual has a history of disordered eating, it is recommended they also engage in the DASH diet with the support of a therapeutic and dietary professional.
This multidisciplinary support will keep the individual accountable to making the best choices for their medical health without falling into harmful restrictive beliefs and behaviors that could lead to eating disorder development.
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Resources Unknown (2022). Diet review: DASH. Harvard T. H. Chan School of Public Health. Retrieved from https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/dash-diet/.  Unknown (2021). DASH eating plan. National Heart, Lung, and Blood Institute. Retrieved from https://www.nhlbi.nih.gov/education/dash-eating-plan.  Unknown (2021). NIH-supported DASH diet tops rankings for “heart healthy” and “healthy eating.” National Heart, Lung, and Blood Institute. Retrieved from https://www.nhlbi.nih.gov/news/2021/nih-supported-dash-diet-tops-rankings-heart-healthy-and-healthy-eating.  Juraschek, S. P. (2017). Effects of sodium reduction and the DASH diet in relation to baseline blood pressure. Journal of the American College of Cardiology, 70:23.  Bellefonds, C. (2019). Restrictive eating plans continue to dominate the health food landscape – where does that leave eating disorder survivors? Well and Good, Retrieved from https://www.wellandgood.com/eating-disorder-recovery-wellness-diets/.
Author: Margot Rittenhouse, MS, LPC, NCC
Page Last Reviewed by Jacquelyn Ekern, MS, LPC @ May 24, 2022