The Mediterranean DASH

March 17, 2015 in General, Health, Health Claims, Mediterranean by Joyce Bunderson

The Mediterranean DASH, it sounds like some kind of a race or a dance. Right? But, of course, I’m writing about eating styles. What I’m addressing today is the question in many persons’ minds; which way should I go to eat in a healthy way? I’ve written quite a bit about the Mediterranean-style of eating, but haven’t really touched much on the DASH (Dietary Approaches to Stop Hypertension) style of eating. So let me see if we can shrink down your decision to a relatively small list of points to consider.

First, I’d like to write a few words about why this issue matters. Problems with hypertension (high blood pressure) are common – about one out of three adults have hypertension and only about half of them have their blood pressure under control. So if you want to translate that to numbers of people, that would be about 17 persons out of every 100 adults do not have their blood pressure under control. Why do we care? We care because hypertension raises the risk of strokes, heart attacks, dementia, kidney disease, and other problems.

The Mediterranean diet and the DASH diet both reduce blood pressure; but different mechanisms are involved. I’d like to share a few facts to help you walk away with the benefits of both eating styles.

To begin with, you may want to review a study published in The American Journal of Clinical Nutrition. That well-done research found that not only did the Mediterranean diet reduce blood pressure, but it also reduced cardiovascular mortality. The researchers were especially looking at the effects of olive oil and found it to be an effective agent to support reduction in blood pressure. In addition, to olive oil they found fruits and vegetables to be significantly inversely associated with both systolic and diastolic blood pressure. I don’t want to forget to mention that this study also found a positive association with arterial blood pressure with cereals, meat and meat products, and alcohol. This study had a large sample size and was very well controlled for bias. They did not ascertain the effects of salt intake, however.

Both eating styles are designed to promote a long-term change in eating, rather than a fad or short-term routine. I am convinced that this is the most effective way to manage weight. Of course, most people are painfully familiar with the experience of regaining weight soon after they stop their diet. These eating styles are designed to be a lifestyle change, not a start-and-stop diet. Either of these two would take effort to change from the western/American eating style to the Mediterranean Diet (MD) or the DASH diet (DD), but it is certainly worth the effort in potential health benefits. Keep in mind that using the term “Diet” with these two is in the sense of a Life-Style change, not a start-and-stop diet.

Both the MD and the DD embrace a plentiful intake of fruits, vegetables, nuts/beans/seeds, and heart healthy fats. Unsaturated fats are strongly encouraged, even as saturated fats, high sugar products and empty calories are discouraged. Neither style of eating involves counting calories. The MD includes whole grains, fish, limited amounts of poultry, red meat, and dairy (mostly cultured, like yogurt and/or cheese products). One of the most important issues here is what the MD is NOT. It is not what is being served at the typical American Italian restaurant. When pasta is served, for example, it should be whole grain pasta or bread. The DD includes more dairy than the MD; and it’s low-fat and nonfat dairy. The DD uses moderate amounts of lean meat/fish/poultry.

So the main difference between the two eating styles is that the MD allows higher amounts of heart healthy fat (olive oil). It’s helpful to know that the new DD is based on newer DASH research, and is now more similar to the MD. The new DD draws close to the MD by reducing refined starchy foods and added-sugar foods. The fact is that the new DD can improve blood pressure even better than the original DD. The DD is much more specifically controlled for sodium, than the MD, as the MD offers no guidelines for salt. There are two main versions of the DD; one allows up to 2300mg of sodium and the other is down to only 1500mg – which is prescribed more for those with hypertension or pre-hypertension. Both eating styles allow up to two standard alcoholic drinks per day for men and one or less for women.

Both diets have been successfully used for weight loss. The DD is generally a little lower in calories and may be more helpful in weight loss (less high calorie oil). In addition, it is lower in sodium so may be more suited to those at risk of high blood pressure. The MD may be a wise approach for those at risk of heart disease. Both eating styles are however, excellent.

If you decide that you want to benefit from both eating styles, choose either (or speak to your healthcare provider to help you choose) and then moderate it to have the benefits of both.

  1. If you choose the DD plan, when using oil choose extra virgin olive oil as your regular cooking oil. When you want a little higher smoke point, use peanut or canola oil. The extra virgin olive oil of the MD, will add additional calories, if too much olive oil is used. But it also has the heart protective feature of the high level of cholesterol lowering fatty acids and antioxidants of the olive oil. So the advice is to use the extra virgin olive oil moderately.
  1. Do pay attention to sodium. Low sodium intake allows stiff arteries to expand. The super good news is that a low sodium diet restores the normal functioning of arteries even if they are stiff with age. If you’ve read a 2013 study that raised fears that the too little salt raises the risk of heart attacks and strokes – forget it. The research was based upon an observational study; people were not randomly assigned to groups with different sodium levels – resulting in design problems. One of the worse problems of that particular study was reverse causation, “meaning that the disease caused the low sodium intake, not the other way around.” The bottom line is that there is no increased risk of heart attacks or strokes at lower sodium intakes.
  1. The DD allows more red meat than the MD. There is quite a bit of excellent research evidence that red meat should not be consumed with wild abandon, or anything close to it. I personally, choose to eat red meat sparingly, and especially processed meat – very infrequently.
  1. The MD encourages greater intake of fish and seafood. There is the benefit of eating seafood and science doesn’t really know if it is the omega 3’s or some other factor of the fish. It’s a good goal to include seafood in your eating plan. Certainly, if you’re a vegan, a healthy vegan eating lots of veggies, you’re getting quite a lot of omega 3’s from your additional vegetables; if the omega 3’s are what’s important about fish consumption.

Whether you choose MD or DD, either way you’re making great progress in reducing risk of serious health problems. Both eating styles can be delicious and thus, easier to maintain for the long term. So I encourage you to do the Mediterranean DASH, to help keep your body, arteries and blood pressure healthy.