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Research · Diets

DASH diet

Meta-analyses of randomized trials find the DASH diet lowers systolic blood pressure about 3 to 7 mmHg against control diets, more in people with hypertension and more again with less sodium. LDL cholesterol and weight fell slightly. Cohorts link it to less heart disease and diabetes. One feeding trial found HDL cholesterol fell 3.7 mg/dL.

Add to Bio HackChecked 2026-11-13
Status
A dietary pattern, not a regulated product.
Also called
Dietary Approaches to Stop Hypertension, DASH eating plan, DASH-Sodium, low-sodium DASH
Followed for
blood pressure, hypertension, cholesterol, heart health, weight loss, blood sugar, diabetes prevention

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

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Reported risks1

What people follow it for, and what was found

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Strong

Blood pressure

Shown to lower systolic blood pressure about 3 to 7 mmHg against control diets in adults, about 11 mmHg in people with hypertension in the original feeding trial.

Compared with control diets that were not DASH-like, otherwise not described [1]; control diets the source does not describe [2], [3]; a control diet low in fruits, vegetables and dairy, with fat typical of the US diet [4]; a control diet typical of US intake, eaten at high sodium [5]

The numbers and sources
Effect
In 30 RCTs (5,545 participants), DASH lowered systolic blood pressure by 3.2 mmHg (95% CI -4.2 to -2.3) and diastolic by 2.5 mmHg (95% CI -3.5 to -1.5), at moderate certainty. Hypertension status did not change the effect, and it was larger in trials with sodium above 2,400 mg a day and in people under 50 [1]. In 17 RCTs (2,561 participants), systolic fell 6.74 mmHg (95% CI -8.25 to -5.23) and diastolic 3.54 mmHg (95% CI -4.29 to -2.79) [2]. In 20 trials (1,917 participants), systolic fell 5.2 mmHg (95% CI -7.0 to -3.4) and diastolic 2.6 mmHg (95% CI -3.5 to -1.7) [3]. In the original 8-week feeding trial, DASH lowered blood pressure by 5.5/3.0 mmHg against a typical US control diet, 11.4/5.5 mmHg in 133 people with hypertension and 3.5/2.1 mmHg in 326 without [4]. In DASH-Sodium, DASH with low sodium gave systolic pressure 7.1 mmHg lower in people without hypertension and 11.5 mmHg lower in people with hypertension than the control diet with high sodium [5].
Population
Adults with and without hypertension in 30 trials [1], 17 trials [2] and 20 trials of 2 to 24 weeks [3]; 459 adults with systolic pressure under 160 mmHg and diastolic 80 to 95 mmHg [4]; 412 adults [5].
Sources
[1], [2], [3], [4], [5]
Caveats
Heterogeneity was high in [2] (I² 78.1% for systolic). Effect sizes differ about twofold between reviews. In the two NEJM feeding trials, all food was supplied and body weight was held steady, so they measure the diet eaten as written [4][5].
Moderate

LDL and total cholesterol

Shown to lower LDL cholesterol slightly in adults, by 0.10 mmol/L across trials and 0.28 mmol/L in the original feeding trial.

Compared with control diets the source does not describe [3]; the DASH trial's control diet [6]; usual, low-fat and low-antioxidant diets, behavioral programs alone and usual gestational diabetes care [7]

The numbers and sources
Effect
Across 20 trials, DASH lowered total cholesterol by 0.20 mmol/L (95% CI -0.31 to -0.10) and LDL by 0.10 mmol/L (95% CI -0.20 to -0.01) [3]. In the 8-week DASH feeding trial, total cholesterol fell 0.35 mmol/L (13.7 mg/dL) and LDL 0.28 mmol/L (10.7 mg/dL) against control, with no triglyceride change. LDL fell 11.2 mg/dL more in men than in women [6]. An umbrella review reported the same pooled figures as [3], with no effect on HDL or triglycerides [7].
Population
Adults in 20 trials of 2 to 24 weeks [3]; 436 adults with total cholesterol of 6.7 mmol/L or less, mean age 44.6, 60% African American [6].
Sources
[3], [6], [7]
Caveats
The umbrella review drew its lipid figures from the same meta-analysis, so the two are not independent [3][7]. The umbrella review rated most secondary outcomes very low to moderate certainty [7].
Moderate

Weight

Shown to lower weight about 1.4 kg more than control diets over 8 to 24 weeks in adults, more in people with overweight or obesity.

Compared with weight-loss, low-fat and usual diets, behavioral programs alone, general heart-failure advice and standard low-sodium blood pressure advice [7]; typical Western or usual diets and other low-energy diets [8]

The numbers and sources
Effect
In 10 trials, adults on DASH lost 1.42 kg more than controls (95% CI -2.03 to -0.82) over 8 to 24 weeks, with BMI down 0.42 and waist down 1.05 cm. Lower-calorie DASH lost more than other low-calorie diets [8]. An umbrella review reported the same weight figure [7].
Population
Adults in 13 trials, with larger effects in those with overweight or obesity [8].
Sources
[7], [8]
Caveats
One meta-analysis supplies the figure, which the umbrella review repeated [7][8]. Trials were short.
Limited

Blood sugar

Small trials found HbA1c fell about 0.5 points. Pooled trials found no change in fasting glucose.

Compared with usual diets, and for fasting glucose also low-antioxidant and weight-loss diets, behavioral programs alone and usual gestational diabetes care [7]

The numbers and sources
Effect
A meta-analysis of 2 controlled trials (65 participants) found HbA1c fell 0.53 points (95% CI -0.62 to -0.43). Fasting insulin fell slightly, and fasting glucose and insulin resistance did not change [7].
Population
Adults with and without diabetes [7].
Sources
[7]
Caveats
Two small trials. Certainty ranged from very low to moderate across secondary outcomes [7].
Moderate

Heart disease, stroke and diabetes in cohorts

Linked to about 20% lower rates of cardiovascular disease, coronary heart disease, stroke and diabetes in cohort studies, at low certainty.

Compared with people who followed DASH less closely [7]

The numbers and sources
Effect
In 15 prospective cohorts (942,140 people), closer adherence to DASH was linked to lower cardiovascular disease (RR 0.80, 95% CI 0.76 to 0.85), coronary heart disease (RR 0.79), stroke (RR 0.81) and diabetes (RR 0.82, 95% CI 0.74 to 0.92) [7].
Population
Adults in prospective cohorts, observational [7].
Sources
[7]
Caveats
Observational. Certainty was low for cardiovascular disease incidence [7]. No trial of DASH has measured heart attacks or strokes.

How trials defined it

The original trial fed adults for 8 weeks a diet rich in fruits, vegetables and low-fat dairy foods, with less saturated and total fat, against a control diet low in fruits, vegetables and dairy with fat typical of the US diet. Sodium and body weight were held constant [4]. DASH-Sodium fed the DASH or control diet at high, intermediate and low sodium for 30 days each, with the low level below 100 mmol a day [5]. Later reviews describe the pattern as emphasizing fruit, vegetables, fat-free or low-fat dairy, whole grains, nuts and legumes, and limiting saturated fat, cholesterol, red and processed meats, sweets, added sugars, salt and sugar-sweetened drinks [7]. Trials in meta-analyses ran 2 to 24 weeks [3].

Risks

Mixed results1

LimitedHow often is not known

Lower HDL cholesterol

Mixed results: one feeding trial lowered HDL cholesterol 3.7 mg/dL, while pooled trials found no HDL change.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
In the 8-week DASH feeding trial, HDL fell 0.09 mmol/L (3.7 mg/dL) against control, more in people with higher starting HDL [6]. Pooled trials found no effect on HDL [7].
Population
436 adults [6]; adults in controlled trials [7].
Sources
[6], [7]
Caveats
The trial authors wrote that the effect of the HDL drop on heart risk needed further study [6].

Sources

  1. Filippou CD, Tsioufis CP, Thomopoulos CG, et al. 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. Advances in Nutrition. 2020. https://doi.org/10.1093/advances/nmaa041
  2. Saneei P, Salehi-Abargouei A, Esmaillzadeh A, et al. Influence of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure: a systematic review and meta-analysis on randomized controlled trials. Nutrition, Metabolism and Cardiovascular Diseases. 2014. https://doi.org/10.1016/j.numecd.2014.06.008
  3. Siervo M, Lara J, Chowdhury S, et al. Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. British Journal of Nutrition. 2015. https://doi.org/10.1017/S0007114514003341
  4. Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. New England Journal of Medicine. 1997. https://doi.org/10.1056/NEJM199704173361601
  5. Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. New England Journal of Medicine. 2001. https://doi.org/10.1056/NEJM200101043440101
  6. Obarzanek E, Sacks FM, Vollmer WM, et al. Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial. The American Journal of Clinical Nutrition. 2001. https://doi.org/10.1093/ajcn/74.1.80
  7. Chiavaroli L, Viguiliouk E, Nishi SK, et al. DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients. 2019. https://doi.org/10.3390/nu11020338
  8. Soltani S, Shirani F, Chitsazi MJ, et al. The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Obesity Reviews. 2016. https://doi.org/10.1111/obr.12391

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