Wednesday, February 29, 2012

My favorite diet ideas including the DASH diet

My comments about the DASH diet

I have seen many diets come and go. Most of them confirmed my opinion that no one knows exactly 
what some one  else should or should not eat. Many of them left general concepts and principles that
have been useful . For example  I think we all agree that that eating a low salt, low saturated fat diet  
helps control  BP and lowers the risk for cardiovascular disease. Some of my favorite diet ideas are
 listed below.

Mediterranean Diet

I became a fan of the Mediterranean Diet
because of its simplicity and the evidence that it did reduce the risk for cardiovascular disease. It also
seemed like something I could actually do myself

Basic idea

The basic idea of  using  olive oil, eating beans daily, 3 fruits , 3 vegetables, a hand full of nuts , 2 cups 
of low fat dairy , 2 to 3 eggs a week and a glass of wine appealed to me. However I soon found that 
I was real good at eating the handful of nuts and fruit each day However I had problems eating the veggies 
 and I really don't care for wine .

"Most of the time"

 Despite my problems I did work on and have been able to follow the ideas most of the time
 "The most of the time "is another one of those concepts that has been useful. I like the 
90/10 rule high lighted in blue green below.

Lilly Diet sheets

Another idea that I have found useful is the Lilly diet sheet which put serving size into our own hands.
A fist is about 1 cup serving ( 30 gms.of carbs), the thumb is about a tablespoon , palm is a serving size 
of meat and the tip of a thumb is about 1 teaspoon. I also like the idea that this is a calorie self adjusting
 process. Big people have bigger hands and get a larger serving , Little people with smaller hands get 
smaller servings. A overweight person with small hands will get smaller servings and lose weight. The lilly 
hand idea promotes the basic concepts of controlling portion size and  consistent carbohydrate intake.

DASH diet

The Dash ( Dietary Approach to Stopping Hypertension )  Diet is relatively new . I generally thought is was 
just a low salt version of the Mediterranean diet. 
 My interest in this diet peaked after reading an article in
 Internal Medicine news Feb.1, 2012              Diet Reverses " 30 Years of Blood Pressure Aging" 

I have read numerous articles and attached some abstracts , head lines and ADA recommendations
below. I also went to the Dash Diet website and bought 3 months of their diet support. 

Tomorrow the reality of the Dash Diet and my first impressions of their program.

Have fun , Be Smart and Defeat Diabetes
David Calder, MD

Head Lines 
Diet Reverses " 30 Years of Blood Pressure Aging"
Internal Medicine News Feb. 1 , 2012

Dietary Approaches to Stop Hypertension  ( DASH ) Diet applicability and accetability to a UK population
   J.Human Nutr. Diet Feb 2010

Adherence to a DASH-Style Diet and risk of coronary heart disease and stroke in women
 Arch. Internal medicine 2008;168:(7):713-20

Copied from " Standards of Medical Care Diabetes- 2012 "  ADA position statement

Treatment strategies. Although there are no well-controlled studies of diet and exercise in the treatment of hypertension in individuals with diabetes, the Dietary Approaches to Stop Hypertension (DASH) study in nondiabetic individuals has shown antihypertensive effects similar to pharmacologic monotherapy. Lifestyle therapy consists of reducing sodium intake (to ,1,500 mg per day) and excess body weight; increasing consumption of fruits, vegetables (8–10 servings per day), and low-fat dairy products (2–3 servings per day); avoiding excessive alcohol consump- tion (no more than two servings per day in men and no more than one serving per day in women) (230); and increasing ac- tivity levels (219). These nonpharmaco- logical strategies may also positively affect glycemia and lipid control. Their effects on cardiovascular events have not been estab- lished. An initial trial of nonpharmacologic therapy may be reasonable in diabetic indi- viduals with mild hypertension (SBP 130– 139 mmHg or DBP 80–89 mmHg). If the blood pressure is 140 mmHg systolic and/or $90 mmHg diastolic at the time of diagnosis, pharmacologic therapy should be initiated along with nonpharma- cologic therapy (219). 

Maintaining a heart-healthy diet most of the time.

J Cardiovasc Nurs.  2010; 25(3):233-7 (ISSN: 1550-5049)

Christie C
Department of Nutrition & Dietetics, University of North Florida, Jacksonville, FL 32224, USA.
Changing dietary behavior is inherently difficult and even more so given the current obesity-promoting environment. Health professionals may facilitate this process for patients by assessing readiness to change, identifying personal priorities and barriers, and providing personalized knowledge, while increasing healthy-eating skills, motivation, and self-efficacy. It is also important to address the obesity-promoting environment through pubic policy as well as individual dietary change. Implementation of the American Heart Association diet and lifestyle recommendations is discussed along with barriers and recent assessment data. Patients may require assistance with interpretation of recommendations to their specific situations and practical application strategies considering their barriers and needs. One concept that may be helpful is a discussion that dietary change is not an end point but a process. Introducing patients to the 90-10 rule applied to food choices may help them conceptualize this process more easily. This idea revolves around the principle that what an individual does 90% of the time is most critical, and allowing some flexibility can make changing any lifestyle behavior more palatable and achievable.


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Your comments and questions are appreciated. David Calder,MD