10/22/2009 The DASH Eating Plan: Moving Beyond Hypertension Natalie Webb, MS, RD, LD [email protected] 301-704301-704-1756 DASH Diet 101 2 DASH Eating Plan • • • Emphasizes nutrient-rich low-fat dairy products, fruits and vegetables Consistent with the 2005 Dietary Guidelines Provides nutrients of concern: calcium, potassium, fiber and magnesium, as well as vitamins A, C and E. Positive approach - focused on what to include, not what to avoid DASH Eating Plan based on a 2,000 calorie diet Food Group Daily Servings Grains 6-8 Vegetables 4-5 Fruits 4-5 LowLow-fat or fat-free dairy products fat2 -3 2Meats, poultry, fish 6 or less Nuts, seeds, dry beans and peas 4-5/week Fats and oils 2-3 Sweets 5 or less/week 3 U.S. Department of Health and Human Services. Your Guide to Lowering Your Blood Pressure with DASH. 2nd Edition, April 2006 • U.S. Department of Health and Human Services. Your Guide to Lowering Your Blood Pressure with DASH. 2nd Edition, April 2006 4 1 10/22/2009 How Are Americans Doing? Fruits/Vegetables: DASH recommendation servings American average Milk Group Foods DASH recommendation American average Calcium Intake DASH trial daily American average 1250mg 970mg daily 5 8-10 daily 3.04 daily servings 3.00 daily servings 1.7 daily servings Dietitian DASHes to Good Health What We Eat in America, NHANES 2001-2002, 2005-2006: Usual Nutrient Intakes from Food Compared to Dietary Reference Intakes;http://www.ars.usda.gov/foodsurvey Medical Family Tree W R i J o l u s J l n a a i e m a J e m H M o s a i R n S W r c o R e W e u g h b s A o N e b r C e e b n a b o l l n r e t W b i W U v l t e r a P n f e t b l a b c W i b t W b l e W P e b e a b r P D b b t W b n a i b b e B a g M N K S b r l b r e o i r n a J b S t o e . r a y S G c i h t A F B e l e r h s u a r l a s e t r H t G n o f n e D r y h t r G d r & i C p S e h o a f a G e r t e o n a r o K n b C r d t o i e c o a D m e h d t k n ie H o n r n c a e t s r H e D s e b h D a i S e y H i i r e l o e t a y e D t r n r D l p d i S e d h D o t i e e t s i k s r h r d e t o d D a e k i s n e e s D D i d i i o e e n d d PUTTING DASH INTO PRACTICE 2 10/22/2009 DC Fire and EMS 32 31 30 29 28 2006 Fitness Testing Body Mass Index Male Female < 25 Normal Weight 25-30 Overweight > 30 Obese Cardiac related* fatalities are typically the #1 cause of death in the line of duty *Source: National Fire Protection Association Statistics 27 26 25 24 20-29 30-39 40-49 50-59 All 2006 Fitness Testing Systolic Blood Pressure 140 135 130 125 120 115 110 20-29 30-39 40-49 50-59 All Male Female 95 90 85 80 75 70 65 2006 Fitness Testing Diastolic Blood Pressure Male Female 20-29 30-39 40-49 50-59 All 563 participants: 499 males, 64 females 3 10/22/2009 Fanning the Flames of Food and Fitness Personal and Group fitness training Fire House Culture Brotherhood – Often male dominated – Eat together and live as a family Fanning the Flames of Food and Fitness Nutrition – Training Table Menu Planning: – Taste good – Convenient – Economical 4 10/22/2009 DASH Tip Mix it up Sprinkle cheese on top of chili, soups and casseroles Make pizza with reduced-fat cheese and vegetables. Create a baked potato bar with vegetables for topping, beans, salsa, and cheese. 17 DASH Tip Super soups Prepare soups with low-fat milk instead of water. Add extra fresh, canned or frozen vegetables to prepared soups. 77 DC Fire and EMS Next Steps – Firehouses Training Tables Supermarket Tours 5 10/22/2009 The mission of AAHP is to eliminate health disparities and improve the number and quality of years of life for African Americans and people of African descent in Montgomery County Maryland. African Americans make up 17% of Montgomery County’s population but over 40% of hospital discharges related to diabetes and cardiovascular disease. Diabetes SelfSelfManagement classes Four class series CURRENT PROGRAMS AND SERVICES INCLUDE: •Diabetes self-management classes •Diabetes dining club Tips and tools to manage diabetes 6 10/22/2009 Diabetes SelfSelfManagement classes Screening Hemoglobin A1C Blood pressure Diabetes SelfSelfManagement classes Healthy meals and recipes provided Chef/RD recipe review DASH Tip Get Veggies Try new vegetables by serving them raw with low-fat yogurt dip, topping them with cheese or adding them to recipes. 27 DASH Tip Make substitutions Use low-fat milk in place of lowwater when cooking, especially with oatmeal, brown rice and wholewhole-grain pasta dishes. 28 7 10/22/2009 The Diabetes Dining Club… Monthly follow-up to classes •Meal •Education •Physical Activity MEAL FOCUS: •Promotes diabetes and blood pressure management •Whole grains •Low-fat and fat-free dairy foods •Vegetables and fruit Issue of Lactose Combine dairy foods with other foods Gradually increase amount Try non-milk dairy foods non– Cheeses – Yogurt Pre-digest lactose Pre– Lactose-reduced milk Lactose– Commercial lactase preparations (capsules, chewable tablets, solutions) 8 10/22/2009 PGCC DASHes to Good Health Stimulating Classes – Self-Assessment Project Self- DASH Tip Start with Breakfast Get ahead of the game and start your day with a whole grain cereal, fruit and low-fat milk or yogurt. 33 34 Community Outreach – Workshops/TV Technology – Ask the Dietitian DASH Tip Rethink your drink Make low-fat and fat-free milk your beverage of choice. Serve low-fat plain or flavored milk at meals. Choose a skinny latte or milk steamer. 35 DASH Tip Nourish your sweet tooth Try low-fat chocolate milk for a nutrient-rich beverage break. Feed your cravings with fresh or dried fruits or fruit filled gelatin. Layer low-fat yogurt with granola and/or fruit for a sweet treat. 36 9 10/22/2009 Healthy Recipes www.3aday.org www.fruitsandveggiesmorematters.org www.nhlbi.nih.gov/health/public/heart /hbp/dash/recipes.html 37 Additional DASH Resources National Heart, Lung and Blood Institute: www.nhlbi.nih.gov American Heart Association: www.americanheart.org American Dietetic Association: www.eatright.org 38 Additional DASH Resources The DASH Diet Action Plan By Marla Heller, MS, RD Product Market Place, booth #41 Questions & Answers 39 10
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Presentation given by Natalie Webb, RD on Sunday, October 18 at American Dietetic Association Food Conference & Nutrition Expo in Denver, Colorado. Details can be found here: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/7540_15499_ENU_HTML.htm?timeid=5
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10/22/2009 The DASH Eating Plan: Moving Beyond Hypertension Natalie Webb, MS, RD, LD [email protected] 301-704301-704-1756 DASH Diet 101 2 DASH Eating Plan • • • Emphasizes nutrient-rich low-fat dairy products, fruits and vegetables Consistent with the 2005 Dietary Guidelines Provides nutrients of concern: calcium, potassium, fiber and magnesium, as well as vitamins A, C and E. Positive approach - focused on what to include, not what to avoid DASH Eating Plan based on a 2,000 calorie diet Food Group Daily Servings Grains 6-8 Vegetables 4-5 Fruits 4-5 LowLow-fat or fat-free dairy products fat2 -3 2Meats, poultry, fish 6 or less Nuts, seeds, dry beans and peas 4-5/week Fats and oils 2-3 Sweets 5 or less/week 3 U.S. Department of Health and Human Services. Your Guide to Lowering Your Blood Pressure with DASH. 2nd Edition, April 2006 • U.S. Department of Health and Human Services. Your Guide to Lowering Your Blood Pressure with DASH. 2nd Edition, April 2006 4 1 10/22/2009 How Are Americans Doing? Fruits/Vegetables: DASH recommendation servings American average Milk Group Foods DASH recommendation American average Calcium Intake DASH trial daily American average 1250mg 970mg daily 5 8-10 daily 3.04 daily servings 3.00 daily servings 1.7 daily servings Dietitian DASHes to Good Health What We Eat in America, NHANES 2001-2002, 2005-2006: Usual Nutrient Intakes from Food Compared to Dietary Reference Intakes;http://www.ars.usda.gov/foodsurvey Medical Family Tree W R i J o l u s J l n a a i e m a J e m H M o s a i R n S W r c o R e W e u g h b s A o N e b r C e e b n a b o l l n r e t W b i W U v l t e r a P n f e t b l a b c W i b t W b l e W P e b e a b r P D b b t W b n a i b b e B a g M N K S b r l b r e o i r n a J b S t o e . r a y S G c i h t A F B e l e r h s u a r l a s e t r H t G n o f n e D r y h t r G d r & i C p S e h o a f a G e r t e o n a r o K n b C r d t o i e c o a D m e h d t k n ie H o n r n c a e t s r H e D s e b h D a i S e y H i i r e l o e t a y e D t r n r D l p d i S e d h D o t i e e t s i k s r h r d e t o d D a e k i s n e e s D D i d i i o e e n d d PUTTING DASH INTO PRACTICE 2 10/22/2009 DC Fire and EMS 32 31 30 29 28 2006 Fitness Testing Body Mass Index Male Female < 25 Normal Weight 25-30 Overweight > 30 Obese Cardiac related* fatalities are typically the #1 cause of death in the line of duty *Source: National Fire Protection Association Statistics 27 26 25 24 20-29 30-39 40-49 50-59 All 2006 Fitness Testing Systolic Blood Pressure 140 135 130 125 120 115 110 20-29 30-39 40-49 50-59 All Male Female 95 90 85 80 75 70 65 2006 Fitness Testing Diastolic Blood Pressure Male Female 20-29 30-39 40-49 50-59 All 563 participants: 499 males, 64 females 3 10/22/2009 Fanning the Flames of Food and Fitness Personal and Group fitness training Fire House Culture Brotherhood – Often male dominated – Eat together and live as a family Fanning the Flames of Food and Fitness Nutrition – Training Table Menu Planning: – Taste good – Convenient – Economical 4 10/22/2009 DASH Tip Mix it up Sprinkle cheese on top of chili, soups and casseroles Make pizza with reduced-fat cheese and vegetables. Create a baked potato bar with vegetables for topping, beans, salsa, and cheese. 17 DASH Tip Super soups Prepare soups with low-fat milk instead of water. Add extra fresh, canned or frozen vegetables to prepared soups. 77 DC Fire and EMS Next Steps – Firehouses Training Tables Supermarket Tours 5 10/22/2009 The mission of AAHP is to eliminate health disparities and improve the number and quality of years of life for African Americans and people of African descent in Montgomery County Maryland. African Americans make up 17% of Montgomery County’s population but over 40% of hospital discharges related to diabetes and cardiovascular disease. Diabetes SelfSelfManagement classes Four class series CURRENT PROGRAMS AND SERVICES INCLUDE: •Diabetes self-management classes •Diabetes dining club Tips and tools to manage diabetes 6 10/22/2009 Diabetes SelfSelfManagement classes Screening Hemoglobin A1C Blood pressure Diabetes SelfSelfManagement classes Healthy meals and recipes provided Chef/RD recipe review DASH Tip Get Veggies Try new vegetables by serving them raw with low-fat yogurt dip, topping them with cheese or adding them to recipes. 27 DASH Tip Make substitutions Use low-fat milk in place of lowwater when cooking, especially with oatmeal, brown rice and wholewhole-grain pasta dishes. 28 7 10/22/2009 The Diabetes Dining Club… Monthly follow-up to classes •Meal •Education •Physical Activity MEAL FOCUS: •Promotes diabetes and blood pressure management •Whole grains •Low-fat and fat-free dairy foods •Vegetables and fruit Issue of Lactose Combine dairy foods with other foods Gradually increase amount Try non-milk dairy foods non– Cheeses – Yogurt Pre-digest lactose Pre– Lactose-reduced milk Lactose– Commercial lactase preparations (capsules, chewable tablets, solutions) 8 10/22/2009 PGCC DASHes to Good Health Stimulating Classes – Self-Assessment Project Self- DASH Tip Start with Breakfast Get ahead of the game and start your day with a whole grain cereal, fruit and low-fat milk or yogurt. 33 34 Community Outreach – Workshops/TV Technology – Ask the Dietitian DASH Tip Rethink your drink Make low-fat and fat-free milk your beverage of choice. Serve low-fat plain or flavored milk at meals. Choose a skinny latte or milk steamer. 35 DASH Tip Nourish your sweet tooth Try low-fat chocolate milk for a nutrient-rich beverage break. Feed your cravings with fresh or dried fruits or fruit filled gelatin. Layer low-fat yogurt with granola and/or fruit for a sweet treat. 36 9 10/22/2009 Healthy Recipes www.3aday.org www.fruitsandveggiesmorematters.org www.nhlbi.nih.gov/health/public/heart /hbp/dash/recipes.html 37 Additional DASH Resources National Heart, Lung and Blood Institute: www.nhlbi.nih.gov American Heart Association: www.americanheart.org American Dietetic Association: www.eatright.org 38 Additional DASH Resources The DASH Diet Action Plan By Marla Heller, MS, RD Product Market Place, booth #41 Questions & Answers 39 10
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