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10/22/2009
The DASH Eating Plan: Moving Beyond Hypertension DASH Diet 101
Natalie Webb, MS, RD, LD [email protected] 301--704 301 704--1756
2
DASH Eating Plan • • •
•
DASH Eating Plan based on a 2,000 calorie diet
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
U.S. Department of Health and Human Services. Your Guide to Lowering Your Blood Pressure with DASH. 2nd Edition, April 2006
Food Group Daily Servings Grains 6-8 Vegetables 4-5 Fruits 4-5 Low--fat or fat Low fat--free dairy products 2 2--3 Meats, 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
4
1
10/22/2009
How Are Americans Doing? Fruits/Vegetables: DASH recommendation servings
8-10 daily
American average
3.04 daily servings
Milk Group Foods DASH recommendation American average
Dietitian DASHes to Good Health
3.00 daily servings 1.7 daily servings
Calcium Intake DASH trial daily American average
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
W R iJ o lu s J ln a a ie m a J e m H M o s a iR n W rS co R e W e u g h b s A ob N re C e e bn a b o ln elW trb il W v tU re a n fP te b lb a c W i b t b lW e W P e b ea b r P D b btW b n a ib be B g a M N S b rK b ril e ro a Jn S e tb o . ra y S icG th F B e lA r h s e ru la a s e trtH n oG fe D ryn h trG d & irC p S e ha o f G e r ta en o ra o K n rb d tC o ie c o a D m h d te k n io H rn n e e ate sc r H D e bs h D a e y H iiS r eilo e t a y D te rD n r ld ip eS h o tD id e ste ik s rh re e td o d D a e k i s n e e s D D id ii o e e n d d
1250mg 970mg daily
5
Medical Family Tree
PUTTING DASH INTO PRACTICE
2
10/22/2009
2006 Fitness Testing Body Mass Index
DC Fire and EMS 32
Male Female
31 30
< 25 Normal Weight
29 28
Cardiac related* fatalities are typically the #1 cause of death in the line of duty
27 26
25-30 Overweight
25
> 30 Obese
24 20-29
30-39
40-49
50-59
All
*Source: National Fire Protection Association Statistics
2006 Fitness Testing Systolic Blood Pressure
95
2006 Fitness Testing Diastolic Blood Pressure
140 Male Female
135
Male Female
90 85
130
80
125
75
120
70
115
65
110 20-29
30-39
40-49
50-59
All
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
DASH Tip
Mix it up
Super soups
Sprinkle cheese on top of chili, soups and casseroles
Prepare soups with low-fat milk instead of water. Add extra fresh, canned or frozen vegetables to prepared soups.
Make pizza with reduced-fat cheese and vegetables. Create a baked potato bar with vegetables for topping, beans, salsa, and cheese. 17
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
CURRENT PROGRAMS AND SERVICES INCLUDE:
Four class series Tips and tools to manage diabetes
•Diabetes self-management classes •Diabetes dining club
6
10/22/2009
Diabetes SelfSelfManagement classes
Diabetes SelfSelfManagement classes
Screening
Hemoglobin A1C
Healthy meals and recipes provided Chef/RD
recipe review
Blood pressure
DASH Tip
DASH Tip Make substitutions
Get Veggies
Use lowlow-fat milk in place of water when cooking, especially with oatmeal, brown rice and whole--grain pasta dishes. whole
Try new vegetables by serving them raw with low-fat yogurt dip, topping them with cheese or adding them to recipes. 27
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 nonnon-milk dairy foods – Cheeses – Yogurt
PrePre-digest lactose – LactoseLactose-reduced milk – Commercial lactase preparations (capsules, chewable tablets, solutions)
8
10/22/2009
PGCC DASHes to Good Health
Stimulating Classes
Community Outreach
DASH Tip Start with Breakfast
– SelfSelf-Assessment Project
Get ahead of the game and start your day with a whole grain cereal, fruit and low-fat milk or yogurt.
– Workshops/TV
Technology – Ask the Dietitian 33
34
DASH Tip
DASH Tip Nourish your sweet tooth
Rethink your drink
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.
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
36
9
10/22/2009
Additional DASH Resources
Healthy Recipes
National Heart, Lung and Blood Institute: www.nhlbi.nih.gov
www.3aday.org
www.fruitsandveggiesmorematters.org
American Heart Association: www.americanheart.org
www.nhlbi.nih.gov/health/public/heart /hbp/dash/recipes.html
American Dietetic Association: www.eatright.org
37
38
Questions & Answers
Additional DASH Resources The DASH Diet Action Plan By Marla Heller, MS, RD Product Market Place, booth #41
39
10
The DASH Eating Plan: Moving Beyond Hypertension DASH Diet 101
Natalie Webb, MS, RD, LD [email protected] 301--704 301 704--1756
2
DASH Eating Plan • • •
•
DASH Eating Plan based on a 2,000 calorie diet
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
U.S. Department of Health and Human Services. Your Guide to Lowering Your Blood Pressure with DASH. 2nd Edition, April 2006
Food Group Daily Servings Grains 6-8 Vegetables 4-5 Fruits 4-5 Low--fat or fat Low fat--free dairy products 2 2--3 Meats, 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
4
1
10/22/2009
How Are Americans Doing? Fruits/Vegetables: DASH recommendation servings
8-10 daily
American average
3.04 daily servings
Milk Group Foods DASH recommendation American average
Dietitian DASHes to Good Health
3.00 daily servings 1.7 daily servings
Calcium Intake DASH trial daily American average
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
W R iJ o lu s J ln a a ie m a J e m H M o s a iR n W rS co R e W e u g h b s A ob N re C e e bn a b o ln elW trb il W v tU re a n fP te b lb a c W i b t b lW e W P e b ea b r P D b btW b n a ib be B g a M N S b rK b ril e ro a Jn S e tb o . ra y S icG th F B e lA r h s e ru la a s e trtH n oG fe D ryn h trG d & irC p S e ha o f G e r ta en o ra o K n rb d tC o ie c o a D m h d te k n io H rn n e e ate sc r H D e bs h D a e y H iiS r eilo e t a y D te rD n r ld ip eS h o tD id e ste ik s rh re e td o d D a e k i s n e e s D D id ii o e e n d d
1250mg 970mg daily
5
Medical Family Tree
PUTTING DASH INTO PRACTICE
2
10/22/2009
2006 Fitness Testing Body Mass Index
DC Fire and EMS 32
Male Female
31 30
< 25 Normal Weight
29 28
Cardiac related* fatalities are typically the #1 cause of death in the line of duty
27 26
25-30 Overweight
25
> 30 Obese
24 20-29
30-39
40-49
50-59
All
*Source: National Fire Protection Association Statistics
2006 Fitness Testing Systolic Blood Pressure
95
2006 Fitness Testing Diastolic Blood Pressure
140 Male Female
135
Male Female
90 85
130
80
125
75
120
70
115
65
110 20-29
30-39
40-49
50-59
All
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
DASH Tip
Mix it up
Super soups
Sprinkle cheese on top of chili, soups and casseroles
Prepare soups with low-fat milk instead of water. Add extra fresh, canned or frozen vegetables to prepared soups.
Make pizza with reduced-fat cheese and vegetables. Create a baked potato bar with vegetables for topping, beans, salsa, and cheese. 17
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
CURRENT PROGRAMS AND SERVICES INCLUDE:
Four class series Tips and tools to manage diabetes
•Diabetes self-management classes •Diabetes dining club
6
10/22/2009
Diabetes SelfSelfManagement classes
Diabetes SelfSelfManagement classes
Screening
Hemoglobin A1C
Healthy meals and recipes provided Chef/RD
recipe review
Blood pressure
DASH Tip
DASH Tip Make substitutions
Get Veggies
Use lowlow-fat milk in place of water when cooking, especially with oatmeal, brown rice and whole--grain pasta dishes. whole
Try new vegetables by serving them raw with low-fat yogurt dip, topping them with cheese or adding them to recipes. 27
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 nonnon-milk dairy foods – Cheeses – Yogurt
PrePre-digest lactose – LactoseLactose-reduced milk – Commercial lactase preparations (capsules, chewable tablets, solutions)
8
10/22/2009
PGCC DASHes to Good Health
Stimulating Classes
Community Outreach
DASH Tip Start with Breakfast
– SelfSelf-Assessment Project
Get ahead of the game and start your day with a whole grain cereal, fruit and low-fat milk or yogurt.
– Workshops/TV
Technology – Ask the Dietitian 33
34
DASH Tip
DASH Tip Nourish your sweet tooth
Rethink your drink
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.
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
36
9
10/22/2009
Additional DASH Resources
Healthy Recipes
National Heart, Lung and Blood Institute: www.nhlbi.nih.gov
www.3aday.org
www.fruitsandveggiesmorematters.org
American Heart Association: www.americanheart.org
www.nhlbi.nih.gov/health/public/heart /hbp/dash/recipes.html
American Dietetic Association: www.eatright.org
37
38
Questions & Answers
Additional DASH Resources The DASH Diet Action Plan By Marla Heller, MS, RD Product Market Place, booth #41
39
10
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