(Hypertension. 2001;38:e33.)
© 2001 American Heart Association, Inc.
Book Reviews |
The Dash Diet for Hypertension: Lower Your Blood Pressure in 14 Days–Without Drugs
Chairman, Department of Preventive Medicine, Rush-Presbyterian-St Luke's Medical Center, Chicago, Illinois 60612
Thomas J. Moore, ed. 288 pp.
US rate: $25.00. ISBN 0-7432-0295-3
The recently published Dash Diet was one of the most important lifestyle modification clinical trials ever performed. It clearly showed the value of a high fruit and vegetable and low saturated fat diet to lower blood pressure. The more recently completed Dash-Sodium study also unequivocally demonstrated that a sodium-restricted diet in addition to the Dash Diet could lower blood pressure even further and do so in a wide variety of subjects with high normal or stage 1 hypertension.
Some of the investigators in that trial, in conjunction with a "freelance writer" have now produced a book entitled The Dash Diet for Hypertension. This book is designed to provide information for the public on how to integrate the findings of the Dash Diet into practical and useful terms. While the premise is admirable, in translating the results of a clinical trial into practice, the authors (with the help of their ghostwriter) seem excessively optimistic and enthusiastic about what the Dash Diet can do. The authors claim that clinical trials are a "foolproof"" way to test a treatment. I wish it were.
In the preface, for example, the authors state that "not only does the Dash Diet treat and prevent high blood pressure, but it will reduce your risk of several deadly illnesses, including heart disease, stroke, cancer and osteoporosis." They go on to say the diet will "make you feel better both mentally and physically" and that these "are not false promises but assurances based on scientific evidence."
This is just one example of numerous claims that the authors claim that the Dash Diet can do. Unfortunately, the problems with the Dash study are barely discussed, if at all. DASH was a feeding study performed at 4 universities in a very highly selected and motivated group of individuals who were provided free food for the entire study. While it is very possible and even likely that the Dash Diet can be an important contribution to public health, the authors suffer from exactly what they claim to be trying to combat: the enormous number of dietary approaches to treating hypertension and other illnesses that are not solidly grounded in science and promise results that they cannot deliver.
Among the good things about this volume is that it is easy to understand and provides very good and easily digestible information. Also, the book is chock full of interesting recipes, none of which I have personally tried to cook; most seem practical and easy to prepare. But there is some silly advice such as telling people not to buy food that smells bad. I suspect most shoppers will already know that and would find such advice a bit patronizing.
The main problem for me is that it is full of promises that are not necessarily based on the good science they claim. For example, on page 29, the antioxidants in Dash foods are recommended as a good reason to follow this diet. Unfortunately, antioxidants have not fulfilled their promise.
In chapter 6, the authors imply that the Dash Diet will, in some way, make it unnecessary to consider reducing body weight. This is very unfortunate advice in view of the increasing epidemic of obesity in the United States and worldwide.
Although the Dash Diet was an excellent contribution to science, I’m afraid that the The Dash Diet for Hypertension is not an excellent contribution to the lay literature. It suffers from so many of the same problems that other diet manuals and quick fixes have that I would hesitate to recommend it to my patients. I wish the recipes themselves had been published without the hype that seems so evident in this book.
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