The Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes vegetables, fruits, whole grains, lean protein sources and lower-fat dairy products, is one of the most widely prescribed diets to reduce blood pressure. High in potassium, magnesium, calcium and dietary fiber this dietary pattern is also low in saturated fat. which is thought to reduce risk for cardiovascular disease (CVD) by lowering LDL-cholesterol levels. 

While the efficacy of the DASH diet has been repeatedly documented, long-term compliance to this way of eating is not optimal. As such, investigators have tested modifications of the DASH diet on blood pressure and lipid risk factors for CVD. In one such study (OmniHeart), partial replacement of carbohydrates with protein or unsaturated fat resulted in similar or greater reductions in blood pressure as the standard DASH diet, while also improving blood lipids. In other studies, inclusion of lean beef or lean pork in a DASH-like diet retained the blood pressure lowering effects of the DASH diet, with comparable effects of the lean beef diet on blood lipids. 

In our study, we tested the effects of replacing non-fat and lower-fat dairy foods with full-fat dairy products (high-fat DASH), in conjunction with a reduction in energy from carbohydrates, achieved primarily by reducing sugars from fruit juices. We found that the high-fat DASH and standard DASH diets similarly reduced blood pressure compared to a control Western diet. Whereas the high-fat DASH diet did not reduce LDL- or HDL-cholesterol levels, it significantly lowered triglycerides and increased LDL peak particle diameter compared to the standard DASH diet.

Taken together, findings to date provide evidence that when core components of the DASH diet are retained, namely servings of fruits, vegetables, whole grains and dairy, aspects of the diet can be modified and still retain the benefits of the DASH diet on blood pressure and blood lipids. This offers flexibility in food choices, which could translate into better long-term adherence for individuals following a DASH-like dietary pattern.