DASH Diet vs Mediterranean Diet: Which Is Best?

The DASH diet vs. the Mediterranean diet may seem like a silly debate since these are two of the healthiest diets in the world. Both diets emphasize plant-based foods, whole grains, and lean protein, and both have been shown to improve heart health, reduce blood pressure, and lower the risk of chronic diseases such as stroke, cancer, and diabetes.

But is one better than the other? Here, I’ll go over the similarities and differences between these two heart-healthy diets so that you can make an informed decision about which is best for you!

For more on these individual diets (and to get a free coinciding shopping list), check out the following articles:

• Mediterranean Diet For Beginners (Get Started Today!)
• The DASH Diet for Beginners (Everything You Need To Know)

What Is The DASH Diet?

The DASH diet stands for Dietary Approaches to Stop Hypertension. Research on this dietary pattern began in 1992 with the support of the National Heart, Lung, and Blood Institute (NHLBI). Results were published in the New England Journal of Medicine in 1997.

The DASH diet is low in sodium, saturated fat, and cholesterol, and high in specific minerals including potassium, magnesium, and calcium. All of these are important nutrients for lowering blood pressure.

Today, it is promoted by the National Institute of Health and the American Heart Association as a top diet to help people lower their blood pressure.

DASH Diet Key Principles

More specifically, the DASH diet promotes the consumption of fruits, vegetables, whole grains, lean protein sources, and low-fat or nonfat dairy products. The key principle component of the DASH diet is limited sodium.

By choosing more unprocessed and fresh foods, sodium intake is restricted to about 2,300 milligrams per day. However, if you have high blood pressure, a more strict sodium limit of 1500 milligrams per day is recommended.

The diet is based on 2,000 calories a day, with the following nutritional profile:

• Total fat: 27% of calories
• Saturated fat: 6% of calories
• Protein: 18% of calories
• Carbohydrate: 55% of calories
• Cholesterol: 150 mg
• Sodium: 2,300 mg
• Potassium: 4,700 mg
• Calcium: 1,250 mg
• Magnesium: 500 mg
• Fiber: 30 g

Here are some other important principles of the DASH diet:

• Eat plenty of fruits, vegetables, and whole grains. Fruits, vegetables, and whole grains are low in calories and high in nutrients, including potassium, magnesium, and calcium. These nutrients are important for lowering blood pressure.
• Choose fat-free or low-fat dairy products. Fat-free and low-fat dairy products are good sources of calcium and potassium.
• Include lean protein in your diet. Lean protein sources, such as poultry, fish, beans, and lentils, are low in saturated fat and cholesterol and can help you feel full and satisfied after meals.
• Limit saturated and unhealthy fats. Saturated fats can raise cholesterol levels and increase your risk of heart disease. Limit your intake of saturated fats from fatty meats, full-fat dairy products, and tropical oils.
• Limit sodium intake. Too much sodium can raise blood pressure. The DASH diet recommends that adults consume no more than 2,300 milligrams of sodium per day.
• Limit sugary drinks and sweets. Sugary drinks and sweets are high in calories and low in nutrients. They can also contribute to weight gain and other health problems.

DASH Diet Supporting Evidence

Several different studies on the DASH diet add to the body of evidence that lower sodium intake in your diet can lead to better blood pressure control and the prevention of heart disease and other chronic diseases.

The OmniHeart Trial for example shows that adjusting the diet to allow for more unsaturated fats or plant-based sources of protein had a stronger impact on lowering blood pressure.

Additionally, the DASH-Sodium Trials confirmed the direct relationship between sodium intake and blood pressure by testing three different levels of daily sodium intake (1.5 grams, 2.2 grams, and 3.3 grams of sodium per day). The results indicated that a greater blood pressure-lowering effect was seen in the lowest sodium group.

It’s also important to note that in other observational studies, reducing salt intake is associated with a reduced risk of congestive heart failure and cardiovascular events resulting from the build-up of plaque in arteries.

The DASH dietary pattern is also shown to benefit those with diabetes when compared to those following a diabetic diet by improving blood pressure and maintaining blood sugar control.

What Is The Mediterranean Diet?

The Mediterranean diet is based on the traditional eating habits of people in countries around the Mediterranean Sea. It all began in 1958 when a researcher named Ancel Keys started his Seven Countries Study. The dietary patterns and lifestyles followed by several different populations around the world were analyzed. The results of this study were the first to link specific dietary components with cardiovascular disease risk.

The Mediterranean diet today is characterized by a high intake of fruits, vegetables, whole grains, legumes, nuts, seeds, and olive oil. The Mediterranean diet is also low in red meat and processed foods. Instead, foods are made fresh with plenty of herbs and spices incorporated for health and flavor.

Olive oil is the main source of fat in a Mediterranean diet and it is used liberally daily. Olive oil is beneficial to heart health because it contains powerful polyphenols that reduce inflammation and improve the lining of artery walls.

Mediterranean Diet Key Principles

The Mediterranean diet is more about a specific way of eating. It is a “lifestyle” that focuses on fruits, vegetables, fish, seafood, poultry, whole grains, and plenty of olive oil. It also incorporates social and cultural aspects that provide further daily fulfillment such as physical activity and enjoying meals as a family.

No foods are off limits however processed foods, red meats, and sweets are eaten only in small amounts.

Here are some other important principles of the Mediterranean diet:

• Eat plenty of plant-based foods. This includes fruits, vegetables, whole grains, legumes, nuts, and seeds. Plant-based foods are low in saturated fat and calories and high in nutrients, including fiber, vitamins, minerals, and antioxidants.
• Choose healthy fats. The main source of fat in the Mediterranean diet is olive oil. Olive oil is a monounsaturated fat that has been shown to lower cholesterol levels and improve heart health.
• Use limited amounts of red meat and processed foods. Red meat and processed foods are high in saturated fat and cholesterol and can increase the risk of heart disease and other chronic diseases.
• Include moderate amounts of fish and poultry in your diet. Fish and poultry are good sources of lean protein and omega-3 fatty acids, which are beneficial for heart health.
• Eat dairy products in moderation. Dairy products are good sources of calcium and protein. However, it is important to choose low-fat or fat-free dairy products to limit your intake of saturated fat.
• Limit sugary drinks and sweets. Sugary drinks and sweets are high in calories and low in nutrients. They can also contribute to weight gain and other health problems.
• Enjoy alcohol in moderation. Alcohol is consumed mainly in the form of red wine and only during meal times.

Mediterranean Diet Supporting Evidence

Like the DASH Diet, the Mediterranean diet is highly researched and has more benefits than to the heart alone. What was initially a study looking at different diet cultures and heart disease risk, has led to studies on other areas of health and aging.

The first major study, the PREDIMED study, found that a Mediterranean-style diet supplemented with either olive oil or nuts was more effective at lowering the risk of heart attack, stroke, and death when compared to a reduced-fat diet.

The next study, the Lyon Diet Heart Study, shows how following a Mediterranean diet can offer protection against a second cardiac event for up to 4 years.

Additional research shows that a Mediterranean diet also improves risk factors for heart disease including obesity, hypertension, metabolic syndrome, and dyslipidemia.

And like the DASH diet, those following a Mediterranean diet may also have a lower incidence of diabetes and better blood sugar control compared to control diets, including low-fat diets.

Similarities and Differences Between The DASH Diet and The Mediterranean Diet

The DASH diet and the Mediterranean diet are similar in many ways. Both diets emphasize plant-based foods, whole grains, and lean protein. Both diets are also low in saturated fat and cholesterol.

They are also both shown to decrease the risk of heart disease by lowering blood pressure, total cholesterol, and LDL cholesterol. The DASH diet was shown to slightly lower beneficial HDL cholesterol as well, which warrants more research.

However, there are some key differences between the two diets. The DASH diet is more specific about sodium intake, recommending that adults consume no more than 2,300 milligrams of sodium per day or 1,500 milligrams per day if they already suffer from hypertension (high blood pressure).

In contrast, the Mediterranean diet does not have specific sodium recommendations nor does it emphasize nonfat dairy products. Instead, it is generally lower in sodium than the typical American diet (which averages around 3,400 mg of sodium per day) and allows full-fat dairy such as feta, Parmesan cheese, and yogurt 2-3 times per day.

Another difference between the two diets is that the Mediterranean diet allows for moderate amounts of alcohol, usually at meals, while the DASH diet recommends limiting alcohol intake.

And finally, the Mediterranean diet includes a component of physical activity and socialization that the DASH diet lacks.

Are The Health Benefits Different?

There are so many similar health benefits that these two diets share. For example, both the DASH diet and Mediterranean diet can lower your risk for heart disease, stroke, cancer, and type 2 diabetes.

However, the DASH diet is also shown to benefit people with kidney disease due to the low sodium allowance (potassium foods will still need to be monitored). Additionally, the DASH diet may help lower uric acid levels which benefit individuals with gout.

The Mediterranean diet has been shown to benefit people with Alzheimer’s disease and Parkinson’s disease. This is likely due to the liberal amounts of olive oil used, which is a good source of healthy fats that benefit brain health.

By combining the DASH diet and Mediterranean diet, you get what is called the MIND diet. This diet aims is to reduce dementia and age-related decline.

For more info on the MIND diet, visit this article on the MIND diet by fellow dietitian Su-Nui Escobar, DCN, RDN, FAND.

Things To Consider

With both of these dietary patterns, there may be drawbacks and challenges along with way. Here are a few drawbacks to consider:

• Cost: Both of these diets can be more expensive to follow than a typical American diet. This is because many processed foods and sugary drinks are cheaper than fresh, whole foods. Additionally, you may choose to splurge on higher quality ingredients like olive oil or other special ingredients.
• Time Commitment: Following either diet requires more time and effort than your previous diet. This is especially true if you are now cooking more meals at home and having to plan meals.
• Social challenges: Consistently eating a healthy diet outside of your home (work, potlucks, etc.) may be difficult. This is especially true if those you surround yourself with eat unhealthy foods.

In addition to some drawbacks, you may also find some challenges along with way. Here are a few common ones:

• Making changes to your diet: It can be difficult to make changes to your diet, especially if you tend to eat unhealthy foods. It is important to start small and gradually make changes over time.
• Finding healthy recipes: It can be difficult to find healthy recipes that are also delicious and easy to make. There are many resources available online and in cookbooks. Browse my recipe page for inspiration!
• Staying motivated: It can be difficult to stay motivated to follow a healthy diet, especially in the long term. It is important to find ways to make healthy eating enjoyable and to set realistic goals for yourself.

Which Diet Is Right For You?

The best diet for you is the one that you can stick with long-term. If you are not sure which diet is right for you, talk to your doctor or a registered dietitian.

Here are some additional things to consider when choosing between the DASH diet and the Mediterranean diet:

• Your personal preferences: Do you prefer to cook at home or eat out? Do you have any dietary restrictions?
• Your health goals: Are you trying to lower your blood pressure, lose weight, or manage a chronic disease?
• Any current health conditions: Do you have any health conditions that require you to limit potassium?
• Your lifestyle: How much time do you have to cook and prepare meals? How active are you?

Once you have considered all of these factors, you can choose the diet that is best for you and your individual needs. And in all honesty, both of these diets have been modified along the way. So, you can most certainly modify different aspects to fit your life as well!

Tips For Starting These Diets

Both of these diets will likely be healthy options if your focus is on heart health or preventing further heart damage as you age. With the following tips, both the DASH diet and the Mediterranean diet will be much easier to follow.

Cook More Meals At Home

By making most of your meals at home, you have more control over what you are putting into your mouth. You can control the amount of salt you use, the method in which you cook your foods, and which foods you use.

Meal planning and preparation can take time, but allowing this control over your diet is more beneficial to your health overall.

Choose Whole Grains Over Refined Grains

Whole grains are generally a better source of nutrients, including fiber, than refined grain products. Choosing more whole grains provides benefits to your heart while also helping keep bowel health in check.

For some great ideas on how to use whole grains at home, I highly recommend the Whole Grains Council website which has many whole grain recipes available.

Read Food Labels

Whether you choose a DASH diet or a Mediterranean diet, you’ll want to read food labels carefully.

While the Mediterranean diet does not pay special attention to sodium, it is still important to look for minimally processed foods and ones low in added sugars.

With the DASH Diet, be sure to look at saturated fat and sodium contents of foods while shopping, remembering to follow the correct serving sizes once home.

Choose Fresh, Seasonal Foods

Eating more fresh and seasonal foods can not only be more nutritious but it can save you money if you know what’s in season.

Purchasing produce from farmer’s markets or signing up for a Community Supported Agriculture (CSA) program are great cost-effective options. You can also make use of frozen or canned fruits and vegetables- look for no-salt-added or reduced sodium options when available.

Make Gradual Changes To Your Diet

And finally, do NOT try to change everything at once. This can be overwhelming and lead to you quitting as soon as you start.

Instead, start by making small changes, such as adding a fruit or vegetable at each meal or choosing olive oil over butter.

Conclusion

When it comes to the DASH diet vs the Mediterranean diet both can offer a variety of health benefits. They have many similarities and a few distinct differences. And more importantly, BOTH are much healthier than the standard American diet!

If you are looking for a diet to specifically help you lower your blood pressure, the DASH diet is the better option. However, if you are looking for a more general healthy diet, the Mediterranean diet is a good choice.

In the end, it’s important to consider all aspects such as personal preferences, health goals, medical conditions you may have, and your current lifestyle. Additionally, consider any drawbacks or challenges you may experience and plan ahead.

Speak with your doctor or a registered dietitian about which diet may be best for you as well.

If you’re leaning more toward either of these proven, heart-healthy diets, the following articles will give you even more detailed information and resources:

Good luck with whichever diet you choose and stay healthy my friends! Visit the BLOG for more heart-healthy articles or the RECIPES page for some yummy inspiration and easy recipes.

Kiran Campbell, RDN

Kiran Campbell is a registered dietitian and entrepreneur with 13 years of experience. She has a degree in psychology as well as dietetics. She is also a proud member of the Academy of Nutrition and Dietetics’ and its Cardiovascular Health and Well-being Dietetics Practice Group among others. Kiran proudly presents and promotes the most up-to-date, science-based nutrition information on all things heart-related. She aims to serve not only individuals with heart disease, but also those wanting to protect against it. Learn more about Kiran by visiting her About Page.

kcampbellnutrition.com