Lower blood pressure

TL;DR. The DASH eating pattern lowers blood pressure about as much as a starter blood pressure drug, in eight weeks, with no side effects. The active ingredients: more potassium from whole plants, less sodium from packaged food, less refined carbohydrate. Watch the ratio of sodium to potassium rather than sodium alone. Most of the sodium in a normal diet comes from a short list of categories: bread, deli meat, soup, frozen meals, condiments, and restaurant food. Cut from that list and the number moves. You do not have to track every label.

What this goal does

This goal flags foods that push blood pressure up and rewards foods that pull it down. It targets the two levers with the most evidence: sodium load per serving, and the sodium-to-potassium ratio of your overall plate. It does not chase every milligram of salt. It goes after the categories where the salt is hiding.

If you turn this goal on, the scanner will:

• Block items with very high sodium per serving.
• Warn on items with moderate sodium, with extra weight if they are ultra-processed.
• Reward potassium-rich whole foods like bananas, leafy greens, beans, potatoes, and plain yogurt.

This is an outcome goal, not a behavior goal. It works best paired with the goals that reduce ultra-processed food and added sugar, since those drive the same biology from a different angle.

Evidence in 3 paragraphs

The DASH trial, published by Appel and colleagues in 1997, is one of the cleanest diet trials on record. Adults with normal-to-high blood pressure ate one of three controlled diets for eight weeks. The DASH arm, heavy on fruit, vegetables, low-fat dairy, beans, nuts, and whole grains, dropped systolic blood pressure by about 11 points in people with hypertension. That is what a starter dose of an antihypertensive drug delivers. Willett walks through it in Eat, Drink, and Be Healthy Chapter 14. The 2001 follow-up, DASH-Sodium, layered three sodium levels on the same diets. The best result came from the DASH pattern combined with lower sodium, ahead of either change on its own.

The deeper signal is the ratio of sodium to potassium rather than sodium by itself. Krause, 16th edition, Chapter 33, lays out the physiology. Sodium pulls water into the bloodstream and raises pressure. Potassium relaxes blood vessels and helps the kidneys excrete sodium. Modern diets flip this ratio. Hunter-gatherer diets ran roughly 10 to 1 potassium-to-sodium. The typical American diet runs it at 1 to 2. Fix the ratio and the number drops even when total sodium holds steady.

Gary Taubes adds the layer the textbooks tend to skip. Refined carbohydrate raises insulin. Insulin tells the kidneys to hold sodium. A low-salt diet eaten alongside soda and white bread fights itself. DASH runs low in refined carbohydrate by design, which is part of why it outperforms a low-salt-only intervention. Tim Spector, who once argued the salt warnings were oversold, walked that back in Food for Life. The U-shaped curve is real at the extremes, and the clinical caveats matter most for people already diagnosed with hypertension, kidney disease, or heart failure. For most adults the practical advice has not changed: less packaged-food sodium, more potassium from whole plants, fewer refined carbs.

What helps

• Whole fruit. Bananas, oranges, melons, berries.
• Leafy greens. Spinach, kale, chard, arugula. Potassium dense, no sodium.
• Beans and lentils. High potassium, high fiber, no sodium unless canned.
• Potatoes and sweet potatoes. A plain baked potato is one of the most potassium-rich foods in the supermarket.
• Plain yogurt. Greek style packs more per spoonful. Potassium, calcium, magnesium, no added sodium.
• Unsalted nuts and seeds.
• Cooking at home. Restaurant and takeout meals are where most adults overshoot sodium without noticing.
• Reading the sodium line on the Nutrition Facts panel. Anything over 800 mg per serving is a single-meal budget.

What hurts

• Bread. A single sandwich can carry 600 to 800 mg of sodium before the filling.
• Deli meat. Turkey, ham, salami, and bologna run 400 to 1,000 mg of sodium per 2-ounce serving.
• Canned and boxed soup. A single can of standard chicken noodle holds 1,500 to 2,000 mg.
• Frozen meals. Most run 700 to 1,500 mg per tray, even the "healthy" ones.
• Condiments and sauces. Soy sauce, salad dressing, BBQ sauce, ketchup, marinades.
• Restaurant and takeout food. The single biggest sodium source for most American adults.
• Refined carbohydrate. Soda, white bread, sugary cereal, and sweet drinks raise insulin, which tells the kidneys to hold sodium. The label can read low-sodium while the body still retains it.

You do not have to memorize numbers across the whole supermarket. Cut from those six categories and you have done most of the work.

How the scanner uses this

The scanner reads the Nutrition Facts panel and the ingredient list. It also checks whether the item is ultra-processed.

Hard rules. A product fails this goal if any is true:

• More than 800 mg of sodium per serving.

Soft rules. A product gets a warning if any is true:

• 400 to 800 mg of sodium per serving.
• Ultra-processed product with refined carbohydrate as a main ingredient. The insulin-sodium loop applies even when the sodium number looks moderate.

Bonuses. A product gets a boost if any is true:

• Less than 300 mg of sodium per serving.
• Whole food rich in potassium: bananas, leafy greens, beans, potatoes, plain yogurt.
• Single-ingredient produce.
• Plain unsalted nuts.

The hard rule is blunt on purpose. It catches the categories where one serving wrecks a daily budget. The soft rules nudge you toward the better version of the same food. The bonuses reward the foods that move the ratio in the right direction.

The scanner does not subtract points for the sodium present in plain dairy or fresh meat. It is looking for added sodium concentrated in packaged products.

Worked examples

Campbell's Chicken Noodle Soup, 1 cup. 890 mg sodium, and a can is two servings. Hard rule failure. Block.

Boar's Head oven-roasted turkey, 2 oz. 440 mg sodium. Soft warning. A sandwich uses 3 to 4 ounces, so a single meal clears 1,200 mg before bread or condiments.

Fresh banana. 0 mg added sodium, 420 mg potassium. Bonus.

Raw kale, 1 cup. Trace sodium, 300 mg potassium. Bonus.

Lunchables Turkey and Cheddar. 740 mg sodium per tray, ultra-processed, refined-carb crackers. Soft warning plus the ultra-processed flag. Streak-breaker for most users.

DiGiorno frozen pizza, one-third pie. 950 mg sodium per serving, and almost no one eats one third. Hard rule failure. Block.

Plain whole-milk Greek yogurt, 6 oz. 60 mg sodium, 240 mg potassium, 0 g added sugar. Bonus.

Canned black beans, drained and rinsed, 1/2 cup. Rinsing cuts sodium by about 40 percent, bringing a standard can to roughly 200 mg per serving. Plus 360 mg potassium. Bonus after rinse.

Chipotle bowl with rice, chicken, salsa, and cheese. Roughly 1,800 to 2,200 mg sodium in a single meal. Soft warning at minimum, hard fail in most builds.

Related reading

• Eat less obvious junk — most high-sodium products are ultra-processed, and cutting those first does most of the work.
• The ultra-processed food problem — why sodium, refined carbs, and additives travel together.
• Sugar: the clearest case — the insulin pathway that links refined carbs to sodium retention.
• Reading labels — how to read the sodium line on the Nutrition Facts panel.

Sources

1. Appel, L.J. et al. (1997). "A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure." New England Journal of Medicine 336(16): 1117-1124. DOI: 10.1056/NEJM199704173361601.
2. Sacks, F.M. et al. (2001). "Effects on Blood Pressure of Reduced Dietary Sodium and the DASH Diet." New England Journal of Medicine 344(1): 3-10. DOI: 10.1056/NEJM200101043440101.
3. Willett, W. (2017 ed.). Eat, Drink, and Be Healthy, Chapter 14. Free Press. The DASH pattern and the 8-week blood pressure drop.
4. Mahan, L.K. and Raymond, J.L. (eds.). Krause's Food and the Nutrition Care Process, 16th edition, Chapter 33. Elsevier. Sodium, potassium, and the sodium-potassium ratio in hypertension.
5. Taubes, G. (2016). The Case Against Sugar. Knopf. Insulin, kidneys, and sodium retention.
6. Spector, T. (2022). Food for Life. Jonathan Cape. The salt-skepticism reversal and the limits of the U-curve at clinical extremes.