得舒飲食 王鳳英 副教授

a healthy eating plan can both reduce the risk of developing high blood pressure and lower an already elevated blood pressure. a clinical study that tested the effects of nutrients in food on blood pressure. Study results indicated that elevated blood pressures were reduced by an eating plan that emphasizes fruits, vegetables, and low fat dairy foods and is low in saturated fat, total fat, and cholesterol.

whole grains, poultry, fish, and nuts The DASH eating plan includes whole grains, poultry, fish, and nuts and has reduced amounts of fats, red meats, sweets, and sugared beverages.

2009年5月21日 發布台灣版 -- 得舒飲食 2009年5月21日 -- 得舒飲食（簡稱DASH ，Dietary Approaches to Stop Hypertension）可降血壓、降血脂肪、減低罹患心血管疾病的風險，並有利骨質健康、預防大腸直腸癌。 得舒飲食是唯一正式納入美國最新高血壓教育計畫手冊的一個經科學及臨床試驗証實，能有效降低血壓的飲食治療 。

「得舒飲食」觀念 近年來醫界倡導「得舒飲食」觀念，每天攝取5份蔬果、多吃白肉、堅果、全穀根莖類食物以及低脂乳品，只要改變飲食習慣，就能控制血壓。 董氏基金會表示，只要連續2周採用「得舒飲食」，不僅可以減重，還能降低8~10%血壓。

「得舒飲食」內容 每天攝取5份蔬菜 5份水果 紅肉改為白肉 吃堅果 用好油 飲用2份低脂乳 主食則以全穀根莖類為主。

得舒飲食-少服用一顆降血壓藥 血壓降8~10%相當於「少服用一顆降血壓藥」。 「得舒飲食」還能防治腦中風、糖尿病、骨質疏鬆、大腸直腸癌與冠狀動脈心臟病。

「得舒飲食」特色 主要在於食物中的成分富含高鉀、高鎂、高鈣、高膳食纖維，並具有降低飽和脂肪酸、膽固醇等優點。 部分高血壓患者在維持健康飲食習慣後，血壓降下來，體重也變輕。

得舒飲食 全穀根莖類主食質地較硬，需慢慢咀嚼，增加飽足感。 吃飽之後，就不會再亂吃零食，達到減重目的。 採用「得舒飲食」後，約可3周減重1.5公斤。　　

主食2/3以上選用全穀根莖類 1.主食盡量2/3以上選用全穀根莖類。 2.全穀根莖類如：糙米、紫米、燕麥、蕎麥、麥片、薏仁、紅綠花豆、地瓜、芋頭、馬鈴薯、蓮藕、栗子、蓮子、菱角、荸薺、山藥等。

每天攝取超過5份蔬菜5份水果 3.每天攝取超過5份蔬菜、5份水果。建議多選含鉀豐富的莧菜、韭菜、菠菜、空心菜、金針菇、綠蘆筍、竹筍、芭樂、哈密瓜、桃子、香瓜、奇異果、椪柑、香蕉等。 4.蔬果入飯。如：彩蔬毛豆拌飯、三色腰果拌飯、芒果咖哩、鳳梨木耳。 5.搭配不同口感蔬菜。如：瓜類滑脆、菇蕈類柔軟多汁、根莖類Q軟、筍類有嚼勁。

少吃油炸食品 50歲以上國人中，約61%罹患高血壓或有高血壓風險。 60歲後，比率更高達77.5%。 食者最為嚴重。 外食族應多挑青菜，少吃油炸食品，才能為自己健康把關。

含鉀豐富的蔬菜 含鉀豐富的蔬菜如莧菜、菠菜、空心菜、韭菜、青花菜、芹菜、香菇、金針菇等；水果有桃子、香瓜、哈密瓜、奇異果、木瓜、芭樂、香蕉等。 多攝取富含鎂、鉀、鈣和纖維質的食物，將有助減少或控制體重與高血壓。

肉類宜攝取白肉 主食至少3分之2選用未精製、含麩皮的全穀類，或以地瓜、芋頭、馬鈴薯、山藥、綠豆等根莖類取代。 成年女性平均每餐半碗飯，老年男性每餐飯七、八分滿，中年男性九分滿為佳； 肉類宜攝取白肉，如魚肉、雞、鴨、鵝等家禽類；油類宜選擇植物油； 每天另可吃一匙未加工的堅果。

添加燕麥、糙米等五穀類 得舒飲食建議增加攝取纖維質，可在主食裡添加燕麥、糙米等五穀類 蔬菜每天攝取4到5份以上、水果攝取2到3份以上。 每天應攝取的4份蛋、豆、魚、肉類 可以用豆類取代一部份的魚、肉、蛋。

鎂可從堅果類攝取 國人普遍有鈣質攝取不足問題，可從奶類、起司、優酪乳、花椰菜補充 富含鉀的食物較常見，像是堅果、蔬菜、水果和奶類都有 鎂可從堅果類攝取，每天只能攝取1湯匙份量。

好油—含多元不飽和脂肪酸 選用各式好油，如：橄欖油、芥花油、沙拉油、葵花油等，取代奶油、豬油、棕櫚油。 每天吃1湯匙核果。如：花生、松子、核桃、杏仁、芝麻、腰果、夏威夷豆等。 將核果加在菜餚、沙拉或灑在飯上。

每天快步走路30分鐘 營養師建議嘗試「得舒飲食」，以多種穀類和根莖類取代白飯，每天吃10份蔬果、2份低脂奶 搭配每天快步走路30分鐘，1、2個月後體重減輕、三酸甘油酯恢復正常、血壓下降，且走路時，腳關節變得輕鬆，排便也變順暢。

高血壓患者若能控制鹽分攝取 15％至30％高血壓患者若能控制鹽分攝取，血壓將可逐漸獲得改善。 目前各大專院校及食品業者進行廚師培訓及研發量產，希望廚師將得舒飲食概念推廣到餐廳。 希望未來鼓勵廠商開發得舒飲食定餐、團購； 並將舉辦4場營養師培訓； 也著手推廣老人得舒飲食教育。

DASH eating plan at the lowest sodium level reducing dietary sodium lowered blood pressure for both the DASH eating plan and the typical American diet. The biggest blood pressure-lowering benefits were for those eating the DASH eating plan at the lowest sodium level (1,500 milligrams per day).

Change gradually If you now eat one or two vegetables a day, add a serving at lunch and another at dinner. If you don't eat fruit now or have only juice at breakfast, add a serving to your meals or have it as a snack.

Use only half the butter, margarine, or salad dressing you do now. Try low fat or fat free condiments, such as fat free salad dressings. Gradually increase dairy products to three servings per day.

For example, drink milk with lunch or dinner, instead of soda, alcohol, or sugar-sweetened tea. Choose low fat (1 percent) or fat free (skim) dairy products to reduce total fat intake.

Treat meat Treat meat as one part of the whole meal, instead of the focus. Buy less meat. If it's not there, you won't eat it. Limit meat to 6 ounces a day (two servings)--all that's needed.

more vegetarian-style (meatless) meals Three to four ounces is about the size of a deck of cards. If you now eat large portions of meat, cut them back gradually--by a half or a third at each meal. Include two or more vegetarian-style (meatless) meals each week.

having less meat and more vegetables grains, and dry beans. Increase servings of vegetables, rice, pasta, and dry beans in meals. Try casseroles and pasta, and stir-fry dishes, having less meat and more vegetables, grains, and dry beans.

Use fruits or low fat foods as desserts Use fruits or low fat foods as desserts and snacks. Fruits and low fat foods offer great taste and variety. Use fruits canned in their own juice. Fresh fruits require little or no preparation. Dried fruits are easy to carry with you. Try these snack ideas: unsalted pretzels or nuts mixed with raisins; graham crackers; low fat and fat free yogurt and frozen yogurt; plain popcorn with no salt or butter added; and raw vegetables.

Daily Nutrient Goals Used in the DASH Studies(for a 2,100 Calorie Eating Plan) fat 27% ( Saturated fat 6% , Cholesterol 150 mg ） Protein 18% Carbohydrate 55% Sodium 2,300 mg* Potassium 4,700 mg Calcium 1,250 mg Magnesium 500 mg Fiber 30 g * 1,500 mg sodium was a lower goal tested and found to be even better for lowering blood pressure. g = grams; mg = milligrams