Dietary Approaches To Stop Hypertension Research Articles

Management and Therapeutic Intervention for Hypertension: A Comprehensive Review

Hypertension, a chronic condition characterized by elevated blood pressure, is a major global health concern, affecting over 1.28 billion people and contributing to significant cardiovascular diseases such as heart attacks, strokes, and kidney failure. This comprehensive review explores the multifaceted approaches to managing and treating hypertension, including lifestyle modifications, pharmacological therapies, and innovative interventions. It highlights key therapeutic strategies such as the DASH diet, regular exercise, and stress management, along with pharmacological treatments like diuretics, beta-blockers, and angiotensin-converting enzyme inhibitors. Additionally, emerging therapies such as renal denervation, baroreceptor activation therapy, and precision medicine offer new avenues for treating resistant hypertension. The role of telemedicine and digital health tools in enhancing blood pressure management is also discussed. Despite these advancements, challenges such as patient adherence, healthcare disparities, and aging populations persist. Future research should focus on precision medicine, improving adherence, and expanding access to cost-effective treatments in low-resource settings. Addressing these challenges through global collaboration can significantly reduce the global burden of hypertension and improve patient outcomes. Keywords: Hypertension, blood pressure management, pharmacological therapy, lifestyle interventions.

Neuroprotective Dietary Patterns and Longitudinal Changes in Cognitive Function in Older Adults

BackgroundNumerous studies have examined the association between neuroprotective diets and cognitive function during aging; however, these studies have produced divergent findings. Some studies find that greater adherence to these dietary patterns is associated with preserved cognition, whereas others find no effect. ObjectiveThe aim of this study was to examine the association of the Mediterranean, the Dietary Approach to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegeneration Delay (MIND) dietary patterns with global cognition over 4 waves of data from the Health and Retirement Study, a longitudinal panel study conducted at the University of Michigan. DesignThis is a longitudinal secondary data analysis using Health and Retirement Study data drawn from the Food Frequency Questionnaire completed as part of the Health Care and Nutrition Survey administered in 2013 to 2014, neuropsychological assessment data obtained from the Core questionnaire in 2014, 2016, 2018, and 2020, and demographic data from the Core questionnaire in 2014. Participants/settingParticipants with total daily energy intake below 600 or 800 kcal and above 6000 and 8000 kcal for women and men, respectively, were excluded based on criteria from a similar study using the same dataset. In addition, participants with a diagnosis of dementia, Alzheimer disease, or stroke as of 2014 were excluded. There were 6154 participants in the Mediterranean diet and DASH diet analyses and 5143 participants in the MIND diet analyses. Main outcome measureA global cognitive measure incorporating immediate and delayed recall, serial 7s, and backward counting scores was calculated for each participant at each wave. Statistical analysisThe primary analyses examined the association between each diet type and cognition over 4 waves using separate multilevel models that controlled for age, gender, self-rated health, years of education, total energy intake, weekly exercise, and body mass index. ResultsMediterranean and DASH diet adherence were positively and significantly associated with baseline cognition and were associated with slower cognitive decline over a 6-year period. MIND diet adherence was positively and significantly correlated with baseline cognition but was not significantly associated with slower cognitive decline over a 6-year period. Cross-level interactions for adherence to each dietary pattern and cognitive change over time, computed with standardized diet scores, were as follows: Mediterranean diet (β = .03; P = .002), DASH diet (β = .04; P = .004), and MIND diet (β = .02; P = .094). ConclusionsThe Mediterranean, DASH, and MIND dietary patterns are associated with better cognitive performance at baseline and the Mediterranean and DASH diets were associated with slower cognitive decline over time. Adherence to the DASH diet had the greatest magnitude of association with baseline cognition and rate of cognitive change.

Abstract P331: Simple Instruction and Provision of Literature on Low Salt Diet Ineffective in Reducing Salt Intake in Patients with Hypertension

Objective: Hypertension remains poorly controlled at the population level. Reduction of salt intake via the DASH diet is effective in reducing blood pressure (BP). We enrolled a cohort of patients with hypertension to assess molecular factors that influence BP control over a follow up period of 6 months. Here we report dietary sodium intake and BP control. Methods: 80 non-diabetic patients aged >40 with hypertension were enrolled in the study. Subjects reccieved brief instruction and a handout on the DASH diet from a study coordinator. Medications were titrated to a BP of <130/80 at enrollment, months 1, 2,3 and 6. BP was measured at each visit using an automated cuff following clinical trial methodology. 24-hour urine sodium excretion was collected at enrollment, months 3 and 6. Descriptive variables were summarized and paired t-tests were used to compare sodium excretion and BP. Results: Cohort characteristics are in Table 1. 73 subjects provided 24-hour urine samples and BP at enrollment and month 3 while 67 had samples at enrollment and month 6. Mean BP at enrollment was 129.9/75.3 (SD 16.6/12.5) which reduced 123/71.8 (SD 12.9/10) at month 3, p <0.001and 125.4/73.4 (SD 15.2/10.5), p=0.02. 24-hour sodium excretion was 152 mmol (SD 73.6) at enrollment. There was no difference in sodium excretion at 3- (154 mmol, SD 86.2, p=0.8) or 6 months (139 mmol, SD 60,, p=0.18). Conclusions: According to 24-hour urine collection, participants consumed roughly 3.5 g of sodium per day. Simple instruction and provision of literature regarding a DASH diet was ineffective in reducing sodium intake. Further study is required to determine a more effective educational delivery method and understand any social factors that may inhibit diet implementation in this urban hypertensive cohort.

Dietary Interventions and Supplements for Managing Attention-Deficit/Hyperactivity Disorder (ADHD): A Systematic Review of Efficacy and Recommendations.

Attention-deficit/hyperactivity disorder (ADHD) significantly impacts children's neurological development, behaviour, and overall well-being, affecting academic performance and social interactions. This systematic review investigates the effectiveness of dietary interventions (DASH(Dietary Approaches to Stop Hypertension) diet, Vitamin D3 supplementation, magnesium, and impact of artificial food colors and marine oils) and supplements alongside standard pharmacotherapy in managing ADHD symptoms. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we extensively searched various databases for studies published from 2016 to 2022. Out of an initial pool of 7873 records, 14 randomized controlled trials met our inclusion criteria following rigorous screening. Our findings suggest that gluten-free diets may alleviate ADHD symptoms despite negative celiac serology, highlighting the role of non-celiac gluten sensitivity. Moreover, vitamin and mineral supplements like vitamin D and magnesium showed varying degrees of effectiveness in improving behavioural and emotional symptoms. Innovative treatments, such as combining saffron with methylphenidate and using marine oil extracts, also demonstrated potential in enhancing behaviours associated with ADHD. The review underscores the importance of dietary approaches, such as the DASH diet and specific exclusions (e.g., a few foods diet and an oligoantigenic diet), in managing symptoms by addressing nutritional factors. Studies on probiotics and interventions targeting gut microbiota composition yielded mixed results, necessitating further exploration. Limitations include study diversity and short-term outcome assessments, cautioning against broad generalizations. Integrating personalized dietary assessments and interventions into ADHD treatment strategies could optimize therapeutic outcomes and potentially reduce reliance on pharmacotherapy alone. In summary, this systematic review highlights the potential benefits of dietary modifications and supplements in managing ADHD symptoms. Future research should prioritize long-term efficacy, interactions with conventional medications, and personalized dietary approaches to refine ADHD treatment strategies.

The Buddy System: African American Women with Self-Reported Hypertension and Their Experiences in a Peer (Dyadic) Support Intervention

INTRODUCTION: Hypertension is the leading modifiable risk factor for cardiovascular disease, and it disproportionately affects African American women, who face increased risks of heart disease, kidney disease, and stroke. The Dietary Approaches to Stop Hypertension (DASH) diet effectively reduces blood pressure, but African American women often face challenges with adhering to it. Peer support, a proven mechanism for improving health behaviors through social connections and community resources, may help these women better manage their diet and hypertension. This qualitative study explored the experiences of African American women participating in an eight-week peer (dyadic) support intervention to improve DASH diet adherence and lowering systolic blood pressure, with an emphasis on understanding the dyadic relationship. METHODS: A purposive sample of 40 African American women (20 dyads) was recruited for five focus groups that were conducted both online and in person. Content analysis was used to identify themes related to the nature and quality of peer interactions and relationships from the perspectives of the 34 women who completed the intervention (Mean age = 71.38 years; SD = 8.38). RESULTS: Four subthemes emerged: emotional support, shared experiences, informational/inspirational support, and accountability. The participants reported forming strong, supportive relationships that were crucial in improving diet and blood pressure management. CONCLUSION: This study underscores the benefits of peer support in managing hypertension among older African American women, suggesting the need for future randomized controlled trials to examine the effectiveness of the DASH diet with and without peer support.

Adherence to dietary approaches to stop hypertension diet and visceral adipose tissue area among U.S. adults, a cross-sectional study

Excessive visceral adipose tissue (VAT) is a significant risk factor for various diseases. Diet plays a crucial role in controlling obesity. This study examined the association between the Dietary Approaches to Stop Hypertension (DASH) diet and VAT in 9027 adults using data from the National Health and Nutrition Examination Survey. Linear regression models were used to explore this association, with subgroup analyses included. Results showed a significant inverse association between DASH scores and VAT area, even after adjusting for covariates (β = −2.18, 95% CI: −3.10, −1.27). Participants in the highest DASH score tertile had significantly lower VAT areas compared to those in the lowest tertile (β = −7.2, 95% CI: −10.40, −4.01). This inverse association was most pronounced in middle-aged participants. Further prospective cohort studies are necessary to confirm these findings.

Expression of Concern: The effects of DASH diet on weight loss and metabolic status in adults with non-alcoholic fatty liver disease: A randomized clinical trial.

Expression of Concern: M. R. Zade, M. H. Telkabadi, F. Bahmani, B. Salehi, S. Farshbaf, and Z. Asemi, 'The effects of DASH diet on weight loss and metabolic status in adults with non-alcoholic fatty liver disease: A randomized clinical trial', Liver International 36, no. 4 (2016): 563-571. https://doi.org/10.1111/liv.12990. This Expression of Concern is for the above article, published online on 26 October 2015 in Wiley Online Library (wileyonlinelibrary.com), and has been published by agreement between the journal Editor-in-Chief, Luca Valenti, and John Wiley & Sons Ltd. The Expression of Concern has been agreed due to concerns raised regarding the integrity of the research and discrepancies in reporting. An investigation has been conducted by the National Committee for Ethics in Biomedical Research Iran, in coordination with Kashan University of Medical Sciences (KAUMS). However, without the verification of clinical records, there remains sufficient doubts about the feasibility and integrity of the research undertaken. As a result, the journal has decided to issue an Expression of Concern to alert readers.

Association between different diet quality scores and depression risk: the REGICOR population-based cohort study

BackgroundOur aim was to determine the association between diet quality and depression incidence in the population-based REGICOR cohort study, Catalonia, Spain.MethodsProspective observational study using participants’ baseline (2003–2006), follow-up (2007–2013) and clinical records data. Five diet quality scores were derived from a food frequency questionnaire (FFQ) at baseline: the relative Mediterranean Diet Score (rMED), the Modified Mediterranean Diet Score (ModMDS), a Dietary Approaches to Stop Hypertension (DASH) score, a Healthful Plant-based Diet Index (HPDI) and the World Health Organization Healthy Diet Indicator (WHO-HDI). Participants using pharmacological antidepressant treatment were excluded as a proxy for presence of depression at baseline. At follow-up, the Patient Health Questionnaire (PHQ-9) was applied to assess depressive symptoms (≥ 10 defining depressive disorder). A secondary outcome was depression diagnosis assessed through clinical records. Logistic regression and Cox proportional hazards models were used.ResultsMain analysis included 3046 adults (50.3% women) with a mean age of 54.7 (SD = 11.6) years. After 6-years follow-up, 184 (6.04%) cases of depressive disorder were identified. There was 16% lower odds of depressive disorder per 1SD increase of rMED (OR = 0.84; 95%CI = 0.71–0.98). Secondary outcome analysis (n = 4789) identified 261 (5.45%) incident cases of clinical depression diagnosis over 12 years follow-up, and 19% lower risk of clinical depression was observed with the WHO-HDI (HR = 0.81; 95%CI = 0.70–0.93). Adjusting for BMI did not attenuate the findings.ConclusionsA significant inverse association between diet quality and depression incidence was found in this population-based cohort study, independent of sociodemographic, health and lifestyle. Adherence to a healthy diet could be a complementary intervention for the prevention of depression.

Dietary interventions for Alzheimer's in Pakistan: The MIND diet perspective.

Dear Editor, Alzheimer’s disease (AD) stands as the prevalent type of dementia, making up 50–75% of total cases, and showing a higher incidence among elderly patients. (1). Pakistan is a lower-middle-income country with an estimated 150,000–200,000 patients affected by dementia (2). Nevertheless, the patient population faces inadequate healthcare resources, with only one neurosurgeon for every 1,000,000 patients (3). The Alzheimer's Association Facts and Figures Guidelines (2014) have highlighted diet as a modifiable risk factor in progression of AD (4). Thus, investigating lifestyle modifications in the early stages of AD to potentially alleviate the disease progression becomes imperative, considering the significant burden the disease imposes on the healthcare system. The MIND diet is a composite dietary approach, derived from both the Mediterranean and DASH diets. It underscores the consumption of leafy greens, berries, nuts, whole grains, fish, legumes, and poultry while advocating for the use of olive oil. Conversely, it discourages the intake of red meat, butter, cheese, pastries, and fried or fast-food items (5). Agarwal et al. investigated the impact of the MIND diet on AD pathology in 581 autopsied participants from the Rush Memory and Aging Project. Their research demonstrated a significant correlation between adherence to the MIND diet and a decline in overall disease pathology, particularly in the reduction of Beta-amyloid plaques (6). Furthermore, another study illustrated that increased compliance with the MIND diet was associated with a reduced risk of hippocampal sclerosis (HS), a neurodegenerative condition linked to AD, even after accounting for other factors, such as APOE-4 status and AD pathology (7). Moreover, Morris et al.'s longitudinal study on US participants found a 53% lower risk for AD among individuals who adhered closely to the MIND diet and a 35% lower risk for those with moderate adherence after a follow-up of approximately 4.5 years (8). These findings indicate a potential role for the MIND diet in reducing the risk of AD and slowing cognitive decline. A comprehensive literature search on PubMed and PakMediNet revealed a lack of research, evaluating the efficacy of the MIND diet in the management of AD in Pakistan. This underscores the inadequacy in the implementation of the MIND diet among the patients. Consequently, it is recommended that researchers submit research grant proposals about the efficacy of the MIND diet in AD to different funding organizations. ---Continue

Dietary Strategies in the Prevention and Treatment of Hypertension in Children and Adolescents: A Narrative Review.

This study aims to gather information on effective dietary strategies for the prevention and treatment of hypertension (HTN) in children and adolescents. It discusses specific nutritional models such as the Diet Approaches to Stop Hypertension (DASH diet), traditional Asian diets, plant-based diets, the Southern European traditional Atlantic diet, and the Mediterranean diet, highlighting the benefits of these approaches. The manuscript also addresses dehydration resulting from insufficient fluid intake among children, as well as the consumption of inappropriate beverages, like soft drinks and energy drinks, which contributes to the development of HTN. Additionally, it examines the role of oxidative stress in the pathomechanism of HTN in children, particularly in relation to the antioxidant potential of food components such as selenium, magnesium, and selected vitamins. The relationship between sodium and potassium intake from food and the development of HTN in children is also explored. Finally, this study discusses public health strategies for the prevention of HTN in children. A comprehensive search was performed across multiple databases, such as PubMed/MEDLINE, the Cochrane Library, Science Direct, and EBSCO. This search focused on locating English-language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from around the globe.

Effect of Dietary Patterns on Human Gut Microbiota: a narrative review

Introduction: Diet plays a crucial role in shaping the human gut microbiota (GM), but studies investigating the effects of dietary patterns on the GM are still limited. Objective: This study aimed to review the effects of different dietary patterns on the human GM. Methods: This review included observational and clinical studies published in PubMed/MEDLINE between 2019 and 2023. Results: Initially, 1,148 articles were identified and 12 articles were included. Studies were conducted in various countries, predominantly in the USA (n=3), and most evaluated the effects of the Mediterranean diet (n=3) and vegetarian/vegan diet (n=3). No included study evaluated the DASH (Dietary Approaches to Stop Hypertension) diet. The Western diet showed negative effects on the GM, characterized by an increase in Firmicutes bacteria and a reduction in bacterial diversity and richness. These effects are associated with cardiovascular and inflammatory diseases. The low carb diet showed conflicting results among studies. The ketogenic diet appears to be associated with a decrease in the Firmicutes/Bacteroidetes ratio, especially when whey protein or plant proteins are the main protein sources in the diet. Mediterranean and vegetarian/vegan diets had beneficial effects on the GM, mainly associated with high fiber intake from fruits, vegetables, and legumes, leading to a reduction in the Firmicutes/Bacteroidetes ratio, an increase in Akkermansia bacteria, and higher production of short-chain fatty acids (SCFAs). Conclusion: Dietary pattern exerts distinct effects on the GM, influencing bacterial richness and diversity differently. Further studies are recommended in this area, including investigation of the DASH diet’s impact on the GM. Keywords: Gastrointestinal microbiome; dietary patterns.

Diet Quality at 3 Years of Age Relates to Lower Body Mass Index but Not Lower Blood Pressure at 10 Years of Age.

A healthy diet prevents overweight problems and hypertension. We investigated the associations of a healthy diet with the body mass index (BMI) and blood pressure (BP) in early childhood. In the GECKO birth cohort, height, weight, and BP were measured at 5 and 10 years of age. Diet was evaluated at 3 years using three diet scores: the Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score (MDS), and the Lifelines Diet Score (LLDS). Linear and logistic regression models assessed the associations of diet scores with the BMI and BP. Of the 1077 children included, 10.8% were overweight or obese at 5 years. That number was 16.5% at 10 years. In addition, 34.5% had elevated BP at 5 years. That number was 23.9% at 10 years. Higher DASH, MDS, and LLDS, which indicate healthier diets, were all associated with lower BMI z-scores at 10 years of age. Higher DASH is related to lower overweight risk at 10 years. None of the diet scores were associated with BP or elevated BP at either 5 or 10 years. Also, in an overweight subset, diet was not related to BP. A healthy diet in early childhood is related to children being less overweight but not having lower BP at 10 years of age.

Serum protein responses to Dietary Approaches to Stop Hypertension (DASH) and DASH-Sodium trials and associations with blood pressure changes.

The Dietary Approaches to Stop Hypertension (DASH) diet reduces blood pressure, but the mechanisms underlying DASH diet-blood pressure relations are not well understood. Proteomic measures may provide insights into the pathophysiological mechanisms through which the DASH diet reduces blood pressure. The DASH (1994-1996) and DASH-Sodium (1997-1999) trials were multicenter, randomized-controlled feeding trials. Proteomic profiling was conducted in serum collected at the end of the feeding period (DASH, N = 215; DASH-Sodium, N = 390). Multivariable linear regression models were used to identify interactions between 71 DASH diet-related proteins and changes in systolic and diastolic blood pressure. Estimates were meta-analyzed across both trials. Elastic net models were used to identify proteins that predict changes in blood pressure. Ten significant interactions were identified [systolic blood pressure: seven proteins; diastolic blood pressure: three proteins], which represented nine unique proteins. A high level of renin at the end of the feeding period was associated with greater reductions in diastolic blood pressure in individuals consuming the control than DASH diets. A high level of procollagen c-endopeptidase enhancer 1 (PCOLCE) and collagen triple helix repeat-containing protein 1 (CTHRC1) were associated with greater reductions in systolic blood pressure in individuals consuming the DASH than control diets, and with elevations in systolic blood pressure in individuals consuming the control diets (P for interaction for all tests < 0.05). Elastic net models identified six additional proteins that predicted change in blood pressure. Several novel proteins were identified that may provide some insight into the relationship between the DASH diet and blood pressure.

Enhancing Brain Health and Well-Being in Older Adults: Innovations in Lifestyle Interventions.

This article will provide clinicians with guidance on helping older adult patients make lifestyle changes to enhance brain health and well-being. Evidence suggests that physical activity might be helpful in improving cognitive functioning. The data on the benefits of cognitive activity is inconsistent and not as robust. The MediDiet, DASH, and MIND diets have been associated with better cognitive health. Sleep hygiene and cognitive behavioral therapies are considered first line evidence-based treatments for insomnia and the maintenance of healthy sleep patterns. Mindfulness based interventions have been shown to reduce anxiety, depression, and stress, and can help some older adults manage pain more constructively. Evidence-based information regarding the four topics of exercise, nutrition, sleep, and mindfulness is reviewed, so that clinicians may be better able to optimize care for their older adult patients.

Association Between Caregiver Strain and Self-Care Among Caregivers With Hypertension: Findings From the REGARDS Study.

Self-care for adults with hypertension includes adherence to lifestyle behaviors and medication. For unpaid caregivers with hypertension, the burden of family caregiving may adversely impact self-care. We examined the association between caregiver strain and hypertension self-care among caregivers with hypertension. We included participants of the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study who identified as caregivers and had hypertension. Caregiver strain, assessed by self-report, was categorized as "none/some" or "high." Hypertension self-care was assessed individually across 5 domains (Dietary Approaches to Stop Hypertension [DASH] diet, physical activity, alcohol use, cigarette smoking, and medication adherence) and a composite self-care score summing performance across them. The association between caregiver strain and hypertension self-care was examined with multivariable linear regression. Among the 2128 caregivers with hypertension, 18.1% reported high caregiver strain. Caregivers with high strain versus those with none/some were less adherent to the DASH diet (50.8% versus 38.9%, P<0.002), physically inactive (44.4% versus 36.2%, P<0.009), current smokers (19.7% versus 13.9%, P<0.004), and had lower overall self-care scores (6.6 [SD 1.7] versus 7.0 [SD 1.7], P<0.001). In an age-adjusted model, high caregiver strain was associated with worse hypertension self-care (β=-0.37 [95% CI, -0.61 to -0.13]); this remained significant but was reduced in magnitude after adjustment for sociodemographics (β=-0.35 [-0.59 to -0.11]), comorbidities (β=-0.34 [-0.57 to -0.10]), caregiving intensity (β=-0.34 [-0.59 to 0.10]), and psychological factors (β=-0.26 [-0.51 to 0.00]). High caregiver strain was associated with worse hypertension self-care overall and across individual domains. Increased awareness of caregiver strain and its potential impact on hypertension self-care is warranted.

Dietary patterns associated with obesity and its comorbidities

Obesity is a major public health challenge, in Spain the prevalence of excess of weight and obesity and is 56 % and 19 %, respectively, and it is linked to numerous preventable chronic diseases. Nutritional epidemiology focused on nutrients has evolved towards the study of dietary patterns that consider synergistic interactions between foods and nutrients. This study aims to investigate the relationship between obesity and its treatment by healthy dietary patterns. The Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH), based on plant products, whole grains and low levels of salt, sugars and red meat, have been shown to promote weight loss and reduce comorbidities associated with obesity. Although vegetarian and vegan diets are adequate options for disease management and prevention, they require planning to avoid nutritional deficiencies. In conclusion, healthy dietary patterns such as the Mediterranean diet, DASH and vegetarian options are effective in both the prevention and treatment of obesity, highlighting the importance of considering the synergy between foods and nutrients in the management of this health condition.

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diet and Metabolites in Chronic Kidney Disease.

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, and its association with renal outcomes remains unclear. In the REasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort, diet data were collected at baseline using food frequency questionnaires. Modified Poisson regression was used to examine the association of MIND diet with incident chronic kidney disease (CKD). In the REGARDS stroke case-cohort, 357 metabolites were measured in baseline plasma. Weighted linear regression was used to test associations between MIND diet and metabolites. Weighted logistic regression was used to test associations between MIND-associated metabolites and incident CKD. Mediation analyses were conducted to determine whether metabolites mediated the relationship between MIND diet and CKD. A higher MIND diet score was associated with a decreased risk of incident CKD (risk ratio 0.90, 95% CI (0.86-0.94); p = 2.03 × 10-7). Fifty-seven metabolites were associated with MIND diet (p < 3 × 10-4). Guanosine was found to mediate the relationship between MIND diet and incident CKD (odds ratio for indirect effects 0.93, 95% CI (0.88-0.97); p < 0.05). These findings suggest a role of the MIND diet in renal outcomes.

The effect of dietary approaches to stop hypertension (DASH) diet on fatty liver and cardiovascular risk factors in subjects with metabolic syndrome: a randomized controlled trial

BackgroundMetabolic syndrome (MetS) as a multifactorial disorder is associated with non-communicable diseases. The dietary approaches to stop hypertension (DASH) diet is a healthy dietary pattern. We investigated the effect of the DASH diet on fatty liver and cardiovascular risk factors in subjects with MetS.Methods60 Subjects with MetS were assigned into the intervention group (DASH diet) or the control group (a healthy diet). Fatty liver index (FLI), hepatic steatosis index (HSI), waist circumference (WC), weight, body mass index (BMI), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) were evaluated at the beginning and after intervention. Equations of fatty liver indices such as FLI and HSI are based on liver enzymes, anthropometric variables, sex and having diabetes.Results30 subjects in the intervention group and 29 subjects in the control group completed the study. We found a significant reduction in the intervention group compared to the control group in FLI (-13.06 ± 10.03 vs. -2.90 ± 6.82;P < 0.001), HSI (-2.72 ± 2.59 vs. -0.81 ± 3.80;P = 0.02), WC (-6.02 ± 4.24 vs. -2.24 ± 4.28;P = 0.001), weight (-3.39 ± 2.53 vs. -1.51 ± 2.72;P = 0.008), BMI (-1.25 ± 0.93 vs. -0.56 ± 1.01;P = 0.008), DBP (-5.16 ± 3.92 vs. -1.50 ± 7.04;P = 0.01), SBP (-6.97 ± 8.21 vs. -1.36 ± 6.83;P = 0.006), TG (-18.50 ± 14.32 vs. 0.60 ± 23.81;P < 0.001), TC (-16.10 ± 17.94 vs. -5.07 ± 23.62;P = 0.04) and LDL-c (-13.50 ± 9.58 vs. -4.90 ± 18.28;P = 0.02). These results remained significant after adjusting for confounding factors, except for TC (P = 0.25).ConclusionsThe DASH diet was more effective than the control diet in managing fatty liver and cardiovascular risk factors.Trial registrationThe trial was registered on 21 October 2022 at Iranian Registry of Clinical Trials (IRCT20180201038585N12, URL: https://irct.behdasht.gov.ir/trial/66161).

Assessment of Diet Quality Based on Selected Dietary Quality Indices and Consumption of Specific Food Items of Midwives Working on a Shift Schedule in Wroclaw, Poland.

The aim of this study was to assess the quality of diets among midwives working in a shift system and to analyze variations in their dietary habits according to their working hours. In a group of fifty midwives employed in four public hospitals in Wrocław, the HDI-2015, HEI-2015, AHEI-2010, and Mellen's DASH diet index were calculated. The significance of differences in terms of the prevalence of selected dietary habits, meal frequency, average content of selected food items, and the percentage of energy obtained from them was assessed. Over half of the diets of the participants exhibited low adherence to the selected dietary indices. Only the scores on Mellen's DASH diet index were significantly associated with other components of the diet. Diets scoring ≥ 4.5 points were characterized by significantly lower processed meat content, meal frequency, and energy value, as well as lower sugar content and lower dietary energy value, compared to diets scoring < 4.5 points. Regardless of their working hours, the diets of midwives are characterized by low quality. Therefore, it appears essential to introduce targeted educational programs and provide guidance on appropriate dietary models, such as the DASH diet.

Precision Nutrition for Management of Cardiovascular Disease Risk during Menopause.

Women can spend up to 40% of their lives in the postmenopausal state. As women begin to transition into menopause, known as perimenopause, changes in hormonal concentrations and body composition dramatically increase overall cardiometabolic risk. Dietary patterns and interventions can be utilized to prevent and treat cardiovascular disease (CVD) and some dietary patterns over others may be more beneficial due to their specific effects on the health aspects of menopause. In this narrative review, we summarize key cardiovascular alterations that occur during the menopause transition and explore current dietary recommendations to address CVD risk as well as explore the new frontier of precision nutrition and the implications for nutrition prescription during menopause. Popular dietary interventions for CVD such as the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet (MED) have limited data in women following menopause. However, both diets improve CVD risk biomarkers of total cholesterol and low-density lipoprotein cholesterol as well as lower oxidative stress and inflammation and improve endothelial function. As the menopause transition increases the risk for developing metabolic syndrome, insulin insensitivity, and dyslipidemia, the DASH diet and MED may be impactful dietary strategies for mediating CVD risk in menopausal women. However, these are "one-size-fits-all" approaches that neglect individual characteristics such as genetic predisposition and environmental factors. Precision nutrition considers individual factors for nutrition prescription, spanning from evaluating food intake preferences and behaviors to deep phenotyping. Data from a large-scale investigation of the menopause transition suggests nutritional strategies that address postprandial glycemic responses, and the gut microbiome may attenuate some of the unfavorable effects of menopause on CVD risk factors. Considering menopause, women are a clinical population that would greatly benefit from precision nutrition. Future research should explore the use of machine learning and artificial intelligence in a precision nutrition framework to modify the DASH diet and MED to address adverse effects that occur during the menopause transition are vital for supporting women's health as they age.