Dietary Approaches To Stop Hypertension Diet Score Research Articles

Genome-Wide Interaction Analysis With DASH Diet Score Identified Novel Loci for Systolic Blood Pressure.

The Dietary Approaches to Stop Hypertension (DASH) diet score lowers blood pressure (BP). We examined interactions between genotype and the DASH diet score in relation to systolic BP. We analyzed up to 9 420 585 single nucleotide polymorphisms in up to 127 282 individuals of 6 population groups (91% of European population) from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (n=35 660) and UK Biobank (n=91 622) and performed European population-specific and cross-population meta-analyses. We identified 3 loci in European-specific analyses and an additional 4 loci in cross-population analyses at Pinteraction<5e-8. We observed a consistent interaction between rs117878928 at 15q25.1 (minor allele frequency, 0.03) and the DASH diet score (Pinteraction=4e-8; P for heterogeneity, 0.35) in European population, where the interaction effect size was 0.42±0.09 mm Hg (Pinteraction=9.4e-7) and 0.20±0.06 mm Hg (Pinteraction=0.001) in Cohorts for Heart and Aging Research in Genomic Epidemiology and the UK Biobank, respectively. The 1 Mb region surrounding rs117878928 was enriched with cis-expression quantitative trait loci (eQTL) variants (P=4e-273) and cis-DNA methylation quantitative trait loci variants (P=1e-300). Although the closest gene for rs117878928 is MTHFS, the highest narrow sense heritability accounted by single nucleotide polymorphisms potentially interacting with the DASH diet score in this locus was for gene ST20 at 15q25.1. We demonstrated gene-DASH diet score interaction effects on systolic BP in several loci. Studies with larger diverse populations are needed to validate our findings.

Diet Quality, Sedentary Time, and Blood Pressure in the POUCHmoms Study

BackgroundElevated blood pressure (BP) is a major contributor to cardiovascular disease in womens; diet and sedentary time (ST) are modifiable lifestyle factors thought to influence BP. ObjectivesThe aim of this study was to examine 2 diet-quality measures and ST in relation to BP among parous womens. MethodsThis cross-sectional analysis uses data from 677 womens (age 25–55 y) enrolled in the Pregnancy Outcomes and Community Health (POUCH) Study and followed up in the POUCHmoms study 7–15 y after delivery (2011 and 2014). Follow-up measures included a food-frequency questionnaire (FFQ), self-report of ST (occupational and leisure), and systolic and diastolic blood pressure (SBP and DBP, respectively). The FFQ was used to calculate 2 diet-quality measures, Alternative Healthy Eating Index-2010 (AHEI) and Dietary Approaches to Stop Hypertension (DASH). Total ST h/wk was dichotomized at the median and labeled “low” or “high.” In weighted unadjusted and adjusted regression models, BP was assessed in relation to diet scores (linear and threshold associations) and combinations of dichotomized diet-quality scores (“poor” = lowest quartile compared with “not poor” = upper 3 quartiles) and ST. ResultsHigher mean SBP and DBP occurred mainly in women with a ‘“poor” diet-quality score (AHEI and DASH). Among womens with a “poor”-quality diet (on the basis of the AHEI score) and “high” ST, (N = 93) adjusted mean SBP and DBP were 4.5 mmHg and 4.4 mmHg higher, respectively, than that of the counterparts who did not have a poor-quality diet and had “low” ST (N = 275). Results were similar in analyses using the DASH diet score. ConclusionsWomen with poor-quality diets and more ST may need closer BP monitoring. Even modest improvements in womens’ diet quality and reductions in ST might help lower their BP, but this observation needs testing in prospective studies..

Adapted Mindfulness Training for Interoception and Adherence to the DASH Diet

Hypertension is a major cause of cardiovascular disease, and although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP), adherence is typically low. Mindfulness training adapted to improving health behaviors that lower BP could improve DASH adherence, in part through improved interoceptive awareness relevant to dietary consumption. To evaluate the effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on interoceptive awareness and DASH adherence. Parallel-group, phase 2, sequentially preregistered randomized clinical trials were conducted from June 1, 2017, to November 30, 2020. Follow-up was 6 months. Participants with elevated unattended office BP (≥120/80 mm Hg) were recruited from the population near Providence, Rhode Island. Of 348 participants assessed for eligibility, 67 did not meet inclusion criteria, 17 declined, and 63 did not enroll prior to study end date. In total, 201 participants were randomly assigned, 101 to the MB-BP program and 100 to the enhanced usual care control group, with 24 (11.9%) unavailable for follow-up. Outcome assessors and the data analyst were blinded to group allocation. Analyses were performed using intention-to-treat principles from June 1, 2022, to August 30, 2023. The 8-week MB-BP program was adapted for elevated BP, including personalized feedback, education, and mindfulness training directed to hypertension risk factors. Both MB-BP and control groups received home BP monitoring devices with instructions and options for referral to primary care physicians. The control group also received educational brochures on controlling high BP. The primary outcome was Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire scores (range 0-5, with higher scores indicating greater interoceptive awareness), and the secondary outcome was DASH adherence scores assessed via a 163-item Food Frequency Questionnaire (range 0-11, with higher scores indicating improved DASH adherence), all compared using regression analyses. Among 201 participants, 118 (58.7%) were female, 163 (81.1%) were non-Hispanic White, and the mean (SD) age was 60.0 (12.2) years. The MB-BP program increased the MAIA score by 0.54 points (95% CI, 0.35-0.74 points; P < .001; Cohen d = 0.45) at 6 months vs control. In participants with poor baseline DASH adherence, the MB-BP program also significantly increased the DASH score by 0.62 points (95% CI, 0.13-1.11 points; P = .01; Cohen d = 0.71) at 6 months vs controls. The intervention was also associated with a 0.34-point improvement in the DASH diet score in all MB-BP participants from baseline (95% CI, 0.09-0.59 points; P = .01; Cohen d = 0.27), while the control group showed a -0.04 point change in DASH diet score from baseline to 6 months (95% CI, -0.31 to 0.24 points; P = .78; Cohen d = -0.03). A mindfulness program adapted to improving health behaviors to lower BP improved interoceptive awareness and DASH adherence. The MB-BP program could support DASH dietary adherence in adults with elevated BP. ClinicalTrials.gov Identifiers: NCT03859076 and NCT03256890.

Concordance between Dash Diet and Hypertension: Results from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study.

High blood pressure is an important predictor of atherosclerotic cardiovascular disease (ASCVD), particularly among South Asians, who are at higher risk for ASCVD when compared to other population groups. The Dietary Approaches to Stop Hypertension (DASH) dietary pattern is established as the best proven nonpharmacological approach to preventing hypertension in adults. Using data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort, we calculated a DASH dietary score to examine the association between adherence to the DASH diet and its components, and prevalent and incident hypertension and systolic and diastolic blood pressure, after five years of follow-up. We found that the relative risk ratio (RRR) of incident hypertension was 67% lower among participants in the highest DASH diet score category (aRRR: 0.33; 95% CI: 0.13, 0.82; ptrend = 0.02) compared with those in the lowest DASH diet score category in fully adjusted models. These findings are consistent with previous clinical trials and large prospective cohort studies, adding to evidence that supports the diet-disease relationship established between DASH diet and hypertension. This study is the first to examine DASH diet adherence and hypertension among South Asian adults in the U.S.

Association between adherence to the Dietary Approaches to Stop Hypertension diet and serum uric acid

To explore the relationship between Dietary Approaches to Stop Hypertension (DASH) diet and serum uric acid (SUA) levels among the Chinese adult population, and verify the mediating effect of BMI between DASH diet and SUA levels. A total of 1125 adults were investigated using a self-administered food frequency questionnaire. SUA levels were determined by uricase colorimetry. The total DASH score ranged from 9 to 72. The relationship between the DASH diet and SUA levels was examined by multiple adjusted regression analysis. Method of Bootstrap was used to test the mediation effect of BMI in the correlation of the DASH diet and SUA levels. After multivariable adjustment, there was a significant linear relationship between the DASH diet and SUA (P < 0.001). Compared with the lowest group, SUA of participants in group of highest DASH diet score decreased by 34.907 (95% CI − 52.227, − 17.588; P trend < 0.001) μmol/L. The association between the DASH diet scores and SUA levels was partly mediated by BMI (− 0.26, Bootstrap 95% CI − 0.49, − 0.07), with 10.53% of the total effect being mediated. Adopting the DASH diet might be helpful in reducing SUA level, and the effect might be partly mediated by BMI.

Adherence to the DASH, MeDi, and MIND diet scores and the incidence of metabolically unhealthy phenotypes

BackgroundA metabolically unhealthy phenotype is associated with the risk of cardiometabolic events and can be prevented by adherence to healthy dietary patterns. The present study was designed to investigate the association between high adherence to the Dietary Approaches to Stop Hypertension (DASH), Mediterranean (MeDi), and Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet scores and the incidence of metabolically unhealthy phenotypes in adults across body mass index (BMI) categories. MethodsIn this cohort study, 512 subjects with metabolically healthy normal weight (MHNW) at baseline and 787 subjects with metabolically healthy overweight/obesity (MHOW/MHO) at baseline were included. Dietary intake was collected by a validated food frequency questionnaire, and DASH, MeDi, and MIND scores were calculated. The Joint Interim Statement (JIS) criteria were used to define a metabolically unhealthy status. ResultsA total of 137 and 388 subjects with metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUOW/MUO) phenotypes, respectively, were observed, over a mean of 5.91 years of follow-up. The Cox proportional hazard regression indicated participants in the third tertile of the DASH score had a lower risk of the MUNW phenotype (HR: 0.59; 95% CI: 0.37–0.92) than those in the lowest tertile. Similarly, the highest adherence to the MeDi and MIND scores was also linked to a 46% (HR: 0.54; 95% CI: 0.36–0.81) and 47% (HR: 0.53; 95% CI: 0.34–0.83) lower risk of the MUNW phenotype, respectively. As well, there was an inverse relationship between the highest adherence to the DASH (HR: 0.66; 95% CI: 0.50–0.86), MeDi (HR: 0.74; 95% CI: 0.58–0.93), and MIND (HR: 0.57; 95% CI: 0.43–0.74) scores and the risk of MUOW/MUO. There was no interaction between age and the three dietary patterns in relation to a metabolically unhealthy phenotype. ConclusionHigh compliance with the DASH, MeDi, and MIND scores was associated with a lower risk of MUNW. An inverse relationship between these three dietary patterns and the incidence of the metabolically unhealthy phenotype was also observed in individuals who had MHOW/MHO at baseline.

Abstract MP12: Dash Diet and Its Components is Associated With Visceral Fat Area and Hepatic Attenuation Among South Asian Adults in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study (2010-2013)

Introduction: South Asians (SA) are a growing population group in the US that remain understudied in research despite their high cardiometabolic risk. Compared to other ethnic groups, SA experience cardiometabolic disease onset at a younger age, and have higher abdominal, visceral and hepatic fat despite lower BMI. SA in the US have a unique dietary pattern characterized by a combination of traditional and western food items. Examining the dietary pattern of SA in relation to central adiposity may provide a tenable strategy for disease prevention and treatment. Hypothesis: We assessed the hypothesis that higher DASH diet score is associated with lower central adiposity, indicated by visceral fat area and hepatic attenuation measurements, among SA in the US. Methods: Using baseline data from 822 adults enrolled in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, we computed a Dietary Approaches to Stop Hypertension (DASH) concordance score from the FFQ validated to measure diet of South Asians in North America. Using an established method, score concordance was based on 8 components including high intake of fruit, vegetables, nuts/legumes, low-fat dairy products, whole grains; and low intake of sodium, sugar-sweetened beverages, and red/processed meats. We examined the association between the DASH score and its components with CT imaging of visceral fat area and hepatic attenuation (higher score indicates lower liver fat). Results: The overall DASH score among participants ranged from 13-35 (mean ± SD, 24.6 ± 4.4). Hepatic attenuation was 5 HU higher among participants in the highest category DASH score compared to the lowest (aβ (SE): 5 (1), 95% CI: 2, 7) in the age-adjusted model. The relationship was not significant in the fully adjusted model. Visceral fat area was 13.6 cm 2 lower among participants in the highest category of DASH score compared to the lowest (aβ (SE): -3.6 (5.1), 95% CI: -23.5, -3.7) in the model adjusted for age, sex, percent of life in US, education, BMI, physical activity, smoking, alcohol, and energy intake. When examining individual components of DASH, participants with the highest intake of low-fat dairy had hepatic attenuation 3 HU higher than those with the lowest intake, and those with the lowest intake of red/processed meat had hepatic attenuation 2 HU higher in the fully adjusted model. Participants with the lowest red/processed meat intake had visceral fat area that was 11 cm 2 lower in the fully adjusted model. Conclusions: In conclusion, our results indicate that greater adherence to DASH and some of its individual components is associated with favorable abdominal fat areas among a sample of SA adults in the US. These findings support the relationship between diet and abdominal fat accretion. Forthcoming analyses will use the DASH score to further elucidate the diet-disease relationship among SA in the US.

Associations of adherence to the DASH diet and the Mediterranean diet with chronic obstructive pulmonary disease among US adults.

The Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet are associated with reduced cardiovascular, tumor, and diabetes risk, but the effect on chronic obstructive pulmonary disease (COPD) is uncertain. To investigate the association of the DASH diet and the Mediterranean diet with the risk of COPD in American adults. This cross-sectional study included 28,605 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 survey cycle who had complete dietary and other questionnaire data. The scores of healthy eating patterns (the DASH diet and the Mediterranean diet) were derived from a 24-h dietary recall interview [individual food and total nutrient data from NHANES and food pattern equivalents data from the United States Department of Agriculture (USDA)]. The primary outcome was the prevalence of COPD. COPD was defined based on participants self-reported whether or not a doctor or health professional had diagnosed chronic bronchitis or emphysema. Secondary outcomes were lung function and respiratory symptoms. All analyses were adjusted for demographics and standard COPD risk factors (primary tobacco exposure, secondhand smoke exposure, and asthma). This study included 2,488 COPD participants and 25,607 non-COPD participants. We found that a higher DASH diet score was associated with a lower risk of COPD [odds ratio (OR): 0.83; 95% confidence interval (CI): 0.71-0.97; P = 0.021]. This association persisted in several subgroups [men (OR: 0.73; 95% CI: 0.58-0.93; P = 0.010), relatively young (OR: 0.74; 95% CI: 0.55-1.01; P = 0.050), and smoker (OR: 0.82; 95% CI: 0.67-0.99; P = 0.038)]. In contrast, the Mediterranean diet score was not significantly associated with COPD prevalence in this large cross-sectional analysis representative of the US adult population (OR: 1.03; 95% CI: 0.88-1.20; P = 0.697). In addition, we found a correlation between DASH diet adherence and lung function [β: -0.01; 95% CI: -0.01-0.00; P = 0.003 (FEV1: FVC)] or respiratory symptoms [OR: 0.80; 95% CI: 0.73-0.89; P < 0.001 (dyspnea); OR: 0.80; 95% CI: 0.70-0.91; P = 0.002 (cough); OR: 0.86; 95% CI: 0.74-0.99; P = 0.042 (expectoration)], especially in non-COPD populations. A higher DASH diet score was associated with improved COPD prevalence, lung function and respiratory symptoms. This new finding supports the importance of diet in the pathogenesis of COPD and expands the scope of the association of the DASH diet score with major chronic diseases.

Dietary Patterns and Risk of Gleason Grade Progression among Men on Active Surveillance for Prostate Cancer: Results from the Canary Prostate Active Surveillance Study

Modifiable lifestyle factors, such as following a healthy dietary pattern may delay or prevent prostate cancer (PCa) progression. However, few studies have evaluated whether following specific dietary patterns after PCa diagnosis impacts risk of disease progression among men with localized PCa managed by active surveillance (AS). 564 men enrolled in the Canary Prostate Active Surveillance Study, a protocol-driven AS study utilizing a pre-specified prostate-specific antigen monitoring and surveillance biopsy regimen, completed a food frequency questionnaire (FFQ) at enrollment and had ≥ 1 surveillance biopsy during follow-up. FFQs were used to evaluate adherence to the Dietary Guidelines for Americans (Healthy Eating index (HEI))-2015, alternative Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH) dietary patterns. Multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals were estimated using Cox proportional hazards models. During a median follow-up of 7.8 years, 237 men experienced an increase in Gleason score on subsequent biopsy (grade reclassification). Higher HEI-2015, aMED or DASH diet scores after diagnosis were not associated with significant reductions in the risk of grade reclassification during AS. However, these dietary patterns have well-established protective effects on chronic diseases and mortality and remain a prudent choice for men with prostate cancer managed by AS.

Diet quality predicts hypertensive disorders of pregnancy in Asian and Pacific Islander Cohort.

Background: There is limited data on diet quality during pregnancy and its impact on hypertensive disorders of pregnancy (HDP). Aim: Examine the association with diet quality and development of HDP in an Asian and Pacific Islander Cohort Methods: Pregnant women from the 4 largest ethnic groups in Hawai'i were recruited for participation. Participants completed a food frequency questionnaire during each trimester. Adherence to three diet quality indices (DQIs) were scored-The Healthy Eating Index (HEI), The Alternate Mediterranean Diet score (aMED), and the Dietary approaches to Stop Hypertension (DASH) score. Mean scores were compared among those who did and did not develop HDP. Logistic Regression models were used to examine the association between diet quality and HDP accounting for confounders (age, parity, obesity, ethnicity, gestational weight gain). Results: Among 55 participants with complete follow-up, there was a high incidence of HDP (23%). There was no significant change of DQIs over time. Non-Hispanic White participants had higher DQIs than Filipinas, Japanese, or Native Hawaiians (not statistically significant). Across gestation, participants who did not have HDP had better diet quality than those who did. Logistic regression showed that HEI and DASH indices are predictive of HDP development, with the high DASH diet score having the greatest reduced odds. Every point higher of DASH diet score portended approximately 30% reduced odds of developing HDP. Conclusions: The DASH diet had the strongest association with reduced odds of HDP, but better diet quality in any of the indices was also predictive.

The Dash Diet Pattern and Blood Pressure Changes in US Veterans With Type 2 Diabetes – a Post-hoc Analysis of the Blueberry Consumption and Type 2 Diabetes Study

ObjectivesThe goals of nutrition therapy for adults with type 2 diabetes include promoting healthful eating patterns and supporting improvements in cardiometabolic risk factors. Hypertension, which is a risk factor for stroke, myocardial infarction and heart failure, is common in persons with diabetes. There is limited data on the relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and blood pressure in US veterans with type 2 diabetes. The primary objective of the study is to determine the effect of the DASH diet pattern on blood pressure in US veterans. MethodsA secondary analysis from the Blueberry Consumption and Type 2 Diabetes study (NCT02972996, clinicaltrials.gov) was conducted in fifty-two men (mean ± SD baseline characteristics: 67 ± 6 years; weight, 102 ± 14 kg; body mass index, 34 ± 4 kg/m2; systolic blood pressure, 129 ± 17 mmHg; diastolic blood pressure, 76 ± 8 mmHg; hemoglobin A1c, 7.3 ± 0.8%) with type 2 diabetes. DASH diet patterns for six nutrients (protein, total fat, calcium, potassium, sodium and fiber) were collected by three-day food records. DASH diet scores were created by summing the scores for the six nutrients. Baseline blood pressure was collected according to standard protocol and used for the analysis. Multiple linear regression was used to determine the association between the DASH diet score and blood pressure. ResultsIn multiple linear regression analysis, adjusted for age, body mass index and comorbid conditions, a higher DASH score was associated with a decrease in systolic blood pressure (β = –5.96; P = 0.026) but not diastolic blood pressure (β = –1.65; P = 0.169). For every one unit increase in the DASH score, the estimated mean systolic blood pressure decreased by approximately 6.0 mmHg. ConclusionsThese findings suggest that adherence to the DASH diet pattern is associated with a decrease in systolic blood pressure in men who are US veterans with type 2 diabetes. The results should be verified by randomized clinical trials evaluating the effects of the DASH diet on blood pressure in adults with type 2 diabetes. Funding SourcesThe U.S. Highbush Blueberry Council; the study is the result of work supported with resources and the use of facilities at the Stratton VA Medical Center, Albany, NY, USA.

A Modified Recommended Food Score Is Associated with a Lower Incidence of High Blood Pressure in Middle-Aged and Older Korean Men: The Korean Genome and Epidemiology Study

ObjectivesThis cohort study investigated the association between the modified RFS (Recommended Food Score) and incident high blood pressure in Korean adults from the Korean Genome and Epidemiology Study (KoGES).MethodsWe prospectively analysed 2,854 (1,028 men and 1,556 women) participants aged 40–69 years without high blood pressure at baseline during a 16-year follow-up period. A dish-based, semi-quantitative, 103-item food frequency questionnaire was used to assess dietary intakes at baseline. The modified RFS (a total of 65 points) is based on the reported consumption of foods recommended in the Dietary Approaches to Stop Hypertension (DASH) diet modified for Korean foods. High blood pressure included hypertension and prehypertension, also known as stage 1 hypertension (a systolic blood pressure ≥120 mmHg, diastolic blood pressure ≥80 mmHg). Cox proportional hazards model was used to examine the association between modified RFS scores and the risk of incident high blood pressure.ResultsA total of 1,663 participants (761 men and 902 women) developed high blood pressure during an average follow-up of 87 months (range 17‒183 months). The modified RFS was positively correlated with the DASH diet score in men (r = 0.6492; p < 0.0001) and women (r = 0.7291; p < 0.0001), respectively. Men with the highest quintile of the modified RFS had a 24% lower incidence of high blood pressure than those with the lowest quintile (adjusted hazard ratio = 0.76, 95% confidence interval = 0.60–0.96, p-trend = 0.0218). However, there was no association between modified RFS and incident high blood pressure in women.ConclusionsA higher modified RFS was associated with a reduced risk of incident high blood pressure in middle-aged and older Korean men. Further prospective studies of larger scale or intervention studies are needed to confirm these findings.Funding SourcesThis work was supported by the Bio & Medical Technology Development Program of the National Research Foundation funded by the Ministry of Science & ICT (2012M3A9C4048761) and the BK21 FOUR (Fostering Outstanding Universities for Research) funded by the Ministry of Education (MOE, Korea) and National Research Foundation of Korea.

Association of dietary patterns with obesity and metabolically healthy obesity phenotype in Chinese population: a cross-sectional analysis of China Multi-Ethnic Cohort Study.

Metabolically healthy obesity (MHO) might be an alternative valuable target in obesity treatment. We aimed to assess whether alternative Mediterranean (aMED) diet and Dietary Approaches to Stop Hypertension (DASH) diet were favourably associated with obesity and MHO phenotype in a Chinese multi-ethnic population. We conducted this cross-sectional analysis using the baseline data of the China Multi-Ethnic Cohort study that enrolled 99556 participants from seven diverse ethnic groups. Participants with self-reported cardiometabolic diseases were excluded to eliminate possible reverse causality. Marginal structural logistic models were used to estimate the associations, with confounders determined by directed acyclic graph (DAG). Among 65699 included participants, 11·2 % were with obesity. MHO phenotype was present in 5·7 % of total population and 52·7 % of population with obesity. Compared with the lowest quintile, the highest quintile of DASH diet score had 23 % decreased odds of obesity (OR = 0·77, 95 % CI 0·71, 0·83, Ptrend < 0·001) and 27 % increased odds of MHO (OR = 1·27, 95 % CI 1·10, 1·48, Ptrend = 0·001) in population with obesity. However, aMED diet showed no obvious favourable associations. Further adjusting for BMI did not change the associations between diet scores and MHO. Results were robust to various sensitivity analyses. In conclusion, DASH diet rather than aMED diet is associated with reduced risk of obesity and presents BMI-independent metabolic benefits in this large population-based study. Recommendation for adhering to DASH diet may benefit the prevention of obesity and related metabolic disorders in Chinese population.

Dietary Approaches to Stop Hypertension (DASH) diet, Mediterranean diet and blood lipid profiles in less-developed ethnic minority regions.

Different from developed countries, there is a paucity of research examining how the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets relate to lipids in less-developed ethnic minority regions (LEMR). A total of 83081 participants from seven ethnic groups were retrieved from the baseline data of the China Multi-Ethnic Cohort study, which was conducted in less-developed Southwest China between May 2018 and September 2019. Multivariable linear regression models were then used to examine the associations of the DASH and alternative Mediterranean diet (AMED) scores, assessed by modified DASH score and AMED, as well as their components with total cholesterol (TC), LDL-cholesterol, HDL-cholesterol, TAG and TC/HDL-cholesterol. The DASH scores were negatively associated with TC, HDL-cholesterol and TAG. Comparing the highest quintiles with the lowest DASH scores, TC decreased 0·0708 (95 % CI -0·0923, -0·0493) mmol/l, HDL-cholesterol decreased 0·0380 (95 % CI -0·0462, -0·0299) mmol/l and TAG decreased 0·0668 (95 % CI -0·0994, -0·0341) mmol/l. The AMED scores were negatively associated with TC, LDL-cholesterol and HDL-cholesterol. Comparing the highest quintiles with the lowest AMED scores, TC decreased 0·0816 (95 % CI -0·1035, -0·0597) mmol/l, LDL-cholesterol decreased 0·0297 (95 % CI -0·0477, -0·0118) mmol/l and HDL-cholesterol decreased 0·0275 (95 % CI -0·0358, -0·0192) mmol/l. Although both the DASH diet and the Mediterranean diet were negatively associated with blood lipids, those associations showed different patterns in LEMR, particularly for TAG and HDL-cholesterol.

The Dietary Approaches to Stop Hypertension (DASH) Diet Pattern and Incident Heart Failure

BackgroundThe Dietary Approaches to Stop Hypertension (DASH) diet pattern has shown some promise for preventing heart failure (HF), but studies have been conflicting. ObjectiveTo determine whether the DASH diet pattern was associated with incident HF in a large biracial and geographically diverse population. Methods and ResultsAmong participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study of adults aged ≥45 years who were free of suspected HF at baseline in 2003–2007, the DASH diet score was derived from the baseline food frequency questionnaire. The main outcome was incident HF defined as the first adjudicated HF hospitalization or HF death through December 31, 2016. We estimated hazard ratios for the associations of DASH diet score quartiles with incident HF, and incident HF with reduced ejection fraction and HF with preserved ejection fraction using the Lunn–McNeil extension to the Cox model. We tested for several prespecified interactions, including with age. Compared with the lowest quartile, individuals in the second to fourth DASH diet score quartiles had a lower risk for incident HF after adjustment for sociodemographic and health characteristics: quartile 2 hazard ratio, 0.69 (95% confidence interval [CI], 0.56–0.85); quartile 3 hazard ratio, 0.71 (95% CI, 0.58–0.87); and quartile 4 hazard ratio, 0.73 (95% CI, 0.58–0.92). When stratifying results by age, quartiles 2–4 had a lower hazard for incident HF among those age <65 years, quartiles 3–4 had a lower hazard among those age 65–74, and the quartiles had similar hazard among those age ≥75 years (Pinteraction = .003). We did not find a difference in the association of DASH diet with incident HF with reduced ejection fraction vs HF with preserved ejection fraction (P = .11). ConclusionsDASH diet adherence was inversely associated with incident HF, specifically among individuals <75 years old.

Adherence to the Dietary Approaches to Stop Hypertension Diet and Hyperuricemia: A Cross-Sectional Study.

Although several individual nutrients/foods are associated with uric acid status, the association of overall diet quality with hyperuricemia remains unclear. The current study was undertaken to examine the association between adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and the odds of having hyperuricemia in a Chinese adult population. Included were 71,893 Chinese participants in the Kailuan I study and the Kailuan II study (mean age 51.4 years) who were free of gout prior to or in 2014. Dietary intakes were assessed using a validated food frequency questionnaire, and the DASH diet score was calculated based on consumptions of vegetables, fruit, dairy, beans, whole grains, meat, fat, sodium, and sugar-sweetened beverages. Fasting blood samples were collected in 2014, and hyperuricemia was defined as serum uric acid concentrations of ≥7 mg/dl for men, and of ≥6 mg/dl for women. The association between DASH diet score and hyperuricemia was assessed using multiple logistic regression models, adjusting for age, sex, total energy, obesity, physical activity, education, smoking, alcohol drinking, blood pressure, fasting glucose, lipid profiles, renal function, and presence of cardiovascular disease. A High DASH diet score was associated with low odds of having hyperuricemia (adjusted odds ratio for quartile 4 versus quartile 1 0.70 [95% confidence interval 0.66, 0.75], P for trend < 0.001) after adjusting for potential confounders. The association between the DASH diet and hyperuricemia was more pronounced among older individuals (age ≥50 years), women, and physically inactive participants compared with their counterparts (P for interaction < 0.01 for all). The DASH diet was associated with a low likelihood of having hyperuricemia in Chinese adults.

Longitudinal changes in adherence to the portfolio and DASH dietary patterns and cardiometabolic risk factors in the PREDIMED-Plus study

The Portfolio and Dietary Approaches to Stop Hypertension (DASH) diets have been shown to lower cardiometabolic risk factors in randomized controlled trials (RCTs). However, the Portfolio diet has only been assessed in RCTs of hyperlipidemic patients. Therefore, to assess the Portfolio diet in a population with metabolic syndrome (MetS), we conducted a longitudinal analysis of one-year data of changes in the Portfolio and DASH diet scores and their association with cardiometabolic risk factors in Prevención con Dieta Mediterránea (PREDIMED)-Plus trial. PREDIMED-Plus is an ongoing clinical trial (Trial registration: ISRCTN89898) conducted in Spain that includes 6874 older participants (mean age 65y, 48% women) with overweight/obesity fulfilling at least three criteria for MetS. Data for this analysis were collected at baseline, six months and one year. Adherence to the Portfolio and DASH diet scores were derived from a validated 143-item food frequency questionnaire. We used linear mixed models to examine the associations of 1-SD increase and quartile changes in the diet scores with concomitant changes in cardiometabolic risk factors. After adjusting for several potential confounders, a 1-SD increase in the Portfolio diet score was significantly associated with lower HbA1c (β [95% CI]:-0.02% [-0.02,-0.01], P<0.001), fasting glucose (-0.47mg/dL [-0.83,-0.11], P=0.01), triglycerides (-1.29mg/dL [-2.31,-0.28], P=0.01), waist circumference (WC) (-0.51cm [-0.59,-0.43], P<0.001), and body mass index (BMI) (-0.17kg/m2 [-0.19,-0.15], P<0.001). A 1-SD increase in the DASH diet score was significantly associated with lower HbA1c (-0.03% [-0.04,-0.02], P<0.001), glucose (-0.84mg/dL [-1.18,-0.51], P<0.001), triglycerides (-3.38mg/dL [-4.37,-2.38], P<0.001), non-HDL-cholesterol (-0.47mg/dL [-0.91,-0.04], P=0.03), WC (-0.69cm [-0.76,-0.60cm], P<0.001), BMI (-0.25kg/m2 [-0.28,-0.26kg/m2], P<0.001), systolic blood pressure (-0.57mmHg [-0.81,-0.32mmHg], P<0.001), diastolic blood pressure (-0.15mmHg [-0.29,-0.01mmHg], P=0.03), and with higher HDL-cholesterol (0.21mg/dL [0.09, 0.34mg/dL, P=0.001]). Similar associations were seen when both diet scores were assessed as quartiles, comparing extreme categories of adherence. Among older adults at high cardiovascular risk with MetS, greater adherence to the Portfolio and DASH diets showed significant favourable prospective associations with several clinically relevant cardiometabolic risk factors. Both diets are likely beneficial for cardiometabolic risk reduction.

Visceral adiposity index and its association with Dietary Approaches to Stop Hypertension (DASH) diet scores among older adults: National Health and Nutrition Examination Surveys 2011–2014

The visceral adiposity index (VAI) has been shown to be a reliable estimate of visceral adiposity, but little is known about its association with specific dietary patterns such as the Dietary Approaches to Stop Hypertension (DASH) diet, particularly in older adults. Many studies have shown the DASH diet to be beneficial for cardiometabolic health. The purpose of this study was to investigate the relationship between DASH diet scores and the VAI in older adults using a nationally representative dataset. Using the National Health and Nutrition Examination Surveys (NHANES) from 2011 to 2014, data from 508 community-dwelling older adults were examined, and dietary intake was evaluated using the Dixon's DASH diet index. Using multiple linear regression analysis, the relationship between VAI and DASH diet score was assessed while controlling for demographic variables. Participants' average DASH diet score was 2.41 (SE=0.07), and the average VAI was 1.55 (SE=0.08). The results suggest a significant inverse relationship between the DASH diet and VAI (β=-0.19, t=-2.73, p=0.009). Results of this study suggest that protective properties of the DASH diet pattern may be due in part to its inverse relationship with visceral adiposity. This information supports practitioners' use of the VAI with older adults in addition to providing nutrition counseling with the DASH diet to reduce patients' cardiometabolic risk.

818 Diet quality predicts hypertensive disorders of pregnancy in hawaii cohort

Data are mixed on whether diet quality in early gestation is associated with adverse pregnancy outcomes. This study aims to see if there is a correlation with diet quality and the development of hypertensive disorders of pregnancy (HDP) in Hawaii. In a longitudinal cohort study, diet quality was measured via a Food Frequency Questionnaire during each trimester in 56 healthy women. Three diet quality indices were assigned – The Healthy Eating Index (HEI), The Alternate Mediterranean Diet score (aMED), and the Dietary approaches to Stop Hypertension (DASH) score. Mean aggregate scores were compared among those who did and did not develop hypertensive disorders of pregnancy. Logistic Regression models were used or confounding demographic covariates (age, parity, BMI, ethnicity). Generalized Estimating equations were also used to see if a longitudinal change in diet quality was associated with HDP. There was a high incidence of HDP in this cohort, with 12 participants (21%) developing the condition. There was no change of diet quality scores over time from 1st to 3rd trimester. Aggregate mean diet quality scores were higher in the unaffected group versus those who developed HDP. Logistic regression models showed that all three scores were significantly associated with development of HDP, with the DASH diet score having the greatest effect, and the best fit modeling. Age and nulliparity were also independently associated with this disorder. Every point higher of DASH diet score portended a 3% less chance of developing HDP. The components of the DASH Score that contributed the most difference between the two groups were consumption of whole grains, dairy, and legumes or nuts. Diet quality can help predict risk of HDP and may be a modifiable risk factor to target. The DASH diet score may be most predictive of this condition. Further studies in a larger cohort may further identify the mechanism by which nutritional components contribute to this risk.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Urinary sodium-to-potassium ratio: a simple and useful indicator of diet quality in population-based studies

BackgroundCurrent evidence regarding the prognostic relevance of urinary sodium-to-potassium ratio (Na-to-K ratio), as an indicator of diet quality is limited. This study was conducted to investigate whether urinary Na-to-K ratio could be related to habitual dietary patterns, in a general population.MethodsThis study was conducted in the framework of the Tehran Lipid and Glucose Study (2014–2017) on 1864 adult men and women. Urinary Na and K concentrations were measured in the morning spot urine samples. Dietary intakes of the participants were assessed using a validated 147-item Food Frequency Questionnaire (FFQ) and major dietary patterns were obtained using principal component analysis. Mediterranean dietary pattern and Dietary Approaches to Stop Hypertension (DASH) score, were also calculated. Multivariable-adjusted linear regression was used to indicate association of dietary patterns and urinary Na-to-K ratio.ResultsMean (± SD) age of participants was 43.7 ± 13.9 years and 47% were men. Mean (± SD) urinary Na, K and the ratio was 139 ± 41.0 and 57.9 ± 18.6 mmol/L, 2.40 ± 0.07, respectively. Higher urinary Na-to-K ratio (> 2.37 vs. < 1.49) was related to lower intakes of vegetables (282 vs. 321 g/day), low-fat dairy (228 vs. 260 g/day) and fruits (440 vs. 370 g/day). Western dietary pattern was related to higher urinary Na-to-K ratio (β = 0.06; 95% CI 0.01, 0.16). Traditional dietary pattern, Mediterranean and DASH diet scores were inversely associated with urinary Na-to-K ratio (β = − 0.14; 95% CI − 0.24, − 0.11, β = − 0.07; 95% CI − 0.09, − 0.01, β = − 0.12; 95% CI − 0.05, − 0.02, respectively).ConclusionsSpot urinary Na-to-K ratio may be used as a simple and inexpensive method to monitor diet quality in population-based epidemiological studies.