Dietary Approaches To Stop Hypertension Diet Score Research Articles

PP16 The Contribution of Changes in Diet and other Risk Factors to recent Favourable Trends in Blood Pressure in Middle-Aged Irish Adults

BackgroundRecent declines in cardiovascular mortality in Ireland and other developed countries are partially attributable to favourable secular trends in blood pressure (BP). However the underlying causes of these BP trends...

DASH Diet Score and Distribution of Blood Pressure in Middle-Aged Men and Women

The Dietary Approaches to Stop Hypertension (DASH) Trial provides critical data on the impact of a specific diet pattern (low in salt, fat, and processed foods and high in fruit and vegetables) on blood pressure (BP). The effect of compliance with a DASH-type diet on BP in a general population sample is less well defined. We studied associations between a DASH style diet and BP. We used cross-sectional data from a study of men and women aged 47-73 years (n = 2,047). Participants completed a physical examination that included 3 standardized clinical BP recordings. A subsample (n = 1,187) had ambulatory BP measurements (ABPM) taken. Diet was assessed using a DASH dietary score constructed from a standard Food Frequency Questionnaire. Lower scores indicated less healthy diets. Hypertension was defined as clinic BP ≥ 140/90 mm Hg on medication or as 24-hour ABPM ≥ 130/80 mmHg. Inverse associations were evident between DASH and systolic BP (SBP). There was a difference in clinic SBP of 7.5 mm Hg and 5.1 mm Hg and a difference in ABPM SBP of 6.3mm Hg and 5.4mm Hg in men and women, respectively, between the highest and lowest DASH quintiles. In fully adjusted multivariable regression analysis, DASH score was inversely associated with SBP. Clear population differences in SBP were evident across DASH quintiles. The observed associations indicate that the findings are consistent with the hypothesis that adherence to DASH-equivalent diet can reduce BP at the population level. Public policy promoting a DASH-style healthy diet could have a significant impact on population health by reducing average BP in the population.

Abstract MP46: Dietary Pattern and Risk of Sudden Cardiac Death in Post-Menopausal Women

Background: The Mediterranean Diet and Dietary Approaches to Stop Hypertension (DASH) diet are characterized by higher intake of fruits, vegetables, whole grains, and unsaturated fatty acids. All of these foods/nutrients may affect cholesterol, inflammation, the development of atherosclerosis, and therefore risk of sudden cardiac death (SCD). Furthermore, the DASH diet is known to lower blood pressure and hypertension is a major risk factor for SCD. Objective: To examine the association between the Mediterranean and DASH dietary patterns and risk of SCD in women. Methods: Post-menopausal women enrolled in the Women’s Health Initiative observational study (n = 93,676) completed a food frequency questionnaire at enrollment and at year three. Women enrolled at 40 clinical sites across the U.S. between 1993 and 1998, and were followed for an average of 10.5 years. We scored their diets according to how closely reported diet resembled each dietary pattern. SCD was defined as death occurring within one hour of symptom onset. We estimated risk of SCD according to quintile of dietary pattern score using hazard models with time-varying exposures. Results: A higher Mediterranean diet score was associated with a lower risk of SCD: women in the highest quintile, or who came closest to following the Mediterranean dietary pattern, had a HR of 0.62 (95% CI 0.41-0.93) compared to women in the lowest quintile, after adjustment for age, total energy, race, income, smoking, and physical activity (Table). After adjusting for other traditional coronary heart disease risk factors which are potential mediators, the association remained statistically significant: HR 0.65 (95% CI 0.43-0.99). A higher DASH diet score was not associated with reduced risk of SCD. However, sodium intake, a crucial component of the DASH dietary pattern, was not well-characterized by the FFQ. Conclusions: The Mediterranean dietary pattern may be associated with a lower risk of SCD in post-menopausal women, however there was no indication of a dose-response relationship.

Comparing Diet Quality Based on a Dietary Screening Tool and the DASH Diet Index in Obese, Older Women

Diet quality impacts chronic disease risk and can be measured by the Dietary Screening Tool (DST) and the Dietary Approaches to Stop Hypertension (DASH) Index, however little research has compared these two methods. A 16‐week randomized clinical trial examined the additive impact of Tai Chi (TC) in obese, older women. Subjects completed a food frequency questionnaire (FFQ) and a DST. The FFQ output was converted to the DASH diet score. The DST provided a summary score. DST and DASH Diet scores were compared at baseline and post intervention using the following risk categories: <25th percentile as at risk, ≥25th –<75th percentile as possible risk, and ≥75th percentile as not at risk. “At risk” and “possible risk” categories were combined and compared to “not at risk.” Thirteen women received modified DASH Diet Education (DE) and 14 women received TC in addition (TC+DE). Mean ages were 62.6 ± 5.9 y for DE and 60.4 ± 6.0 y for TC+DE. The number of participants in each risk category from the two questionnaires at baseline were compared and significant differences were seen as determined by fisher's exact test (p =.01). Though not significant, from baseline to post, those subjects classified as “not at risk” via DST increased from 4 to 15 versus from 5 to 7 via DASH score. Discrepancies between the classifications of risk may be because the DST measures diet patterns and the FFQ reflects nutrient intake.Research supported by the USDA.Grant Funding Source: USDA

Relationships between emotional eating and coronary heart disease risk factors in college students

Emotional eating (EE) is hypothesized to have a negative impact on diet quality and body weight that could affect chronic disease risk. Our aim was to determine if EE was associated with diet quality, physical activity (PA), and coronary heart disease (CHD) risk factors among 261 freshmen at a Northeast university. EE was scored with the Weight Related Eating Questionnaire. Three, 24‐hour food recalls were collected to compute Dietary Approaches to Stop Hypertension (DASH) diet scores. Moderate‐vigorous PA (MVPA) was assessed by the International PA Questionnaire. CHD risk factors were measured after a 12‐hour fast. Most participants had a normal body mass index (BMI) (73%; 23.3 ± 3.8 kg/m2), were female (67%), and ranged in age from 18–21 y. Males and females differed significantly (p < 0.01) on all variables except for glucose and low‐density lipoprotein cholesterol concentrations. By multiple regressions, which included gender, we observed borderline significant associations between EE and MVPA (β = −0.12, p = 0.07), and with BMI (β = 0.12, p = 0.06) and diastolic blood pressure (β = 0.12, p = 0.07). Waist circumference was significantly associated with EE (β = 0.16, p < 0.01). However, DASH diet scores and MVPA failed to explain the observed associations between CHD risk factors and EE. Findings confirm associations among EE and some CHD risk factors that appeared independent of diet quality and PA.Research funded by the USDAGrant Funding Source: USDA

Circulation: Clinical Summaries

Circulation: Clinical Summaries

Consistency With the DASH Diet and Incidence of Heart Failure

The Dietary Approaches to Stop Hypertension (DASH) diet effectively reduces blood pressure. In observational studies, the association between diets consistent with DASH and risk of coronary heart disease and stroke has been examined with varying results. We hypothesized that diets consistent with the DASH diet would be associated with a lower incidence of heart failure (HF). We conducted a prospective observational study in 36 019 participants in the Swedish Mammography Cohort who were aged 48 to 83 years and without baseline HF, diabetes mellitus, or myocardial infarction. Diet was measured using food-frequency questionnaires. We created a score to assess consistency with the DASH diet by ranking the intake of DASH diet components and 3 additional scores based on food and nutrient guidelines. Cox proportional hazards models were used to calculate rate ratios of HF-associated hospitalization or death, determined using the Swedish inpatient and cause-of-death registers between January 1, 1998, and December 31, 2004. During 7 years, 443 women developed HF. Women in the top quartile of the DASH diet score based on ranking DASH diet components had a 37% lower rate of HF after adjustment for age, physical activity, energy intake, education status, family history of myocardial infarction, cigarette smoking, postmenopausal hormone use, living alone, hypertension, high cholesterol concentration, body mass index (calculated as weight in kilograms divided by height in meters squared), and incident myocardial infarction. Rate ratios (95% confidence intervals) across quartiles were 1 [Reference], 0.85 (0.66-1.11), 0.69 (0.54-0.88), and 0.63 (0.48-0.81); P(trend) < .001. A similar pattern was seen for the guideline-based scores. In this population, diets consistent with the DASH diet are associated with lower rates of HF.