Dietary Approaches To Stop Hypertension Diet Research Articles

Effect of DASH vs. Mediterranean diet on metabolic syndrome and cardiometabolic profile in adults with high normal blood pressure or grade 1 hypertension: the DASH-MedDiet randomized controlled trial

Abstract Background Lifestyle interventions are recommended as the first-line treatment to control metabolic syndrome components and improve cardiometabolic profile. However, studies directly comparing the effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) on metabolic syndrome prevalence and cardiometabolic risk factors are currently lacking. Purpose We aimed to assess the effects of a 3-month intensive dietary intervention implementing salt restriction either alone or on top of the DASH and MedDiet compared to no/ minimal intervention on metabolic syndrome prevalence and cardiometabolic profile in never drug-treated adults with high normal blood pressure (BP) or grade 1 hypertension. Methods We randomly assigned individuals to the control group (CG, n = 60), salt restriction group (SRG, n = 60), DASH diet with salt restriction group (DDG, n = 60), or MedDiet with salt restriction group (MDG, n = 60). All patients were followed monthly for 3 months in individual sessions coordinated by the clinical dietician. For the patients of all four study groups, the goal was to maintain the initial body weight unchanged. Patients in the CG received general advice on dietary principles for BP control. For the patients in all three intervention groups, the goal was to limit sodium intake to 2,000 mg/ day (equivalent to 5,0g salt/ day). In addition, patients in the DDG and the MDG received an individualized dietary plan with six daily sample menus to facilitate the adoption of the assigned dietary pattern. Anthropometric indices, dietary intake, office BP, and fasting blood samples were evaluated pre- and post-intervention. Results According to the intention-to-treat analysis, at 3 months post-intervention, the DDG and the MDG had lower odds ratio (OR) (95% CI) of metabolic syndrome [0.29 (0.12, 0.72), and 0.15 (0.06, 0.41), respectively] compared to the CG. Moreover, the MDG had lower odds of elevated BP levels compared to both the DDG and the SRG [0.08 (0.03, 0.19), and 0.13 (0.05, 0.34), respectively], and lower odds of metabolic syndrome compared to the SRG [0.25 (0.09, 0.67)]. In addition, the DDG and the MDG had lower odds of elevated fasting glucose compared to both the CG and the SRG, whereas the study groups did not differ regarding the odds of elevated waist circumference, elevated triglycerides, and reduced HDL- cholesterol. Regarding cardiometabolic indices, total and LDL-cholesterol, fasting glucose, HbA1c, and systolic/ diastolic BP were reduced in all three intervention groups compared to the CG. Conclusions On a background of salt restriction, the MedDiet was superior in BP reduction, but the DASH and MedDiet reduced the prevalence of metabolic syndrome to the same extent.

Comparison of diet quality indices for predicting metabolic syndrome in Iran: cross-sectional findings from the persian cohort study

BackgroundThe metabolic syndrome (MetS) comprises metabolic irregularities, including hypertension and central obesity, which are influenced by genetic, metabolic, environmental, and dietary factors. As diet and lifestyle are risk factors for MetS, it is important to know which diet quality index better predicts MetS. The aim of this study is to compare the ability of different diet quality indices in predicting MetS and to identify the most effective one.MethodsThis cross-sectional study involved 5,206 participants aged 35 to 70 engaged in the Prospective Epidemiological Research Study in Iran (PERSIAN) cohort. Assessment of one year’s food intake via a validated 134-item semi-quantitative food frequency questionnaire (FFQ) facilitated the calculation of adherence to five diet quality indices: Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), Dietary Inflammatory Index (DII), and Diet Quality Indices (DQI). While bivariate Pearson correlation and binary logistic regression aided in identifying the strongest correlation and predictor for MetS among the indices.ResultsThis study showed a significant association between adhering to the DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, and the odds of developing MetS (OR: 0.94, (95% CI: 0.93–0.95), OR: 0.85, (95% CI: 0.81–0.89), OR: 0.84, (95% CI: 0.80–0.89), OR: 1.22, (95%CI: 1.11–1.34), OR: 0.95, (95%CI 0.94–0.96) respectively). Therefore, with each unit increase in DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, the odds of MetS was reduced by 5.4%, 14.5%, 15.6%, 22%, 5%, respectively. All the indices were correlated with the intake of most of the micronutrients, with the strongest correlations being observed in the DII. DASH diet score aligned with the most favourable MetS biomarker risk, while DII score primarily associated with MetS and could be considered as a predictor for MetS.ConclusionThe present study’s findings reveal that between all these five diet quality indices, the DASH diet score correlates strongly with a favourable biomarker risk profile, while the DII score is predominantly linked to MetS.

The Effect of Dietary Approaches to Stop Hypertension (DASH) Plan on Quality of Life in Hypertensive with Acute Coronary Syndrome Patients

Objective: The aim of the study was to evaluate the effect of Dietary Approaches to Stop Hypertension (DASH) on quality of life in hypertensive patients with acute coronary syndrome (ACS). Methods: This study was designed and conducted with 34 patients using a single-group and pre-test/post-test design in two public hospitals. Descriptive characteristics of the patients were obtained through a questionnaire. The questionnaire included socio-demographic characteristics, dietary habits, physical activity levels and quality of life using the MacNew Heart Disease Health-Related Quality of Life scale. The DASH diet plan was planned individually based on the daily energy requirement and explained to the patients. Patients were requested to achieve maximum adherence to the DASH diet plan for 12 weeks. Patients’ adherence to the DASH diet and quality of life were compared at the baseline and at study completion using SPSS 25.0 paired sample t-test. Results: Patients’ adherence to the DASH diet showed a statistically significant increase compared to the baseline (p

Dietary patterns and cardiorespiratory fitness in midlife and subsequent all-cause dementia: findings from the Cooper Center Longitudinal Study

BackgroundIdentifying lifestyle factors that independently or jointly lower dementia risk is a public health priority given the limited treatment options available to patients. In this cohort study, we examined the associations between Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diet adherence and cardiorespiratory fitness (CRF) with later-life dementia, and assessed whether the associations between dietary pattern and dementia are modified by CRF.MethodsData are from 9,095 adults seeking preventive care at the Cooper Clinic (1987–1999) who completed a 3-day dietary record and a maximal exercise test. Alzheimer’s disease and related disorders or senile dementia (i.e., all-cause dementia) was identified from Medicare administrative claims (1999–2019). Illness-death models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between Mediterranean or DASH diet adherence (primary exposure), CRF (secondary exposure), and all-cause dementia, adjusted for demographic and clinical factors. An interaction term was included between diet score and CRF to assess effect modification by CRF.ResultsThe mean age at baseline was 50.6 (standard deviation [SD]: 8.4) years, and a majority of the study sample were men (77.5%) and White (96.4%). 1449 cases of all-cause dementia were identified over a mean follow-up of 9.2 (SD: 5.8) years. Neither Mediterranean nor DASH diet adherence was associated with dementia risk in fully adjusted models (HR per SD of Mediterranean diet score: 1.00, 95% CI: 0.94, 1.05; HR per SD of DASH diet score: 1.02, 95% CI: 0.96, 1.08). However, participants with higher CRF had a decreased hazard of dementia (HR, per metabolic equivalent of task [MET] increase, Mediterranean model: 0.95, 95% CI: 0.92, 0.98; HR, per MET increase, DASH model: 0.96, 95% CI: 0.92, 0.97). No effect modification by CRF was observed in the association between diet and dementia.ConclusionsIn this sample of apparently healthy middle-aged adults seeking preventive care, higher CRF at midlife was associated with a lower risk of all-cause dementia, though adherence to a Mediterranean or DASH diet was not, and CRF did not modify the diet-dementia association. CRF should be emphasized in multimodal interventions for dementia prevention and investigated among diverse samples.

Adherence to Dietary Approaches to Stop Hypertension (DASH) Diet as a Protective Factor for Ischemic Stroke and Its Influence on Disability Level: A Case-Control Study in Lebanon.

Hypertension is a major risk factor for ischemic stroke. An important strategy in controlling hypertension is dietary modification. The present study evaluates the effect of Dietary Approaches to Stop Hypertension (DASH) diet on the risk of ischemic stroke. A case-control study was carried out, including 214 ischemic stroke cases recruited within the first 48 h of diagnosis and 214 controls, divided equally into hospitalized and non-hospitalized participants. Controls were matched to cases based on age and gender. Socio-demographic characteristics were assessed, in addition to adherence to the DASH diet, which was measured using a preconstructed DASH diet index (ranging from 0 (lowest) to 11 (highest)). For stroke patients, Modified Rankin Score (mRS) was measured to assess disability. Smoking, hypertension, hyperlipidemia, atrial fibrillation, and myocardial infarction were significantly associated with ischemic stroke (p < 0.001). Higher adherence to the DASH diet was correlated to lower rates of stroke, where cases scored 5.042 ± 1.486 compared to 6.654 ± 1.471 for controls (p < 0.001). Eating more grains, vegetables, fruits, dairy products, nuts, seeds, and beans, and lower levels of fat, fewer sweets, and less sodium were associated with lower rates of ischemic stroke (p = 0.038 for sweets and p < 0.001 for all the remaining), while meat, poultry, and fish did not have any significant effect (p = 0.46). A multivariate analysis showed that lower adherence to the DASH diet (p < 0.001, OR: 0.526, CI95% 0.428-0.645) was associated with a higher incidence of ischemic stroke and an increased likelihood of having high disability levels (mRS 5-6) (p = 0.041, OR: 2.49 × 10-8, CI95% 0-2.49 × 10-8). The relation between the DASH diet and risk of stroke highlights the necessity for strict adherence to dietary restrictions, suggesting a protective role for the DASH diet in stroke pathogenesis and prognosis.

Dietary Approaches to Stop Hypertension (DASH) and mortality risk among patients with liver cirrhosis: a prospective cohort study

Background and purposeThe relationship between dietary patterns and cirrhosis is undeniable. The present study aimed to investigate the association between the Dietary Approaches to Stop Hypertension (DASH) diet and the risk of mortality in patients with cirrhosis prospectively.MethodsIn this cohort study, 121 cirrhotic patients were enrolled and followed up annually for four years. Nutritional status and dietary intakes were assessed initially, and the DASH score was calculated accordingly. Crude and multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazard analyses.ResultsDASH components including fruits, vegetables, legumes, nuts and seeds, and low-fat dairy products were significantly associated with lower mortality risk in cirrhotic patients. Also, a higher DASH score was significantly associated with a reduction in the risk of mortality in patients with cirrhosis, so that after adjusting for all confounders, the risk of mortality in the upper tertile was 89% lower than the first tertile (HR = 0.11, 95% CI: 0.03–0.42, P trend < 0.001). The 4-year survival rate among patients across tertiles of DASH was 32%, 37%, and 46%, respectively (P = 0.005).ConclusionIt can be concluded that a higher DASH diet score may be associated with a reduced risk of mortality in cirrhotic patients. However, larger studies are needed to confirm the findings and determine their potential mechanisms.

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.

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.

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.

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.

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.

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).

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.

Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is associated with lower visceral and hepatic lipid content in recent-onset type 1 diabetes and type 2 diabetes.

To investigate the associations of the Dietary Approaches to Stop Hypertension (DASH) score with subcutaneous (SAT) and visceral (VAT) adipose tissue volume and hepatic lipid content (HLC) in people with diabetes and to examine whether changes in the DASH diet were associated with changes in these outcomes. In total, 335 participants with recent-onset type 1 diabetes (T1D) and type 2 diabetes (T2D) from the German Diabetes Study were included in the cross-sectional analysis, and 111 participants in the analysis of changes during the 5-year follow-up. Associations between the DASH score and VAT, SAT and HLC and their changes were investigated using multivariable linear regression models by diabetes type. The proportion mediated by changes in potential mediators was determined using mediation analysis. A higher baseline DASH score was associated with lower HLC, especially in people with T2D (per 5 points: -1.5% [-2.7%; -0.3%]). Over 5 years, a 5-point increase in the DASH score was associated with decreased VAT in people with T2D (-514 [-800; -228] cm3). Similar, but imprecise, associations were observed for VAT changes in people with T1D (-403 [-861; 55] cm3) and for HLC in people with T2D (-1.3% [-2.8%; 0.3%]). Body mass index and waist circumference changes explained 8%-48% of the associations between DASH and VAT changes in both groups. In people with T2D, adipose tissue insulin resistance index (Adipo-IR) changes explained 47% of the association between DASH and HLC changes. A shift to a DASH-like diet was associated with favourable VAT and HLC changes, which were partly explained by changes in anthropometric measures and Adipo-IR.

Association between DASH diet and asthma symptoms among a large sample of adolescents: a cross-sectional study

BackgroundThe Dietary Approaches to Stop Hypertension (DASH) diet, which has a lot of emphasis on the consumption of fruits, vegetables, and whole grains, and on the other hand, the consumption of red meat and sodium is limited, due to its anti-inflammatory properties, which can be related to reducing the risk of asthma.ObjectivesThe aim of this study was to determine the relationship between the DASH diet and asthma symptoms among children and adolescents.MethodsThis cross-sectional study was conducted among7667 children (3414 boys and 4253 girls) aged 6–7 and 13–14 years living in central Iran. Dietary food consumption was assessed using a multiple-choice questionnaire. Logistic regression was used to obtain odds ratios for the association between the DASH-like diet with current asthma and asthma symptoms.ResultsOur findings revealed that higher adherence to a DASH-like diet resulted in lower odds of asthma confirmed by a doctor among the whole population (OR = 0.53; 95%CI: 0.36–0.76) and also in females (OR = 0.47; 95%CI: 0.29–0.78). Moreover, the higher adherence to the DASH-like diet was inversely associated with the chance of wheezing in the past 12 months in all subjects (OR = 0.67; 95%CI: 0.51–0.86) and in boys (OR = 0.57; 95%CI: 0.38–0.85).ConclusionThe findings of the present study showed that following the DASH diet can be associated with the improvement of asthma symptoms in children and adolescents. However, more research is needed to improve dietary recommendations for asthma prevention.

Effects of DASH diet with or without time-restricted eating in the management of stage 1 primary hypertension: a randomized controlled trial

BackgroundTime-restricted eating (TRE), a popular form of intermittent fasting, has shown benefits for improving metabolic diseases and cardiometabolic health. However, the effect of TRE in the regulation of blood pressure in primary hypertension remains unclear.MethodsA 6-week randomized controlled trial was conducted, in which a total of 74 stage 1 primary hypertensive patients without high-risk were randomly assigned to Dietary Approaches to Stop Hypertension (DASH) group (n = 37) or DASH + TRE group (n = 37). Participants in the DASH + TRE group were instructed to consume their food within an 8-h window. Scientific research platform in We Chat application was used to track participants. The primary outcome was blood pressure. The secondary outcomes included body composition, cardiometabolic risk factors, inflammation-related parameters, urinary Na+ excretion, other clinical variables and safety outcomes.ResultsThe reduction of systolic blood pressure and diastolic blood pressure were 5.595 ± 4.072 and 5.351 ± 5.643 mm Hg in the DASH group and 8.459 ± 4.260 and 9.459 ± 4.375 mm Hg in the DASH + TRE group. DASH + TRE group improved blood pressure diurnal rhythm. Subjects in DASH + TRE group had decreased extracellular water and increased urinary Na+ excretion. Furthermore, the decrease in blood pressure was associated with a reduction of extracellular water or increase in urinary Na+ excretion. In addition, safety outcomes such as nighttime hunger were also reported.ConclusionOur study demonstrated that 8-h TRE + DASH diet caused a greater decrease in blood pressure in stage 1 primary hypertensive patients than DASH diet. This study may provide novel insights into the benefits of lifestyle modification in the treatment of primary hypertension.Trial registrationhttps://www.chictr.org.cn/ (ChiCTR2300069393, registered on March 15, 2023).

Associations Between Ultra-Processed Food Consumption and Adverse Brain Health Outcomes.

Ultra-processed foods (UPFs) are linked to cardiometabolic diseases and neurologic outcomes, such as cognitive decline and stroke. However, it is unclear whether food processing confers neurologic risk independent of dietary pattern information. We aimed to (1) investigate associations between UPFs and incident cognitive impairment and stroke and (2) compare these associations with other commonly recommended dietary patterns in the REasons for Geographic and Racial Differences in Stroke study. This prospective, observational cohort study enrolled Black and White adults in the United States from 2003 to 2007. The NOVA system was used to categorize items from a baseline food frequency questionnaire according to the level of processing. Participants with incomplete or implausible self-reported dietary data were excluded. Consumption for each category (grams) was normalized to total grams consumed. Scores quantifying adherence to a Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet were also calculated. Incident cognitive impairment was defined using performance relative to a normative sample on memory and fluency assessments. Incident stroke was identified through adjudicated review of medical records. The cognitive impairment cohort (n = 14,175) included participants without evidence of impairment at baseline who underwent follow-up testing. The stroke cohort (n = 20,243) included participants without a history of stroke. In multivariable Cox proportional hazards models, a 10% increase in relative intake of UPFs was associated with higher risk of cognitive impairment (hazard ratio [HR] = 1.16, 95% CI 1.09-1.24, p = 1.01 × 10-5) and intake of unprocessed or minimally processed foods with lower risk of cognitive impairment (HR = 0.88, 95% CI 0.83-0.94, p = 1.83 × 10-4). Greater intake of UPFs (HR = 1.08, 95% CI 1.02-1.14, p = 1.12 × 10-2) and unprocessed or minimally processed foods (HR = 0.91, 95% CI 0.86-0.95, p = 2.13 × 10-4) were also associated with risk of stroke in multivariable Cox models. The effect of UPFs on stroke risk was greater among Black than White participants (UPF-by-race interaction HR = 1.15, 95% CI 1.03-1.29, p = 1.50 × 10-2). Associations between UPFs and both cognitive impairment and stroke were independent of adherence to the Mediterranean, DASH, and MIND diets. Food processing may be important to brain health in older adults independent of known risk factors and adherence to recommended dietary patterns.

Salt and Cardiovascular Disease

Heart disease is a leading cause of mortality and morbidity globally. Sedentary lifestyle, bad eating habits, and little to no exercise have led to an alarming rise of lifestyle-mediated diseases in recent times. Table salt is one of the staples of all our kitchens and dining tables. Salt contains almost 98% sodium chloride. The unregulated amount of salt in our diet has led to adverse cardiovascular consequences. Fast foods such as salted French fries and Chinese cuisine may contain as much as 7,000 mg of sodium in a single meal! The American Heart Association (AHA) recommends a daily intake of not more than 2.3 g of salt per day (roughly one teaspoon). For patients with hypertension, heart failure, or kidney disease, a lower daily cut-off of 1.5 g of salt has been proposed but is still under debate. There is conflicting evidence of going too low with salt restriction as recent studies have shown increased adverse events when salt was restricted to beyond the recommended per-day threshold. The DASH (dietary approaches to stop hypertension) diet is a novel dietary pattern that is recommended for patients with hypertension. The DASH diet is not a restrictive or short-term diet but rather a sustainable and balanced approach to eating. It promotes a wide variety of foods, focusing on whole, unprocessed options, and encourages portion control. Adhering to a DASH eating pattern by itself can lower the systolic blood pressure by 6–11 mm Hg. Reducing salt intake can be challenging, as salt is present in many processed and packaged foods, restaurant meals, and fast food. More than 70% of the salt we eat, according to the AHA, comes from processed, prepackaged, and restaurant foods. “Salt Lite” is often marketed as a healthier alternative for individuals looking to lower their sodium intake. It typically contains a blend of potassium chloride with sodium chloride and is hence not totally “sodium free.” Individuals considering the use of “Salt Lite” should be aware of its higher potassium content and should not use it if they have a kidney disease or are on drugs that can cause hyperkalemia. There is a common misconception that pink Himalayan salt is lower in sodium than regular table salt. However, both types consist of approximately 98% sodium chloride. Research has not shown that Himalayan salt has any unique health benefits compared to other dietary salts. It is hence imperative for all individuals to restrict dietary salt intake to the recommended levels—as a measure toward a healthy lifestyle as well as a therapeutic modality for those with established cardiovascular diseases.

A qualitative study of patients’ perceptions of DASH diet apps for dietary self- management of hypertension in Saudi Arabia

Nutrition smartphone apps have become a popular and readily accessible approach to improving dietary behaviour. Hypertension is often associated with a poor diet, and its prevalence is increasing in Saudi Arabia(1). The Dietary Approaches to Stop Hypertension (DASH) eating plan has been shown to reduce blood pressure in people with hypertension(2). A previous study identified two high-quality, safe, and potentially effective smartphone apps for managing hypertension: NOOM and DASH To TEN(3). This study aimed to explore the potential of these two DASH diet self- management apps for controlling blood pressure in the Saudi Arabian context.Fifteen patients were recruited at King Abdullah bin Abdulaziz University Hospital in Riyadh, Saudi Arabia. Ten patients had hypertension, and five had prehypertension (mean age = 45). Patients were given the two apps and asked to try each for one week. Focus groups (n=4) were held at the end of the trial to understand the patient perceptions of the apps. Discussions were recorded, and the transcriptions were analysed using a thematic framework analysis(4).The following four themes emerged:1.Managing hypertension through diet was perceived as important. Most patients reported thatadhering to the DASH diet was challenging due to a lack of motivation and willpower,inadequate support from household members, and high prices for healthy food.2.The potential and current reach of dietary apps emerged as a main theme, and manycomments related to patients’ belief that dietary apps could increase their motivation and awareness about the DASH diet. Barriers to the use of apps were also identified including their difficulty of use, a preference for dietetic monitoring, and cost.3.Interactive app functionality was identified as a key theme, as evidenced by comments about a straightforward sign-up process, an extensive food database for dietary self-monitoring, feedback, goal setting, and reminders, considered essential for diet adherence.4.A preference for the NOOM app emerged. Patients perceived the NOOM app more suitable in the Saudi context. Noom was deemed to support DASH self-management because it supports weight reduction, which helps lower blood pressure. NOOM was perceived as highly interactive, offering motivational reminders, feedback, realistic dietary plans, and a comprehensive food database. Patients made several recommendations for app improvement; these included Arabic language support, automatic calculation of sodium and potassium consumption, and lower cost. Patients also expressed a desire for training in the use of the app.This qualitative analysis suggests that the NOOM app could be suitable for use with hypertensive patients in Saudi Arabia. Further research is needed to determine the feasibility and efficacy of long- term use of the NOOM app with a Saudi Arabia population.