Dietary Approaches To Stop Hypertension Group Research Articles

The effect of the dietary approaches to stop hypertension diet on total antioxidant capacity, superoxide dismutase, catalase, and body composition in patients with non-alcoholic fatty liver disease: a randomized controlled trial.

Non-alcoholic fatty liver disease (NAFLD) is a condition characterized by the accumulation of fat in the liver without excessive alcohol consumption. Lifestyle modifications, such as adopting a healthy diet, represent the standard treatment for NAFLD. However, the impact of the Dietary Approaches to Stop Hypertension (DASH) diet on oxidative stress biomarkers in patients with NAFLD remains unclear. Therefore, this study aimed to determine the effect of the DASH diet on total antioxidant capacity (TAC), catalase (CAT), superoxide dismutase (SOD) levels, and body composition in overweight and obese patients with NAFLD. A total of 70 overweight and obese patients aged 1870 years were randomly assigned to either the intervention (DASH diet, n = 35) or the control group (control diet, n = 35) for 12 weeks, with both groups following a calorie-restricted diet. The mean age of participants was 43.1 ± 8.1 years in the DASH group and 45.1 ± 8.6 years in the control group. At the end of the study, a significant difference was observed in the mean TAC and SOD levels between the two groups (p = 0.02). After adjusting for potential confounding factors, such as age, sex, diabetes, smoking, physical activity, and baseline values, the DASH diet maintained its significant effects on TAC and SOD compared to the control diet (p = 0.03). However, there were no significant differences in CAT levels between the two groups. Moreover, a significant reduction in visceral fat (p = 0.01) and a marginally significant decrease in BMI (p = 0.06) were observed in the DASH group compared to the control group after adjusting for potential confounders. In conclusion, our study showed that following the DASH diet for 12 weeks in overweight and obese patients with NAFLD has beneficial effects on TAC, SOD, and visceral fat. These findings support the use of the DASH diet as a potential therapeutic intervention for the improvement of oxidative biomarkers in patients with NAFLD. www.irct.ir/, identifier IRCT20170117032026N3.

Effectiveness of Mental and Physical Training on Blood Pressure and Resting Heart rate among Prehypertensive Young Adults

Mental and physical training (MAP) has been reported to improve outcomes related to mental health issues, but there is scarcity in current literature with regards to its effect on blood pressure (BP) in prehypertensive population. Therefore, aim of this study was to evaluate the effect of MAP on BP and resting heart rate (RHR) among prehypertensive young male adults. Methods – A single blinded randomized controlled trial with 43 prehypertensive (BP 120-139/80-89 mmHg) participants were divided into 2 experimental and 1 control groups. Mental training group (MT) participated in mindfulness meditation, while physical training group (PT) engaged in moderate intensity aerobic exercise. Both groups underwent training for 6-weeks, 3 sessions/week, each session lasting for 20 minutes. Control group did not participate in any training and was debriefed about Dietary Approaches to Stop Hypertension (DASH) eating plan. Participants in all 3 groups were instructed not to engage in any type of relaxation training or physical activity throughout this study. Systolic BP, diastolic BP, and RHR were assessed at baseline, at end of 3-weeks and 6-weeks intervention. Results – Mean age of participants in MT, PT and DASH group were 20.8±1.5, 20.1±1.8 and 19.8±1.8 respectively. Within group time effect demonstrated a significant difference in SBP (F=42.392, P=0.000), DBP (F=1836.863, P=0.000) and a non-significant difference in RHR (F=1.856, P=0.171), while between group analysis did not show significant difference in SBP (F=0.222, P=0.802); DBP (=0.325, P=0.739), and RHR (=0.63, P=0.939). Conclusions – All 3 interventions are equally effective in reducing the BP in pre-hypertensive young adults, however they did not have any effect on RHR.

The effect of DASH diet on atherogenic indices, pro-oxidant-antioxidant balance, and liver steatosis in obese adults with non-alcoholic fatty liver disease: A double-blind controlled randomized clinical trial.

Background: The present clinical trial aimed to examine whether adherence to Dietary Approaches to Stop Hypertension (DASH) diet could improve lipid profile, the Pro-oxidant-antioxidant balance (PAB) as well as liver function in obese adults with non-alcoholic fatty liver disease (NAFLD). Methods: Sixty two patients with NAFLD were equally allocated into either DASH or low-calorie diet (LCD) group for 8 weeks. The primary and secondary outcomes were determined before and after the trial. Results: Forty patients completed the trial. Significant within group differences were found in dietary saturated fat, selenium, vitamins A and E as well as body weight and body mass index (BMI) and waist circumference (WC) after the intervention (P<0.05). DASH diet showed greater significant change in systolic and diastolic blood pressure without significant differences between the groups after 8 weeks. Apart from serum high-density lipoprotein cholesterol (HDL-C) and triglyceride/HDL-C, greater reductions were found not only in serum lipids and atherogenic indices (P<0.05) but also in serum aspartate aminotransferase (AST), AST to platelet ratio index (APRI) and lipid accumulation product (LAP) in DASH group in comparison to control group (P=0.008, P=0.019 and P=0.003, respectively). Nevertheless, there was not any difference in PAB level between the groups. Furthermore, adherence to DASH diet was more effective in alleviating liver steatosis compared with usual LCD (P=0.012). Conclusion: Adherence to DASH diet appears to be more effective in improving obesity, atherogenic and liver steatosis biomarkers but not oxidative stress (OS) than usual LCD.

The effect of DASH diet on glycemic response, meta-inflammation and serum LPS in obese patients with NAFLD: a double-blind controlled randomized clinical trial

BackgroundAs dietary approaches to stop hypertension (DASH) dietary pattern has been shown to be effective in hypertension and obesity, the present study investigated the effects of following DASH diet on glycemic, meta-inflammation, lipopolysaccharides (LPS) and liver function in obese patients with non-alcoholic fatty liver disease (NAFLD).MethodsIn this double-blind controlled randomized clinical trial, 40 obese patients with NAFLD were randomly allocated into either “DASH diet” (n = 20) or calorie-restricted diet as "Control” (n = 20) group for 8 weeks. Anthropometric measures, blood pressure, glycemic response, liver enzymes, toll-like reseptor-4 (TLR-4) and monocyte chemoattractant protein (MCP-1) and LPS as well as Dixon's DASH diet index were assessed at baseline and after 8 weeks.ResultsAfter 8 weeks, although all obesity indices decreased significantly in both groups, the reduction in all anthropometric measures were significantly greater in DASH vs control group, after adjusting for baseline values and weight change. Fasting glucose level decreased in both group, however, no inter-group significant difference was found at the end of study. Nevertheless, serum levels of hemoglobin A1c (HbA1c), TLR-4, MCP-1 and LPS as well as aspartate aminotransferase (AST) decreased significantly in DASH group, after adjusting for baseline values and weight change (p < 0.001, p = 0.004, p = 0.027, p = 0.011, and p = 0.008, respectively). The estimated number needed to treats (NNTs) for one and two grade reductions in NAFLD severity following DASH diet were 2.5 and 6.67, respectively.ConclusionAdherence to DASH diet could significantly improve weight, glycemia, inflammation and liver function in obese patients with NAFLD.

Effect of dietary approaches to stop hypertension (DASH) diet, high in animal or plant protein on cardiometabolic risk factors in obese metabolic syndrome patients: A randomized clinical trial

AimsThis study aimed to investigate the effect of replacing plant proteins with animal proteins in the dietary approaches to stop hypertension (DASH) diet on cardiometabolic risk factors in obese metabolic syndrome participants. MethodsIn this double-blind randomized controlled clinical trial, 90 obese patients with metabolic syndrome, aged 30–70 years were randomly allocated into the DASH diet based on plant or animal proteins for 8 weeks. Fasting blood samples were collected to assess the biochemical markers. Also, blood pressure, weight, and waist circumference (WC) were measured at the beginning and end of the trial. ResultsThe participants in both groups experienced significant reductions in the fasting plasma glucose (FPG), systolic blood pressure (SBP) and diastolic blood pressure (DBP), triglyceride (TG) concentrations, weight and WC. However the reduction in FPG and SBP was higher in the plant-based DASH group, compared to the animal-based DASH group, after adjustment for weight change. No significant changes were found within or between groups with regard to total cholesterol, LDL-C, HDL-C. ConclusionsSubstituting plant proteins with animal proteins in the DASH diet improves FPG and SBP in obese individuals with metabolic syndrome, independent of weight change. IRCT registration number: IRCT20090203001640N16.

The effect of the Dietary Approaches to Stop Hypertension (DASH) diet on body composition, complete blood count, prothrombin time, inflammation and liver function in haemophilic adolescents.

There is no dietary strategy that has yet been specifically advocated for haemophilia. Therefore, we sought to assess the effect of the Dietary Approaches to Stop Hypertension (DASH) diet in adolescents with haemophilia. In this parallel trial, forty male adolescents with haemophilia were dichotomised into the DASH group or control group for 10 weeks. The serum high sensitivity C-reactive protein, IL-6, complete blood count (CBC), serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, partial thromboplastin time (PTT), waist circumference (WC), percentage of body fat, fat-free mass and liver steatosis were measured at the beginning and end of the study. Serum vitamin C was measured as a biomarker of compliance with the DASH diet. The DASH diet was designed to include high amounts of whole grains, fruits, vegetables and low-fat dairy products, as well as low amounts of saturated fats, cholesterol, refined grains, sweets and red meat. Serum vitamin C in the DASH group was significantly increased compared with the control (P = 0·001). There was a significant reduction in WC (P = 0·005), fat mass (P = 0·006), hepatic fibrosis (P = 0·02) and PTT (P = 0·008) in the DASH group, compared with the control. However, there were no significant differences regarding other selected outcomes between groups. Patients in the DASH group had significantly greater increase in the levels of erythrocyte, Hb and haematocrit, as compared with the control. Adherence to the DASH diet in children with haemophilia yielded significant beneficial effects on body composition, CBC, inflammation and liver function.

Usefulness of MCP-1 Chemokine in the Monitoring of Patients with Coronary Artery Disease Subjected to Intensive Dietary Intervention: A Pilot Study.

Monocyte chemotactic protein-1 (MCP-1) plays an important role in the entire atherosclerotic process, from atherogenesis to destabilisation of the atherosclerotic plaque. The purpose of this study is to evaluate the effect of the dietary approaches to stop hypertension (DASH) diet in patients with coronary artery disease on the MCP-1 plasma concentration and to evaluate the potential usefulness of this chemokine as a marker of change in the volume and composition of coronary plaque. Material and method. As part of the dietary intervention to stop coronary atherosclerosis in computed tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40) in which the DASH diet was introduced, and to a control group (n = 39) with no dietary intervention. In the DASH group, dietary counselling was provided at all follow-up visits within 12 months of the follow-up period. MCP-1 plasma concentration was determined using enzyme-linked immunosorbent assay (ELISA). Coronary plaque analysis was performed using a semi-automated plaque analysis software system (QAngioCT, Medis, The Netherlands). Results. In the DASH group, MCP-1 plasma concentration significantly decreased by 34.1 pg/mL (p = 0.01), while in the control group, the change in MPC-1 was not significant. Significant inverse correlations were revealed for the change in MCP-1 plasma concentration and change in the consumption of vitamin C and dietary fibre both in the DASH (r = −0.519, p = 0.0005; r = −0.353, p = 0.025, respectively) and in the control group (r = −0.488 p = 0.001; r = −0.502, p = 0.001, respectively). In patients with the highest decrease in percent atheroma volume (PAV), a significant positive correlation was observed between the change in MCP-1 plasma concentration and changes in PAV (r = 0.428, p = 0.033) and calcified plaque component (r = 0.468, p = 0.018), while the change in noncalcified plaque component correlated inversely with change in MCP1 (r = −0.459, p = 0.021). Conclusion. Dietary intervention based on the DASH diet model reduces the MCP-1plasma concentration, mostly due to an increased intake of plant-derived, fibre-rich foods and antioxidants. The change in MCP-1 plasma concentration seems to reflect changes in the atheroma volume and proportions between the calcified and non-calcified plaque elements.

The effects of the dietary approaches to stop hypertension (DASH) diet on oxidative stress and clinical indices of migraine patients: a randomized controlled trial

ABSTRACT Aims The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and oxidative stress (OS) in patients diagnosed with migraine is unknown and remains to be examined. Hence, we conducted a parallel-group, randomized controlled trial to investigate this issue. Methods Of the 102 women who met all the inclusion criteria, 51 individuals were randomized to the DASH diet group and 51 to the usual dietary advice group to receive allocated intervention for three months. In order to assess the compliance of participants to the DASH diet, dietary records, and serum vitamin C levels were examined. Parameters of OS status (e.g. nitric oxide (NO), total antioxidant capacity (TAC), total oxidative status (TOS), malondialdehyde (MDA), and oxidative stress index (OSI)) and clinical indices of migraine (e.g. migraine index (MI), headache dairy result (HDR), and migraine headache index score (MHIS)) were assessed at the beginning and the end of the study. Results There was a significant reduction in NO (–5.75 vs. + 4.18, P = 0.025) and TOS (–1.55 vs. + 0.71, P = 0.034), and a marginally significant reduction in OSI (-0.10 vs. + 0.14, P = 0.060) in the DASH group compared with the control. Compliance with the DASH diet resulted in a significant decrease in the score of MI (–31.33 vs. – 15.09), HDR (–5.04 vs. –2.51), and MHIS (–44.21 vs. –26.74). Moreover, no significant change was observed in TAC, MDA, and total thiol content. Conclusion This type of dietary approach can be considered as a complementary treatment for migraine patients, also further investigations are needed to replicate our findings. Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20121216011763N38.

Lifestyle Interventions Reduce the Need for Guideline-Directed Antihypertensive Medication.

The 2017 ACC-AHA Hypertension Guideline recommends initiation of antihypertensive drug therapy based on blood pressure (BP) and an assessment of global cardiovascular disease (CVD) risk, but intensive lifestyle modification may lower BP to below recommended thresholds for treatment in some patients. We examined the effects of lifestyle modification on calculated CVD risk and on the indications for BP-lowering medications in individuals with untreated hypertension. Participants included 144 adults with BP 130-160/80-99 mm Hg who were randomized to 16 weeks of DASH (Dietary Approaches to Stop Hypertension) diet plus behavioral weight management (DASH + WM), DASH diet alone (DASH), or Usual Care. The mean age of the study cohort was 52.0 years; the average baseline BP was 138 ± 9/86 ± 6 mm Hg. The 10-year CVD risk, as calculated by the Pooled Cohort Equations, was 5.7%. The adjusted 10-year risk fell to 4.4% in the DASH + WM group and to 5.0% in the DASH arm, but was not significantly changed (5.7%) in the Usual Care controls. The percentages of participants with guideline-based indications for antihypertensive drugs fell from 51% to 18% in the DASH + WM group and from 48% to 22% in the DASH group; and did not change significantly (49% to 44%) in the Usual Care group (P = 0.010 for the active intervention groups vs. Usual Care; P = 0.042 for DASH + WM vs. DASH). These data demonstrate that in men and women with mildly elevated BP, lifestyle interventions can lower the calculated CVD risk and dramatically decrease the number of individuals for whom guideline-directed antihypertensive medication is indicated.

Plasma lipocalin-2/NGAL is stable over 12\xa0weeks and is not modulated by exercise or dieting

Amongst other immune cells, neutrophils play a key role in systemic inflammation leading to cardiovascular disease and can release inflammatory factors, including lipocalin-2 (LCN2). LCN2 drives cardiac hypertrophy and plays a role in maladaptive remodelling of the heart and has been associated with renal injury. While lifestyle factors such as diet and exercise are known to attenuate low-grade inflammation, their ability to modulate plasma LCN2 levels is unknown. Forty-eight endurance athletes and 52 controls (18–55 years) underwent measurement for various cardiovascular health indicators, along with plasma LCN2 concentration. No significant difference in LCN2 concentration was seen between the two groups. LCN2 was a very weak predictor or absent from models describing blood pressures or predicting athlete status. In another cohort, 57 non-diabetic overweight or obese men and post-menopausal women who fulfilled Adult Treatment Panel III metabolic syndrome criteria were randomly allocated into either a control, modified Dietary Approaches to Stop Hypertension (DASH) diet, or DASH and exercise group. Pre- and post-intervention demographic, cardiovascular health indicators, and plasma LCN2 expression were measured in each individual. While BMI fell in intervention groups, LCN2 levels remained unchanged within and between all groups, as illustrated by strong correlations between LCN2 concentrations pre- and 12 weeks post-intervention (r = 0.743, P < 0.0001). This suggests that circulating LCN2 expression are stable over a period of at least 12 weeks and is not modifiable by diet and exercise.

The Effect of Intensive Dietary Intervention on the Level of RANTES and CXCL4 Chemokines in Patients with Non-Obstructive Coronary Artery Disease: A Randomised Study.

Simple SummaryThe dietary approaches to stop hypertension (DASH) diet contains meals with plenty of vegetables, fruits and low-fat dairy products, as well as whole grains, fish, poultry and nuts. One of the potential mechanisms of the beneficial effects of the DASH diet on the cardiovascular system may be modification of the inflammatory process. In the present study, we assessed the impact of the DASH diet on selected inflammatory markers in patients with atherosclerosis. The study lasted 12 months and involved 79 patients (40 followed the DASH diet, while 39 were in the control group). The results indicate that the DASH diet lowers the level of the inflammatory markers, which may contribute to the inhibition of atherosclerosis.Background: Inflammation is the key pathophysiological mechanism of the initiation and progression of atherosclerosis. The study objective was to assess the effects of a dietary intervention based on the model of the dietary approaches to stop hypertension (DASH) diet on the levels of chemokines RANTES and CXCL4 in patients with non-obstructive coronary artery disease. Methods: As part of Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40), where the DASH diet was introduced along with optimal pharmacotherapy, and to a control group (n = 39), with optimal pharmacotherapy alone. In the DASH group, systematic dietary counselling was provided for the follow-up period. RANTES and CXCL4 levels were determined using ELISA. Results: In the DASH group, the RANTES level insignificantly reduced from 42.70 ± 21.1 ng/mL to 38.09 ± 18.5 ng/mL (p = 0.134), and the CXCL4 concentration significantly reduced from 12.38 ± 4.1 ng/mL to 8.36 ± 2.3 ng/mL (p = 0.0001). At the same time, an increase in the level of both chemokines was observed in the control group: RANTES from 34.69 ± 22.7 to 40.94 ± 20.0 ng/mL (p = 0.06) and CXCL4 from 10.98 ± 3.6 to 13.0 5± 4.8 ng/mL (p = 0.009). The difference between the changes in both groups was significant for both RANTES (p = 0.03) and CXCL4 (p = 0.00001). The RANTES/CXCL4 ratio reduced in the control group (from 3.52 ± 2.8 to 3.35 ± 2.8; p = 0.006), while in the DASH group, an increase was observed (from 3.54 ± 1.7 to 4.77 ± 2.4; p = 0.001). Conclusions: A 12-month-long intensive dietary intervention based on DASH diet guidelines as an addition to optimal pharmacotherapy causes changes in the levels of chemokines CXCL4 and RANTES and their mutual relationship in comparison to conventional treatment.

Impact of the Dietary Approaches to Stop Hypertension (DASH) diet on glycaemic control and consumption of processed and ultraprocessed foods in pregnant women with pre-gestational diabetes mellitus: a randomised clinical trial.

The aim of this study was to evaluate the impact of the Dietary Approaches to Stop Hypertension (DASH) diet on glycaemic control and consumption of processed (PF) and ultraprocessed (UPF) foods in pregnant women with pre-gestational diabetes mellitus (PGDM). This is a randomised, controlled, single-blind clinical trial with forty-nine adult women with PGDM, followed at a public maternity hospital in Rio de Janeiro, Brazil. The control group (CG) received a standard diet consisting of 45-55 % of the total energy intake of carbohydrates, 15-20 % of proteins and 25-30 % of lipids. The DASH group (DG) received an adapted DASH diet, which did not differ from the standard diet in the percentage of macronutrients, but had higher contents of fibre, unsaturated fats and minerals such as Ca, Mg and K; and lower contents of Na and saturated fats than the standard diet. In the analysis by protocol, the DG presented a higher incidence of glycaemic control after 12 weeks of intervention (57·1 v. 8·3 %, P = 0·01, moderate effect size) and a lower mean consumption of UPF (-9·9 %, P = 0·01) compared with the CG. There was no statistically significant difference in fasting and postprandial blood glucose concentrations, or in the consumption of PF between the groups (P > 0·05). The DASH diet may be a strategy for glycaemic control in pregnant women with PGDM, favouring the adoption of a nutritionally adequate diet with lower consumption of UPF. Further studies are needed to investigate the effect of the DASH diet on glycaemic profile, and maternal and perinatal outcomes in women with PGDM.

The Effect of Dietary Approaches to Stop Hypertension on Weight, Body Composition, and Blood Pressure of Children with Attention Deficit Hyperactivity Disorder: A Randomized Controlled Clinical Trial

Background: Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children. Children with ADHD usually have low blood pressure and weight disorders. Therefore, the present randomized clinical trial was conducted to evaluate the effect of Dietary Approaches to Stop Hypertension (DASH) on weight and blood pressure of children with ADHD.&#x0D; Methods: In this research, 86 children aged 6 to 12 years with diagnosed ADHD according to Conner’s Teacher's Questionnaire and DSM-4 criteria were investigated. Participants were randomly assigned into two groups to receive a DASH diet and a control diet for 12 weeks. Participants' anthropometric indices, blood pressure, physical activity, and dietary compliance were evaluated each month. Adherence to the diet was studied using a three-day food report completed by the participants' parents.&#x0D; Results: A total of 80 children completed the study (40 in each group). No significant difference was observed in any of the weight composition indices measured before and after the intervention between the study groups (P &gt; 0.05). No significant difference was reported in the systolic and diastolic blood pressure between the study groups at the baseline. However, diastolic blood pressure increased in the DASH group significantly compared to the control group (P = 0.02).&#x0D; Conclusion: The DASH diet might increase the diastolic blood pressure in children with ADHD. Further studies with a longer follow-up period are necessary to confirm these results.

Does Intermittent Energy Restriction Plus Mediterranean Diet Reduce Visceral Adipose Tissue and Minimize Adaptive Responses of Energy Restriction? A Randomized Pilot Study (P21-016-19)

ObjectivesTest if an intermittent energy restriction with a Mediterranean diet (IER + MED) preferentially promotes loss of visceral adipose tissue (VAT) over subcutaneous adipose tissue (SAT), with minimal changes to resting energy expenditure (REE) and physical activity level (PAL), compared to an active control, the Dietary Approaches to Stop Hypertension (DASH) diet, in an East Asian adult population. MethodsMen and women in Hawai’i (n = 60, aged 35–55, BMI 25–40, VAT ≥ 90cm2 for men and ≥ 80cm2 for women) of East Asian origin, were randomized equally to IER + MED (2 days with 70% energy restriction and 5 days euenergetic MED) or a 7 day euenergetic DASH diet for 12 weeks. Dual energy X-ray absorptiometry (DXA) for estimation of VAT and abdominal SAT, REE through indirect calorimetry, and physical activity questionnaires were collected at baseline and week 12. Four-days mobile food records were completed at baseline, weeks 5–6 and 11. ResultsAt week 12, participants in the IER + MED group lost greater amounts of VAT (−22.6 ± 3.6 cm2 vs. −10.7 ± 3.5 cm2 in DASH, P = 0.022) and SAT (−48.2 ± 6.4 cm2 vs. −15.0 ± 6.1 cm2 in DASH, P < 0.001). The IER + MED diet did not preferentially promote loss of VAT over SAT compared to DASH. Changes in VAT: SAT were 0.01 ± 0.01 for both groups (IER + MED vs. DASH, P = 0.825). Mean daily energy intake reductions at week 11 were larger in IER + MED (27%) than DASH (16%); and mean loss of weight at week 12 was higher in the IER + MED group (−5.9 ± 0.7 kg vs. −3.3 ± 0.6 kg in DASH, P = 0.007). Despite the significant drop in energy and weight for IER + MED, there was a non-significant change in REE of −105 ± 56 kcal/day for IER + MED (P = 0.068) and −25 ± 57 kcal/day for DASH (P = 0.663). Hours of moderate-to-vigorous physical activity per day were 1.6 ± 0.2 for IER + MED and 1.4 ± 0.3 for DASH at baseline and did not change significantly over 12 weeks. ConclusionsIn this short-term pilot study, the IER + MED diet was more effective at reducing VAT, SAT and weight; however, it did not preferentially promote loss of VAT over SAT, as compared to the active control DASH group. Loss of VAT, SAT and weight from the IER + MED diet may be sustainable long term as REE and PAL, which commonly decrease with large energy restriction, did not significantly change over 12 weeks. Funding SourcesThe William & Ellen Melohn Endowed Research Fund, University of Hawaii; National Institutes of Health, National Cancer Institute.

The efficacy of the Dietary Approaches to Stop Hypertension diet with respect to improving pregnancy outcomes in women with hypertensive disorders.

The DASH (Dietary Approaches to Stop Hypertension) diet serves as a dietary pattern for the prevention and control of hypertension. The present study aimed to investigate whether the DASH diet can improve the outcomes of pregnancy with gestational hypertension (GH) and chronic hypertension. The current randomised controlled clinical trial was performed in 85 pregnant women diagnosed with GH and chronic hypertension between July 2015 and December 2017. The women were categorised into a control group (41 cases) and a DASH group (44 cases). Participants were followed until delivery. The clinical outcomes of mothers included gestational weeks of birth, deliverymode, postpartum haemorrhage and GH, as well as the incidenceof pre-eclampsia during the second and third trimesters. Newborn measurements were collected by evaluating prematurity, birth weight, body length and neonatal Apgar score. The incidence of pre-eclampsia, prematurity and low birth weight in the DASH group was lower than that in the control group (P<0.05). Significant differences were also observed in gestational age at delivery and the newborn body length between the two groups (P<0.05). We failed to find a significant difference in changes of deliverymode, postpartum haemorrhage, postpartum GH, mean birth weight and Apgar score (P>0.05) between the two diets. A DASH diet might comprise a potential strategy for improving the clinical outcomes in pregnant women with GH and chronic hypertension. Future robust clinical trials are warranted to corroborate these findings.

Abstract P372: The Effect of Periodic Fasting on Patients With Hypertension and Metabolic Syndrome

Periodic fasting may serve as therapeutic strategy for the management of hypertension and metabolic syndrome. We hypothesize that fasting affects the gut microbiome and promotes immune cell homeostasis resulting in lower blood pressure. Patients suffering from metabolic syndrome and hypertension were randomized either to 7-day periodic fasting combined with lifestyle change or Dietary Approaches to Stop Hypertension (DASH) intervention. Data derived from clinical parameters, 16S sequencing of the gut microbiome and immunophenotyping were collected at baseline, at day 7 and 3 months post intervention. At baseline, 21 out 30 patients in the fasting and 23 out of 31 in the DASH group had elevated systolic office blood pressure (SBP &gt;130 mmHg), which dropped significantly by 10 mmHg after fasting, and remained lower 3 months post intervention (7 mmHg). In the DASH group, SBP significantly decreased by 12 mmHg after 1 week and 8 mmHg after 3 months. At 3 months post intervention, 24-h ABPM confirmed the decrease in fasting, but not in DASH. Fasting, but not DASH significantly reduced body weight and BMI after 7 days compared to baseline, and this effect persisted for 3 months post-intervention. Furthermore, 50 % (15/30) of patients in fasting and 23 % (7/31) in DASH were able to decrease their use of medications for treatment of metabolic syndrome. Spearman correlation tests showed that fasting, but not DASH, altered the gut microbiome. After fasting Bacteroides , Lachnoclostridium , Coprococcus , and Ruminococcus Operational Taxonomic Units (OTUs) decreased, while the Eubacterium rectale OTU increased. In contrast to DASH, fasting significantly reduced the frequency of CD4+ Th17 cells, active CD69+ mucosa-associated invariant T cells (MAIT) and IFNg+IL-2+ or TNFa+ MAITs indicating the anti-inflammatory effect of fasting. While some of these changes reverted to baseline after 3 months, several persisted. Despite a similar decrease in office SBP in both study arms, the periodic fasting intervention is more beneficial in reducing body weight and BMI compared to baseline. Fasting altered the prevalence of certain gut microbes and influenced immune cell signatures whereas DASH did not, suggesting a distinct role of fasting for improving cardiometabolic health.

Comparison of the effect of the Dietary Approaches to Stop Hypertension diet with usual dietary advice on expression of peroxisome proliferators-activated receptor gamma gene in women: A randomized controlled clinical trial.

BACKGROUNDPeroxisome proliferator-activated receptor gamma (PPAR-γ) which controls body weight, glucose homeostasis, and adipocyte differentiation is a valuable candidate gene for insulin resistance (IR). The present study aimed to compare the effects of the Dietary Approaches to Stop Hypertension (DASH) diet and usual dietary advice (UDA) on PPAR-γ gene expression in women at risk for cardiovascular disease (CVD).METHODSThis randomized controlled trial was performed on 44 women aged 20-50 years at risk for CVD (BMI > 25 kg/m2 and low physical activity). Participants were randomly assigned to the UDA (n = 22) or DASH (n = 22) diets for 12 weeks. The DASH diet was rich in fruits, vegetables, whole grains and low-fat dairy products and low in saturated fat, total fat, cholesterol, refined grains and sweets, with a total of 2400 mg/day sodium. The UDA diet was a regular diet with healthy dietary advice. Anthropometric indices and PPAR-γ gene expression were measured and compared between the two groups at the end of the study.RESULTSAfter the intervention, body mass index (BMI) and waist circumference (WC) significantly decreased in the DASH group (P < 0.050) but the results showed no significant differences between the two groups. At the end of the trial, PPAR-γ gene expression was significantly different between the UDA and the DASH diet groups (P = 0.040) and this difference remained significant after adjustment for BMI, and physical activity (P = 0.030).CONCLUSIONThe result of the study showed that the DASH diet significantly decreased the expression of PPAR-γ. This finding was unexpected and future studies on the current topic are therefore recommended.

The Effects of Diet Alone or in Combination with Exercise in Patients with Prehypertension and Hypertension: a Randomized Controlled Trial.

Background and ObjectivesSupervised lifestyle interventions, including dietary and exercise programs, may be infeasible to implement in real-world settings. Therefore, this study aimed to evaluate the effectiveness of a home-based lifestyle modification intervention on blood pressure (BP) management.MethodsEighty-five patients aged over 20 years and diagnosed with prehypertension or mild hypertension were randomly assigned to an advice-only comparison group (C group, n=28), a Dietary Approaches to Stop Hypertension (DASH) diet education group (D group, n=30), or a DASH and home-based exercise group (D+Ex group, n=27). The intervention lasted for 8 weeks. The primary outcome was the difference in office systolic blood pressure (SBP) before and after the study period (Trial registry at ClinicalTrials.gov, NCT01637909).ResultsSeventy-two participants (87.8%) completed the trial. The degree of change in office SBP did not significantly differ among the intervention groups; however, the D+Ex group demonstrated a tendency toward decreased SBP. Upon analysis of 24-hour ambulatory BP measurements, daytime ambulatory SBP was significantly lower in the D+Ex group (134 mmHg; 95% confidence interval [CI], 131 to 137; p=0.011) than in the C group (139.5 mmHg; 95% CI, 130.9 to 137), and daytime ambulatory SBP was significantly decreased in the D+Ex group (−5.2 mmHg; 95% CI, −8.3 to −2.1; p=0.011) compared to the C group (0.4 mmHg, 95% CI, −2.5 to 3.3).ConclusionsIn conclusion, lifestyle modification emphasizing both diet and exercise was effective for lowering BP and should be favored over diet-only modifications.

한국형 DASH 교육 프로그램이 여성노인의 산화스트레스, 항산화능력과 호모시스테인 농도에 미치는 효과

Purpose: The purpose of this study was to investigate the effects of the Korean Dietary Approaches to Stop Hypertension (DASH) education program on oxidative stress, antioxidant capacity, and serum homocysteine (Hcy) level in elderly Korean women. Methods: This was a quasi-experimental study employing non-equivalent control group pretest-posttest design. The DASH group (n=27) underwent the DASH education program for 12 weeks, whereas the control group (n=21) was provided one education session. The survey was conducted before and after the intervention period. Results: In DASH group, monounsaturated fatty acid (MUFA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) intakes significantly increased after the intervention as compared to prior to the intervention. No significant differences were found in the control group. After the intervention, thiobarbituric acid reactive substance (TBARS) and Hcy levels significantly decreased in the DASH group but not in the control group. Conclusion: The DASH education program was effective in reducing oxidative stress and Hcy levels in elderly Korean women. Key Words: Diet; Oxidative stress; Antioxidants; Homocysteine; Women Key Words: DASH 식이; ì‚°í™”ìŠ¤íŠ¸ë ˆìŠ¤; í•­ì‚°í™”ëŠ¥ë ¥; í˜¸ëª¨ì‹œìŠ¤í Œì¸; ì—¬ì„±ë ¸ì¸

Effects of Dietary Approach to Stop Hypertension diet on androgens, antioxidant status and body composition in overweight and obese women with polycystic ovary syndrome: a randomised controlled trial.

Polycystic ovary syndrome (PCOS) is the most common endocrine disease in reproductive age women. The present study aimed to determine the effects of Dietary Approaches to Stop Hypertension (DASH) diet on reproductive hormones, plasma total antioxidant status and anthropometric indices in overweight and obese PCOS women. In this randomised controlled clinical trial, 60 women with PCOS were randomly assigned to one of two diets with energy restriction: the DASH diet and a control diet. The DASH and control diets consisted of 50-55% carbohydrate, 15-20% protein and 25-30% total fat. The DASH diet was designed to be rich in vegetables, fruits, whole grains and low-fat dairy products, as well as low in saturated fats, cholesterol, refined grains and sweets. In the present study, the anthropometric indices, body composition, total testosterone, androstenedione, sex hormone binding globulin (SHBG), free androgen index and 2,2'-diphenyl-1-picryylhydrazyl (DPPH) scavenging activity were measured before and after 3 months. The consumption of DASH diet compared to the control diet was associated with a significant reduction in weight [-5.78 (1.91) kg versus -4.34 (2.87) kg, P = 0.032], body mass index (BMI) [-2.29 (0.15) kg m-2 versus -1.69 (0.20) kg m-2 , P = 0.02], fat mass [-3.23(1.66) kg versus -2.13 (1.26) kg, P = 0.008] and serum androstenedione [-1.75 (1.39) ng mL-1 versus -1.02 (0.72) ng mL-1 , P-value = 0.019]. Increased concentrations of SHBG [28.80 (21.71) versus 11.66(18.82) nmol L-1 , P = 0.003) and DPPH scavenging activity [30.23% (19.09) versus 12.97% (25.12) were also found in the DASH group. The DASH diet could improve weight loss, BMI and fat mass. Furthermore, it could result in a significant reduction in serum androstenedione and a significant increase in antioxidant status and SHBG.