Hypertension Diet Research Articles

Protocol for a randomized comparative effectiveness trial comparing a very low-carbohydrate diet to DASH diet for polycystic ovary syndrome: the SUPER (Supporting Understanding of PCOS Education and Research) trial

BackgroundPolycystic ovary syndrome (PCOS), the most common endocrine disorder for women of reproductive age, is associated with increased risk for insulin resistance and type 2 diabetes. Current PCOS treatments insufficiently address the spectrum and severity of the disorder, and there is little evidence-based guidance available for lifestyle management of PCOS, especially through nutritional approaches. Some evidence shows that a very low-carbohydrate diet can improve glucose control compared to low-fat or moderate-carbohydrate diets, leading to improved glucose control and insulin levels that may help to treat symptoms of PCOS. This research investigates whether a very low-carbohydrate diet is more effective in improving glucose control and decreasing symptoms of PCOS in comparison to a DASH diet.MethodsThe SUPER study aims to address the gap in knowledge about nutritional advice for people with PCOS through a randomized, comparative effectiveness trial comparing two approaches to glucose control: the dietary approaches to stopping hypertension (DASH) diet, and a very low-carbohydrate (VLC) diet. We will randomize 184 women with PCOS with body mass indexes (BMIs) between 25 and 50 kg/m2 to a VLC or DASH diet. All participants will follow a 24-session, 12-month, online diet, and lifestyle intervention that teaches their assigned diet. Participants will receive nutritional education, support from diet coaches, and education about behavioral strategies to improve dietary adherence. The primary outcome measure is HbA1c, and secondary outcomes include glucose variance, lipid and hormone levels (including total and free testosterone), PCOS symptoms, inflammation (measured by high-sensitivity C-reactive protein), body composition and weight, psychological well-being, and intervention feasibility and acceptability.DiscussionThe SUPER study is a randomized comparative effectiveness trial that compares two promising approaches to glucose control in people with PCOS. The study also aims to assess the effects of each diet on PCOS symptoms. The research addresses an important gap in knowledge regarding nutritional advice for people with PCOS.Trial registrationClinicalTrials.gov NCT05452642. Registered 6 July 2022.

Benefit of Probiotics on Cardiovascular Health- A Narrative Review

Coronary artery disease (CAD) is a leading cause of death globally and a prevalent cardiovascular disease (CVD) in which plaque buildup in artery walls results in inadequate blood flow. Risk factors for CAD include hypertension, inflammation, diabetes, and poor diet. In the past few decades, research has emerged on the employment of probiotics in cardiovascular health, particularly focused on methods for using probiotics as preventative measures for the risk factors of CAD. Probiotics can reduce hypertension and inflammation, improve insulin sensitivity, and possibly reduce salt levels in individuals with high-sodium diets. Still, more research needs to be done on the safety and considerations of administering probiotics and their underlying mechanisms since the evidence is predominantly experimental. Probiotics have proven to be a valuable research point given the urgency and incidence rates of coronary artery disease.

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.

Safety and efficacy of Lippia multiflora in the management of stage I hypertension: outcomes of a randomised controlled trial

IntroductionHypertension is a growing public health problem in the developing world. The chronic nature of the disease has been a driver for the use of traditional medicines. Clinical validation of such products for their safety and efficacy is thus of public health importance. We report on the clinical safety and effectiveness of a Lippia multiflora-based herbal antihypertensive (LMT-19). MethodsA randomised controlled study was conducted among 80 volunteers clinically diagnosed, per the WHO criteria, with stage I hypertension. Participants received either an aqueous infusion of LMT-19 plus a standard lifestyle and dietary recommendation based on a Dietary Approaches to Stop Hypertension (DASH) diet or the lifestyle and dietary recommendation alone. ResultsThe use of LMT-19 resulted in a significant decline of blood pressure over a 60-day period. Diastolic blood pressure in the LMT-19 group was found to be significantly lower compared to the control (mean diff: 8.25 (±1.50); P ≤ 0.001). Systolic blood pressure was also significantly better compared to the control group (mean diff: 12.70 ± 2.02; P ≤ 0.001). The product was also well tolerated as no adverse drug reactions were also recorded during the study. ConclusionThese outcomes suggest LMT-19 as a potential alternative remedy for management of stage I hypertension. Clinical trial registrationPan-African Clinical Trial Registry, PACTR202107733803271.

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.

Beneficial Effect of Dietary Approaches to Stop Hypertension Diet Combined with Regular Physical Activity on Fat Mass and Anthropometric and Metabolic Parameters in People with Overweight and Obesity.

Obesity and overweight have become growing health-related issues worldwide, which also applies to Poland. Excess fat mass is associated with an increased risk of metabolic and non-metabolic complications. The aim of our pre-post-designed study was to assess the effect of behavioral intervention on body weight, fat mass and anthropometric and metabolic parameters in obese and overweight individuals. The study included one hundred people (85 women) with excess fat mass who voluntarily declared their willingness to participate in the weight-loss program consisted of 12 weeks of the DASH diet combined with regular, supervised physical activity. Anthropometric measurements and laboratory tests were performed in all study participants, and anthropometric and metabolic indices were calculated at baseline and after three months of treatment. Body weight decreased significantly by 5.63 ± 4.03 kg, BMI by 2.06 ± 1.44 kg/m2, waist circumference by 5.6 ± 3.7 cm, fat mass from 40.04 ± 6.90 to 36.56 ± 7.07% and uric acid level by 16.0 ± 41.6 μmol/L (p < 0.001 in all cases). We also found an improvement in lipid profile and anthropometric and metabolic indices, except for HDL cholesterol and plasma glucose levels. The effect of the DASH diet and supervised physical activity was beneficial regardless of age, sex and the presence of hypertension or dysglycemia at baseline. The implementation of a healthy lifestyle was associated with a significant improvement in anthropometric and metabolic parameters, which, if continued, may reduce the risk of unfavorable health-related outcomes in the future.

Dietary Recommendations for Glioma: A Mini-Review.

Glioma is the most common type of brain cancer, associated with a high mortality rate. Diet is one of the most modifiable factors that can influence the risk of various cancers, including glioma. While the relationship between diet and glioma has been explored in recent years, the number of studies in this area remains limited, and the findings are often controversial. Moreover, all existing studies are observational, which means they may be influenced by a range of confounding variables. In this mini-review, we aim to provide a comprehensive and informative overview of the dietary recommendations related to glioma that have been published to date. Research suggests that adherence to healthy dietary patterns-such as the Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH) diet, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, Paleolithic diet, high-protein dietary patterns, and vegetarian dietary patterns-may be associated with a reduced risk of glioma. These diets are rich in phytochemicals and antioxidants. Additionally, certain food groups, including fruits, vegetables, legumes, nuts, eggs, fresh fish, tea, and coffee, are emphasized for their protective effects against glioma. Conversely, adherence to unhealthy dietary patterns, such as the Western diet, or diets with high inflammatory potential, glycemic and insulinemic loads, and high consumption of grains (especially refined grains), processed meats, and processed fish, has been linked to an increased risk of glioma. Current studies suggest that following a healthy diet may reduce the odds of developing glioma. However, due to the limited number of studies and the observational nature of the existing research, further investigations with more robust designs, such as randomized controlled trials, are needed to clarify these associations.

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.

P102 PH-SENSOR GPR68 PLAYS A ROLE IN THE CARDIOPROTECTIVE EFFECTS OF A HIGH FIBRE DIET

Background/Objective: Dietary fibre lowers blood pressure (BP) via short-chain fatty acids, acidic metabolites released from fibre fermentation by the bacteria in the large intestine. This acidic microenvironment may activate pH-sensing receptor GPR68, expressed primarily on immune cells, which play a crucial role in BP regulation. Here, we aimed to investigate whether GPR68 confers the cardioprotective effects of a high-fibre diet in hypertension by regulating inflammatory responses. Methods: 6–8-week-old male wildtype (WT) and GPR68-deficient (Gpr68-/-) fed a control or high-fibre diet underwent subcutaneous implantation of minipumps containing Angiotensin II (0.75 mg/kg body weight/day, 4 weeks, n=8/group). BP was measured weekly by tail-cuff. Morphometric, histological, and flow cytometric analyses were performed following the 4-week protocol. Results: High-fibre-fed WT mice exhibited blunted elevations in systolic BP (week 4; p=0.0508) and lower cardiac interstitial collagen deposition (p=0.0495) compared to WT mice fed a control diet. However, high fibre did not lower BP (week 4; control vs high-fibre, p=0.689) or cardiac collagen deposition (p=0.842) in Gpr68-/- mice. High-fibre-fed WT mice exhibited improved aortic elastin content compared to control-fed WT mice (p=0.0503), whereas this remained negligible in Gpr68-/- mice (p=0.885). Flow cytometric analysis revealed that high fibre decreased aortic macrophage (p=0.0072) and neutrophil cell counts (p=0.0273) in mice, irrespective of genotype. High fibre also decreased overall renal immune cell counts (p=0.0213) and dendritic cells (p=0.0488) in mice, irrespective of genotype. Finally, high fibre-fed mice had overall decreased circulating immune cell counts (p=0.0264), specifically CD8+ T cells (p=0.0235), and γδ T cells (p=0.0264). Conclusions: High fibre intervention on Angiotensin II-treated GPR68-deficient mice did not lower their BP or cardiac fibrosis. All angiotensin II-treated mice fed a high-fibre diet exhibited prominent changes in various immune cell populations, irrespective of genotype. Nonetheless, this study provides novel insight that GPR68 is involved in the cardioprotective effects of a high-fibre diet. This is most likely via in an immune-independent manner, warranting further investigations into its underlying mechanisms of action.

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

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

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

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

Health System Guidance as Nursing Intervention for Ineffective Health Management in Aggregate Adults with Hypertension

Introduction: Hypertension is a type of non-communicable disease that can significantly cause morbidity and mortality of sufferers. Adult age is a risk factor that has a great influence on hypertension. Interventions that can be given to the community are Health System Guidance to identify hypertension problems in the community and develop the ability to overcome existing health problems, namely hypertension problems. Objective: To determine the effectiveness of nursing interventions for health system guidance. Method: Descriptive and analytical research design with a sample of 50 productive age who have hypertension in the RW 08 area of Patrang Village and 5 health cadre. This research carried out implementation in the form of primary prevention (health education), secondary prevention (hypertension screening and cadre empowerment) and tertiary prevention (education and demonstration of giving star fruit juice). Data collection used respondent characteristic instruments, hypertension knowledge questionnaire, hypertension diet questionnaire, standart operating procedure for blood pressure measurement, standart operating procedure for making star fruit juice. Data analysis used paired sample t-test, wilcoxon test, and mann whitney test. Results: There was a significant difference between knowledge before health education and after health education (p = 0.000). In cadre empowerment, there was an increase in the percentage of cadre ability and the mean of cadre knowledge. In tertiary prevention, there was a significant difference between blood pressure after giving star fruit juice therapy between the intervention and control groups (p &lt; 0.05). Conclusion: Health system guidance is effective in improving health management of hypertension.

Hypoxic Cardioprotection by New Antihypertensive Compounds in High Salt-Diet Hypertensive Rats: Glucose Transport Participation and Its Possible Pathway.

Hypertension (HP) is a health condition that overloads the heart and increases the risk of heart attack and stroke. In an infarction, the lack of oxygen causes an exclusive use of glycolysis, which becomes a crucial source of ATP for the heart with a higher glucose uptake mediated by glucose transporters (GLUTs). Due to the unpleasant effects of antihypertensives, new drugs need to be researched to treat this disease. This study aimed to evaluate the cardioprotective effect of three novel antihypertensive compounds (LQMs, "Laboratorio de Química Medicinal") synthesized from Changrolin under hypoxic conditions with the participation of two primary cardiac GLUT1 and GLUT4 using a high-salt diet HP model. The model used a diet with 10% salt to increase arterial blood pressure in Wistar rats. In isolated cardiomyocytes from these rats, glucose uptake was measured during hypoxia, evaluating the participation of GLUTs with or without the animals' previous treatment with LQM312, 319, and 345 compounds. In silico calculations were performed to understand the affinity of the compounds for the trafficking of GLUTs. Results: Control cells do shift to glucose uptake exclusively in hypoxia (from 1.84 ± 0.09 µg/g/h to 2.67 ± 0.1 µg/g/h). Meanwhile, HP does not change its glucose uptake (from 2.38 ± 0.24 µg/g/h to 2.33 ± 0.26 µg/g/h), which is associated with cardiomyocyte damage. The new compounds lowered the systolic blood pressure (from 149 to 120 mmHg), but only LQM312 and LQM319 improved the metabolic state of hypoxic cardiomyocytes mediated by GLUT1 and GLUT4. In silico studies suggested that Captopril and LQM312 may mimic the interaction with the AMPK γ-subunit. Therefore, these compounds could activate AMPK, promoting the GLUT4 trafficking signaling pathway. These compounds are proposed to be cardioprotective during hypoxia under HP.

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.

Projected Impact of Nonpharmacologic Management of Stage 1 Hypertension Among Lower-Risk US Adults.

The 2017 American College of Cardiology/American Heart Association blood pressure guideline classified 31 million US adults as having stage 1 hypertension and recommended clinicians provide counseling on behavioral change to the low-risk portion of this group. However, nationwide reductions in cardiovascular disease (CVD) and associated health care expenditures achievable by nonpharmacologic therapy remain unquantified. We simulated interventions on a target population of US adults aged 35 to 64 years, identified from the 2015-2018 National Health and Nutrition Examination Survey, with low-risk stage 1 systolic hypertension: that is, untreated systolic blood pressure 130 to 139 mm Hg with diastolic BP <90 mm Hg; no history of CVD, diabetes, or chronic kidney disease; and a low 10-year risk of CVD. We used meta-analyses and trials to estimate the effects of population-level behavior modification on systolic blood pressure. We assessed the extent to which restricting intervention to those in regular contact with clinicians might prevent the delivery of nonpharmacologic therapy. Controlling systolic blood pressure to <130 mm Hg among the 8.8 million low-risk US adults with stage 1 hypertension could prevent 26 100 CVD events, avoid 2900 deaths, and save $1.7 billion in total direct health care costs over 10 years. Adoption of the Dietary Approaches to Stop Hypertension diet could prevent 28 000 CVD events. Other nonpharmacologic interventions could avert between 3800 and 19 500 CVD events. However, only 51% of men and 75% of women regularly interacted with clinicians for counseling opportunities. Among low-risk adults with stage 1 hypertension, substantial benefits to cardiovascular health could be achieved through public policy that promotes the adoption of nonpharmacologic therapy.

THE CORRELATION OF LEVEL KNOWLEDGE AND ELDERLY HYPERTENSION DIET ADHERENCE IN NGANJUK REGENCY

Hypertension or high blood pressure is one of the non-communicable diseases caused by lifestyle. One prevention so that complications do not occur is to change lifestyle, food intake and routine blood pressure control. The purpose of this study was to determine the correlation of level knowledge and elderly hypertension diet adherence in Nganjuk Regency This research design used was correlative with a cross-sectional approach. The population was 28 hypertension elderly people who actively participated in the elderly Posyandu of Cepoko Village the sample all of 28 people as taken by total sampling. The independent variable is the level of knowledge in hypertension, the dependent variable was Elderly Hypertension Diet Adherence. Data collection was carried out using questionnaires. The data was analysed by Spearmen Rank Correlation test with an alpha of 0.05. The results of the study found that 67.86% of respondents including compliant and 32.14% non- adherence, following the hypertension diet and the results of the calculation of SPSS 25 significance value of 0.000, meaning was Ho rejected. The conclusion of this study was there are The Correlation of Level Knowledge and Elderly Hypertension diet adherence In Nganjuk Regency For this reason, it is hoped that the increasing role of families, cadres and nurses providing health education through interesting information such as using audiovisual such as social media content will be very capable of influencing knowledge that ultimately changes behaviour and compliance with something. Keywordslevel of knowledge, diet adherence, elderly hypertension

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.

Dietary adherence and associated factors among hypertensive patients in governmental hospitals of Guji zone, Oromia, Ethiopia

BackgroundThe Dietary Approaches to Stop Hypertension (DASH) diet has been shown to reduce blood pressure in hypertensive adults, but there is limited information available on dietary adherence and related factors among hypertensive patients in the study area. Hence, the current study aimed to assess dietary adherence and associated factors among hypertensive patients aged greater than or equal to 18 years old in governmental hospitals of Guji zone, Oromia region, Ethiopia.MethodsA facility-based cross-sectional study was conducted between June 5, 2023, and August 30, 2023. For this study, patients with a systolic blood pressure of 140 mmHg or higher and/or a diastolic blood pressure of 90 mmHg or higher on two separate occasions were classified as hypertensive. Thus, the study involved 399 hypertensive patients who were selected using systematic random sampling methods. The level of knowledge regarding hypertension was measured through the use of hypertension knowledge-level scale (HK-LS) questionnaires, while the reliability and validity of the questionnaire were assessed using the Cronbach’s alpha test (α ≥ 0.70).The association between factors was analyzed using adjusted odds ratio (AOR) and a 95% confidence interval. Variables with p-values below 0.05 were considered statistically significant.ResultsAmong the respondents, only 28.30% (CI: 23.9, 33) of participants were found to be adherent to the recommended diet. Factors like participation in nutritional education, level of knowledge, respondents’ ages, and length of time since hypertension diagnosis showed a strong association with adherence to recommended dietary guidelines.ConclusionsThe research findings indicated that the level of compliance with the prescribed diet was generally subpar among individuals with hypertension in comparison to the Dietary Approaches to Stop Hypertension (DASH) diet recommendations. So, it is essential to offer hypertensive patients an education focused on health and nutrition in order to enhance their adherence to dietary guidelines and promote a healthier dietary routine. The results of this research will also be valuable in increasing awareness among policymakers and the general public about the dietary adherence and its associated factors, thus aiding in the development and execution of suitable interventions.

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.