Nutritional Pearls: Can The DASH Diet Treat More Than High Blood Pressure?
Susan is a 45-year-old woman with hypertension and high low-density lipoprotein cholesterol levels.
She is already careful about her daily sodium intake, but is curious if there are any other dietary options available to her to help manage both cholesterol and hypertension.
How would you advise your patient?
What is the correct answer?
(Answer and discussion on next page)
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Answer: The DASH Diet can improve both blood pressure and cholesterol levels.
For years, the go-to diet for treating high blood pressure has been the Dietary Approaches to Stop Hypertension (DASH) diet; in fact, it was created by the National Institute of Health for that exact purpose. There's significant research to demonstrate that the DASH diet is effective at both treating high blood pressure in patients who are already hypertensive, as well as improving scores in individuals with blood pressure levels that are closer to normal.
However, high blood pressure is just 1 of the risk factors for cardiovascular disease. What about cholesterol scores and glucose levels? There have been studies that looked at the incidence of heart disease or stroke, but data on the specific risk factors has been somewhat lacking. Researchers in the United Kingdom recently reviewed the literature of published studies to determine the impact of the DASH diet on other heart disease factors.1
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The Research
For their meta-analysis, researchers reviewed 20 randomized, controlled trials (n=1900 men and women) that compared participants following the DASH diet to a control group in 2 to 24 week studies. Risk factors, including blood pressures, glucose scores, and cholesterol scores, were tabulated.
The Results
Unsurprisingly, the DASH diet did report improved blood pressure—the stronger results were seen in participants with higher initial blood pressure levels or higher body mass indices. The DASH diet also helped improve total and low-density lipoprotein cholesterol scores (ie, the “bad” cholesterol), whereas no effect was noted on high-density lipoprotein cholesterol scores (ie, the “good” cholesterol), triglyceride levels, or glucose scores.
What’s the “Take Home”?
Of particular interest was the authors’ mentaion that “the lack of a significant association between changes in blood pressure and dietary sodium intake is unanticipated.”
For the past several years, there have been small indications that dietary sodium—the amount of sodium in your diet—is not the single cause of high blood pressure.
This does not mean that your patients should stop worrying about sodium altogether. We know that sodium intake does matter and that cutting salt from your diet does help reduce blood pressure. But it’s equally important to remember that sodium is just a single factor when computing cardiovascular risk.
1. Siervo M, Lara J, Chowdhury S, et al. Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. Brit J Nutr. 2015;1(13):1-15.