Diet and DASH
Download as PPT, PDF2 likes786 views
The DASH diet is recommended for lowering blood pressure and reducing the risk of heart disease and stroke. It focuses on fruits, vegetables, whole grains, low-fat dairy, nuts and beans. Studies have shown the DASH diet can lower systolic blood pressure by 11 mmHg and diastolic blood pressure by 6 mmHg in hypertensive individuals, and by 6 mmHg and 3 mmHg respectively in pre-hypertensive individuals. However, some controversies exist around its effectiveness for weight loss, diabetes prevention, and impact on cholesterol and heart disease risk factors. Long-term studies of its effects are also limited.
Diet and DASH
- 1. Diet and “DASH” Dr Arindam Pande, MBBS (Hons), MD, DM, FESC, FSCAI (USA), FACC (USA), FRCP (Glasg.) Consultant Cardiologist, Medica SuperSpecialty Hospital, Kolkata www.drarindampande.com
- 2. • Make a “Dash” for more – – fruits and vegetables – whole grains and breads – non-fat and low fat dairy foods – nuts, seeds and beans PBRC 20112
- 4. Effectiveness • In Hypertensive SBP reduction 11 mmHg, DBP reduction 6 mmHg • In Pre-Hypertensive SBP reduction 6 mmHg, DBP reduction 3 mmHg
- 5. DASH is recommended by.. • National Heart Lung and Blood Institute (part of NIH) • United States Department of Agriculture (USDA) • JNC 7 • American Heart Association (AHA) • 2010 Dietary Guidelines for Americans • US Guidelines for treatment of high blood pressure • 2011 AHA Treatment Guidelines for Women • The Mayo Clinic
- 6. In 2018, DASH was named • “Best Diets Overall”, “For Healthy Eating”, and “Best Heart-Healthy Diets”; • “For Diabetes” joint best Source: U. S. News & World Report’s annual “Best Diets” ranking 2018
- 7. Benefits? • Reduce blood pressure • Reduce risk of stroke and heart disease • Reduce development of kidney stones • Improve cholesterol (??) • Improve insulin sensitivity (??)
- 9. Facts about the DASH Diet and preventing nutrition-related chronic disease: • DASH has never been shown to help people lose weight or prevent diabetes • DASH has only been tested on hypertensive populations (only 1 trial, in Iran, tested a healthy population, and those subjects were 60 adolescent girls). Thus, DASH cannot be generalized to normal, healthy, non-hypertensive populations.
- 10. Facts about the DASH Diet and preventing nutrition-related chronic disease: • DASH has, at best, mixed results for heart-disease risk factors. While it sometimes lowers LDL-C (a possible, though unreliable sign of improving CVD risk), it also invariably lowers HDL-C and fails to lower (or raises) triglycerides (both reliable signs of increasing CVD risk). • DASH has been tested on fewer than 2200 people. • Only 1 DASH trial has lasted longer than 8 weeks (and that trial was only 5 months).
- 11. DASH Trial Results • DASH (Original), Appel, 1997 459 hypertensive adults, 8 week trial • DASH (Original), Conlin, 2000 133 hypertensive adults, 8 week trial • DASH (Original), Obarzanek, 2001 436 hypertensive adults, 8 week trial • DASH (Original), Moore, 1999 354 hypertensive adults, 8 week trial
- 12. Modified DASH Trial Results • DASH (Variation), Blumenthal Babyak Sherwood, 2010 459 hypertensive adults, 8 week trial • DASH (Variation), Saneei, 2013 60 adolescent girls with metabolic syndrome, 6 week trial • DASH (Variation), Appel, 2005 The “Omniheart Trial” 164 hypertensive adults, 6 week trial • DASH (Sodium), Sacks, 2001 412 hypertensive adults, 30 day trial
- 13. • “high-fat DASH” study was conducted, it outperformed a regular DASH diet on improving cardiovascular risk factors. This is consistent with evidence that the vast majority of higher-fat diets outperform low- fat, high-carb diets on nearly all outcome markers.
- 14. In Summary • In sum, a total of 2,162 people have been studied on DASH, in trials • Nearly all of which lasted 8 weeks or less. • Only 60 of these 2,162 subjects were normal (not hypertensive/pre-hypertensive), and those 60 were adolescent girls. PBRC 201114
Editor's Notes
- #3: To summarize what we have said today, make a DASH to more fruits and vegetables, whole grain breads and cereals, non-fat and low fat dairy foods and nuts, seeds, and dried beans.
- #15: To summarize what we have said today, make a DASH to more fruits and vegetables, whole grain breads and cereals, non-fat and low fat dairy foods and nuts, seeds, and dried beans.