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Lawrence J Appel - One of the best experts on this subject based on the ideXlab platform.
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a low sodium DASH Dietary pattern affects serum markers of inflammation and mineral metabolism in adults with elevated blood pressure
Journal of Nutrition, 2021Co-Authors: Valerie K Sullivan, Lawrence J Appel, Jesse C Seegmiller, Scott T Mcclure, Casey M RebholzAbstract:BACKGROUND The blood pressure-lowering effects of the Dietary Approaches to Stop Hypertension (DASH) Dietary pattern and reduced sodium intake are well established. The effects on other biomarkers related to vascular health are of interest and might assist in explaining the effects of the DASH Diet and sodium reduction. OBJECTIVES We hypothesized that a low-sodium DASH Diet improves (lowers) biomarkers of inflammation [C-reactive protein (CRP) and soluble urokinase plasminogen activator receptor (suPAR)] and mineral metabolism [phosphorus and fibroblast growth factor-23 (FGF23)]. METHODS We conducted a secondary analysis of the DASH-Sodium trial using frozen serum samples. This controlled feeding study randomly assigned 412 adults (≥22 y) with elevated blood pressure (120-159/80-95 mmHg) to consume either a DASH Diet or control Diet. Within each arm, participants received 3 sodium levels [low (1150 mg), intermediate (2300 mg), high (3450 mg)] in random sequence, each for 30 d. To maximize contrast, samples collected at the end of the low-sodium DASH (n = 198) and high-sodium control (n = 194) Diets were compared. Between-Diet differences in serum CRP, suPAR, phosphorus, and FGF23 concentrations were assessed using linear regression adjusted for age, sex, race, income, education, smoking status, and BMI. RESULTS CRP concentrations did not differ between groups (P = 0.83), but suPAR was higher after the low-sodium DASH Diet than the high-sodium control [geometric mean 2470 pg/mL (95% CI: 2380, 2560 pg/mL), compared with 2290 pg/mL (95% CI: 2210, 2380 pg/mL); P = 0.006]. Phosphorus was higher after the low-sodium DASH Diet [geometric mean 3.50 mg/dL (95% CI: 3.43, 3.57 mg/dL)] compared with the high-sodium control Diet [geometric mean 3.39 mg/dL (95% CI: 3.33, 3.46 mg/dL); P = 0.04]. FGF23 was also higher after the low-sodium DASH Diet [geometric mean 35.3 pg/mL (95% CI: 33.3, 37.3 pg/mL) compared with 28.2 pg/mL (95% CI: 26.6, 29.8 pg/mL); P < 0.001]. CONCLUSIONS Contrary to our hypothesis, biomarkers of inflammation and mineral metabolism were increased or unchanged by a low-sodium DASH Diet compared with a high-sodium control Diet in adults with elevated blood pressure.
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abstract 024 effects of Diet on 10 year atherosclerotic cardiovascular disease risk using the pooled cohort equations risk calculator results from the DASH trial
Circulation, 2021Co-Authors: Sun Young Jeong, Lawrence J Appel, Edgar R Miller, Lara C Kovell, Kenneth J Mukamal, Timothy B Plante, Christina C Wee, Stephen P JuraschekAbstract:Background: The Dietary Approaches to Stop Hypertension (DASH) Diet is known to reduce cardiovascular disease (CVD) risk factors, but its effects on 10-year CVD risk based on the pooled cohort esti...
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abstract 023 effects of sodium reduction and the DASH Diet on subclinical cardiac damage results from the DASH sodium trial
Circulation, 2021Co-Authors: Stephen P Juraschek, Lawrence J Appel, Frank M Sacks, Edgar R Miller, Alex R Chang, Lara C Kovell, Robert H Christenson, Heather Rebuck, Kenneth J MukamalAbstract:Background: We recently documented that the DASH Diet has beneficial effects on cardiac biomarkers. The effects of sodium reduction, alone or combined with the DASH Diet, are unknown. Objective: To...
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urine metabolites associated with the Dietary approaches to stop hypertension DASH Diet results from the DASH sodium trial
Molecular Nutrition & Food Research, 2021Co-Authors: Hyunju Kim, Lawrence J Appel, Alice H Lichtenstein, Kari E Wong, Josef Coresh, Casey M RebholzAbstract:Scope Serum metabolomic markers of the Dietary Approaches to Stop Hypertension (DASH) Diet were previously reported. We investigated if urine metabolomic markers were similar in an independent clinical trial. Methods and results In the DASH-Sodium trial, participants were randomly assigned to the DASH Diet or control Diet, and received three sodium interventions (high, intermediate, low) within each randomized Diet group in random order for 30 days each. Urine samples were collected at the end of the intervention period and analyzed for 938 metabolites. We conducted two comparisons of metabolomic profiles: 1) DASH-high sodium (n = 199) versus control-high sodium (n = 193), and 2) DASH-low sodium (n = 196) versus control-high sodium. We compared significant metabolites identified using multivariable linear regression and the top 10 influential metabolites identified using partial least-squares discriminant analysis to the results from a previous analysis of the DASH trial. Nine out of 10 predictive metabolites of the DASH-high sodium and DASH-low sodium Diets were identical. Most candidate biomarkers from the DASH trial replicated. N-methylproline, chiro-inositol, stachydrine, and theobromine replicated as influential metabolites of DASH Diets. Conclusions Candidate biomarkers of the DASH Diet identified in serum replicated in urine. Replicated influential metabolites are likely to be objective biomarkers of the DASH Diet. This article is protected by copyright. All rights reserved.
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effects of the DASH Diet and sodium intake on bloating results from the DASH sodium trial
The American Journal of Gastroenterology, 2019Co-Authors: Allison W Peng, Lawrence J Appel, Edgar R Miller, Stephen P Juraschek, Noel T MuellerAbstract:INTRODUCTION:Bloating is one of the most common gastrointestinal complaints. Evidence has linked fiber and sodium to bloating; however, randomized trials examining these Diet components are lacking. Here, we used a randomized trial to examine the effects of the high-fiber DASH Diet and Dietary sodiu
Edgar R Miller - One of the best experts on this subject based on the ideXlab platform.
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abstract 024 effects of Diet on 10 year atherosclerotic cardiovascular disease risk using the pooled cohort equations risk calculator results from the DASH trial
Circulation, 2021Co-Authors: Sun Young Jeong, Lawrence J Appel, Edgar R Miller, Lara C Kovell, Kenneth J Mukamal, Timothy B Plante, Christina C Wee, Stephen P JuraschekAbstract:Background: The Dietary Approaches to Stop Hypertension (DASH) Diet is known to reduce cardiovascular disease (CVD) risk factors, but its effects on 10-year CVD risk based on the pooled cohort esti...
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abstract 023 effects of sodium reduction and the DASH Diet on subclinical cardiac damage results from the DASH sodium trial
Circulation, 2021Co-Authors: Stephen P Juraschek, Lawrence J Appel, Frank M Sacks, Edgar R Miller, Alex R Chang, Lara C Kovell, Robert H Christenson, Heather Rebuck, Kenneth J MukamalAbstract:Background: We recently documented that the DASH Diet has beneficial effects on cardiac biomarkers. The effects of sodium reduction, alone or combined with the DASH Diet, are unknown. Objective: To...
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effects of the DASH Diet and sodium intake on bloating results from the DASH sodium trial
The American Journal of Gastroenterology, 2019Co-Authors: Allison W Peng, Lawrence J Appel, Edgar R Miller, Stephen P Juraschek, Noel T MuellerAbstract:INTRODUCTION:Bloating is one of the most common gastrointestinal complaints. Evidence has linked fiber and sodium to bloating; however, randomized trials examining these Diet components are lacking. Here, we used a randomized trial to examine the effects of the high-fiber DASH Diet and Dietary sodiu
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effects of sodium intake on postural lightheadedness results from the DASH sodium trial
Journal of Clinical Hypertension, 2019Co-Authors: Allison W Peng, Lawrence J Appel, Edgar R Miller, Olive Tang, Noel T Mueller, Stephen P JuraschekAbstract:Lightheadedness after standing contributes to adverse clinical events, including falls. Recommendations for higher sodium intake to treat postural lightheadedness have not been evaluated in a trial setting. The Dietary Approaches to Stop Hypertension (DASH)-Sodium trial (1998-1999) tested the effects of the DASH Diet and sodium reduction on blood pressure (BP). Participants were randomly assigned to DASH or a typical Western Diet (control). During either Diet, participants ate three sodium levels (50, 100, 150 meq/d at 2100 kcal) in random order for 30-days, separated by 5-day breaks. Participants reported the presence and severity of postural lightheadedness at baseline and after each feeding period. There were 412 participants (mean age 48 years; 57% women; 57% black). Mean baseline SBP/DBP was 135/86 mm Hg; 9.5% reported baseline lightheadedness. Among those consuming the DASH Diet, high vs low sodium increased lightheadedness (OR 1.71; 95% CI: 1.01, 2.90; P = 0.047) and severity of lightheadedness (P = 0.02), but did not affect lightheadedness in those consuming the control Diet (OR 0.77; 95% CI: 0.46, 1.29; P = 0.32). Among those consuming high vs low sodium in the context of the DASH Diet, adults <60 vs ≥60 years old experienced more lightheadedness (P-interaction = 0.04), along with obese vs non-obese adults (P-interaction = 0.01). In the context of the DASH Diet, higher sodium intake was associated with more frequent and severe lightheadedness. These findings challenge traditional recommendations to increase sodium intake to prevent lightheadedness.
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effects of a Dietary approach to stop hypertension DASH Diet intervention on serum uric acid in african americans with hypertension
Arthritis Care and Research, 2018Co-Authors: Stephen P Juraschek, Olive Tang, Karen White, Hsin Chieh Yeh, Lisa A Cooper, Edgar R MillerAbstract:Objective To examine whether partial replacement of a Diet typical of the average American Diet with Dietary Approaches to Stop Hypertension (DASH)-related foods in the home environment lowers the serum uric acid (UA) level in individuals with hypertension. Methods We conducted an ancillary study of a randomized trial of African American adults with controlled hypertension from an urban clinic. Participants were assigned to either a control group or an intervention (DASH-Plus) group. DASH-Plus participants received coach-directed Dietary advice, assistance with purchasing DASH-related foods ($30/week), and home delivery of food via a community supermarket. Participants in the control group received a DASH Diet brochure and a debit card account ($30/week) to purchase foods. Serum UA levels were measured at baseline and after 8 weeks. Results Of the original 123 randomized participants, 117 had available serum UA measurements. Seventy percent of the participants were women, the mean ± SD age was 59 ± 9.5 years, and the mean ± SD serum UA level was 6.4 ± 1.7 mg/dl. The DASH-Plus Diet did not reduce serum UA levels compared with the control Diet (difference in difference -0.01 mg/dl [95% confidence interval -0.39, 0.38]). However, there was a significant trend toward a greater reduction in the serum UA level in participants with higher baseline serum UA levels (P for trend = 0.008). Baseline changes in the serum UA level were inversely associated with changes in systolic blood pressure (P = 0.002), diastolic blood pressure (P = 0.001), and urinary sodium excretion (P = 0.05). Conclusion Overall, in African American individuals, partial replacement of a typical Diet with DASH foods did not lower serum UA levels compared with a control Diet. However, there was a significant trend toward a greater reduction in serum UA levels in subjects with higher baseline serum UA levels. Furthermore, changes in serum UA levels were associated with known correlates, suggesting heterogeneity of effects in the treatment and control arms. Future pragmatic studies of consumption of the DASH Diet to lower serum UA levels should optimize replacement strategies and enroll individuals with hyperuricemia or gout.
Ahmad Esmaillzadeh - One of the best experts on this subject based on the ideXlab platform.
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adherence to the DASH Diet and prevalence of the metabolic syndrome among iranian women
European Journal of Nutrition, 2015Co-Authors: Parvane Saneei, Farzaneh Barak, Ammar Hassanzadeh Keshteli, Ahmadreza Yazdannik, Ebrahim Fallahi, Negar Ghasemifard, Ahmad EsmaillzadehAbstract:Purpose Epidemiologic data linking adherence to the Dietary approaches to stop hypertension (DASH) Diet and metabolic abnormalities is sparse and inconsistent. The association between habitual intake of the DASH Diet and metabolic syndrome (MetS) has not been investigated in the Middle East. We aimed to determine whether usual adherence to the DASH Dietary pattern was associated with MetS in a group of Iranian women.
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adherence to the Dietary approaches to stop hypertension DASH Diet in relation to obesity among iranian female nurses
Public Health Nutrition, 2015Co-Authors: Farzaneh Barak, Ebrahim Falahi, Ammar Hassanzadeh Keshteli, Ahmadreza Yazdannik, Ahmad EsmaillzadehAbstract:OBJECTIVE Limited observational studies have considered habitual consumption of the general population to examine the relationship between the Dietary Approaches to Stop Hypertension (DASH) Diet and obesity. The aim of the present study was to investigate adherence to the DASH Diet in relation to general and central obesity among female nurses in Isfahan, Iran. DESIGN Cross-sectional study carried out among 293 female nurses aged >30 years who were selected by a multistage, cluster random sampling method. Usual Dietary intakes were assessed using a validated FFQ. We constructed the DASH score based on foods and nutrients emphasized or minimized in the DASH Diet, focusing on eight components: high intake of fruits, vegetables, nuts and legumes, low-fat dairy products and whole grains and low intakes of sodium, sweetened beverages, and red and processed meats. General and abdominal obesity were defined as BMI ≥ 25 kg/m2 and waist circumference ≥ 88 cm, respectively. SETTING Isfahan, Iran. SUBJECTS Female nurses (n 293) aged >30 years. RESULTS Increased adherence to the DASH Diet was associated with older age (P<0.01) and lower waist circumference (P=0.04). There was no statistically significant difference in the prevalence of general obesity between extreme quartiles of the DASH Diet score. After adjustment for age, energy intake and other confounding factors, DASH Diet score was not significantly associated with obesity. However, with further controlling for other Dietary factors, those in the highest quartile of DASH Diet score were 71 % less likely to have general obesity compared with those in the lowest quartile. In addition, following a DASH Diet was inversely associated with central obesity after adjustment for potential confounders (OR=0.37; 95 % CI 0.14, 0.96). CONCLUSIONS We found that adherence to the DASH Diet was inversely related to central obesity among Iranian adult females. This association remained significant even after adjustment for potential confounders.
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influence of Dietary approaches to stop hypertension DASH Diet on blood pressure a systematic review and meta analysis on randomized controlled trials
Nutrition Metabolism and Cardiovascular Diseases, 2014Co-Authors: Parvane Saneei, Ahmad Esmaillzadeh, Amin Salehiabargouei, Leila AzadbakhtAbstract:Abstract Background and aims Findings were not consistent on the therapeutic effect of Dietary Approaches to Stop Hypertension (DASH) Diet on blood pressure. We aimed to review systematically and perform a meta-analysis to assess the magnitude of the effect of the DASH Diet on blood pressure in randomized controlled trials (RCTs) among adults. Methods and results We conducted a systematic review and random effects meta-analysis of all RCTs which evaluated the effect of the DASH Diet on blood pressure including published papers until June 2013, using PubMed, ISI Web of Science, Scopus and Google scholar database. Subgroup analysis and meta-regression were used to find out possible sources of between-study heterogeneity. Seventeen RCTs contributing 20 comparisons with 2561 participants were included. Meta-analysis showed that the DASH Diet significantly reduced systolic blood pressure by 6.74 mmHg (95%CI: −8.25, −5.23, I 2 = 78.1%) and diastolic blood pressure by 3.54 mmHg (95%CI: −4.29, −2.79, I 2 = 56.7%). RCTs with the energy restriction and those with hypertensive subjects showed a significantly greater decrease in blood pressure. Meta-regression showed that mean baseline of SBP and DBP was explained 24% and 49% of the variance between studies for SBP and DBP, respectively. Conclusion The results revealed the profitable reducing effect of the DASH-like Diet on both systolic and diastolic blood pressure in adults; although there was a variation in the extent of the fall in blood pressure in different subgroups.
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effects of DASH Diet on lipid profiles and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome a randomized clinical trial
Nutrition, 2014Co-Authors: Zatollah Asemi, Mansooreh Samimi, Zohreh Tabassi, Hossein Shakeri, Simasadat Sabihi, Ahmad EsmaillzadehAbstract:Abstract Objective The aim of this study was to assess the effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on lipid profiles and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome (PCOS). Methods This randomized controlled clinical trial was conducted with 48 women diagnosed with PCOS. The women were randomly assigned to consume either the control (n = 24) or DASH Diet (n = 24) for 8 wk. Both Diets were designed to be calorie-restricted. Both Diets consisted of 52% carbohydrates, 18% proteins, and 30% total fats. The DASH Diet was designed to be rich in fruits, vegetables, whole grains, and low-fat dairy products and to be low in saturated fats, cholesterol, and refined grains. Fasting blood samples were taken at baseline and after 8-wk intervention to measure lipid profiles and biomarkers of oxidative stress including plasma total antioxidant capacity (TAC) and total glutathione (GSH). Results Adherence to the DASH Diet, compared with the control Diet, resulted in a significant decrease in weight (−4.4 versus −1.5 kg; P 2 ; P P interaction=0.005) and very-low-density lipoprotein cholesterol levels (−2.0 versus +3.9 mg/dL; P interaction=0.005). Increased concentrations of TAC (+98.6 versus −174.8 mmol/L; P interaction P interaction=0.005) also were found in the DASH group compared with the control group. Conclusion Consumption of DASH Diet for 8 wk led to a significant reduction in serum insulin, triglycerides and very-low-density lipoprotein cholesterol and a significant increase in TAC and GSH levels.
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DASH Diet insulin resistance and serum hs crp in polycystic ovary syndrome a randomized controlled clinical trial
Hormone and Metabolic Research, 2014Co-Authors: Zatollah Asemi, Ahmad EsmaillzadehAbstract:This study was designed to assess the effects of Dietary Approaches to Stop Hypertension (DASH) eating plan on insulin resistance and serum hs-CRP in overweight and obese women with PCOS. This randomized controlled clinical trial was done on 48 women diagnosed with PCOS. Subjects were randomly assigned to consume either the control (n=24) or the DASH eating pattern (n=24) for 8 weeks. The DASH Diet consisted of 52% carbohydrates, 18% proteins, and 30% total fats. It was designed to be rich in fruits, vegetables, whole grains, and low-fat dairy products and low in saturated fats, cholesterol, refined grains, and sweets. Sodium content of the DASH Diet was designed to be less than 2 400 mg/day. The control Diet was also designed to contain 52% carbohydrates, 18% protein, and 30% total fat. Fasting blood samples were taken at baseline and after 8 weeks intervention to measure insulin resistance and serum hs-CRP levels. Adherence to the DASH eating pattern, compared to the control Diet, resulted in a significant reduction of serum insulin levels (−1.88 vs. 2.89 μIU/ml, p=0.03), HOMA-IR score (−0.45 vs. 0.80; p=0.01), and serum hs-CRP levels (−763.29 vs. 665.95 ng/ml, p=0.009). Additionally, a significant reduction in waist (−5.2 vs. −2.1 cm; p=0.003) and hip circumference (−5.9 vs. −1 cm; p Clinical trial registration number: www.irct.ir : IRCT201304235623N6
Laura P Svetkey - One of the best experts on this subject based on the ideXlab platform.
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urine and plasma metabolome of healthy adults consuming the DASH Dietary approaches to stop hypertension Diet a randomized pilot feeding study
Nutrients, 2021Co-Authors: Shirin Pourafshar, Laura P Svetkey, Crystal C Tyson, Mira Nicchitta, David L Corcoran, James R Bain, Michael J Muehlbauer, Olga IlkayevaAbstract:We aimed to identify plasma and urine metabolites altered by the Dietary Approaches to Stop Hypertension (DASH) Diet in a post-hoc analysis of a pilot feeding trial. Twenty adult participants with un-medicated hypertension consumed a Control Diet for one week followed by 2 weeks of random assignment to either Control or DASH Diet. Non-missing fasting plasma (n = 56) and 24-h urine (n = 40) were used to profile metabolites using untargeted gas chromatography/mass spectrometry. Linear models were used to compare metabolite levels between the groups. In urine, 19 identifiable untargeted metabolites differed between groups at p < 0.05. These included a variety of phenolic acids and their microbial metabolites that were higher during the DASH Diet, with many at false discovery rate (FDR) adjusted p < 0.2. In plasma, eight identifiable untargeted metabolites were different at p < 0.05, but only gamma-tocopherol was significantly lower on DASH at FDR adjusted p < 0.2. The results provide insights into the mechanisms of benefit of the DASH Diet.
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ambulatory blood pressure in the DASH Diet trial effects of race and albuminuria
Journal of Clinical Hypertension, 2018Co-Authors: Crystal C Tyson, Pao Hwa Lin, Shelly Sapp, Huiman X Barnhart, Victor Poon, Laura P SvetkeyAbstract:We evaluated whether low-grade albuminuria or black race modulates ambulatory blood pressure (BP) or nocturnal BP response to the DASH Diet. Among 202 adults enrolled in the DASH multicenter trial who were fed the DASH or control Diet for 8 weeks, reductions in 24-hour daytime and nighttime SBP and DBP were significantly larger for DASH compared to control. Median changes in nocturnal BP dipping were not significant. Compared to urine albumin excretion of <7 mg/d, ≥7 mg/d was associated with larger significant median reductions in 24-hour SBP (-7.3 vs -3.1 mm Hg), all measures of DBP (24-hour: -5.9 vs -1.8 mm Hg; daytime: -9.9 vs -4.0 mm Hg; nighttime -9.0 vs -2.0 mm Hg), and with increased nocturnal SBP dipping (2.3% vs -0.5%). Black race was associated with larger median reduction in 24-hour SBP only (-5.5 vs -2.4 mm Hg). This analysis suggests greater effect of DASH on ambulatory BP in the presence of low-grade albuminuria.
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the DASH Diet 20 years later
JAMA, 2017Co-Authors: Dori M Steinberg, Gary G Bennett, Laura P SvetkeyAbstract:This year marks the 20th anniversary of the publication showing the blood pressure–lowering effects of the Dietary Approaches to Stop Hypertension (DASH) Diet.1 The DASH Diet is considered an important advance in nutritional science. It emphasizes foods rich in protein, fiber, potassium, magnesium, and calcium, such as fruits and vegetables, beans, nuts, whole grains, and low-fat dairy. It also limits foods high in saturated fat and sugar.1 DASH is not a reduced-sodium Diet, but its effect is enhanced by also lowering sodium intake.1 Since the creation of DASH 20 years ago, numerous trials have demonstrated that it consistently lowers blood pressure across a diverse range of patients with hypertension and prehypertension.
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short term effects of the DASH Diet in adults with moderate chronic kidney disease a pilot feeding study
Ndt Plus, 2016Co-Authors: Crystal C Tyson, Pao Hwa Lin, Chinazo Nwankwo, Leonor Corsino, Bryan C Batch, Jenifer Allen, Shelly Sapp, Huiman X Barnhart, Jasmine Burroughs, Laura P SvetkeyAbstract:Background Although the Dietary Approaches to Stop Hypertension (DASH) Diet lowers blood pressure (BP) for adults with normal kidney function, evidence is lacking regarding its safety and efficacy in chronic kidney disease (CKD). We aimed to test the effects of the DASH Diet on serum electrolytes and BP in adults with moderate CKD.
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impact of kidney function on effects of the Dietary approaches to stop hypertension DASH Diet
Journal of Hypertension, 2013Co-Authors: Crystal C Tyson, Maragatha Kuchibhatla, Uptal D Patel, Patrick H Pun, Alex R Chang, Chinazo Nwankwo, Michael A Joseph, Laura P SvetkeyAbstract:Objectives: Although the Dietary Approaches to Stop Hypertension (DASH) Diet lowers blood pressure in adults with hypertension, how kidney function impacts this effect is not known. We evaluated whether Estimated Glomerular Filtration Rate (eGFR) modifies the effect of the DASH Diet on blood pressure, markers of mineral metabolism, and markers of kidney function. Methods: Secondary analysis of the DASH-Sodium trial, a multicenter, randomized, controlled human feeding study that evaluated the blood pressure lowering effect of the DASH Diet at three levels of sodium intake. Data from 92 participants with pre-hypertension or stage 1 hypertension during the 3450 mg /day sodium Diet assignment contributed to this analysis. Stored frozen plasma and urine specimens were used to measure kidney related laboratory outcomes. Results: Effects of the DASH Diet on blood pressure, phosphorus, intact parathyroid hormone, creatinine, and albuminuria were not modified by baseline eGFR (mean 84.5 ± 18.0 ml/min/1.73 m2, range 44.1 to 138.6 ml/min/1.73 m2) or the presence of chronic kidney disease (N=13%). Conclusions: The impact of the DASH Diet on blood pressure, markers of mineral metabolism, and markers of kidney function does not appear to be modified by eGFR in this small subset of DASH-Sodium trial participants with relatively preserved kidney function. Whether greater reduction in eGFR modifies the effects of DASH on kidney related measures is yet to be determined. A larger study in individuals with more advanced kidney disease is needed to establish the efficacy and safety of the DASH Diet in this patient population.
Stephen P Juraschek - One of the best experts on this subject based on the ideXlab platform.
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abstract 024 effects of Diet on 10 year atherosclerotic cardiovascular disease risk using the pooled cohort equations risk calculator results from the DASH trial
Circulation, 2021Co-Authors: Sun Young Jeong, Lawrence J Appel, Edgar R Miller, Lara C Kovell, Kenneth J Mukamal, Timothy B Plante, Christina C Wee, Stephen P JuraschekAbstract:Background: The Dietary Approaches to Stop Hypertension (DASH) Diet is known to reduce cardiovascular disease (CVD) risk factors, but its effects on 10-year CVD risk based on the pooled cohort esti...
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abstract 023 effects of sodium reduction and the DASH Diet on subclinical cardiac damage results from the DASH sodium trial
Circulation, 2021Co-Authors: Stephen P Juraschek, Lawrence J Appel, Frank M Sacks, Edgar R Miller, Alex R Chang, Lara C Kovell, Robert H Christenson, Heather Rebuck, Kenneth J MukamalAbstract:Background: We recently documented that the DASH Diet has beneficial effects on cardiac biomarkers. The effects of sodium reduction, alone or combined with the DASH Diet, are unknown. Objective: To...
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effects of the DASH Diet and sodium intake on bloating results from the DASH sodium trial
The American Journal of Gastroenterology, 2019Co-Authors: Allison W Peng, Lawrence J Appel, Edgar R Miller, Stephen P Juraschek, Noel T MuellerAbstract:INTRODUCTION:Bloating is one of the most common gastrointestinal complaints. Evidence has linked fiber and sodium to bloating; however, randomized trials examining these Diet components are lacking. Here, we used a randomized trial to examine the effects of the high-fiber DASH Diet and Dietary sodiu
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effects of sodium intake on postural lightheadedness results from the DASH sodium trial
Journal of Clinical Hypertension, 2019Co-Authors: Allison W Peng, Lawrence J Appel, Edgar R Miller, Olive Tang, Noel T Mueller, Stephen P JuraschekAbstract:Lightheadedness after standing contributes to adverse clinical events, including falls. Recommendations for higher sodium intake to treat postural lightheadedness have not been evaluated in a trial setting. The Dietary Approaches to Stop Hypertension (DASH)-Sodium trial (1998-1999) tested the effects of the DASH Diet and sodium reduction on blood pressure (BP). Participants were randomly assigned to DASH or a typical Western Diet (control). During either Diet, participants ate three sodium levels (50, 100, 150 meq/d at 2100 kcal) in random order for 30-days, separated by 5-day breaks. Participants reported the presence and severity of postural lightheadedness at baseline and after each feeding period. There were 412 participants (mean age 48 years; 57% women; 57% black). Mean baseline SBP/DBP was 135/86 mm Hg; 9.5% reported baseline lightheadedness. Among those consuming the DASH Diet, high vs low sodium increased lightheadedness (OR 1.71; 95% CI: 1.01, 2.90; P = 0.047) and severity of lightheadedness (P = 0.02), but did not affect lightheadedness in those consuming the control Diet (OR 0.77; 95% CI: 0.46, 1.29; P = 0.32). Among those consuming high vs low sodium in the context of the DASH Diet, adults <60 vs ≥60 years old experienced more lightheadedness (P-interaction = 0.04), along with obese vs non-obese adults (P-interaction = 0.01). In the context of the DASH Diet, higher sodium intake was associated with more frequent and severe lightheadedness. These findings challenge traditional recommendations to increase sodium intake to prevent lightheadedness.
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effects of a Dietary approach to stop hypertension DASH Diet intervention on serum uric acid in african americans with hypertension
Arthritis Care and Research, 2018Co-Authors: Stephen P Juraschek, Olive Tang, Karen White, Hsin Chieh Yeh, Lisa A Cooper, Edgar R MillerAbstract:Objective To examine whether partial replacement of a Diet typical of the average American Diet with Dietary Approaches to Stop Hypertension (DASH)-related foods in the home environment lowers the serum uric acid (UA) level in individuals with hypertension. Methods We conducted an ancillary study of a randomized trial of African American adults with controlled hypertension from an urban clinic. Participants were assigned to either a control group or an intervention (DASH-Plus) group. DASH-Plus participants received coach-directed Dietary advice, assistance with purchasing DASH-related foods ($30/week), and home delivery of food via a community supermarket. Participants in the control group received a DASH Diet brochure and a debit card account ($30/week) to purchase foods. Serum UA levels were measured at baseline and after 8 weeks. Results Of the original 123 randomized participants, 117 had available serum UA measurements. Seventy percent of the participants were women, the mean ± SD age was 59 ± 9.5 years, and the mean ± SD serum UA level was 6.4 ± 1.7 mg/dl. The DASH-Plus Diet did not reduce serum UA levels compared with the control Diet (difference in difference -0.01 mg/dl [95% confidence interval -0.39, 0.38]). However, there was a significant trend toward a greater reduction in the serum UA level in participants with higher baseline serum UA levels (P for trend = 0.008). Baseline changes in the serum UA level were inversely associated with changes in systolic blood pressure (P = 0.002), diastolic blood pressure (P = 0.001), and urinary sodium excretion (P = 0.05). Conclusion Overall, in African American individuals, partial replacement of a typical Diet with DASH foods did not lower serum UA levels compared with a control Diet. However, there was a significant trend toward a greater reduction in serum UA levels in subjects with higher baseline serum UA levels. Furthermore, changes in serum UA levels were associated with known correlates, suggesting heterogeneity of effects in the treatment and control arms. Future pragmatic studies of consumption of the DASH Diet to lower serum UA levels should optimize replacement strategies and enroll individuals with hyperuricemia or gout.
