Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: a randomized controlled trial. The Dietary Approaches to Stop Hypertension eating plan affects C-reactive protein, coagulation abnormalities, and hepatic function tests among type 2 diabetic patients. The DASH diet and diet costs among ethnic and racial groups in the United States. DASH Diet Lowers Blood Pressure and Lipid-Induced Oxidative Stress in Obesity Effects of a DASH-like diet containing lean beef on vascular health A randomized controlled clinical trial investigating the effect of DASH diet on insulin resistance, inflammation, and oxidative stress in gestational diabetes. Dietary Approaches to Stop Hypertension (DASH) diet: applicability and acceptability to a UK population. Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on the Pressure-Natriuresis Relationship Does the DASH diet lower blood pressure by altering peripheral vascular function? DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. The Effect of Dietary Patterns on Estimated Coronary Heart Disease Risk: Results From the Dietary Approaches to Stop Hypertension (DASH) Trial The dietary approaches to stop hypertension (DASH) clinical trial: implications for lifestyle modifications in the treatment of hypertensive patients. Low-Sodium Dietary Approaches to Stop Hypertension Diet Reduces Blood Pressure, Arterial Stiffness, and Oxidative Stress in Hypertensive Heart Failure With Preserved Ejection Fraction Effects of the Dietary Approaches to Stop Hypertension (DASH) Eating Plan on Cardiovascular Risks Among Type 2 Diabetic Patients Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Inflammation Modifies the Effects of a Reduced-Fat Low-Cholesterol Diet on Lipids: Results From the DASH-Sodium Trial Determinants and consequences of adherence to the dietary approaches to stop hypertension diet in African-American and white adults with high blood pressure: results from the ENCORE trial.
BACKGROUND The DASH ( Dietary Approaches to Stop Hypertension ) dietary pattern , which is high in fruit , vegetables , and low-fat dairy foods , significantly lowers blood pressure as well as low-density lipoprotein ( LDL ) and high-density lipoprotein ( HDL ) cholesterol . OBJECTIVE The study was design ed to test the effects of substituting full-fat for low-fat dairy foods in the DASH diet , with a corresponding increase in fat and a reduction in sugar intake , on blood pressure and plasma lipids and lipoproteins . DESIGN This was a 3-period r and omized crossover trial in free-living healthy individuals who consumed in r and om order a control diet , a st and ard DASH diet , and a higher-fat , lower-carbohydrate modification of the DASH diet ( HF-DASH diet ) for 3 wk each , separated by 2-wk washout periods . Laboratory measurements , which included lipoprotein particle concentrations determined by ion mobility , were made at the end of each experimental diet . RESULTS Thirty-six participants completed all 3 dietary periods . Blood pressure was reduced similarly with the DASH and HF-DASH diets compared with the control diet . The HF-DASH diet significantly reduced triglycerides and large and medium very-low-density lipoprotein ( VLDL ) particle concentrations and increased LDL peak particle diameter compared with the DASH diet . The DASH diet , but not the HF-DASH diet , significantly reduced LDL cholesterol , HDL cholesterol , apolipoprotein A-I , intermediate-density lipoprotein and large LDL particles , and LDL peak diameter compared with the control diet . CONCLUSIONS The HF-DASH diet lowered blood pressure to the same extent as the DASH diet but also reduced plasma triglyceride and VLDL concentrations without significantly increasing LDL cholesterol . This trial was registered at clinical trials.gov as NCT01404897 Few studies exist regarding the effects of the Dietary Approaches to Stop Hypertension ( DASH ) diet on novel cardiovascular risk factors among type 2 diabetic patients . We evaluated the effects of the DASH eating pattern on C-reactive protein ( CRP ) level , coagulation abnormalities , and hepatic function tests in type 2 diabetic patients . In this r and omized , crossover clinical trial , 31 type 2 diabetic patients consumed a control diet or the DASH diet  for 8 wk . 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/d sodium . The control diet was a st and ard diet for diabetic patients .  There was a 4-wk washout between the 2 trial phases . The main outcome measures were CRP level , coagulation indices , and hepatic function tests . The mean percent change for plasma CRP level was -26.9 ± 3.5 % after the DASH diet period and -5.1 ± 3.8 % after the control diet period ( P = 0.02 ) . Decreases in both alanine aminotransferase and aspartate aminotransferase levels were greater after consuming the DASH diet compared with the control diet ( -14.8 ± 3.0 % vs -6.6 ± 3.4 % ; P = 0.001 ; -29.4 ± 3.7 % vs -5.9 ± 1.4 % ; P = 0.001 , respectively ) . The decrease in the plasma fibrinogen level during the DASH diet period ( -11.4 ± 3.6 % ) was greater than that during the control diet ( 0.5 ± 3.4 % ) ( P = 0.03 ) . Among diabetic patients , the DASH diet can play an important role in reducing inflammation , plasma levels of fibrinogen , and liver aminotransferases . Future longer term studies are recommended The Dietary Approaches to Stop Hypertension ( DASH ) diet is perhaps the best example of how a nutrient dense dietary pattern can prevent chronic disease . In r and omized trials , DASH dietary patterns lowered blood pressure  in hypertensive individuals.1 Subsequent trials and observational studies have consistently found that DASH-type diets reduced cardiovascular and metabolic Abstract — Evidence suggests that obesity may raise blood pressure ( BP ) through oxidative stress – sensitive mechanisms and that the Dietary Approaches to Stop Hypertension combination diet ( DASH-CD ) may decrease BP by enhancing antioxidant capacity . To address this question , 12 obese patients with high-normal – to – stage 1 hypertension ( hypertensives ) and 12 lean normotensives were studied on their usual diets and after following the DASH-CD and a low-antioxidant diet in r and om sequence for 4 weeks each . Acute oxidative stress was induced by a 4-hour infusion of intralipid and heparin  . Ferric-reducing activity of plasma ( FRAP ) and plasma F2-isoprostanes were measured as biomarkers of antioxidant capacity and oxidative stress , respectively . BP was lower in obese hypertensives on the DASH-CD than on the usual and low-antioxidant diets ( −8.1±1.5/−7.4±1.6 mm Hg , P < 0.05 ) . BP did not change significantly in lean normotensives after 4 weeks on the DASH-CD but tended to rise on the low-antioxidant diet  . FRAP on usual diets was higher in lean subjects than in obese subjects . FRAP increased in obese but not lean volunteers on the DASH-CD compared with usual diet , and the group difference disappeared . F2-isoprostanes increased from baseline during intralipid and heparin in both groups on the low-antioxidant diet but not in obese hypertensives on the DASH-CD . Among free-living obese hypertensives , the DASH-CD  raises antioxidant capacity , lowers BP , and reduces oxidative stress induced by acute hyperlipidemia . The findings are consistent with evidence that elevated BP in obese subjects may reflect an imbalance between antioxidant capacity and oxidative stress that is improved by the DASH-CD A DASH ( dietary approaches to stop hypertension ) dietary pattern rich in fruits and vegetables and low-fat dairy products with increased dietary protein provided primarily from plant protein sources decreases blood pressure . No studies , however , have evaluated the effects of a DASH-like diet with increased dietary protein from lean beef on blood pressure and vascular health . The aim of this study was to study the effect of DASH-like diets that provided different amounts of protein from lean beef ( DASH 28 g beef per day ; beef in an optimal lean diet ( BOLD ) 113 g beef per day ; beef in an optimal lean diet plus additional protein ( BOLD+ ) 153 g beef per day ) on blood pressure , endothelial function and vascular reactivity versus a healthy American diet ( HAD ) . Using a r and omized , crossover study design , 36 normotensive participants ( systolic blood pressure ( SBP ) , 116±3.6 mm Hg ) were fed four isocaloric diets , : HAD ( 33 % total fat , 12 % saturated fatty acids ( SFA ) , 17 % protein ( PRO ) , 20 g beef per day ) , DASH ( 27 % total fat , 6 % SFA , 18 % PRO , 28 g beef per day ) , BOLD ( 28 % total fat , 6 % SFA , 19 % PRO , 113 g beef per day ) and BOLD+ ( 28 % total fat , 6 % SFA , 27 % PRO , 153 g beef per day ) , for 5 weeks . SBP decreased ( P<0.05 ) in subjects on the BOLD+ diet ( 111.4±1.9 mm Hg ) versus HAD ( 115.7±1.9 ) . There were no significant effects of the DASH and BOLD diets on SBP . Augmentation index ( AI ) was significantly reduced in participants on the BOLD diet ( −4.1 % ) . There were no significant effects of the dietary treatments on diastolic blood pressure or endothelial function ( as measured by peripheral arterial tonometry ) . A moderate protein DASH-like diet including lean beef decreased SBP in normotensive individuals . The inclusion of lean beef in a heart healthy diet also reduced peripheral vascular constriction OBJECTIVE To our knowledge , no reports are available indicating the effects of the dietary approaches to stop hypertension ( DASH ) eating plan on insulin resistance , inflammation , and oxidative stress among pregnant women with gestational diabetes mellitus ( GDM ) . This study was design ed to investigate the effects of the DASH diet on insulin resistance , serum high-sensitivity C-reactive protein ( hs-CRP ) and biomarkers of oxidative stress among pregnant women with GDM . METHODS This r and omized controlled clinical trial was performed with 32 pregnant women diagnosed with GDM at 24 to 28 wk gestation . Participants were r and omly assigned to consume either the control ( n = 16 ) or DASH diet ( n = 16 ) for 4 wk . The DASH diet was rich in fruits , vegetables , whole grains , and low-fat dairy products and was low in saturated fats , total fats , cholesterol , refined grains , and sweets , with a total of 2400 mg/d of sodium . The control diet contained 40 % to 55 % of its energy as carbohydrates , 10 % to 20 % as proteins , and 25 % to 30 % as total fats . Fasting blood sample s were taken at baseline and after 4 wk of intervention to measure fasting plasma glucose ( FPG ) , serum insulin , and hs-CRP , homeostasis model of assessment -insulin resistance ( HOMA-IR ) , plasma total antioxidant capacity ( TAC ) , and total glutathione levels ( GSH ) . RESULTS Consumption of the DASH diet compared with the control diet result ed in decreased FPG ( -7.62 versus 3.68 mg/dL ; P = 0.02 ) , serum insulin levels ( -2.62 versus 4.32 μIU/mL , P = 0.03 ) , and HOMA-IR score ( -0.8 versus 1.1 ; P = 0.03 ) . Increased concentrations of plasma TAC ( 45.2 versus -159.2 mmol/L ; P < 0.0001 ) and GSH ( 108.1 versus -150.9 μmol/L ; P < 0.0001 ) also were seen in the DASH group compared with control group . We failed to find a significant difference in mean changes of serum hs-CRP levels between the two diets . Within-group comparisons revealed significant reductions in plasma TAC and GSH levels in the control diet , while a significant increase in these biomarkers in the DASH diet . CONCLUSION Consumption of the DASH diet in pregnant women with GDM had beneficial effects on FPG , serum insulin levels , HOMA-IR score , plasma TAC , and total GSH levels . The effects of this dietary pattern on pregnancy outcomes need to be investigated in future studies BACKGROUND The Dietary Approaches to Stop Hypertension ( DASH ) diet is widely promoted in the USA for the prevention and treatment of high blood pressure . It is high in fruit and vegetables , low-fat dairy and wholegrain foods and low in saturated fat and refined sugar . To our knowledge , the use of this dietary pattern has not been assessed in a free-living UK population . METHODS The DASH diet was adapted to fit UK food preferences and portion sizes . Fourteen healthy subjects followed the adapted DASH diet for 30 days in which they self-selected all food and beverages .  Dietary intake was assessed by 5-day food diaries completed before and towards the end of the study . Blood pressure was measured at the beginning and end of the study to assess compliance to the DASH style diet . RESULTS The DASH diet was easily adapted to fit with UK food preferences . Furthermore , it was well tolerated and accepted by subjects . When on the DASH style diet , subjects reported consuming significantly ( P < 0.01 ) more carbohydrate and protein and less total fat ( 5 % , 6 % and 9 % total energy , respectively ) . Sodium intakes decreased by 860 mg day(-1 ) ( P < 0.001 ) . Systolic and diastolic blood pressure decreased significantly ( P < 0.05 ) by 4.6 and 3.9 mmHg , respectively when on the DASH style diet . CONCLUSIONS The DASH style diet was well accepted and was associated with a decrease in blood pressure in normotensive individuals and should be considered when giving dietary advice to people with elevated blood pressure in the UK Abstract —Blood pressure-lowering mechanisms of the Dietary Approaches to Stop Hypertension ( DASH ) diet , rich in fruits , vegetables , and low-fat dairy foods , were analyzed based on the pressure-natriuresis relationship . Participants ( n=375 ) were r and omly assigned to control or DASH diet groups by using a parallel-group design . They then ate their assigned diet for 3 consecutive 30-day intervention feeding periods , during which sodium intake varied among 3 levels by a r and omly assigned sequence . Urinary sodium excretion rate and mean arterial pressure were measured at the end of each sodium intake level . Mean arterial pressure and urinary sodium excretion were plotted on x and y axes , respectively , for participants eating control and DASH diets and were modeled as linear relationships for simplicity to allow the estimation of the extrapolated x-intercept and slope of the relationships . The DASH diet steepened the slope of the relationship ( 29.5±3.4 vs 64.9±13.1 [mmol/d]/mm Hg , P = 0.0002 ) without significantly shifting the x-intercept ( 94.1±0.5 vs 93.2±0.6 mm Hg , NS ) of the relationship . These data suggest a natriuretic action of the DASH diet We tested whether lowering of blood pressure ( BP ) on the dietary approaches to stop hypertension ( DASH ) diet was associated with changes in peripheral vascular function : endothelial function , assessed by flow-mediated vasodilatation ( FMD ) of the brachial artery , and subcutaneous adipose tissue blood flow ( ATBF ) . We also assessed effects on heart rate variability ( HRV ) as a measure of autonomic control of the heart . We allocated 27 men and women to DASH diet and control groups .  We measured FMD , ATBF and HRV on fasting and after ingestion of 75 g glucose , before and after 30 days on dietary intervention , aim ing for weight maintenance . The control group did not change their diet . The DASH-diet group complied with the diet as shown by significant reductions in systolic ( P<0.001 ) and diastolic ( P=0.005 ) BP , and in plasma C-reactive protein ( P<0.01 ) , LDL-cholesterol ( P<0.01 ) and apolipoprotein B ( P=0.001 ) , a novel finding . Body weight changed by < 1 kg . There were no changes in the control group . We found no changes in FMD , or in ATBF , in the DASH-diet group , although heart rate fell ( P<0.05 ) . Glucose and insulin concentrations did not change . In this small-scale study , the DASH diet lowered BP independently of peripheral mechanisms BACKGROUND There are established guidelines for recommended dietary intake for hypertension treatment and cardiovascular disease prevention . Evidence is lacking for effective dietary patterns for kidney disease prevention . STUDY DESIGN Prospect i ve cohort study . SETTING & PARTICIPANTS Atherosclerosis Risk in Communities ( ARIC ) Study participants with baseline estimated glomerular filtration rate ( eGFR ) ≥ 60mL/min/1.73m2 ( N=14,882 ) . PREDICTOR The Dietary Approaches to Stop Hypertension ( DASH ) diet score was calculated based on self-reported dietary intake of red and processed meat , sweetened beverages , sodium , fruits , vegetables , whole grains , nuts and legumes , and low-fat dairy products , averaged over 2 visits . OUTCOMES Cases were ascertained based on the development of eGFRs<60mL/min/1.73m2 accompanied by ≥25 % eGFR decline from baseline , an  International Classification of Diseases , Ninth/Tenth Revision code for a kidney disease-related hospitalization or death , or end-stage renal disease from baseline through 2012 . RESULTS 3,720 participants developed kidney disease  during a median follow-up of 23 years . Participants with a DASH diet score in the lowest tertile were 16 % more likely to develop kidney disease than those with the highest score tertile ( HR , 1.16 ; 95 % CI , 1.07 - 1.26 ; P for trend < 0.001 ) , after adjusting for sociodemographics , smoking status , physical activity , total caloric intake , baseline eGFR , overweight/obese status , diabetes status , hypertension status , systolic blood pressure , and antihypertensive medication use . Of the individual components of the DASH diet score , high red and processed meat intake was adversely associated with kidney disease and high nuts , legumes , and low-fat dairy products intake was associated with reduced risk for kidney disease . LIMITATIONS Potential measurement error due to self-reported dietary intake and lack of data for albuminuria . CONCLUSIONS Consuming a DASH-style diet was associated with lower risk for kidney disease independent of demographic characteristics , established kidney risk factors , and baseline kidney function . Healthful dietary patterns such as the DASH diet may be beneficial for kidney disease prevention Background —The Dietary Approaches to Stop Hypertension ( DASH ) diet is recommended in the 2005 US Dietary Guidelines . To underst and the potential benefits of DASH on coronary heart disease ( CHD ) , we applied the Framingham risk equations to calculate 10-year risk of developing CHD using data from the DASH trial . Methods and Results —In the DASH trial , 459 individuals with prehypertension or stage-1 hypertension not taking antihypertensive medication were r and omly assigned to 1 of 3 diets : control , fruits and vegetables ( F/V ) , or DASH ( rich in fruits , vegetables , low-fat dairy , and reduced in fats and cholesterol ) . Weight was held constant . Estimated 10-year CHD risk was the primary outcome of this secondary analysis . Among 436 participants with complete data , mean ( SD ) age was 44.7 ( 10.7 ) years , 51 % were male , and 60 % were African-American .  Median 10-year CHD risk was 0.98 % at baseline and decreased in all groups . Compared with control , the relative risk ratio comparing 8-week with baseline 10-year CHD risk was 0.93 ( 95 % confidence interval , 0.85 to 1.02 ; P=0.12 ) for F/V and 0.82 ( 95 % confidence interval , 0.75 to 0.90 ; P<0.001 ) for DASH . Comparing DASH with F/V , the relative risk ratio was 0.89 ( 95 % confidence interval , 0.81 to 0.97 ; P=0.012 ) . With the exception of an interaction between dietary pattern and race suggesting a greater risk reduction in blacks than whites ( P for interaction=0.038 ) , results were similar across subgroups . Conclusions —Compared with control and F/V , the DASH diet reduced estimated 10-year CHD risk by 18 % and 11 % , respectively . In addition to reducing blood pressure , the DASH diet should substantially reduce the risk of CHD . Clinical Trial Registration —URL : http:// clinical trials.gov . Unique identifier : NCT00000544 Lifestyle modifications , such as weight loss , sodium restriction , and limiting alcohol consumption , are important components of the initial treatment of hypertensive patients . The Dietary Approaches to Stop Hypertension ( DASH ) study investigated the effects of dietary patterns on blood pressure in individuals with diastolic blood pressure between 80 - 95 mmHg . Two different dietary patterns were tested in this feeding study . A diet enriched in fruits and vegetables and a diet enriched in fruits , vegetables , and low-fat dairy products and low in total and saturated fat ( combination diet ) were compared with a control diet . Dietary intake was adjusted so that participants did not lose weight , and all study diets had comparable sodium intake ( approximately 3 grams/day ) . All meals were provided for 459 participants for an 11-week period . Those r and omized to the combination diet ( n = 151 ) had a significant change in systolic ( -5.5 mmHg ; p < 0.001 ) and diastolic blood pressure ( -3.0 mmHg ; p < 0.001 ) after subtracting the response to the control diet ( n = 154 ) . The fruits- and -vegetables diet ( n = 154 ) produced a significant but lesser decrease in blood pressure ( systolic , -2.8 mmHg ; p < 0.001 and diastolic , -1.1 mmHg ; p = 0.07 ) . Hypertensive individuals and African Americans had particularly favorable responses with blood pressure reductions , which were significantly greater than other subgroups . The combination diet was well-accepted and adherence to the diet was high ( > 90 % ) for all participants . The DASH combination diet is an effective lifestyle modification for lowering blood pressure in patients with high-normal or Stage 1 hypertension Recent studies suggest that oxidative stress and vascular dysfunction contribute to heart failure with preserved ejection fraction ( HFPEF ) . In salt-sensitive HFPEF animal models , diets low in sodium and high in potassium , calcium , magnesium , and antioxidants attenuate oxidative stress and cardiovascular damage . We hypothesized that the sodium-restricted Dietary Approaches to Stop Hypertension diet ( DASH/SRD ) would have similar effects in human hypertensive HFPEF . Thirteen patients with treated hypertension and compensated HFPEF consumed the DASH/SRD for 21 days ( all food/most beverages provided ) . The DASH/SRD  reduced clinic systolic ( 155–138 mm Hg ; P=0.02 ) and diastolic blood pressure ( 79–72 mm Hg ; P=0.04 ) , 24-hour ambulatory systolic ( 130–123 mm Hg ; P=0.02 ) and diastolic blood pressure ( 67–62 mm Hg ; P=0.02 ) , and carotid-femoral pulse wave velocity ( 12.4–11.0 m/s ; P=0.03 ) . Urinary F2-isoprostanes decreased by 31 % ( 209–144 pmol/mmol Cr ; P=0.02 ) despite increased urinary aldosterone excretion . The reduction in urinary F2-isoprostanes closely correlated with the reduction in urinary sodium excretion on the DASH/SRD . In this cohort of HFPEF patients with treated hypertension , the DASH/SRD  reduced systemic blood pressure , arterial stiffness , and oxidative stress . These findings are characteristic of salt-sensitive hypertension , a phenotype present in many HFPEF animal models and suggest shared pathophysiological mechanisms linking these 2 conditions . Further dietary modification studies could provide insights into the development and progression of hypertensive HFPEF OBJECTIVE To determine the effects of the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern on cardiometabolic risks in type 2 diabetic patients . RESEARCH DESIGN AND METHODS A r and omized crossover clinical trial was undertaken in 31 type 2 diabetic patients . For 8 weeks , participants were r and omly assigned to a control diet or the DASH eating pattern . RESULTS After following the DASH eating pattern , body weight ( P = 0.007 ) and waist circumference ( P = 0.002 ) reduced significantly . Fasting blood glucose levels and A1C decreased after adoption of the DASH diet ( −29.4 ± 6.3 mg/dl ; P = 0.04 and −1.7 ± 0.1 % ; P = 0.04 , respectively ) . After the DASH diet , the mean change for HDL cholesterol levels was higher ( 4.3 ± 0.9 mg/dl ; P = 0.001 ) and LDL cholesterol was reduced ( −17.2 ± 3.5 mg/dl ; P = 0.02 ) . Additionally , DASH had beneficial effects on systolic ( −13.6 ± 3.5 vs. −3.1 ± 2.7 mmHg ; P = 0.02 ) and diastolic blood pressure ( −9.5 ± 2.6 vs. −0.7 ± 3.3 mmHg ; P = 0.04 ) . CONCLUSIONS Among diabetic patients , the DASH diet had beneficial effects on cardiometabolic risks BACKGROUND Although the DASH ( Dietary Approaches to Stop Hypertension ) diet has been shown to lower blood pressure ( BP ) in short-term feeding studies , it has not been shown to lower BP among free-living individuals , nor has it been shown to alter cardiovascular biomarkers of risk . OBJECTIVE To compare the DASH diet alone or combined with a weight management program with usual diet controls among participants with prehypertension or stage 1 hypertension ( systolic BP , 130 - 159 mm Hg ; or diastolic BP , 85 - 99 mm Hg ) . DESIGN AND SETTING R and omized , controlled trial in a tertiary care medical center with assessment s at baseline and 4 months . Enrollment began October 29 , 2003 , and ended July 28 , 2008 . PARTICIPANTS Overweight or obese , unmedicated out patients with high BP ( N = 144 ) . INTERVENTIONS Usual diet controls , DASH diet alone , and DASH diet plus weight management . OUTCOME MEASURES The main outcome measure is BP measured in the clinic and by ambulatory BP monitoring . Secondary outcomes included pulse wave velocity , flow-mediated dilation of the brachial artery , baroreflex sensitivity , and left ventricular mass . RESULTS Clinic-measured BP was reduced by 16.1/9.9 mm Hg ( DASH plus weight management ) ; 11.2/7.5 mm ( DASH alone ) ; and 3.4/3.8 mm ( usual diet controls ) ( P < .001 ) . A similar pattern was observed for ambulatory BP ( P < .05 ) . Greater improvement was noted for DASH plus weight management compared with DASH alone for pulse wave velocity , baroreflex sensitivity , and left ventricular mass ( all P < .05 ) . CONCLUSION For overweight or obese persons with above-normal BP , the addition of exercise and weight loss to the DASH diet result ed in even larger BP reductions , greater improvements in vascular and autonomic function , and reduced left ventricular mass . CLINICAL TRIAL REGISTRATION clinical trials.gov Identifier : NCT00571844 Background —Inflammatory mediators regulate key aspects of lipid metabolism . We hypothesized that inflammation could diminish the cholesterol-lowering effect of a reduced-fat/low-cholesterol diet . Methods and Results —After a 2-week run-in period on a control diet ( 37 % total fat , 16 % saturated fat ) , 100 participants were r and omized to the control or DASH diet ( 27 % total fat , 6 % saturated fat ) for 12 weeks . Median C-reactive protein ( CRP ) at baseline was 2.37 mg/L ( interquartile range , 1.20 , 3.79 ) . The DASH diet , net of control , had no effect on CRP . Overall , there were significant net reductions in total ( −0.34 mmol/L ) , LDL ( −0.29 mmol/L ) , and HDL ( −0.12 mmol/L ) cholesterol from the DASH diet ( each , P < 0.001 ) and little change in triglycerides ( + 0.05 mmol/L , P = 0.21 ) . Baseline CRP was strongly associated with lipid responsiveness to the DASH diet . Total and LDL cholesterol were reduced to a greater degree in those with a “ low ” ( below median ) compared with a “ high ” ( above median ) baseline CRP ( total , −9.8 % versus −3 % ; P for interaction=0.006 ; LDL cholesterol , −11.8 % versus −3 % ; P for interaction=0.009 ) . Reductions in HDL cholesterol ( −8.8 % ) were similar in persons with low versus high CRP . Triglycerides were increased in those with a high CRP but not in those with a low CRP ( 19.8 % versus + 0 % ; P for interaction=0.019 ) . Conclusions —In this study , the presence of increased CRP was associated with less total and LDL cholesterol reduction and a greater increase in triglycerides from a reduced-fat/low-cholesterol diet . These findings document an additional mechanism by which inflammation might increase  cardiovascular disease risk BACKGROUND Although the Dietary Approaches to Stop Hypertension ( DASH ) diet is an accepted nonpharmacologic treatment for hypertension , little is known about what patient characteristics affect dietary adherence and what level of adherence is needed to reduce blood pressure ( BP ) . OBJECTIVE Our aim was to determine what factors predict dietary adherence and the extent to which dietary adherence is necessary to produce clinical ly meaningful BP reductions . DESIGN Ancillary study of the ENCORE ( Exercise and Nutrition Interventions for Cardiovascular Health ) trial -- a 16-week r and omized clinical trial of diet and exercise . PARTICIPANTS / SETTING Participants included 144 sedentary , overweight , or obese adults ( body mass index 25 to 39.9 ) with high BP ( systolic 130 to 159 mm Hg and /or diastolic 85 to 99 mm Hg ) . INTERVENTION Patients were r and omized to one of three groups : DASH diet alone , DASH diet plus weight management , and Usual Diet Controls . MAIN OUTCOMES MEASURES Our primary outcomes were a composite index of adherence to the DASH diet and clinic BP . STATISTICAL ANALYSES PERFORMED General linear models were used to compare treatment groups on post-treatment adherence to the DASH diet . Linear regression was used to examine potential predictors of post-treatment DASH adherence . Analysis of covariance was used to examine the relation of adherence to the DASH diet and BP . RESULTS Participants in the DASH diet plus weight management ( 16.1 systolic BP [ SBP ] ; 95 % CI 13.0 to 19.2 mm Hg and 9.9 diastolic BP [ DBP ] ; 95 % CI 8.1 to 11.6 mm Hg ) and DASH diet alone ( 11.2 SBP ; 95 % CI 8.1 to 14.3 mm Hg and 7.5 DBP ; 95 % CI 5.8 to 9.3 mm Hg ) groups showed significant reductions in BP in comparison with Usual Diet Controls participants ( 3.4 SBP ; 95 % CI 0.4 to 6.4 mm Hg and DBP 3.8 ; 95 % CI 2.2 to 5.5 mm Hg ) . Greater post-treatment consumption of DASH foods was noted in both the DASH diet alone ( mean = 6.20 ; 95 % CI 5.83 to 6.57 ) and DASH diet plus weight management groups ( mean = 6.23 ; 95 % CI 5.88 to 6.59 ) compared with Usual Diet Controls ( mean = 3.66 ; 95 % CI 3.30 to 4.01 ; P<0.0001 ) , and greater adherence to the DASH diet was associated with larger reductions in clinic SBP and DBP ( P ≤ 0.01 ) . Only ethnicity predicted dietary adherence , with African Americans less adherent to the DASH diet compared with whites ( 4.68 ; 95 % CI 4.34 to 5.03 vs 5.83 ; 95 % CI 5.50 to 6.11 ; P<0.001 ) . CONCLUSIONS Greater adherence to the DASH diet was associated with larger BP reductions independent of weight loss . African Americans were less likely to be adherent to the DASH dietary eating plan compared with whites , suggesting that culturally sensitive dietary strategies might be needed to improve adherence to the DASH diet
Adherence to DASH diet is effective in improving circulating serum inflammatory biomarkers in adults , compared with usual diet ; therefore , it could be a valuable strategy to suppress inflammation process
BACKGROUND & AIMS Dietary approaches to stop hypertension ( DASH ) diet is associated with improved blood pressure and risk of cardiovascular diseases .
It is proposed that DASH might also improve systemic inflammatory markers like highly sensitive C-reactive protein ( hs-CRP ) ; however , interventional studies have led to conflicting results .
The aim of current systematic review was to summarize results of r and omized clinical trials examining the effect of DASH on inflammatory biomarkers .