The PREMIER intervention helps participants follow the Dietary Approaches to Stop Hypertension dietary pattern and the current Dietary Reference Intakes recommendations. Efficacy of a school-based cardiac health promotion intervention program for African-American adolescents. The influence of a physician and patient intervention program on dietary intake. Community-based Randomized Controlled Trial of Non-pharmacological Interventions in Prevention and Control of Hypertension among Young Adults The Prevention Education Program (PEP) Nuremberg: design and baseline data of a family oriented intervention study The efficacy of a clinic-based behavioral nutrition intervention emphasizing a DASH-type diet for adolescents with elevated blood pressure. Primary prevention of hypertension--a randomized controlled trial. Dietary adherence in the Dietary Approaches to Stop Hypertension trial. DASH Collaborative Research Group. Primary prevention of hypertension by nutritional-hygienic means. Final report of a randomized, controlled trial. Community-based interventions in hypertensive patients: a comparison of three health education strategies Dietary treatment of patients with mild to moderate hypertension in a general practice: a pilot intervention study (2). Beyond three months. A significant decrease in blood pressure through a family-based nutrition health education programme among community residents in Taiwan. A Randomized Community Intervention to Improve Hypertension Control among Mexican Americans: Using the Promotoras de Salud Community Outreach Model Design, methods, and rationale in the Hypertension Prevention Trial. Hypertension Prevention Trial Research Group. Result of school-based intervention on cardiovascular risk factors Recruitment in the Hypertension Prevention trial. Hypertension Prevention Trial Research Group. Baseline characteristics of participants in phase I of the Trials of Hypertension Prevention.
OBJECTIVE To examine the influence of the PREMIER study lifestyle interventions on dietary intakes and adherence to the Dietary Approaches to Stop Hypertension ( DASH ) dietary pattern and the Dietary Reference Intakes ( DRI ) . DESIGN An 18-month multicenter , r and omized controlled trial comparing two multicomponent lifestyle intervention programs to an advice only control group . SUBJECTS/ SETTING A total of 810 participants were recruited from local communities and r and omized into the study . Individuals were eligible if they were aged 25 years or older , had body mass index between 18.5 and 45.0 , not taking antihypertensive medication , and had prehypertension or stage 1 hypertension ( systolic blood pressure 120 to 159 mm Hg and diastolic blood pressure 80 to 95 mm Hg ) . INTERVENTION The two active intervention programs were a behavioral lifestyle intervention that implements established recommendations , and an established intervention plus the DASH dietary pattern . Both interventions consisted of intensive group and individual counseling sessions . The control group received a brief advice session after r and omization and again after 6 months of data collection . Dietary intakes were collected by two r and om 24-hour recalls at baseline , 6 months , and 18 months . MAIN OUTCOME MEASURES The primary outcome of the PREMIER study was change in systolic blood pressure at 6 months . The main outcomes examined here include dietary variables collected by 24-hour recall at each time point . STATISTICAL ANALYSES Nutrient intakes were calculated and compared among the time points and the three intervention groups using mixed models with repeated measures at 6 and 18 months . Proportion of participants who met or achieved the original DASH nutrient intake levels and the DRIs were calculated and compared among the three intervention groups . P<0.01 was considered statistically significant . RESULTS Participants in both the established intervention and established intervention plus DASH dietary pattern groups substantially reduced energy , total fat , saturated fat , and sodium intake and these reductions persisted throughout the study . Established intervention plus DASH dietary pattern group participants increased intakes of fruits , vegetables , dairy , and many vitamins and minerals ; these increases were significantly greater than that of the control and established intervention groups . A majority of established intervention plus DASH dietary pattern group participants achieved at least two thirds of the DRI recommendations for most nutrients at 6 months , despite their reduction in total energy intake . Some but relatively small recidivism occurred at 18 months . CONCLUSIONS Both the established intervention and established intervention plus DASH dietary pattern group intervention were effective in helping participants follow established recommendations to control blood pressure . The advice-only control group also made some behavior changes , mainly decreasing energy and sodium intake . Only the established intervention plus DASH dietary pattern group significantly increased intakes of DASH-specific food groups , including fruits , vegetables , and dairy products , and nutrients , including protein , fiber , calcium , potassium , and magnesium . Most of the increases did not reach the levels consumed in the original DASH feeding studies . Whereas the established intervention plus DASH dietary pattern group intervention provides a useful platform to achieve the DASH dietary pattern and current DRI recommendations , intervention enhancements , including a greater emphasis on nutrient-dense foods , would likely improve this intervention OBJECTIVE African-American adolescents are twice as likely to develop hypertension in early adulthood than adolescents from other racial groups . The purpose of this study was to determine the efficacy of a school-based health promotion intervention . METHOD Participants were African-American adolescents aged between 14 and 17 years attending an urban high school . The 9-week intervention program focused on the participants ' knowledge , diet , exercise , and blood pressure . CONCLUSIONS The intervention program was efficacious in knowledge ( p = .0001 ) , exercise ( p = .0001 ) , as well as fruit and vegetable intake ( p = .0001 ) . Differences in systolic ( p = .5548 ) and diastolic ( p = .9719 ) blood pressure levels were not significant BACKGROUND Efficient dietary interventions for patients with hypertension in clinical setting s are needed . OBJECTIVE To assess the separate and combined influence of a physician intervention ( MD-I ) and a patient intervention ( PT-I ) on dietary intakes of patients with hypertension . DESIGN A nested 2 × 2 design , r and omized controlled trial conducted over 18 months . PARTICIPANTS A total of 32 physicians and 574 out patients with hypertension . INTERVENTION MD-I included training modules addressing the Seventh Report of the Joint National Committee on Prevention , Detection , Evaluation , and Treatment of High Blood Pressure hypertension management guidelines and lifestyle modification . PT-I included lifestyle coaching to adopt the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern , reduce sodium intake , manage weight , increase exercise , and moderate alcohol intake . MAIN OUTCOME MEASURES Dietary intakes were measured by the Block Food Frequency Question naire . Concordance with the DASH dietary pattern was estimated by a DASH score . STATISTICAL ANALYSES The main effects of MD-I and PT-I , and their interaction , were evaluated using analysis of covariance . RESULTS After 6 months of intervention , MD-I participants significantly increased intakes of potassium , fruits , juices , and carbohydrate ; decreased intake of fat ; and improved overall dietary quality as measured by the Healthy Eating Index . PT-I intervention result ed in increased intakes of carbohydrate , protein , fiber , calcium , potassium , fruits and fruit juices , vegetables , dairy and Healthy Eating Index score , and decreased intakes in fat , saturated fat , cholesterol , sodium , sweets , and added fats/oils/sweets . In addition , PT-I improved overall DASH concordance score . The change in DASH score was significantly associated with the changes in blood pressure and weight at 6 months . At 18 months , most changes reversed back toward baseline levels , including the DASH score . CONCLUSIONS Both MD-I and PT-I  improved eating patterns at 6 months with some sustained effects at 18 months . Even though all dietary changes observed were consistent with the DASH nutrient targets or food group guidelines , only the PT-I intervention was effective in improving the overall DASH concordance score . This finding affirms the role of medical nutrition therapy in long-term intensive interventions for hypertension risk reduction and weight management and underlines the need for development of maintenance strategies . Furthermore , this study emphasizes the importance of collaborations among physicians , registered dietitians and other dietetics practitioners , and lay health advisors while assisting patients to make healthy behavior changes Context : Hypertension is a major chronic lifestyle disease . Several non-pharmacological interventions are effective in bringing down the blood pressure ( BP ) . This study focuses on the effectiveness of such interventions among young adults . Aims : To measure the efficacy of physical exercise , reduction in salt intake , and yoga , in lowering BP among young ( 20 - 25 ) pre-hypertensives and hypertensives , and to compare their relative efficacies . Setting s and Design : The study was done in the urban service area of JIPMER . Pre-hypertensives and hypertensives , identified from previous studies , constituted the universe . The participants were r and omized into one control and three interventional groups . Material s and Methods : A total of 113 subjects : 30 , 28 , 28 and 27 in four groups respectively participated for eight weeks : control ( I ) , physical exercise ( II ) - brisk walking for 50 - 60 minutes , four days/week , salt intake reduction ( III ) - to at least half of their previous intake , and practice of yoga ( IV ) - for 30 - 45 minutes/day on at least five days/week . Statistical Analysis Used : Efficacy was assessed using paired t test and ANOVA with Games Howell post hoc test . An intention to treat analysis was also performed . Results : A total of 102 participants ( 29 , 27 , 25 and 21 in groups I , II , III and IV ) completed the study . All three intervention groups showed a significant reduction in BP ( SBP/DBP : 5.3/6.0 in group II , 2.6/3.7 in III , and 2.0/2.6 mm Hg in IV respectively ) . There was no significant change ( SBP/DBP : 0.2/0.5 mmHg ) of BP in control group ( I ) . Physical exercise was most effective ( considered individually ) ; salt intake reduction and yoga were also effective . Conclusions : Physical exercise , salt intake reduction , and yoga are effective non-pharmacological interventions in significantly reducing BP among young hypertensives and pre-hypertensives . These can therefore be positively recommended for hypertensives . There is also a case to deploy these interventions in the general population OBJECTIVE : We describe the design and baseline data of the Prevention Education Program ( PEP ) , a home-based and family oriented intervention program , aim ed to assess and improve cardiovascular risk factors in school children and their families during an intervention period of 10 y. DESIGN AND METHODS : At study entry all participants were r and omized either to an intervention group ( screening and intervention program ) or to a control group ( risk screening , general advice ) . Cardiovascular risk factors ( hypertension , elevated lipids , smoking , obesity ) as well as dietary behaviour are evaluated yearly using structured interview , physical examination , laboratory analysis , and seven-day dietary protocol . RESULTS : During the years 1993–1998 , 3547 adults ( age 36.2±7 y ) and 3495 children ( age 6.5±2 y ) were recruited . Adults show a high prevalence of risk factors : hypertension 21 % ; active smoking 39 % , elevated LDL-cholesterol 19 % ; and obesity 42 % . Children exhibit these risk factors in comparable frequency : hypertension 20 % ; passive smoking 44 % ; elevated LDL-cholesterol 17 % ; and obesity 19 % . The analysis of the dietary protocol s ( 1926 adults , 1569 children ) shows that both generations adhere to a diet exceeding the recommended fat intake ( adults 38 % of total energy , children 38 % ) , while carbohydrate intake ( adults 43 % of total energy intake , children 50 % ) is reduced compared to NCEP-(step I)- guidelines . CONCLUSION : The finding , that children show a prevalence of  risk factors  which is comparable to that found in adults , supports the need for an early beginning of intervention . Since both generations adhere to an unhealthy diet which contributes to cardiovascular risk , dietary intervention may be a promising method in primary prevention of cardiovascular risk OBJECTIVE To examine the efficacy of a 3-month clinic-based behavioral nutrition intervention emphasizing a diet high in fruits , vegetables , and low fat dairy ( DASH intervention ) versus routine outpatient hospital-based nutrition care ( RC ) on diet and blood pressure ( BP ) in adolescents with elevated BP . STUDY DESIGN Fifty-seven adolescents with a clinical diagnosis of prehypertension or hypertension ( systolic BP or diastolic BP , 90(th ) to 99(th ) percentile ) were r and omly assigned to  DASH or  RC  .  SBP , DBP , 3-day diet recall , weight , and height were assessed at pretreatment , post-treatment , and 3 months later ( follow-up ) . RESULTS In completer analysis , DASH versus RC had a greater decrease in SBP z scores from baseline to post-treatment ( P < 0.01 ) and a trend for a greater decrease in SBP z scores from baseline through follow-up ( P = .07 ) . DBP z scores changed similarly for conditions from baseline through follow-up . Relative to RC , DASH had a greater increase in intake of fruits ( P < .001 ) , potassium and magnesium ( P < .01 ) , and a greater decrease in total fat ( P < .05 ) from baseline to post-treatment . From baseline through follow-up , DASH versus RC had a greater increase in low fat dairy ( P < .001 ) . CONCLUSIONS The DASH intervention proved more effective than RC in improving SBP and diet quality in adolescents with elevated BP Nutritional-hygienic intervention is a key strategy in the control of hypertension through primary prevention . To test the efficacy of this approach , 201 men and women were selected to participate in a r and omized controlled trial on the primary prevention of hypertension . Individuals were taken into the trial if their diastolic blood pressure at entry was 80 - 89 mm Hg with either relative weight 1.10 - 1.49 or heart rate of 80 or greater . Half of the eligible persons were r and omized into the monitored group and half were r and omized into the intervention group receiving individual intervention to achieve a weight loss of 10 or more lbs ( greater than or equal to 4.5 kg ) , to reduce Na intake to 75 mmol ( 1800 mg ) , to limit alcohol intake to no more than 2 drinks per day ( 26 g ) and to engage in regular moderate physical activity . At two years , the 75 participants of the intervention group showed a mean weight loss of 5.2 lbs . among those initially overweight , a mean reduction in Na intake of 44 % of goal and a moderate reduction of alcohol intake . Self-reported exercise had also increased and was reflected in the larger decrease in mean heart rate compared with the monitored group . Diastolic blood pressure was only slightly lower among the intervention group compared to the monitored group , but was an additional 4.0 mm Hg lower among those intervention participants achieving weight loss and reduction in Na intake greater than the median for the group . In addition , at two years , a rise in diastolic blood pressure sufficient to require antihypertensive medication occurred in 5 participants of the control group compared to 0 of the intervention group . At three years , 11 monitored and 3 intervention group participants required antihypertensive medication Participants in controlled feeding studies must consume all study foods and abstain from all other foods . In outpatient studies in which adherence may be compromised by free-living conditions , promoting , documenting , and monitoring dietary adherence are necessary . In the Dietary Approaches to Stop Hypertension ( DASH ) trial , a thorough participant screening process , an orientation session , and a run-in feeding period before r and omization aided in the selection of participants who would most likely adhere to the dem and s of the study protocol . Throughout the feeding period , various educational and motivational techniques were used to encourage DASH participants to adhere to the dietary protocol . Both objective and subjective methods documented excellent participant adherence . Daily monitoring of individual adherence was based on meal attendance , body weight measurements , and daily diaries . Urinary sodium , potassium , phosphorus , and urea nitrogen values and an anonymous post study survey were used to evaluate adherence at the end of the study . Most DASH participants adhered to the feeding regimen by consuming only study foods and no other foods . When adherence lapsed , participants generally cited the lack of menu variety as a reason . Successful participant adherence to the constraints of an outpatient controlled feeding study is possible with carefully selected participants and a variety of adherence-promoting strategies incorporated into the study protocol A 5-year trial involving 201 men and women with high-normal blood pressure at baseline demonstrated the ability to reduce the incidence of hypertension in participants r and omized to nutritional-hygienic intervention compared with a control group . The incidence of hypertension was 8.8 % among 102 intervention group participants vs 19.2 % among 99 control group members . The odds ratio for the incidence of hypertension in the control group was 2.4 . Mean trial blood pressure also was lower in the intervention compared with the control group ( -1.2 and -1.9 mm Hg , respectively , for diastolic blood pressure at work-site and office visits and -1.3 and -2.0 mm Hg , respectively , for systolic blood pressure at the two sites ) . Net weight loss in the intervention group averaged 2.7 kg during the trial ; sodium intake was reduced by 25 % and reported alcohol intake decreased by 30 % . The majority of intervention participants also reported an increase in physical activity . Effect on blood pressure was related particularly to degree of weight loss . Results indicate that even a moderate reduction in risk factors for hypertension among hypertension-prone individuals contributes to the primary prevention of the disease Background Community-based health education programs may be helpful in improving health outcomes in patients with chronic illnesses . This study aim ed to evaluate community-based health education strategies in the management of hypertensive patients with low socioeconomic status in Dongguan City , China . Methods This was a r and omized , non-blinded trial involving 360 hypertensive patients enrolled in the community health service centre of Liaobu Town , Dongguan City , China . Participants were r and omized to receive one of the three community-based health education programs  over 2 years : self-learning reading ( Group 1 ) , monthly regular didactic lecture ( Group 2 ) , monthly interactive education workshop ( Group 3 ) . Outcomes included the changes in the proportion of subjects with normalized blood pressure ( BP ) , hypertension-related knowledge score , adherence to antihypertensive treatment , lifestyle , body mass index and serum lipids . Results After the 2-y intervention , the proportion of subjects with normalized BP increased significantly in Group 2 ( from 41.2 % to 63.2 % , p<0.001 ) , and increased more substantially in Group 3 ( from 40.2 % to 86.3 % , p<0.001 ) , but did not change significantly in Group 1 . Improvements in hypertension-related knowledge score , adherence to regular use of medications , appropriate salt intake and regular physical activity were progressively greater from group 1 to group 2 to group 3 . Group 3 had the largest reductions in body mass index and serum LDL cholesterol levels . Conclusion Interactive education workshops may be the most effective strategy in community-based health promotion education programs for hypertensive patients in improving patients ’ knowledge on hypertension and alleviating clinical risk factors for preventing hypertension-related complications In a general primary care practice the feasibility and the effects of dietary counselling in mild and moderate hypertension were studied for a period of 18 months . Significant decreases in blood pressure and sodium excretion compared to baseline occurred , while serum lipids showed transient improvement . Of the original 35 participants , 28 finished the study OBJECTIVE To evaluate the effect on decrease in blood pressure of modifying risk factors for stroke , such as blood lipid profiles , diet habits and indices of body weight , through a family-based nutrition health education programme among hypertensive patients and pre-hypertensive subjects without taking any antihypertensive drugs . DESIGN AND SETTING This was a community-based prospect i ve study . The study population was r and omly selected from communities in Taipei ; potential subjects were invited by telephone to participate . SUBJECTS After excluding subjects whose blood pressure was normal and those using antihypertensive drugs , there were 390 participants included in the study . Subjects in the intervention group ( n 293 ) received nutrition health education on blood pressure control and stroke-related risk factor modification at each visit . Non-intervention subjects ( n 97 ) only acquired a general education sheet available in clinics . The blood pressure of study subjects was measured at baseline and 6-month follow-up to evaluate the intervention 's effect on decrease in blood pressure . RESULTS Significant decreases of 2.0 mmHg and 5.9 mmHg in systolic blood pressure were observed both in pre-hypertensive and hypertensive subjects in the intervention group . Additionally , intervention subjects with improvement of total cholesterol and LDL cholesterol , decrease in indices of body weight and increase in consumption of fruit and vegetables also had significant lowering of blood pressure . CONCLUSIONS The present study provided evidence that the blood pressure of pre-hypertensive and hypertensive subjects could decrease significantly , without taking antihypertensive drugs , after modifying blood lipid profiles and waist by dietary habits changed through a family-based nutrition heath education programme , result ing in a significant effect on stroke risk reduction The objectives of this study were : 1 ) to evaluate the acceptance , effectiveness , and sustainability of a promotora ( community health worker ) pilot program to improve hypertension control among medically underserved Mexican Americans of the El Paso , Texas area , and 2 ) to demonstrate improvements in clinical measures of blood pressure , BMI and waist circumference , self-reported behaviors and changes in attitudes and beliefs about blood pressure among Mexican American hypertensives . Participants were eligible if they had been diagnosed with hypertension and if they were willing to be r and omized as either participants in the intervention or as controls . A total of 58 participants enrolled in the intervention group and 40 participants served as controls . This was a 9-week promotora intervention .  Health behavior constructs and clinical data were measured pre-post intervention . Perceived benefits , and two heart-healthy behaviors ( salt and sodium , and cholesterol and fat ) were shown to be statistically significantly different between the intervention and control groups The Hypertension Prevention Trial ( HPT ) was a r and omized , controlled , multicenter ( four clinics , four re source centers ) trial design ed to test the feasibility of achieving and sustaining dietary changes in the intake of calories , sodium , and potassium and to assess the effect of those changes on blood pressure in a normotensive population . The trial involved 841 men and women ( plus a test cohort of 78 ) who , at the first baseline ( BL ) examination , were in the age range of 25 - 49 years and had diastolic blood pressure ( DBP ) greater than or equal to 76 but less than 100 mm Hg ( average of two readings ) , and at the examination prior to r and omization ( BL 2 ) had DBP greater than or equal to 78 but less than 90 mm Hg ( also averaged ) . Participants were r and omly assigned to a control treatment group ( no dietary counseling ) or to one of four dietary treatment groups involving counseling design ed to reduce calorie intake , reduce sodium intake , reduce sodium and calorie intake , and reduce sodium and increase potassium intake . Dietary counseling was provided primarily in group setting s and was aim ed at changing participants ' shopping , cooking , and eating habits related to a design ated treatment assignment . The effect of dietary counseling was measured through changes in urinary excretion of sodium and potassium , changes in body weight , and changes in reported food intake based on 24-hour food records . Blood pressure changes during the 3-year course of followup were based on measurements taken at 6-month intervals from enrollment using a r and om-zero sphygmomanometer . This chapter provides a general description of the design and methods of the HPT and the underlying rationale for decisions affecting the design Abstract Objective . To assess the effectiveness of a two-year school-based intervention , consisting of integrated and replicable physical activity and nutritional education on weight , fat percentage , cardiovascular risk factors , and blood pressure . Design and setting . Six elementary schools in Reykjavik were r and omly assigned to be either intervention ( n = 3 ) or control ( n = 3 ) schools . Seven-year-old children in the second grade in these schools were invited to participate ( n = 321 ) ; 268 ( 83 % ) underwent some or all of the measurements . These 286 children were followed up for two years . Intervention . Children in intervention schools participated in an integrated and replicable physical activity programme , increasing to approximately 60 minutes of physical activity during school in the second year of intervention . Furthermore , they received special information about nutrition , and parents , teachers , and school food service staff were all involved in the intervention . Subjects . 321seven-year-old schoolchildren . Main outcome measures . Blood pressure , obesity , percentage of body fat , lipid profile , fasting insulin . Results . Children in the intervention group had a 2.3 mmHg increase in systolic blood pressure ( SBP ) and a 2.9 mmHg increase in diastolic blood pressure ( DBP ) over the two-year intervention period , while children in the control group increased SBP by 6.7 mmHg and DPB by 8.4 mmHg . These changes were not statistically significant . Furthermore there were no significant changes in percentage body fat , lipid profile , or fasting insulin between the intervention and control schools . Conclusion . A two-year school-based intervention with increased physical activity and healthy diet did not have a significant effect on common cardiovascular risk factors The Hypertension Prevention Trial ( HPT ) was a r and omized , controlled , multicenter ( four clinics , four re source centers ) trial design ed to test the feasibility of achieving and sustaining dietary changes in the intake of calories , sodium , and potassium and to assess the effect of those changes on blood pressure in a normotensive population . The trial involved 841 men and women ( plus a test cohort of 78 ) who , at the first baseline ( BL ) examination were in the age range of 25 - 49 years and had diastolic blood pressure ( DBP ) greater than or equal to 76 but less than 100 mm Hg ( average of two readings ) , and at the examination prior to r and omization ( BL 2 ) , had DBP greater than or equal to 78 but less than 90 mm Hg ( also averaged ) . Participants were r and omly assigned to a control treatment group ( no dietary counseling ) or to one of four dietary treatment groups involving counseling design ed to reduce calorie intake , reduce sodium intake , reduce sodium and calorie intake , and reduce sodium and increase potassium intake .  This chapter describes the process of recruiting participants for the trial . Methods used to identify and contact study participants are presented . Details of the steps involved in the recruitment process and strategies for reducing costs are discussed Phase I of the Trials of Hypertension Prevention was design ed to test the effectiveness and safety of three life-style ( weight loss , sodium restriction , and stress management ) and four nutrition supplement ( calcium , magnesium , potassium , and fish oil ) interventions in reducing diastolic blood pressure ( DBP ) in persons with a high-normal blood pressure . A total of 2182 persons with a DBP between 80 and 89 mm Hg met the eligibility criteria for participation in phase I and were r and omized to one of the active intervention or control treatment groups . Most were white ( 82 % ) , male ( 70 % ) , married ( 76 % ) , nonsmoking ( 88 % ) , college graduate ( 53 % ) , full-time employees ( 91 % ) . The average blood pressure  prior to entry into the trial was 124.9 mm Hg systolic and 83.8 mm Hg diastolic . A variety of baseline observations , including sociodemographic characteristics , personal and family medical history , health habits , diet , and biologic measurements , were documented before r and omization and compared among the seven active intervention and control groups . As might be expected in a r and omized trial of this sample size , the distribution of measured baseline characteristics was virtually identical in the treated and control groups . Based on this finding and the knowledge that r and omization procedures were implemented without deviation from the phase I protocol , it is probable that unknown potential confounders were also equally distributed at entry into the study . Given the achievement of high rates of follow-up , subsequent differences in blood pressure are unlikely to have been due to baseline differences between the active treatment and control groups , and can probably be attributed to effects of the active interventions
Results of the analysis indicated that increased consumption of unsaturated fats , fruits , vegetables and low-fat dietary products  , decreased consumption of dietary sodium and beverages containing caffeine , and breastfeeding were found to have preventive effects against high blood pressure in later years of life .
The effects of training given during youth to encourage a healthy lifestyle and behavior changes based on diet and physical activity were also noted
The aim of this systematic review was to analyze the results of observational and interventional research / studies on nutrition-based practice s in the prevention of hypertension among healthy youth .