Dietary Approaches to Stop Hypertension (DASH) trials

Carbohydrate rich diet with emphasis on fruits, vegetables and low fat dairy products with reduced saturated fat, total fat and cholesterol resulting in lowered blood pressure, lower low-density lipoprotein (LDL) cholesterol.

The DASH diet is a dietary pattern promoted by the U.S.-based National Heart, Lung, and Blood Institute to prevent and control hypertension.

The unique feature of the DASH diet was that the foods and menu were chosen based on conventionally consumed food items so it could be more easily adopted by the general public if results were positive.

The initial DASH study was begun in August 1993 and ended in July 1997.

It is rich in fruits, vegetables, whole grains, and low-fat dairy foods; includes meat, fish, poultry, nuts, and beans; and is limited in sugar-sweetened foods and beverages, red meat, and added fats.

In addition to its effect on blood pressure, it is designed to be a well-balanced approach to eating for the general public.

The DASH diet also features a high quotient of anti-oxidant rich foods thought to retard or prevent chronic health problems including cancer, heart disease, and stroke.

Recommended by the United States Department of Agriculture (USDA) as one of its ideal eating plans for all Americans.

DASH diet reduces systolic blood pressure by 6 mm Hg and diastolic blood pressure by 3 mm Hg in patients with high normal blood pressure.

Those with hypertension dropped by 11 and 6 mm Hg, respectively.

These changes in blood pressure occurred with no changes in body weight.

Results in reduces high-density lipoprotein (HDL) cholesterol and has no effect on triglyceride levels.

Patients on such a diet associated with a 45% reduction in the risk of developing kidney stones (Taylor EN). Dietary Approaches to Stop

DASH diet-high levels of fruits, vegetables, nuts, legumes, low fat dairy products, whole grains and low levels of salt, sweetened beverages and red and processed meat.

DASH diet has been associated with a lower risk of death in adults with hypertension, women with heart failure, older adults, and African-American women.

The DASH diet is more effective than a low oxalate diet in the prevention and treatment of kidney stones, specifically calcium oxalate kidney stones, the most common type.

In a study examining the effect of the Dietary Approaches to Stop Hypertension (DASH) diet containing lean red meat on measures of body composition and muscle strength in a cohort of obese adults 65 and older.



Each consumed 1800 kcal/day for 12 weeks under controlled feeding conditions. 



The study diet included daily intakes of 126 g of meat. 



Measures of body composition and muscle strength were obtained.



Breakfast, lunch, and dinner were provided every day for 12 weeks, and equal portions of meat were distributed at each meal. 



From baseline to study end, total body weight decreased by 6.3%, body fat percentage decreased by 2.5% and absolute fat mass decreased by 4.4 kg.



DASH diet has the potential to be a tool to preserve muscle strength while reducing fat mass in obese older adults.



In the elderly an accumulation of fat mass occurs simultaneously with reduced muscle mass and strength leading to metabolic dysregulation, resulting in accelerated disease onset and increased mortality. 



Maintaining muscle mass and strength while reducing fat mass accumulation are vital to maintaining mobility and reducing disease risk in the elderly.



Diet quality and dietary protein intake are vital for maintaining body composition and muscle mass, as well as improving physical performance 



Malnutrition in dietary protein intake is a major cause of reduced muscle mass, strength, and function in older adults.


The current recommended dietary allowance (RDA) for protein for adults is 0.8 g/kg/day, which averages to ~50 g/d (56 g/d for men; 46 g/d for women) for average weight sedentary adults.



Consuming less than the protein RDA results in significant declines in muscle mass, strength, and function in older populations.



To preserve muscle mass and strength, older adults should consume at least 1.1–1.3 g/kg of protein daily.



The Dietary Approaches to Stop Hypertension (DASH) dietary pattern improves health status in various diverse and at-risk populations resulting in improved heart health, maintained cognitive function, and reductions in metabolic diseases such as diabetes, metabolic syndrome, and nonalcoholic fatty liver disease.



The primary protein recommendations of the DASH diet are poultry and fish, and it is recommended to decrease red meats from the diet. 



Lean red meat incorporated into a DASH-like diet does not exacerbate cardiovascular health indices in adults.



Lean red meat can be included in the DASH diet without negative effects on heart health. 



In all participants, body weight decreased by 6.3% from baseline to study end.



BMI decreased from baseline from 32.0 to study end, 30.1.



Waist decreased from baseline (101 cm) to study end (96.3 cm).



The hip decreased from baseline (115 cm) to study end (111 cm); body fat percentage decreased from baseline (37.2%) to study end (34.7%).



Daily meat as a part of the DASH diet was associated with preserved handgrip strength, a significantly increased strength-to-weight ratio, and increased resting energy expenditure in adults 65 and older.



In the present study diet intakes, total body weight was significantly reduced by 6.3% (p < 0.001) at a rate of 0.5 kg (1.1 lb) per week as a result of consumption of the study diet over the course of 12 weeks. 



The 0.5 kg per week of weight loss follows CDC recommendation of gradual and steady weight loss of 1–2 lbs per week for long-term success 



More studies are required to determine body fat levels that define obese phenotypes in males and females and determine the relationships of such levels with poor health outcomes.



The accumulation of abdominal body fat is the hallmark of the obese phenotype in older adults. 



Abdominal fat accumulation is the primary contributing factor to the development of obesity-related chronic diseases afflicting this population and promotes the onset of sarcopenia and osteopenia 



DASH diet may be a potential method to improve body composition that may in turn lead to obesity management and reduce disease risk in obese older adults.



Systolic and diastolic blood pressure were drastically reduced with the Dash diet.



Controlling for weight loss did not alter the beneficial drop in blood pressure. 



The study supports the effectiveness of the DASH diet to lower blood pressure in obese adults with hypertension.



The study diet consumed by all participants contained foods that provided daily average dietary intakes of 1895 mg of sodium, 585 mg of magnesium, 4395 mg of potassium, and 1187 mg of calcium, and all participants consumed a daily multivitamin/multimineral supplement that provided an additional 50 mg of magnesium, 80 mg of potassium, and 220 mg of calcium. 



Muscle strength is considered the most reliable measure of muscle function in older adults, superseding the role of muscle mass. 



Grip strength is a dominant predictor of poor health outcomes in older adults such as poor quality of life, increased hospitalizations, reduced functional capabilities, and death.



Despite the loss in total body mass, grip strength was well preserved in all participants,  with an increase observed in females.



In all participants, there is an increase in relative body strength. 



The body mass decreased over time, grip strength increased during the study period, indicating strength-to-weight ratio was significantly improved. 



Reduced walking mobility and activities of daily living in obese older adults is due in part to poor strength-to-weight ratio, which may increase the risk of falls and subsequent mobility disability. 



By improving the strength to weight ratio, older obese patients will be able to perform activities of daily living, including walking and stair climbing at a lower percentage of their strength capacity. 



Grip strength alone serves as a dominant predictor of poor health outcomes in older adults, gait and sit/stand serve as additional indicators of physical performance and strength. 



Gait is a measure of physical performance that has been shown to be a predictor for adverse outcomes related to sarcopenia such as falls, cognitive impairment, disability, and mortality.



Sitting and standing requires strength and endurance and serves as a proxy for leg muscle strength. 



In this Dash diet study gait and balance was well preserved and sit/stand increased over the course of 12 weeks. 



The study demonstrated that total body energy expenditure was well maintained, and the total body energy expenditure was moderately associated with skeletal muscle mass.



The per kg of body fat and muscle mass, energy expenditure was increased, even though the total amount of muscle mass and body weight were reduced. 



Suggests that the DASH diet coupled with high-quality protein from lean red meat increases the efficiency to maintain muscle strength and energy expenditure. 



Measures of muscular strength, muscle function, and resting energy expenditure were maintained or increased as a result of consuming daily intakes of 126 g of high-quality meat as a part of the study diet.



These findings suggest an improved health status over time.



In addition to dietary protein intake, micronutrients provided by the study diet and the supplement, such as vitamin D, vitamin B12, and iron may have also played a role in the outcomes related to muscle strength. 



DASH dietary patterns can be an effective tool to reduce body fat and manage obese phenotypes in adults 65 and older. 



Daily intakes of high-quality protein consumed throughout the day aids in the maintenance of strength, performance, and total body energy expenditure. 



This study supports the recommendation that older adults should consume protein above the current RDA, and suggests the consumption of at least 126 g of high-quality protein per day as a part of a healthy dietary pattern to maintain muscle strength and performance. 



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