Hypertension is one of the leading causes of many serious illnesses, such as heart disease, stroke, and kidney failure, worldwide. It is often known as a ‘silent killer’ due to the lack of any signs or symptoms. The DASH (Dietary Approaches to Stop Hypertension) diet is often considered the ideal diet to keep blood pressure in check. Researchers have now found that a modified version of the DASH, tailored for people with type 2 diabetes, can significantly lower blood pressure, even in those already taking multiple antihypertensive medications.A study led by Johns Hopkins researchers found that eating ‘DASH for diabetes’ lower-sodium diet can produce a clinically meaningful reduction in blood pressure for people with type 2 diabetes. The study is published in JAMA Internal Medicine.What is a DASH diet
DASH, also known as the Dietary Approaches to Stop Hypertension, is a flexible and balanced eating plan that promotes a heart-healthy eating style. This diet is rich in fruits, vegetables, and low-fat dairy products, and is lower in saturated fat and cholesterol. This diet also limits foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils. It also limits sugar-sweetened beverages and sweets.The new modified DASH diet for people with diabetes
The Johns Hopkins researchers modified the original DASH diet for people with type 2 diabetes by lowering carbohydrates and increasing unsaturated fat. They also decreased the potassium content to ensure the diet was safe for chronic kidney disease, which affects many people with diabetes.“The DASH diet has been around for a long time, and is part of the standard treatment for hypertension. We know that it lowers blood pressure, but there has been little study of this diet and sodium reduction in people with diabetes. The goal of the study was to develop a new version of the DASH diet and see how effective it was in lowering blood pressure for people with diabetes. We called it DASH4D,” lead author Scott Pilla, M.D., M.H.S., an assistant professor of medicine at the Johns Hopkins University School of Medicine, said in a statement. The overlooked riskPilla stated that diabetic people often tend to focus on their blood sugar levels, even though high blood pressure commonly affects them. It increases the risk of stroke and heart disease. The blood pressure goal for people with diabetes is less than 130 mmHg over less than 80 mmHg. When they take blood pressure medication, it typically lowers systolic blood pressure (the top number) by about 10 points. However, with the low-sodium DASH4D diet, diabetic people were able to lower systolic blood pressure by about 5 additional points. This 5-point reduction in blood pressure reduced the risk of stroke by 14%, cardiovascular events by 6% and heart failure by 8% in diabetic people. “A lot of people are interested in controlling diabetes and their blood pressure through diet and other lifestyle changes,” Lawrence Appel, M.D., M.P.H., corresponding author and a professor of medicine at the Johns Hopkins University School of Medicine, who helped develop the original DASH diet said. “Most people in this study were taking more than one blood pressure medication, but we found that you can lower it further with dietary change. Blood pressure is one of the most important numbers to control because the higher the number, the higher the risk of stroke and heart disease.”
The study
The study included 102 participants, 85 of whom completed all diet phases. Most were older adults (mean age 66), predominantly Black (87%), and 66% were women. Two-thirds of participants were taking two or more blood pressure medications. The participants received four diets in a randomly assigned sequence.1) DASH4D diet with lower sodium 2) DASH4D diet with higher sodium 3) a typical American diet with lower sodium4) a typical American diet with higher sodium. The participants sticked to the given diet for five weeks. The average starting blood pressure was 135/75 mmHg, and 66% of participants were on two or more blood pressure medications. Compared to the typical high-sodium American diet, the lower-sodium DASH4D diet lowered systolic blood pressure by 4.6 mmHg and diastolic pressure by 2.3 mmHg. Most of this drop happened within the first three weeks of the diet.The researchers said that the DASH4D diet could be an effective, non-pharmacological strategy to help people with diabetes reduce the risk of cardiovascular diseases, which is driven by hypertension. “The next steps are to get the knowledge that we gained out to people with diabetes and help them use the diet to make healthy changes. We need to make it easier for people to follow this diet in ways that are affordable and accessible to people of different cultures and with different dietary habits so they can integrate them into their daily life and make them part of their daily routine,” Pilla added.
