Modifying the DASH Diet Could Potentially Lower High Blood Pressure in Type 2 Diabetes Sufferers
Revised Article:
People with diabetes often grapple with high blood pressure and specific nutritional requirements. A study investigated the impact of a modified DASH (Dietary Approaches to Stop Hypertension) diet, considering the nutritional needs of people with type 2 diabetes, combined with lowered sodium intake on blood pressure levels.
The study found that the blood pressure of participants improved significantly. Reduced sodium consumption was the primary factor driving this decrease, particularly in terms of systolic blood pressure (dropping by about 5 points) and diastolic blood pressure (down around 2 points). These improvements compared favorably to dietary plans with higher sodium intake that better mirror typical American diets for people with diabetes[1][2].
The research, co-authored by Scott J. Pilla, MD, MHS, demonstrated that the modified DASH diet, now known as DASH4D, is indeed beneficial for patients with type 2 diabetes. The diet emphasizes fruits, vegetables, whole grains, and low-fat dairy products while restricting salt and saturated fats[2].
The DASH4D diet was compared to two other diets in the study: lower sodium and higher sodium diets, which reflect the average American dietary patterns of diabetic individuals. The DASH4D diet with reduced sodium showed better overall blood pressure reduction compared to higher sodium diets[1][2].
The research included 102 adults with type 2 diabetes, whose blood pressure levels ranged between 120 and 159 mmHg. Participants were ineligible if they had type 1 diabetes, a hemoglobin A1C over 9%, or were on weight loss medications. The average age was 66, with most participants using multiple blood pressure and blood sugar medications[1].
The trial assigned participants to four diets in a rotating sequence, each for five weeks. One was the DASH4D diet with low sodium, another was the DASH4D diet with higher sodium, and the comparison diets had either lower or higher sodium and were similar to American diets for diabetic individuals[1].
Participants adhered to their assigned diets without losing weight during the study. Researchers measured and compared blood pressure levels during the last two weeks of each diet intervention. They monitored adverse events, such as excessively high blood pressure[1].
The findings indicated that the majority of the blood pressure changes occurred within the first three weeks of diet adherence. The DASH4D diet with reduced sodium produced a statistically and clinically meaningful reduction in blood pressure compared to the diets with higher sodium intake[1][2].
"The main finding was that a low-sodium DASH4D diet (versus a higher sodium typical American diet) caused a significant reduction in blood pressure. Sodium reduction appeared to contribute more strongly to reducing blood pressure than the DASH4D diet," explained Pilla[2].
Cardiologist Jennifer Wong, MD, pointed out that research like this highlights the impact of a heart-healthy diet, particularly a low-salt diet, on blood pressure management. It's important to note that studies like this can benefit those with type 2 diabetes[2].
Certain limitations exist with the research, however. The study included only a small number of participants and focused on a specific demographic, making it hard to generalize the findings. However, the majority of participants were African American, which provides crucial insights into high-risk groups. The dietary interventions lasted only five weeks[1].
Additionally, self-reported participant data was utilized for some aspects of the research, which could potentially introduce inaccuracies. While adverse events on the low-sodium DASH4D diet were minimal, further research could help identify potential risks[1].
Researchers suggested a need for investigations into the DASH4D diet's feasibility and affordability, as well as its applicability to various cultures and communities. It may also be beneficial to explore the impact of the diet in individuals with a higher level of risk for diabetes complications[1].
Researchers acknowledged the challenge in decreasing sodium intake to just 1,500 mg per day and called for future research in this area. The authors recommend conducting "implementation research in community settings" to investigate the diet's long-term efficacy and applicability[1].
In essence, the research suggests that the DASH4D eating plan, combined with lower sodium intake, effectively reduces blood pressure in people with type 2 diabetes. The five mmHg reduction in systolic blood pressure reduces the risk of stroke, heart failure, and cardiovascular events, while improving kidney health outcomes[2].
Pilla stated, "Diet change can improve blood pressure in people with diabetes, even those on multiple antihypertensive medications. Hence, clinicians should continue to focus on diet, even for these individuals."
He further emphasized, "Dietary sodium reduction is important for blood pressure control in people with diabetes, and the specific DASH4D diet with lower sodium now has strong evidence supporting it for this population. Therefore, it should be strongly considered as a recommended diet in individuals with diabetes."[2]
Enrichment Insights:- The DASH4D diet is a diabetes-specific adaptation of the DASH diet designed to help manage blood pressure in people with type 2 diabetes by focusing on low-sodium, heart-healthy foods and restricting saturated fats[2].- The diet's significant blood pressure reduction (about 5 mmHg in systolic blood pressure) has the potential to lower the risk of stroke, heart failure, and cardiovascular events, as well as improve kidney health outcomes[2].- The DASH4D diet's sodium restriction has proven feasible and well-accepted among participants, suggesting that it can be achievable with proper guidance and access to prepared meals or education[2].
- The modified DASH (Dietary Approaches to Stop Hypertension) diet, specifically the DASH4D, which focuses on fruits, vegetables, whole grains, and low-fat dairy products with salt and saturated fat restrictions, was proven beneficial for individuals with type 2 diabetes in managing chronic diseases like diabetes and hypertension.
- The study found that a low-sodium DASH4D diet significantly improved blood pressure levels compared to higher-sodium diets, with reductions in systolic blood pressure (around 5 points) and diastolic blood pressure (around 2 points).
- Cardiologist Jennifer Wong emphasized the importance of research like this, as it showcases the impact of a heart-healthy diet, particularly a low-salt diet, on blood pressure management, benefiting not only those with type 2 diabetes but also individuals with chronic diseases like hypertension and diabetes.
- The DASH4D diet also has potential applicability to various cultures and communities, yet researchers suggest further exploration into its feasibility, affordability, and long-term efficacy in these groups.
- A decreased sodium intake of 1,500 mg per day was challenging for the participants in the study, but future research is necessary to develop practical strategies for achieving this target.
- As diet changes play a crucial role in blood pressure management, especially for individuals with diabetes on multiple antihypertensive medications, clinicians are encouraged to recommend the DASH4D diet as a knowledgeable approach for weight management and health and wellness improvements.
