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 trial1–3

We previously showed that with limitation of carbohydrate intake, the increase in low-density lipoprotein cholesterol induced by saturated fat is due primarily to large, cholesterol-rich LDL particles and not small, dense LDL particles

Sally Chiu; Nathalie Bergeron; Paul T Williams; George A Bray; Barbara Sutherland; Ronald M Krauss

2015

Scholarcy highlights

  • The Dietary Approaches to Stop Hypertension6 dietary eating pattern, which emphasizes fruit and vegetables, low-fat dairy foods, and whole grains, is one of the most widely prescribed dietary modifications for reducing blood pressure and cardiovascular disease risk
  • Fasting plasma triglycerides and total, low-density lipoprotein, and high-density lipoprotein cholesterol measured after each of the 2 washout periods showed no significant differences between screening values and their values after the first
  • We tested whether the BP benefit, as well as a favorable lipid and lipoprotein profile, could be maintained by the HF-DASH diet that includes full-fat dairy foods, with a corresponding increase in total and saturated fat, and a reduction in carbohydrate achieved primarily by reducing fruit juices and sugars, because sugar intake is associated with detrimental effects on cardiovascular disease risk factors
  • The HF-DASH diet lowered both systolic and diastolic BP to an extent similar to the DASH diet, indicating that the diet components responsible for the BP reduction were retained in the HF-DASH diet
  • 24-h urine sodium measurements were similar on all 3 diets, indicating that the BP reductions with the DASH and HF-DASH diets were not attributable to lower sodium intake
  • In the present study, we found that the reduction in LDL cholesterol with the DASH diet compared with the control diet occurred in conjunction with lower concentrations of large LDL particles as well as of intermediate-density lipoprotein particles, which both contribute cholesterol content to the standard LDL-cholesterol measurement
  • The results of this study indicate that modification of the Dietary Approaches to Stop Hypertension diet to allow for more liberal total and saturated fat intake in conjunction with moderate limitation of carbohydrate intake, primarily from fruit juices and sugars, results in lower concentrations of triglycerides and very-lowdensity lipoprotein particles, with no increases in total or low-density lipoprotein cholesterol and no attenuation of the favorable blood pressure response to the standard DASH diet

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