A High-Quality Diet, as Measured by the DASH Score, Is Associated with a Lower Risk of Metabolic Syndrome and Visceral Obesity

Effect of dietary approaches to stop hypertension (DASH) diet on adiposity indices in children with overweight and obesity: an 8-week triple-blind randomized controlled trial

We aimed to investigate the potential effects of Dietary Approaches to Stop Hypertension (DASH) diet on adiposity indices in children with overweight and obesity. This study was a triple-blind, randomized controlled trial. Sixty girls and boys (aged 8-12 years) were randomly assigned to either DASH diet or control group, and the intervention duration was 8 weeks. Body weight (BW), height, waist circumference (WC), skinfold thickness (SFT), neck circumference (NC), body mass index (BMI), waist-to-height ratio (WHtR), body round index (BRI), and weight-adjusted waist index (WWI) were assessed before and after the intervention. The primary analysis was conducted on a per-protocol basis, including only participants who completed at least two visits and adhered to the study protocol. This approach was chosen to ensure that the results reflect the actual effects of the intervention among compliant participants. Analysis of covariance (ANCOVA) was used to compare after treatment adiposity indices between groups. Mean ± SD age and BMI of the participants was 11.8 ± 0.8 years (69% were girls) and 25.9 ± 3.52 kg/m2, respectively. A total of 58 patients (n = 29 in DASH group and n = 29 in control group) who completed at least two visits and adhered to the study protocol were included in the final per-protocol analysis. Two participants (one from each group) were lost to follow-up and excluded from the analysis due to incomplete data. After 8 weeks, the DASH group had a significantly lower BW (59.5 vs. 62.6 kg), WC (84.3 vs. 85.5 cm), NC (32.9 vs. 33.3 cm), SFT (3.57 vs. 3.57 cm), BMI (25.9 vs. 25.9 kg/m2), WHtR (0.55 vs. 0.56), BRI (4.57 vs. 4.75), and WWI (10.42 vs. 10.84 cm/√kg) compared with the controls (P for all < 0.01). The mean change percent of adiposity indices was higher in the control than the DASH group (P for all < 0.05); however, for the WWI, a significant reduction was observed in the DASH group.

CONCLUSION

Adherence to DASH diet may be an effective approach for obesity management in children who are overweight and obese.

TRIAL REGISTRATION

Our study was registered with IRCT.IR ( https://irct.behdasht.gov.ir ) under the identifier IRCT20240623062229N1 on 30 June 2024.

WHAT IS KNOWN

• The DASH diet is effective in improving cardiovascular health and metabolic outcomes in adults, but its impact on adiposity indices in children with overweight/obesity remains understudied. • Previous studies on the DASH diet in pediatric populations have yielded inconsistent results, with some showing  benefits in weight management and others reporting neutral effects.

WHAT IS NEW

• This first triple-blind randomized controlled trial demonstrates that an 8-week DASH diet intervention significantly reduces multiple adiposity indices (body weight, waist circumference, BMI, and novel indices like WWI and BRI) in children with overweight/obesity. • The study highlights the DASH diet's potential as a practical, non-restrictive dietary strategy for pediatric obesity management, with benefits observed even without caloric restriction.

The effects of wine consumption and lipid profile: A systematic review and meta-analysis of clinical trials

BACKGROUND AND OBJECTIVE

The aim of this study was to analyze the effects of wine consumption on the lipid profile, distinguishing between triglycerides, total cholesterol, LDL, HDL and fibrinogen.

METHODS

We examined the MEDLINE (via PubMed), Scopus, Cochrane, and Web of Science databases to conduct this systematic review and meta-analysis. PROSPERO has already recorded this study under registration number CRD42023396666.

RESULTS

Thirty-three studies were included in this systematic review, and 29 were included in the meta-analysis. The pooled ES for the effect of red wine consumption on the different lipid profile parameters was significant only for the effect of red wine on the LDL parameter in the prepost studies (-0.29 (95% CI -0.54, -0.05)). The pooled ES for the effect of white wine in prepost studies and clinical trials for the effect of wine consumption on the different parameters did not show any significant results.

CONCLUSION

This systematic review and meta-analysis revealed that wine consumption has an effect on reducing LDL and has no effect on total cholesterol, HDL, triglycerides, or fibrinogen. This research revealed that the duration of the intervention affects triglyceride and total cholesterol levels, indicating that longer interventions are more effective for these two parameters.

REGISTRATION ID

CRD42023396666 (PROSPERO). URL REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=396666.

Dietary Patterns, Kidney Function, and Sarcopenia in Chronic Kidney Disease

Sarcopenia is a condition characterized by the loss of muscle mass and function. It is a risk factor for adverse clinical outcomes, including falls, disability, and mortality in patients with chronic kidney disease (CKD). The progression of CKD leads to metabolic disturbances and pathophysiological changes. These alterations, such as metabolic acidosis, dysregulated muscle proteostasis, and excessive inflammation, contribute to accelerated muscle wasting, resulting in sarcopenia. Proper nutritional interventions are essential in the management of sarcopenia in patients with CKD. Appropriate dietary intake of protein and specific micronutrients, carefully considering the needs and restrictions of CKD, may help maintain muscle mass and function. Specific dietary patterns, such as an anti-inflammatory diet, Dietary Approaches to Stop Hypertension diet, and a plant-based diet, may be beneficial for attenuating muscle wasting in CKD patients. The underlying mechanisms of how these dietary patterns affect sarcopenia are multifaceted, including inflammation, oxidative stress, and defects in muscle protein homeostasis. This review summarizes the current evidence on the relationship between dietary patterns and sarcopenia, as well as the underlying mechanisms of how dietary patterns modulate sarcopenia in CKD patients.

Theoretically Based Factors Affecting Diet Quality of Preschool Children: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

Diet quality during early childhood significantly influences long-term health outcomes, including obesity and chronic disease risks. Parental feeding practices, dietary beliefs, and demographic factors have been shown to impact children's diet quality. This study aimed to determine the extent to which the demographic characteristics and the factors of primary caregivers (dietary beliefs, intention to provide a healthy diet, feeding practices) can explain the variance in the diet quality of preschoolers in the US Methods: This descriptive correlational cross-sectional study was guided by the Theory of Planned Behavior (TPB). A total of 146 primary caregivers of preschool children (aged 3-5) were recruited through convenience and snowball sampling. Data were collected using a self-reported questionnaire and a structured telephone interview. Diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) score. Hierarchical multiple regression analyses were conducted to determine the factors associated with preschoolers' diet quality.

RESULTS

The mean DASH score was 40.5 (SD = 10.1), reflecting moderate to low diet quality. The results showed that 16% of the variance in diet quality was significantly explained by race (non-White) and three caregiver feeding practices (food as a reward, restriction food for health, and restriction for weight control). Of these, race (non-White) and restriction food for health were significant predictors and associated with lower diet quality in preschoolers.

CONCLUSIONS

These findings align with previous studies and suggest that the conceptual framework of this study might be further refined and tested in future studies.

Providing medically tailored groceries and food resource coaching through the charitable food system to patients of a safety-net clinic in Dallas, Texas: a randomised controlled trial protocol

INTRODUCTION

Linking patients living with chronic, diet-related diseases and food insecurity to charitable food assistance, medically tailored groceries (MTGs) and food resource coaching may empower patients to better manage their health in a way that is economically sustainable. This protocol paper describes the implementation of a study evaluating MTGs and food resource coaching in a food pantry setting.

METHODS AND ANALYSIS

A randomised controlled trial whereby patients of a safety-net health centre will be screened for The Emergency Food Assistance Program (TEFAP) and study eligibility. Eligible patients will be randomised to receive 4 months of usual pantry services (control), MTGs (intervention 1) or MTGs and food resource coaching (intervention 2) from a colocated food pantry. Measures collected monthly include adherence, fidelity and food selections from the pantry. Measures collected at baseline and follow-up include food and nutrition security, diet quality, household resiliency, loneliness and overall well-being. Qualitative interviews (n=60) will be conducted preintervention and postintervention. Analyses will include multiple regression models to analyse changes from baseline to follow-up as well as changes between groups over time. Deductive thematic analysis of qualitative data will be conducted.

ETHICS AND DISSEMINATION

This study was approved by the UT Southwestern Medical Center Institutional Review Board (STU-2023-1166) and the Parkland Health Office of Research Administration. This is protocol version two, modification approved on 3 June 2024. Findings will be disseminated through academic conferences, journals and to the public.

TRIAL REGISTRATION NUMBER

NCT06242808.

Adherence to dietary approaches to stop hypertension diet and visceral adipose tissue area among U.S. adults, a cross-sectional study

Excessive visceral adipose tissue (VAT) is a significant risk factor for various diseases. Diet plays a crucial role in controlling obesity. This study examined the association between the Dietary Approaches to Stop Hypertension (DASH) diet and VAT in 9027 adults using data from the National Health and Nutrition Examination Survey. Linear regression models were used to explore this association, with subgroup analyses included. Results showed a significant inverse association between DASH scores and VAT area, even after adjusting for covariates (β = -2.18, 95% CI: -3.10, -1.27). Participants in the highest DASH score tertile had significantly lower VAT areas compared to those in the lowest tertile (β = -7.2, 95% CI: -10.40, -4.01). This inverse association was most pronounced in middle-aged participants. Further prospective cohort studies are necessary to confirm these findings.

Narrative review of lifestyle interventions in breast cancer survivors: current evidence and future directions

BACKGROUND

In 8 females, 1 will be diagnosed with breast cancer in their lifetime. Although medical advances have increased the likelihood of survival, up to 90% of females will gain weight during and after treatment increasing the risk of breast cancer recurrence and obesity-related comorbidities in survivorship. Behavioral lifestyle interventions focused on diet with or without physical activity can provide breast cancer survivors nonpharmacological options to decrease weight gain and cardiometabolic risk.

METHOD

A PubMed search was conducted to identify all behavioral lifestyle interventions focused on diet or diet combined with physical activity longer than 4 weeks of duration in breast cancer survivors that included body weight as an outcome. This review aims to summarize the effects on body weight, body composition, and cardiometabolic risk markers.

RESULTS

The review shows there is high heterogeneity in type and duration of the intervention to affect weight and cardiometabolic risk in survivorship. Calorie restriction with and without physical activity appears to promote weight loss among breast cancer survivors. However, the effects on cardiometabolic factors are less clear.

CONCLUSIONS

Future studies should be powered for body weight and cardiometabolic effects. Researchers should also consider interventions that (1) are less complex, (2) recruit a more racially and ethnically diverse sample, (3) integrate resistance training, (4) implement the intervention in closer proximity to diagnosis, (5) target weight management in this population before it occurs, and (6) analyze body composition in addition to body weight measurements.

Comparison of diet quality indices for predicting metabolic syndrome in Iran: cross-sectional findings from the persian cohort study

BACKGROUND

The metabolic syndrome (MetS) comprises metabolic irregularities, including hypertension and central obesity, which are influenced by genetic, metabolic, environmental, and dietary factors. As diet and lifestyle are risk factors for MetS, it is important to know which diet quality index better predicts MetS. The aim of this study is to compare the ability of different diet quality indices in predicting MetS and to identify the most effective one.

METHODS

This cross-sectional study involved 5,206 participants aged 35 to 70 engaged in the Prospective Epidemiological Research Study in Iran (PERSIAN) cohort. Assessment of one year's food intake via a validated 134-item semi-quantitative food frequency questionnaire (FFQ) facilitated the calculation of adherence to five diet quality indices: Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), Dietary Inflammatory Index (DII), and Diet Quality Indices (DQI). While bivariate Pearson correlation and binary logistic regression aided in identifying the strongest correlation and predictor for MetS among the indices.

RESULTS

This study showed a significant association between adhering to the DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, and the odds of developing MetS (OR: 0.94, (95% CI: 0.93-0.95), OR: 0.85, (95% CI: 0.81-0.89), OR: 0.84, (95% CI: 0.80-0.89), OR: 1.22, (95%CI: 1.11-1.34), OR: 0.95, (95%CI 0.94-0.96) respectively). Therefore, with each unit increase in DASH diet score, Mediterranean diet score, MIND diet score, DII score, and DQI score, the odds of MetS was reduced by 5.4%, 14.5%, 15.6%, 22%, 5%, respectively. All the indices were correlated with the intake of most of the micronutrients, with the strongest correlations being observed in the DII. DASH diet score aligned with the most favourable MetS biomarker risk, while DII score primarily associated with MetS and could be considered as a predictor for MetS.

CONCLUSION

The present study's findings reveal that between all these five diet quality indices, the DASH diet score correlates strongly with a favourable biomarker risk profile, while the DII score is predominantly linked to MetS.

The Association between Diet Quality and Metabolic Syndrome among Older African American Women

Diet is a modifiable lifestyle factor that could impact the development of Metabolic Syndrome (MetS) and its components. MetS prevalence is high and diet quality is suboptimal among older African American women. MetS has been associated with many individual food groups, however, emerging research suggests that analyzing overall diet quality provides insight into the synergistic effects of food groups on health outcomes. In the current cross-sectional study, we examined the relationship between diet quality and MetS, and investigated associations between diet quality and MetS components among older African American women. This study was based on 357 African American women between 45 and 65 years from the NHANES 2011-2018 datasets. This analysis utilized the NCEP ATP III (2001) criteria for women to diagnose MetS. MetS was dichotomized in addition to a MetS z-score being calculated for each participant using a sex- and race-specific equation. Participants' diet quality was measured using the HEI-2015. Linear and logistic regressions were performed to assess the association between HEI-2015 diet quality and metabolic syndrome and its components. 65% of African American women aged 45-65 in the NHANES 2011-2018 had MetS. Study participants had an average HEI-2015 score of 55.4 out of 100. As HEI-2015 quartiles increased, the mean MetS z-score decreased (p-value: 0.0011). Age-adjusted models demonstrated statistically significant inverse relationships between HEI-2015 and waist circumference (β: -0.217; 95% CI: -0.372, -0.063), systolic blood pressure (β: -0.215; 95% CI: -0.359, -0.072), blood glucose (β: -0.344; 95% CI: -0.681, -0.0066), and triglycerides (β: -0.652; 95% CI: -1.05, -0.251). Significant associations could not be established between MetS and diet quality, assessed with the HEI-2015, among African American women aged 45-65 enrolled in NHANES 2011-2018. However, statistically significant relationships were observed between increased HEI-2015 scores and lowered risks of abdominal obesity, hyperglycemia, hypertriglyceridemia, and systolic hypertension. The findings of this study affirm the necessity of public health strategies to improve diet quality among African-American women which could help to reduce their risks of chronic diseases.

[Dietary Management of Obesity]

Obesity is defined as a condition characterized by the abnormal accumulation of fat cells, which results in increased body weight. Worldwide, obesity is progressively on the rise, leading to an increased prevalence of chronic conditions such as cardiovascular disease, type 2 diabetes, and hyperlipidemia. Obesity is a result of the interplay between genetic, metabolic, social, behavioral, and cultural factors, necessitating an interdisciplinary and multimodal management approach. Diet therapy, which includes dietary modifications and nutritional interventions, is a fundamental component of the multifaceted approach to managing obesity. The principle of diet therapy is based on achieving weight loss through a negative energy balance and maintaining weight through an equilibrium of energy intake and expenditure. Strategies for weight loss and control rely on caloric restriction, macronutrient distribution, and dietary patterns such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets. Recently, studies have been conducted on weight control using information and communication technology-based interventions, as well as interventions based on intestinal microorganisms which consider inter-individual variability and long-term adherence. In conclusion, diet therapy stands as a pivotal element in the management of obesity, providing a personalized and comprehensive approach to weight control. By combining evidence-based dietary strategies with behavioral modifications and consistent support, healthcare professionals can enable individuals to attain and sustain a healthier weight, thereby reducing related health risks.

The Association Between Food Quality Score (FQS) and Metabolic Syndrome Risk Factors in Overweight and Obese Individuals: A Cross-Sectional Study

Obesity and overweight pose a significant public health problem, as they are associated with an elevated risk of metabolic syndrome (MetS). Several studies have shown that diet quality is associated with the development of MetS risk factors. Analyzing dietary patterns may be more helpful in determining the relationship between eating habits and chronic diseases compared to focusing on single foods or nutrients. In this study, our objective was to evaluate the association of food quality score (FQS) with risk factors for MetS in individuals with obesity and overweight. The participants in this cross-sectional study were 340 adults with overweight and obesity. Participants' food intake was measured using a Food Frequency Questionnaire, then the FQS was calculated. A fasting blood sample assessed serum glucose, triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol, and serum insulin levels. Fat-free mass, height, basal metabolic rate, socio-economic score, and waist-to-hip ratio significantly differed among FQS tertiles. TC, systolic and diastolic blood pressure, and fasting blood glucose were significantly lower in the highest tertile of FQS. After multivariable adjustment, our results showed that individuals in the third tertile of FQS had reduced risk of higher levels of TC (odds ratio [OR], 0.982; 95% confidence interval [CI], 0.970-0.984) and higher levels of low-density lipoprotein cholesterol (OR, 0.974; 95% CI, 0.974-0.999). Our findings demonstrate an inverse relationship between diet quality, as measured by FQS, and MetS risk factors. However, further experimental and longitudinal investigations are warranted to elucidate the causal nature of this association.

Changes in Choline Metabolites and Ceramides in Response to a DASH-Style Diet in Older Adults

This feeding trial evaluated the impact of the Dietary Approaches to Stop Hypertension diet on changes in plasma choline, choline metabolites, and ceramides in obese older adults; 28 adults consumed 3oz (n = 15) or 6oz (n = 13) of beef within a standardized DASH diet for 12 weeks. Plasma choline, betaine, methionine, dimethylglycine (DMG), phosphatidylcholine (PC), lysophosphotidylcholine (LPC), sphingomyelin, trimethylamine-N-oxide (TMAO), L-carnitine, ceramide, and triglycerides were measured in fasted blood samples. Plasma LPC, sphingomyelin, and ceramide species were also quantified. In response to the study diet, with beef intake groups combined, plasma choline decreased by 9.6% (p = 0.012); DMG decreased by 10% (p = 0.042); PC decreased by 51% (p < 0.001); total LPC increased by 281% (p < 0.001); TMAO increased by 26.5% (p < 0.001); total ceramide decreased by 22.1% (p < 0.001); and triglycerides decreased by 18% (p = 0.021). All 20 LPC species measured increased (p < 0.01) with LPC 16:0 having the greatest response. Sphingomyelin 16:0, 18:0, and 18:1 increased (all p < 0.001) by 10.4%, 22.5%, and 24%, respectively. In contrast, we observed that sphingomyelin 24:0 significantly decreased by 10%. Ceramide 22:0 and 24:0 decreased by 27.6% and 10.9% (p < 0.001), respectively, and ceramide 24:1 increased by 36.8% (p = 0.013). Changes in choline and choline metabolites were in association with anthropometric and cardiometabolic outcomes. These findings show the impact of the DASH diet on choline metabolism in older adults and demonstrate the influence of diet to modify circulating LPC, sphingomyelin, and ceramide species.

Associations between adherence to MIND diet and general obesity and lipid profile: A cross-sectional study

Background

The term "Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)" has recently been coined to describe a new eating pattern. Recent research is looking at how this food pattern affects chronic illnesses. Thus, this study aimed to investigate the association between the use and adherence to the MIND diet with general obesity and blood lipid profile.

Methods

In this cross-sectional study, 1,328 Kurdish adults between the ages of 39 and 53 had their dietary intake evaluated using a valid and reliable 168-item Food Frequency Questionnaire (FFQ). Adherence to the MIND diet was examined based on the components advised in this eating pattern. Each subject's lipid profiles and anthropometric measurements were documented.

Results

The mean age and BMI in the study population were 46.16 ± 7.87 year and 27.19 ± 4.60 kg/m², respectively. The chances of having increased serum triglycerides (TG) were 42% lower in those in the third tertile of the MIND diet score compared to those in the first tertile (ORs: 0.58; 95% CI 0.38-0.95; P = 0.001). In the crude model and after adjusting for confounders, lowering high-density lipoprotein cholesterol (HDL-C) (ORs: 0.72; 95% CI 0.55-1.15; P = 0.001).

Conclusion

We found that greater adherence to the MIND diet was associated with the decrease odds of general obesity and lipid profile. Further study is essential owing to the relevance of chronic diseases like MetS and obesity in health status.