Effects on blood lipids of a blood pressure–lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial123

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ABSTRACT

Background:

Effects of diet on blood lipids are best known in white men, and effects of type of carbohydrate on triacylglycerol concentrations are not well defined.

Objective:

Our goal was to determine the effects of diet on plasma lipids, focusing on subgroups by sex, race, and baseline lipid concentrations.

Design:

This was a randomized controlled outpatient feeding trial conducted in 4 field centers. The subjects were 436 participants of the Dietary Approaches to Stop Hypertension (DASH) Trial [mean age: 44.6 y; 60% African American; baseline total cholesterol: ≤6.7 mmol/L (≤260 mg/dL)]. The intervention consisted of 8 wk of a control diet, a diet increased in fruit and vegetables, or a diet increased in fruit, vegetables, and low-fat dairy products and reduced in saturated fat, total fat, and cholesterol (DASH diet), during which time subjects remained weight stable. The main outcome measures were fasting total cholesterol, LDL cholesterol, HDL cholesterol, and triacylglycerol.

Results:

Relative to the control diet, the DASH diet resulted in lower total (−0.35 mmol/L, or −13.7 mg/dL), LDL- (−0.28 mmol/L, or −10.7 mg/dL), and HDL- (−0.09 mmol/L, or −3.7 mg/dL) cholesterol concentrations (all P < 0.0001), without significant effects on triacylglycerol. The net reductions in total and LDL cholesterol in men were greater than those in women by 0.27 mmol/L, or 10.3 mg/dL ( P = 0.052), and by 0.29 mmol/L, or 11.2 mg/dL ( P < 0.02), respectively. Changes in lipids did not differ significantly by race or baseline lipid concentrations, except for HDL, which decreased more in participants with higher baseline HDL-cholesterol concentrations than in those with lower baseline HDL-cholesterol concentrations. The fruit and vegetable diet produced few significant lipid changes.

Conclusions:

The DASH diet is likely to reduce coronary heart disease risk. The possible opposing effect on coronary heart disease risk of HDL reduction needs further study.

KEY WORDS

Diet
plasma total cholesterol
LDL cholesterol
HDL cholesterol
triacylglycerol
feeding study
Dietary Approaches to Stop Hypertension Trial
DASH

Cited by (0)

1

From the Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; the Endocrine-Hypertension Division, Brigham & Women’s Hospital, Harvard Medical School, Boston; Kaiser Permanente, Center for Health Research, Portland, OR; the Pennington Biomedical Research Center, Louisiana State University, Baton Rouge; the Welch Center for Prevention, Johns Hopkins University, Baltimore; the Sarah W Stedman Center for Nutritional Studies, Duke University School of Medicine, Durham, NC; Merck & Co, Boston; and the Geriatric Research, Education and Clinical Center, VA Medical Center, Durham, NC.

2

Supported by NHLBI Cooperative Agreements U01-HL50968, U01-HL50972, U01-HL50977, U01-HL50981, and U01-HL50982; by RR00722 and RR02635; and by a supplement from the NIH Office of Research and Minority Health.

3

Address correspondence to E Obarzanek, Division of Epidemiology and Clinical Applications, National, Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Room 8136, MSC 7936, Bethesda, MD 20892-7936. E-mail: [email protected].