Effect of dietary approaches to stop hypertension diet on insulin resistance and lipid accumulation product in subjects with metabolic syndrome

Introduction

Metabolic syndrome (MetS) is a cluster of metabolic dysregulations that contribute to the development of type 2 diabetes and cardiovascular diseases^1,2. It has been estimated that 20%−35% of adults suffer from MetS^3,4. Insulin resistance, which is known as a reduced ability of insulin to stimulate glucose utilization, is involved in the development of MetS as well as the progression of its related complications through various mechanisms^5,6. In addition, visceral obesity as a key criterion in diagnosis of MetS is one of the main risk factors for non-communicable diseases^7,8. Lipid accumulation product (LAP) is a valid tool to evaluate the cardiovascular risk and accumulation of fat^9,10. It is based on waist circumference (WC) and triglyceride (TG), and is a better predictor than WC or TG alone in assessing the risk of complications related to obesity and dyslipidemia^11,12. It has been confirmed that following unhealthy dietary patterns and sedentary lifestyle are the important modifiable risk factors of MetS¹³.

The dietary approaches to stop hypertension (DASH) diet is a plant-based dietary pattern with limited amounts of saturated fat, cholesterol, red and processed meats, sugar-sweetened beverages, as well as sodium, and provides high amounts of whole grains, vegetables, fruits, low-fat dairy products, legumes, and nuts¹⁴. It has been reported that following DASH diet can be useful in the management of cardiometabolic risk factors including dyslipidemia, hypertension and obesity^{15, 16, 17–18}. There are limited number of studies investigating the effects of DASH diet in subjects with MetS^19,20. Only Saneei et al.²⁰ assessed the effect of recommendations to follow the DASH diet on childhood metabolic syndrome. To date, no clinical trial has evaluated the effect of adherence to DASH diet on LAP. The present study was designed to determine the effect of DASH diet on insulin resistance and LAP in subjects with MetS. It has been hypothesized DASH diet can improve insulin resistance and LAP in subjects with MetS.

Methods

Participants

The present study is a randomized controlled trial (RCT). The subjects were recruited from October 2022 to November 2022 in Diabetes Research Center, Yazd, Iran. The inclusion criteria were: age between 30 and 60 years and diagnosis of...