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Dietary Surveys and Nutritional Epidemiology
Abbreviations: BP, blood pressure; DASH, Dietary Approaches to Stop Hypertension; DBP, diastolic blood pressure; EBP, elevated blood pressure; FV, fruits and vegetables; NGHS, National Heart Lung and Blood Institute's Growth and Health Study; SBP, systolic blood pressure; SES, socio-economic status; USDA, United States Department of Agriculture
The original 1997 Dietary Approaches to Stop Hypertension (DASH) clinical trial randomly assigned adults with a diastolic blood pressure (DBP) between 80 and 95 mmHg and a systolic blood pressure (SBP) < 160 mmHg to one of three dietary patterns: a control diet, a high-fruit and vegetable diet, or a diet high in fruits and vegetables (FV) as well as low-fat dairy products (the 'combined' diet)(1). The 'combined' dietary pattern (generally termed the DASH diet) was characterised by the highest intakes of Ca and Mg; fibre and K intakes were similar in the fruit-and-vegetable and combined diets. The combined DASH eating pattern led to the greatest blood pressure (BP)-lowering effects regardless of initial BP level when compared with either the control diet or the high-fruit-and-vegetable diet. Subsequent studies confirmed these results(2).
The PREMIER trial demonstrated only modest BP benefits from adding a DASH-style dietary intervention to other lifestyle measures(3)while the Exercise and Nutrition Interventions for Cardiovascular Health (ENCORE) Study, which examined DASH in combination with an exercise or weight reduction intervention in overweight and obese adults, found that the beneficial effects of DASH were even stronger among those who exercised or lost weight(4). Other studies(5), such as the French Supplementation en Vitamines et Mineraux Antioxydants (SU.VI.MAX) study, found beneficial effects from FV intake but not from dairy.
BP levels track from childhood to adulthood(6)and recent data from the Fels Longitudinal Study indicate that childhood SBP is a strong predictor of the risk of both hypertension and the metabolic syndrome later in life(7). A limited number of studies have examined the effects of a DASH-style eating pattern among children and adolescents. In the Framingham Children's Study, those whose early diets were characterised by higher intakes of both dairy products...