Cardiovascular disease: the DASH diet associated with a 10% reduced risk

Cardiovascular disease: the DASH diet associated with a 10% reduced risk

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New research strengthens the evidence for the cardiovascular benefits of the DASH diet. Image credit: Ivan Gener/Stocksy.
  • The prevalence of cardiovascular disease is increasing due to changing lifestyles, an aging population and better survival rates for heart attacks and strokes.
  • There is growing evidence that diet is key to the risk of developing heart and circulatory diseases.
  • Now, a study has found that switching to a healthier diet, like the DASH diet or a diet high in fruits and vegetables, could reduce that risk by up to 10%.

According to World Health Organization (WHO), heart and circulatory diseases now cause one in three deaths worldwide, or 17.9 million.

Many types of cardiovascular disease (CVD) are preventable, with lifestyle changes being one of the most effective ways to reduce risk.

WHO recommended:

  • stop smoking
  • reduce salt and increase fruits and vegetables in your diet
  • regular physical activity
  • avoid harmful use of alcohol.

However, there is so much conflicting advice that people can have a hard time deciding which diet to follow.

A new study, from Beth Israel Deaconess Medical Center (BIDMC) at Harvard Medical School, suggests that switching to the DASH diet or a diet high in fruits and vegetables could reduce the risk of cardiovascular disease by up to 10%.

The study appears in The American Journal of Cardiology.

The DASH — short for “dietary approaches to stopping hypertension” — the diet is based on changing eating habits to reduce blood pressure by:

  • eating vegetables, fruits, and whole grains
  • including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
  • limiting foods foods high in saturated fat, such as fatty meats, whole dairy products, and coconut, palm kernel, and palm oils
  • limit sugary drinks and sweets.

It is designed be easy to follow, provide healthy alternatives to junk food, and be adaptable to any cultural heritage.

In the study, the researchers randomly divided the 437 participants into three groups. After 3 weeks of the typical American diet – few fresh produce, high total fat, saturated fat and cholesterol – each group then followed a different diet for 8 weeks.

The participants had an average age of 45, and about half were black women and the other half were women. The three groups were well matched for BMI, hypertension status and physical exercise.

People in the control group continued to follow the initial diet. The second group ate a similar diet, but with added fruits and vegetables. The third group followed the DASH diet.

After the 8-week dieting period, the researchers calculated the participants’ risk of atherosclerotic cardiovascular disease (ASCVD) using the pooled cohort equation. This uses age, sex, race, blood pressure, cholesterol level and other health factors to estimate CVD risk.

“The authors attempt to extrapolate the very short-term effects of different diets into long-term projections of the effects [of] these diets on the risk of suffering cardiovascular events. Fewer than 150 people per group were assigned to follow different diets for just 8 weeks. Changes in blood parameters and blood pressure after these 8 weeks were then used to predict cardiovascular risk over the following 10 years.

– Dr. Richard Wright, cardiologist at Providence Saint John’s Health Center in Santa Monica, CA

Compared to the control diet, the DASH diet gave a relative reduction in a 10-year ASCVD risk of 10.3%.

The diet rich in fruits and vegetables reduced it by 9.9%.

However, Dr. Wright, who was not involved in the study, observed that the absolute differences in risk were small, as “following a ‘standard American’ diet gave a formula-predicted risk of 1.84% d one cardiovascular event in those 10 years, and following a DASH diet is expected to result in a 1.69% risk over 10 years.

“This absolute difference of 0.15% means that we could prevent a cardiovascular event in less than two in a thousand people who changed their diet in the next 10 years,” he pointed out.

The DASH diet also reduced levels of high-density lipoprotein (HDL) or “good” cholesterol.

The study’s corresponding author, Dr. Stephen Juraschek, a clinician-scientist in the Department of Medicine at BIDMC, said DTM:

“The health implications of lowering HDL cholesterol are unclear. […] [T]Here are a number of recommended modifications to improve the DASH diet. One of them is to increase the consumption of healthy forms of unsaturated fats.

The DASH diet reduced the risk over 10 years more than twice as much in women as in men. The relative risk reduction for women was 13%, compared to only 6% for men.

For black adults, the relative risk reduction on the DASH diet was 14%, while for everyone else it was only 3%.

Dr Juraschek speculated that “this may be partly related to the baseline diet that was changed through the intervention.”

“It is also related to the role of gender and race in the ASCVD risk score estimator,” he added.

“Since DASH acted differently on cardiovascular risk factors – greater effects on blood pressure, LDL cholesterol – than the fruit/vegetable diet, which did not affect HDL cholesterol in the same way as DASH lowered HDL cholesterol, and the impact of these risk factors on 10-year CVD risk differed by gender and race According to the pooled estimating equation, we observed that DASH reduced risk more in women and black adults.

The researchers did not observe similar differences on diets high in fruits and vegetables.

The researchers urge caution in interpreting their results and emphasize the need for further research.

The risk figures were estimates using an ASCVD calculator, not recordings of actual cardiovascular events, the study lasted only 8 weeks, and the typical diet was based on that of the study Original DASH, 30 years ago.

“Our study shows a modest risk reduction over a short-term period […] This should simplify our general dietary advice and help avoid some of the complexity of nutritional science that is sometimes lost on patients. I think we all need to eat more fruits and vegetables in the United States”

– Dr. Stephen Jurashek

Dr Wright agreed that the results needed to be confirmed: “With such a small study and such short follow-up, analysis of subgroup response carries the risk of potentially spurious conclusions. From this study, it is impossible to determine whether the response to dietary changes might differ by ethnic group or gender.

Whether or not the DASH diet or a diet high in fruits and vegetables reduces the risk of cardiovascular events, incorporating more fresh foods into your diet is an essential part of a healthy lifestyle.

“We believe that a critical step toward healthier eating begins at the grocery store and requires that healthy foods be accessible to families in the United States, regardless of where they live,” said Dr. Juraschek.

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