An estimated 38.1 million adults in the United States were diagnosed with diabetes in 2021, according to the Centers for Disease Control and Prevention. Of these, approximately 90% to 95% had type 2 diabetes. A new Johns Hopkins medicine study found that in adults with type 2 diabetes (most of whom were taking multiple antihypertensive drugs), a low-sodium dash-style diet (a dietary approach to stop hypertension) achieved a clinically meaningful reduction in blood pressure, primarily due to reduced sodium.
The dash diet is rich in fruits, vegetables and low-fat dairy products, with low saturated fat and cholesterol. For the study of Dash for Diabetes, the Johns Hopkins study corrected the original dash diet for people with type 2 diabetes by lowering carbohydrates and increasing unsaturated fats. Researchers also confirmed that diet is safe for chronic kidney disease, which reduces potassium content and affects many people with diabetes.
“The dash diet has been around for a long time and is part of the standard treatment for hypertension. We know it will lower blood pressure, but there has been little research into this diet and sodium reduction in diabetic patients.” “The goal of this study was to develop a new version of the dash diet and see how effective it is in lowering blood pressure in diabetic patients.
This study was presented at Jama Internal Medicine on June 9th.
Pira says that despite hypertension generally affects diabetic patients and an important cause of stroke and heart disease, people with diabetes tend to concentrate on their blood sugar levels. Blood pressure targets for diabetic patients are below 130 mmHg, below 80 mmHg. When people take blood pressure medications, their systolic blood pressure (top number) usually drops about 10 percentage points. In this study, eating the low-sodium Dash4D diet reduced systolic blood pressure by about 5 percentage points. In people with diabetes, a 5 percentage point reduction in blood pressure reduced the risk of stroke by 14%, cardiovascular events by 6%, and heart failure by 8%.
“Many people are interested in controlling diabetes and blood pressure through diet and other lifestyle changes,” says corresponding authors Lawrence Appell, MD, MPH, a professor of medicine at Johns Hopkins University School of Medicine, who helped develop the original dash diet. Risk of stroke and heart disease. ”
According to Pilla, the study was a crossover feeding study, where all patients who participated in the study received four meals in a randomly assigned sequence: 1) the Dash4D diet with lower sodium, 2) the Dash4D diet with higher sodium, 3) the typical American diet with lower sodium, and 4) the typical American diet with higher sodium. Participants ate each meal for five weeks. They were provided with all the food and did not eat any food other than what was provided by the research. Those calories were adjusted to keep weight stable throughout the study.
Of the 102 participants, 85 completed all meal periods. The average age was 66 years, 66% were women, and 87% were self-reported black races. The mean baseline blood pressure was 135/75 mmHg, with 66% using two or more antihypertensive drugs. In contrast to the typical American diet with higher sodium, the low sodium Dash4D diet reduced systolic blood pressure by 4.6 mmHg and diastolic blood pressure by 2.3 mmHg during the period. The majority of blood pressure decline occurred during the first 3 weeks of each meal.
“The next step is to gain knowledge we gain from people with diabetes and help them use their diet to make healthy changes,” says Pira. “We need to make this diet easier and have different eating habits for people from different cultures in affordable and accessible ways, allowing them to be integrated into their daily lives and become part of their everyday lives.”
Other researchers who contributed to this study include Hsin-Chieh Yeh, Christine M. Mitchell, Edgar R. Miller, Susan Oh, Karen White, Nowella Durkin, Ariella A. Stein, Jeanne B. Charleston, Mengyang Lu, Xiao Hu, Beiwen Wu, Elizabeth Selvin, Nisabet T. Muller, and Nae Yu Wang.
Appel receives uptordate chapter payments from Wolters Kluwer on the relationship between blood pressure and weight, exercise, smoking and sodium intake. Other authors report no conflict of interest.
Funding for this study for this study is primarily provided by the Sheikh Khalifa Stroke Institute at Johns Hopkins University School of Medicine, and is funded by the National Center for Advancement of Translational Science through the National Institute of Diabetes and Kidney Diseases (R01DK128900), National Heart, Lung, and Brad Institute Grant (R0166473) Clinical Science Awards Program.
