Effect of Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure indices and urinary metabolites in children with overweight and obesity: an 8-week triple-blind randomized controlled trial.
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Abstract
Background: This study aimed to evaluate the effects of the Dietary Approaches to Stop Hypertension (DASH) diet on blood pressure (BP) indices and urinary metabolites in overweight and obese children over an 8-week period.
Methods: In this triple-blind randomized controlled trial, 60 children (8-12 years) were assigned to a DASH or control group for 8-week. Urinary sodium (UNa), potassium (UK), creatinine, UNa-UK ratio, systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), mid-BP (MBP), mean proportional arterial pressure (MPAP), and pulse pressure were measured before and after the intervention. Twenty-four-hour UNa excretion and salt intake were estimated using the INTERSALT equation. Outcomes were analyzed using analysis of variance on an intention-to-treat basis.
Results: The mean age and body mass index of participants were 11.8 ± 0.8 years (69% girls) and 25.9 ± 3.52 kg/m2, respectively. Fifty-eight children completed the study (29 per group). After 8-week, the DASH group showed significantly lower UNa (110 vs. 123 mmol/L), UNa-UK ratio (1.84 vs. 1.99 mmol/L), SBP (97.7 vs. 105 mmHg), DBP (68.9 vs. 64.6 mmHg), MBP (88.1 vs. 81.2 mmHg), MAP (81.6 vs. 75.6 mmHg), and MPAP (92.3 vs. 84.7 mmHg) compared with controls (P for all < 0.05). The mean change percent in UNa, UNa-UK ratio, SBP, MBP, MAP, and MPAP was significantly greater in the control group than in the DASH group (P for all < 0.05). Salt intake increased in the control group, but decreased in the DASH group (8.32 vs. -2.88 gr/day; P-value = 0.001).
Conclusions: The DASH diet improved BP indices and urinary metabolites in overweight and obese children, suggesting its potential as a non-pharmacological intervention for hypertension management in pediatric populations.
Trial registration: Iranian Registry of Clinical Trials Identifier: IRCT20240623062229N1.
背景：本研究旨在评估DASH饮食对超重和肥胖儿童8周内血压（BP）指数和尿代谢物的影响。方法：在这项三盲随机对照试验中，60名儿童（8-12岁）被分配到DASH组或对照组，为期8周。测量干预前后尿钠（UNa）、钾（UK）、肌酐、UNa-UK比值、收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、中BP （MBP）、平均动脉比例压（MPAP）、脉压。使用INTERSALT方程估计24小时UNa排泄和盐摄入量。使用意向治疗基础上的方差分析对结果进行分析。结果：参与者的平均年龄和体重指数分别为11.8±0.8岁（女生占69%）和25.9±3.52 kg/m2。58名儿童完成了这项研究（每组29名）。8周后，DASH组与对照组相比，UNa （110 vs. 123 mmol/L）、UNa- uk比值（1.84 vs. 1.99 mmol/L）、收缩压（97.7 vs. 105 mmHg）、舒张压（68.9 vs. 64.6 mmHg）、MBP （88.1 vs. 81.2 mmHg）、MAP （81.6 vs. 75.6 mmHg）和MPAP （92.3 vs. 84.7 mmHg）均显著降低（P均< 0.05）。对照组UNa、UNa- uk比值、SBP、MBP、MAP、MPAP的平均变化率均显著高于DASH组（P均< 0.05）。对照组的盐摄入量增加，而DASH组的盐摄入量减少（8.32克/天vs -2.88克/天，p值= 0.001）。结论：DASH饮食改善了超重和肥胖儿童的血压指数和尿代谢物，表明它有可能作为一种非药物干预措施用于儿科人群的高血压管理。试验注册：伊朗临床试验注册中心标识符：IRCT20240623062229N1。
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