Effects of the Dietary Approaches to Stop Hypertension Diet Alone and in Combination With Exercise and Caloric Restriction on Insulin Sensitivity and Lipids

• Type of Material: Article
• Authors: James A. Blumenthal, Duke University; Michael A. Babyak, Duke University; Andrew Sherwood, Duke University; Linda Craighead, Emory University; Pao-Hwa Lin, Duke University; Julie Johnson, Duke University; Lana L. Watkins, Duke University; Jenny T. Wang, Duke University; Cynthia Kuhn, Duke University; Mark Feinglos, Duke University; Alan Hinderliter, University of North Carolina
• Language: English
• Date: 2010-05-01
• Publisher: American Heart Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010 American Heart Association. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.149153
• Title of Journal or Parent Work: Hypertension
• ISSN: 0194-911X
• Volume: 55
• Issue: 5
• Start Page: 1199
• End Page: 1205
• Grant/Funding Information: This publication was made possible by Grant Number 5UL1RR024128-03 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH); and NIH Roadmap for Medical Research.; Supported by grants from the National Heart, Lung, and Blood Institute (HL074103) and the General Clinical Research Center, National Institutes of Health (M01-RR-30).
• Keywords: hypertension; CARDIOVASCULAR RISK-FACTORS; WEIGHT-LOSS; insulin resistance; RESISTANCE; Science & Technology; exercise; Peripheral Vascular Disease; LOW-FAT DIET; Cardiovascular System & Cardiology; RANDOMIZED-TRIAL; LOW-CARBOHYDRATE-DIET; Life Sciences & Biomedicine; lipids; GLUCOSE-TOLERANCE; BLOOD-PRESSURE; LIFE-STYLE MODIFICATION; BODY-COMPOSITION; diet
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Nutrition; Psychology, Behavioral

Abstract

This study examined the effects of the Dietary Approaches to Stop Hypertension (DASH) diet on insulin sensitivity and lipids. In a randomized control trial, 144 overweight (body mass index: 25 to 40) men (n=47) and women (n=97) with high blood pressure (130 to 159/85 to 99 mm Hg) were randomly assigned to one of the following groups: (1) DASH diet alone; (2) DASH diet with aerobic exercise and caloric restriction; or (3) usual diet controls (UC). Body composition, fitness, insulin sensitivity, and fasting lipids were measured before and after 4 months of treatment. Insulin sensitivity was estimated on the basis of glucose and insulin levels in the fasting state and after an oral glucose load. Participants in the DASH diet with aerobic exercise and caloric restriction condition lost weight (-8.7 kg [95% CI:-2.0 to-9.7 kg]) and exhibited a significant increase in aerobic capacity, whereas the DASH diet alone and UC participants maintained their weight (-0.3 kg [95% CI:-1.2 to 0.5 kg] and +0.9 kg [95% CI: 0.0 to 1.7 kg], respectively) and had no improvement in exercise capacity. DASH diet with aerobic exercise and caloric restriction demonstrated lower glucose levels after the oral glucose load, improved insulin sensitivity, and lower total cholesterol and triglycerides compared with both DASH diet alone and UC, as well as lower fasting glucose and low-density lipoprotein cholesterol compared with UC. DASH diet alone participants generally did not differ from UC in these measures. Combining the DASH diet with exercise and weight loss resulted in significant improvements in insulin sensitivity and lipids. Despite clinically significant reductions in blood pressure, the DASH diet alone, without caloric restriction or exercise, resulted in minimal improvements in insulin sensitivity or lipids.