Suboptimal nutritional intake for hypertension control in 4 ethnic groups.
BACKGROUND
This study compared intake of specific nutrients based on the Dietary Approaches to Stop Hypertension (DASH) guidelines for hypertension management among multiethnic middle-aged and older adults.


METHODS
We conducted quantitative analysis using baseline data of a prospective cohort study of 5972 adults aged 45 to 84 years recruited between July 2000 and August 2002 who participated in the Multi-Ethnic Study of Atherosclerosis (MESA). Diet information was collected using a 120-item food frequency questionnaire. Bivariate and multivariate methods were used to evaluate associations between DASH-accordant intake of each nutrient (fat, saturated fat, cholesterol, protein, fiber, calcium, magnesium, and potassium) with ethnicity and hypertension status.


RESULTS
Less than 30% of MESA participants met any DASH nutrient target. DASH accordance was lowest in saturated fat intake and highest in cholesterol intake (5.3% and 29.5% of the participants, respectively). Multivariate analyses showed significant ethnic differences in DASH accordance in all nutrients but saturated fat. Compared with white participants, Chinese American participants had greater DASH accordance in cholesterol (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.13-1.67) and protein intake (2.32; 1.55-3.49) but less in total fat (0.47; 0.30-0.74), magnesium (0.58; 0.51-0.67), and potassium intake (0.40; 0.20-0.81); African Americans and Hispanics had greater DASH accordance in fiber intake (1.36; 1.13-1.62; and 2.23; 1.53-3.23, respectively) but less in calcium intake (0.44; 0.37-0.52; and 0.79; 0.68-0.91, respectively). Diagnosed and uncontrolled hypertension was associated with less DASH accordance in saturated fat (OR, 0.80; 95% CI, 0.70-0.91) and magnesium (0.80; 0.71-0.91). DASH accordance differed significantly with and without inclusion of dietary supplements in the analysis.


CONCLUSIONS
There is significant variation in DASH goal attainment among different ethnic groups. Assessments of nutrient intake that exclude dietary supplements may be underestimating DASH accordance.
Gao
Sue K
SK
Amgen Inc, 1 Amgen Center Dr, MS28-3A, Thousand Oaks, CA 91320-1799, USA. sgao@amgen.com
Fitzpatrick
Annette L
AL
Psaty
Bruce
B
Jiang
Rui
R
Post
Wendy
W
Cutler
Jeffrey
J
Maciejewski
Matthew L
ML
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D017408:Guidelines as Topic; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000208:ethnology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D009751:Nutritional Requirements; D010349:Patient Compliance / Q000208:ethnology*; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D014481:United States