title: Effects of the dietary approaches to stop hypertension diet alone and in combination with exercise and caloric restriction on insulin sensitivity and lipids.
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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3119, Durham, NC 27710, USA. Blume003@mc.duke.edu
authors.forename: James A
authors.initials: JA
authors.lastname: Blumenthal
authors.forename: Michael A
authors.initials: MA
authors.lastname: Babyak
authors.forename: Andrew
authors.initials: A
authors.lastname: Sherwood
authors.forename: Linda
authors.initials: L
authors.lastname: Craighead
authors.forename: Pao-Hwa
authors.initials: PH
authors.lastname: Lin
authors.forename: Julie
authors.initials: J
authors.lastname: Johnson
authors.forename: Lana L
authors.initials: LL
authors.lastname: Watkins
authors.forename: Jenny T
authors.initials: JT
authors.lastname: Wang
authors.forename: Cynthia
authors.initials: C
authors.lastname: Kuhn
authors.forename: Mark
authors.initials: M
authors.lastname: Feinglos
authors.forename: Alan
authors.initials: A
authors.lastname: Hinderliter
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D015992:Body Mass Index; D031204:Caloric Restriction; D003131:Combined Modality Therapy; D004032:Diet; D004522:Educational Status; D015444:Exercise / Q000502:physiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D007328:Insulin / Q000097:blood*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D050177:Overweight / Q000097:blood / Q000150:complications / Q000178:diet therapy*
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids