Dietary Patterns, Sodium Reduction, and Blood Pressure in Type 2 Diabetes: The DASH4D Randomized Clinical Trial

Area of Science:

• Cardiovascular Health
• Metabolic Disorders
• Nutritional Science

Background:

• Individuals with type 2 diabetes and hypertension face elevated risks for cardiovascular events.
• Limited research exists on dietary interventions, beyond weight loss, for blood pressure management in this demographic.

Purpose of the Study:

• To investigate the impact of specific dietary patterns and sodium reduction on blood pressure levels in adults diagnosed with type 2 diabetes.
• To evaluate the efficacy of the Dietary Approaches to Stop Hypertension for Diabetes (DASH4D) diet in conjunction with sodium modification.

Main Methods:

• A randomized 4-period crossover feeding study (DASH4D) involving adults with type 2 diabetes and elevated blood pressure.
• Participants consumed four diets for 5 weeks each: DASH4D with low sodium, DASH4D with high sodium, a typical US diet with low sodium, and a typical US diet with high sodium.
• Weight was maintained constant, and all food was provided to participants.

Main Results:

• The DASH4D diet with lower sodium demonstrated a significant reduction in systolic blood pressure by 4.6 mm Hg and diastolic blood pressure by 2.3 mm Hg compared to the high-sodium typical US diet.
• Blood pressure reductions were observed within the initial 3 weeks of each dietary period.
• The impact of sodium reduction on blood pressure was more pronounced than the effect of the DASH4D diet itself.

Conclusions:

• The DASH4D diet, particularly when combined with sodium reduction, effectively lowers blood pressure in adults with type 2 diabetes, many of whom are on multiple antihypertensive medications.
• Sodium reduction emerged as the key factor in achieving clinically relevant blood pressure improvements in this population.