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The DASH Diet in treating Hypertension & Type 2 Diabetes


The DASH Diet in treating Hypertension & Type 2 Diabetes Kathleen T. Morgan Chair, Family & Community Health Sciences Special Thanks to Colorado State Univ and ... – PowerPoint PPT presentation

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Title: The DASH Diet in treating Hypertension & Type 2 Diabetes

The DASH Diet in treating Hypertension Type 2
  • Kathleen T. Morgan
  • Chair, Family Community Health Sciences
  • Special Thanks to Colorado State Univ and Western
    Dairy Council

Hypertension Type 2 Diabetes
  • 72 million people in the US age 20 and older have
    high blood pressure
  • 20.8 million 7 of the US population have
  • 13.3 of all non-Hispanic blacks aged 20 and
    older have diabetes
  • After adjusting for population age differences,
    Mexican Americans, the largest Hispanic/Latino
    subgroup, are 1.7 times as likely to have
    diabetes as non-Hispanic whites.

Hypertension Type 2 Diabetes
  • The prevalence of hypertension is about twice as
    high among patients diagnosed with type 2
    diabetes as it is among patients without diabetes
  • The current obesity epidemic contributes to
    hypertension and type 2 diabetes
  • Losing as little as 10 pounds can contribute to
    reducing hypertension and improving glucose

Diabetes HTN Disparities
  • African American men develop diabetes and high
    blood pressure earlier in life than other men and
    are more likely to suffer serious side-effects
    from these diseases
  • Within the African-American community, those with
    the highest rates of hypertension, are likely to
    be middle aged or older, less educated,
    overweight or obese, physically inactive and to
    have diabetes

Diabetes HTN Disparities
  • Remediable factors
  • Worse access to high-quality healthcare
  • Socioeconomic barriers to buying healthy food and
    necessary medications
  • Lack of culturally appropriate care

Dietary Approaches to High Blood Pressure
  • DASH Diet
  • Dietary Approaches to Stop Hypertension
  • Promotes fruits, vegetables, whole grains and low
    fat dairy products
  • Adequate Calcium, Potassium, Magnesium
  • Low in red meat, sweets and sugar beverages

Hypertension Prevalence
  • 50 million hypertensive US adults
  • One-third of people are unaware
  • Less than half of American adults have optimal
    blood pressure
  • Increases in prevalence and severity in African

Blood Pressure Categories - Adults
Untreated Hypertension
  • Target Organ Damage Includes
  • Hypertensive heart disease
  • Cerebrovascular disease
  • Renal disease
  • Large vessel disease

Public Health Challenge of Hypertension
  • Prevent BP rise with age
  • Decrease existing prevalence
  • Healthy People 2010 goal 16
  • Increase awareness and detection
  • Has no symptoms, called the silent killer
  • Improve control
  • Reduce cardiovascular risks
  • Increase recognition of importance of controlling
    systolic hypertension

National High Blood Pressure Education Program
  • Updated Recommendations to Prevent Hypertension
  • Maintain normal body weight for adults
  • BMI 18.5-24.9 kg/m2
  • Reduce sodium intake to no more than 100 mmol/day
  • Regular physical activity at least 30 minutes
    most days of the week
  • Limit alcohol consumption
  • Maintain adequate potassium intake
  • Consume a diet rich in fruits, vegetables and
    low-fat dairy products
  • Reduce saturated fat and total fat in diet
  • JAMA, Oct 16, 2002

Mineral Intake and Hypertension
  • Calcium
  • American Heart Association Statement
  • Increasing calcium intake may preferentially
    lower blood pressure in salt-sensitive people
  • Benefits more evident with low initial calcium
  • (300-600 mg/day)

Mineral Intake and Hypertension
  • Potassium
  • Clinical trials and meta-analyses indicate
    potassium (K) supplementation lowers BP
  • Adequate K intake, preferably from food sources,
    should be maintained
  • Evidence is strong enough to support a health
    claim on high potassium foods

Mineral Intake and Hypertension
  • Magnesium
  • Evidence suggests an association between lower
    dietary magnesium intake and high blood pressure
  • Not enough evidence exists to justify a
    recommendation of increased Mg intake

DASH is Unique
  • Tested dietary patterns rather than single
  • Experimental diets used common foods that can be
    incorporated into recommendations for the public
  • Investigators planned the DASH diet to be fully
    compatible with dietary recommendations for
    reducing risk of CVD, osteoporosis and cancer

DASH Reduces Homocysteine Levels
  • Effect a result of diet high in vitamin B-rich
    milk and milk products, fruits and vegetables
  • Lowering homocysteine with DASH may reduce CVD
    risk an additional 7-9
  • -Appel, et al. Circulation, 102852, 2000

DASH Diet Patternbased on a 2,000 calorie diet
  • Food Group Servings
  • Grains 7-8
  • Vegetables 4-5
  • Fruits 4-5
  • Low-fat or fat free dairy 2-3
  • Meats, poultry, fish less than 2
  • Nuts, seeds, dry beans and peas 4-5/week
  • Fats and oils 2-3
  • Sweets 5/ week

DASH Dietary Recommendations
  • DASH meets multiple dietary recommendations
  • AHA
  • USDA/DHHS Dietary Guidelines
  • NCI and AICR
  • Surgeon General Recommendations

Dietary recommendations includesTherapeutic
Lifestyle Changes (TLC)
  • Saturated fat ??7 of total calories
  • Cholesterol lt 200 mg/day
  • Weight reduction
  • Increased physical activity
  • Viscous (soluble) fiber 10-25 g/day
  • Plant stanols/sterols 2 g/day

Take Time for Some TLC
  • Choose foods low in saturated fat
  • Whole grains
  • Fruits
  • Vegetables
  • Fat free or 1 dairy products
  • Lean meats, fish, skinless poultry
  • Dried peas/beans

Take Time for Some TLC (cont)
  • Choose foods low in cholesterol
  • Plant-based foods
  • Grains
  • Fruits
  • Vegetables
  • Dried beans

Easily implemented suggestions
  • Make connections between dietary practices and
    health concerns very concrete, address options
    for reducing sodium
  • De-emphasize the low-income designation of the
    audience for whom the program is intended
  • Encourage participants to attend classes in
    teams to support each other
  • Emphasize food demonstrations
  • Encourage participants to visit supermarkets,
    read labels or conduct an informal survey of
    friends or family

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Rutgers Cooperative Extension Programs
  • Encourage participation in Rutgers Essex Countys
    Cooperative Extensions
  • Food Stamp Nutrition Education Program (FSNEP)
  • Expanded Food and Nutrition Education Program
  • Thank you