The Dietary Approaches to Stop Hypertension (DASH) diet is recognized as an effective dietary intervention to reduce blood pressure (BP). However, among randomized controlled trials (RCTs) investigating the DASH diet–mediated BP reduction, there are significant methodological and clinical differences. The purpose of this study was to comprehensively assess the DASH diet effect on BP in adults with and without hypertension, accounting for underlying methodological and clinical confounders. We systematically searched Medline and the Cochrane Collaboration Library databases and identified 30 RCTs (n = 5545 participants) that investigated the BP effects of the DASH diet compared with a control diet in hypertensive and nonhypertensive adults. Both random-effects and fixed-effect models were used to calculate the mean attained systolic BP (SBP) and diastolic BP (DBP) differences during follow-up. Subgroup and meta-regression analyses were also conducted. Compared with a control diet, the DASH diet reduced both SBP and DBP (difference in means: −3.2 mm Hg; 95% CI: −4.2, −2.3 mm Hg; P < 0.001, and −2.5 mm Hg; 95% CI: −3.5, −1.5 mm Hg; P < 0.001, respectively). Hypertension status did not modify the effect on BP reduction. The DASH diet compared with a control diet reduced SBP levels to a higher extent in trials with sodium intake >2400 mg/d than in trials with sodium intake ≤2400 mg/d, whereas both SBP and DBP were reduced more in trials with mean age <50 y than in trials of older participants. The quality of evidence was rated as moderate for both outcomes according to the Grading of Recommendations, Assessment, Development, and Evaluation approach. The adoption of the DASH diet was accompanied by significant BP reduction in adults with and without hypertension, although higher daily sodium intake and younger age enhanced the BP-lowering effect of the intervention. This meta-analysis was registered at www.crd.york.ac.uk/prospero as CRD42019128120.

In essential hypertension, pronounced low-grade inflammation in conjunction with hypoadiponectinaemia exerts an additive detrimental effect on aortic stiffness, accelerating the vascular ageing process.

The data regarding the role of serum uric acid (SUA) along with subclinical inflammation in the context of hypertensive vascular damage are rather scarce and controversial. Towards this end, we assess the links between SUA, high-sensitivity CRP (hs-CRP), adiponectin and carotid to femoral pulse wave velocity (c-f PWV) in 292 subjects with never-treated stage I-II essential hypertension. On the basis of the median SUA levels (0.31 mmol l À1 ), the study population was divided into subjects with low (n ¼ 149) and high (n ¼ 143) SUA values. By multiple regression analysis, it was revealed that SUA was independently associated with log hs-CRP (R 2 ¼ 0.098; P ¼ 0.02), log adiponectin (R 2 ¼ 0.102; P ¼ 0.03), waist circumference (R 2 ¼ 0.049; P ¼ 0.04), 24-h systolic blood pressure (SBP) (R 2 ¼ 0.179; P ¼ 0.001) and estimated glomerular filtration rate (R 2 ¼ 0.156; b (s.e.) ¼ À0.169 (0.023); P ¼ 0.02). In addition, c-f PWV was independently associated with age (R 2 ¼ 0.116; Po0.0001), waist circumference (R 2 ¼ 0.088; Po0.0001), 24-h SBP (R 2 ¼ 0.167; P ¼ 0.001), log adiponectin (R 2 ¼ 0.07; P ¼ 0.006) and log hs-CRP (R 2 ¼ 0.06; P ¼ 0.034). In conclusion, SUA levels are independently associated with hs-CRP and adiponectin levels but not with c-f PWV in essential hypertensive patients. Increased SUA levels are accompanied by a state of pronounced inflammatory activation and hypoadiponectinemia that significantly impairs the arterial stiffness accelerating the vascular ageing process in this setting.

Objective: To evaluate whether consumption of breakfast cereals is associated with BMI in a sample of Greek adolescents. Design: A cross-sectional health and nutrition survey. Setting and subjects: During 2004-5, 2008 schoolchildren aged 12-17 years were selected from twelve schools located in Vyronas region (Athens metropolitan area). Height and weight were measured and BMI was calculated. A semiquantitative FFQ was applied and multiple logistic regression analysis was used. Results: Overall, 4?7 % of boys and 1?7 % of girls were obese, whereas 19?4 % of boys and 13?2 % of girls were overweight. Only 20?7 % of boys and 15?5 % of girls reported that they consume cereals as a first choice for breakfast. Consumption of breakfast cereals was associated with lower BMI in boys (P 5 0?08) and girls (P 5 0?019), irrespective of age and physical activity status. More prominent results were observed for daily cereal consumption or for more than two daily servings of cereals consumed for breakfast. Consumption of pre-sweetened breakfast cereals was associated with lower BMI compared with non-pre-sweetened or no intake of cereals, in both genders (P , 0?001). Consumption of breakfast cereals was associated with 33 % (95 % CI 14 %, 48 %) lower likelihood of overweight/obesity, irrespective of age, sex and physical activity status. Conclusions: Consumption of breakfast cereals was associated with lower BMI levels and a lower likelihood of overweight/obesity in both genders; thus a solid basis for public health professionals could be built when issuing advice on weight management.

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