Effects of the dietary approach to stop hypertension (DASH) diet on blood pressure, blood glucose, and lipid profile in adolescents with hemophilia: A randomized clinical trial

Abstract

Children with hemophilia are an enhanced risk of modifiable cardiovascular and metabolic abnormalities. There is currently no nutritional guideline to prevent or manage cardiometabolic risk factors in these patients. Therefore, the present study sought to investigate the effect of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiovascular and metabolic risk factors among children with hemophilia. In this parallel randomized clinical trial, 40 children (all male) with hemophilia were randomly allocated to the DASH group (n = 20) or control group (n = 20) for 10 weeks. The intervention group received the DASH diet (50%–55% of energy from carbohydrate, 27%–30% of energy from fat and 16%–18% energy from protein), and the control group received nutritional recommendations based on healthy eating practices. Systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), triglyceride (TG), total cholesterol (TC), low‐density lipoprotein (LDL), and high‐density lipoprotein (HDL) were measured at the beginning and end of the study. Serum vitamin C was measured as a biomarker of compliance with the DASH diet. Study was registered at IRCT.ir (IRCT20130903014551N6). A significant increase in serum vitamin C in the DASH diet group was observed compared to the control group (p = .001), indicating good compliance with the DASH diet. There was a significant reduction in SBP (−0.48 mmHg), DBP (−0.48 mmHg), FBS (−5.86 mg/dl), TC (−16.07 mg/dl), TG (−17.21 mg/dl), and LDL‐C (−9.79 mg/dl), and a significant increase in HDL‐C (3.39 mg/dl), in the DASH diet group compared with the control group. Adherence to the DASH diet in children with hemophilia yielded beneficial effects in blood pressure, lipid profiles, and FBS.

Dietary Models and Cardiovascular Risk Prevention in Pediatric Patients

“…Saneei et al demonstrated that DASH diet could prevent the rise in diastolic BP (DBP) but not in systolic BP (SBP); also, no significant changes in glucose and lipid profiles were evident [ 80 ]. Mahdavi et al analyzed the effect of DASH Diet in a group of adolescents with hemophilia, which is an important CVD risk factor [ 91 ]. In the intervention group, they found lower SBP, but no effect on DBP; fasting glucose level was improved in the intervention group as well [ 91 ].…”

“…Mahdavi et al analyzed the effect of DASH Diet in a group of adolescents with hemophilia, which is an important CVD risk factor [ 91 ]. In the intervention group, they found lower SBP, but no effect on DBP; fasting glucose level was improved in the intervention group as well [ 91 ]. These different results may be explained by the different adherence to the dietary interventions (lower in the first study, higher in the second one) and the duration of the trials (6 weeks in first study, 10 weeks in the second one).…”

Social epidemiology of the Mediterranean-dietary approaches to stop hypertension intervention for neurodegenerative delay (MIND) diet among early adolescents: the Adolescent Brain Cognitive Development Study

“…19 For youth with hemophilia, higher adherence to the DASH diet had beneficial effects on blood pressure and lipid profiles. 20 Adolescents with elevated blood pressure and hypertension also showed effective improvements in initial systolic blood pressure, longerterm endothelial function, and diet quality when following the DASH diet instead of routine care. 21 Additionally, the DASH diet was protective against gastroesophageal reflux disease.…”

Adherence to the Dietary Approaches to Stop Hypertension diet reduces the risk of diabetes mellitus: A systematic review and dose-response meta-analysis

“…For instance, the Dietary Approaches to Stop Hypertension (DASH) diet, originally developed for the management of high blood pressure, has been proposed to potentially lower the levels of blood glucose (13).The DASH diet, a well-established healthy dietary pattern, underscores high consumption of fruits, vegetables, whole grains, nuts and legumes, moderate consumption of low-fat dairy products, as well as low consumption of sodium,sweetened beverages and red and processed meats (14). At the same time, DASH diet has been shown as one of three healthy diets recommended in the 2020-2025 United States Dietary Guidelines for the public (15).…”