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DASH Diet Improves Insulin Sensitivity as Well as Hypertension

Posted: Friday, February 13, 2004

"As the DASH (Dietary Approaches to Stop Hypertension)dietary pattern is implemented as a routine part of nonpharmacologic management of hypertension, it will be important to know the effects on insulin action of a comprehensive behavioral program that includes the DASH dietary pattern," write Jamy D. Ard, MD, from Duke University Medical Center in Durham, North Carolina, and colleagues. "If the addition of the DASH dietary pattern adds to a lifestyle intervention (i.e., weight loss, moderate sodium reduction, and increased physical activity) by increasing insulin sensitivity, such a finding would provide added evidence for the need to recommend the DASH dietary pattern as part of a comprehensive lifestyle intervention for treatment of hypertension and overall cardiovascular risk reduction."

In this ancillary study of PREMIER, 52 subjects were randomized to one of three nonpharmacologic interventions for hypertension. Group A received advice only; the group B intervention included weight loss, reduced sodium intake, increased physical activity, and moderate alcohol intake; and group C received all interventions of group B as well as the DASH dietary pattern. This diet is high in fruits, vegetables, and low-fat dairy products but lower in total fat, saturated fat, and cholesterol. It is replete with nutrients associated with improved insulin sensitivity, including magnesium, calcium, and protein.

Groups B and C had similar decreases in total calories, percentage of calories from fat, and sodium intake, and similar amounts of energy expenditure and weight loss. As expected from the DASH diet, group C had increased intake of protein, potassium, calcium, and magnesium. Compared with the other groups, group C had a significant improvement in insulin sensitivity, from 1.96 to 2.95 (P = .047). Although group B also had a significant decrease in fasting insulin and glucose levels, the changes in insulin sensitivity were not statistically different from those in control subjects.

Study limitations include insufficient power to determine the importance of the change in insulin sensitivity in group B, and the use of two nonconsecutive dietary recalls to estimate nutrient intake.

"Based on the results of this study, including the DASH dietary pattern as a basic part of a hypocaloric dietary plan can lead to significant improvements of up to 50% in insulin sensitivity," the authors write. "This combination of foods and nutrients may have an effect on a variety of different cellular targets that ultimately promotes changes in body composition during weight loss, resulting in a favorable impact on insulin action."

Source: Diabetes In Control