Acceptability of Sodium-reduced Research Diets, Including the Dietary Approaches To Stop Hypertension Diet, Among Adults with Prehypertension and Stage 1 Hypertension

Overview

Journal J Am Diet Assoc

Publisher Elsevier

Specialty Nutritional Sciences

Date 2007 Sep 1

PMID 17761230

Citations 13

Authors

Njeri Karanja

Kristie J Lancaster

William M Vollmer

Pao-Hwa Lin

Marlene M Most

Jamy D Ard

Janis F Swain

Frank M Sacks

Eva Obarzanek

Affiliations

Soon will be listed here.

Abstract

Objective: Examine the acceptability of sodium-reduced research diets.

Design: Randomized crossover trial of three sodium levels for 30 days each among participants randomly assigned to one of two dietary patterns.

Participants/setting: Three hundred fifty-four adults with prehypertension or stage 1 hypertension who were participants in the Dietary Approaches to Stop Hypertension (DASH-Sodium) outpatient feeding trial.

Intervention: Participants received their assigned diet (control or DASH, rich in fruits, vegetables, and low-fat dairy products), each at three levels of sodium (higher, intermediate, and lower) corresponding to 3,500, 2,300, and 1,200 mg/day (150, 100, and 50 mmol/day) per 2,100 kcal.

Main Outcome Measures: Nine-item questionnaire on liking and willingness to continue the assigned diet and its level of saltiness using a nine-point scale, ranging from one to nine.

Statistical Analyses Performed: Generalized estimating equations to test participant ratings as a function of sodium level and diet while adjusting for site, feeding cohort, carryover effects, and ratings during run-in.

Results: Overall, participants rated the saltiness of the intermediate level sodium as most acceptable (DASH group: 5.5 for intermediate vs 4.5 and 4.4 for higher and lower sodium; control group: 5.7 for intermediate vs 4.9 and 4.7 for higher and lower sodium) and rated liking and willing to continue the DASH diet more than the control diet by about one point (ratings range from 5.6 to 6.6 for DASH diet and 5.2 to 6.1 for control diet). Small race differences were observed in sodium and diet acceptability.

Conclusions: Both the intermediate and lower sodium levels of each diet are at least as acceptable as the higher sodium level in persons with or at risk for hypertension.

Citing Articles

Economic and Cultural Assessment of the DASH Eating Plan for Low-Income African Americans: An Integrative Review.

White B, OoNorasak K, Sesay N, Haskins D, Robinson C Int J Environ Res Public Health. 2024; 21(11).

PMID: 39595747 PMC: 11594161. DOI: 10.3390/ijerph21111480.

Feasibility of Low-Sodium, High-Potassium Processed Foods and Their Effect on Blood Pressure in Free-Living Japanese Men: A Randomized, Double-Blind Controlled Trial.

Umeki Y, Hayabuchi H, Adachi H, Ohta M Nutrients. 2021; 13(10).

PMID: 34684498 PMC: 8540744. DOI: 10.3390/nu13103497.

The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study.

Rai S, Fung T, Lu N, Keller S, Curhan G, Choi H BMJ. 2017; 357:j1794.

PMID: 28487277 PMC: 5423545. DOI: 10.1136/bmj.j1794.

Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet and Sodium Intake on Serum Uric Acid.

Juraschek S, Gelber A, Choi H, Appel L, Miller 3rd E Arthritis Rheumatol. 2016; 68(12):3002-3009.

PMID: 27523583 PMC: 5363397. DOI: 10.1002/art.39813.

Salt reduction and hypertension in China: a concise state-of-the-art review.

Liu Y, Li H, Hong S, Yin X Cardiovasc Diagn Ther. 2015; 5(3):191-6.

PMID: 26090330 PMC: 4451313. DOI: 10.3978/j.issn.2223-3652.2015.05.01.

References

Svetkey L, Sacks F, Obarzanek E, Vollmer W, Appel L, Lin P . The DASH Diet, Sodium Intake and Blood Pressure Trial (DASH-sodium): rationale and design. DASH-Sodium Collaborative Research Group. J Am Diet Assoc. 1999; 99(8 Suppl):S96-104. DOI: 10.1016/s0002-8223(99)00423-x. View

Campbell M, Demark-Wahnefried W, Symons M, Kalsbeek W, Dodds J, Cowan A . Fruit and vegetable consumption and prevention of cancer: the Black Churches United for Better Health project. Am J Public Health. 1999; 89(9):1390-6. PMC: 1508774. DOI: 10.2105/ajph.89.9.1390. View

Kumanyika S, Cook N, Cutler J, Belden L, Brewer A, Cohen J . Sodium reduction for hypertension prevention in overweight adults: further results from the Trials of Hypertension Prevention Phase II. J Hum Hypertens. 2004; 19(1):33-45. DOI: 10.1038/sj.jhh.1001774. View

Lichtenstein A, Appel L, Brands M, Carnethon M, Daniels S, Franch H . Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006; 114(1):82-96. DOI: 10.1161/CIRCULATIONAHA.106.176158. View

Appel L . Salt reduction in the United States. BMJ. 2006; 333(7568):561-2. PMC: 1569959. DOI: 10.1136/bmj.38971.635799.AB. View

Funk K, Elmer P, Stevens V, Harsha D, Craddick S, Lin P . PREMIER--a trial of lifestyle interventions for blood pressure control: intervention design and rationale. Health Promot Pract. 2006; 9(3):271-80. DOI: 10.1177/1524839906289035. View

Korhonen M, Litmanen H, Rauramaa R, Vaisanen S, Niskanen L, Uusitupa M . Adherence to the salt restriction diet among people with mildly elevated blood pressure. Eur J Clin Nutr. 1999; 53(11):880-5. DOI: 10.1038/sj.ejcn.1600869. View

Sacks F, Svetkey L, Vollmer W, Appel L, Bray G, Harsha D . Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001; 344(1):3-10. DOI: 10.1056/NEJM200101043440101. View

Resnicow K, Jackson A, Wang T, De A, McCarty F, Dudley W . A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: results of the Eat for Life trial. Am J Public Health. 2001; 91(10):1686-93. PMC: 1446855. DOI: 10.2105/ajph.91.10.1686. View

10.

Vollmer W, Sacks F, Ard J, Appel L, Bray G, Simons-Morton D . Effects of diet and sodium intake on blood pressure: subgroup analysis of the DASH-sodium trial. Ann Intern Med. 2001; 135(12):1019-28. DOI: 10.7326/0003-4819-135-12-200112180-00005. View

11.

Hooper L, Bartlett C, Davey Smith G, Ebrahim S . Systematic review of long term effects of advice to reduce dietary salt in adults. BMJ. 2002; 325(7365):628. PMC: 126303. DOI: 10.1136/bmj.325.7365.628. View

12.

Lin P, Aickin M, Champagne C, Craddick S, Sacks F, McCarron P . Food group sources of nutrients in the dietary patterns of the DASH-Sodium trial. J Am Diet Assoc. 2003; 103(4):488-96. DOI: 10.1053/jada.2003.50065. View

13.

Appel L, Champagne C, Harsha D, Cooper L, Obarzanek E, Elmer P . Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA. 2003; 289(16):2083-93. DOI: 10.1001/jama.289.16.2083. View

14.

Most M, Craddick S, Crawford S, Redican S, Rhodes D, Rukenbrod F . Dietary quality assurance processes of the DASH-Sodium controlled diet study. J Am Diet Assoc. 2003; 103(10):1339-46. DOI: 10.1016/s0002-8223(03)01080-0. View

15.

Chobanian A, Bakris G, Black H, Cushman W, Green L, Izzo Jr J . Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42(6):1206-52. DOI: 10.1161/01.HYP.0000107251.49515.c2. View

16.

Havas S, Roccella E, Lenfant C . Reducing the public health burden from elevated blood pressure levels in the United States by lowering intake of dietary sodium. Am J Public Health. 2004; 94(1):19-22. PMC: 1449816. DOI: 10.2105/ajph.94.1.19. View

17.

He F, Macgregor G . Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev. 2004; (3):CD004937. DOI: 10.1002/14651858.CD004937. View

18.

Bertino M, Beauchamp G, Engelman K . Long-term reduction in dietary sodium alters the taste of salt. Am J Clin Nutr. 1982; 36(6):1134-44. DOI: 10.1093/ajcn/36.6.1134. View

19.

Jeffery R, Pirie P, Elmer P, Mullenbach V, Kurth C, Johnson S . Low-sodium, high-potassium diet: feasibility and acceptability in a normotensive population. Am J Public Health. 1984; 74(5):492-4. PMC: 1651627. DOI: 10.2105/ajph.74.5.492. View

20.

DiNicolantonio R, Teow B, Morgan T . Sodium detection threshold and preference for sodium chloride in humans on high and low sodium diets. Clin Exp Pharmacol Physiol. 1984; 11(4):335-8. DOI: 10.1111/j.1440-1681.1984.tb00273.x. View