DASH Diet for High Blood Pressure

(DISH Trial)

Overseen By Carissa M Baker-Smith, MD MPH MS

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Nemours Children's Clinic

Disqualifiers: Inability to eat, Secondary hypertension

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests the effectiveness of the DASH diet, which emphasizes fruits and vegetables, in managing high blood pressure in teenagers. The study compares two groups: one receives the DASH diet delivered to their home, while the other receives standard nutrition advice. The trial aims to determine if the diet can better control blood pressure than usual care. Teenagers aged 12 to 17 with high blood pressure who can eat normally are invited to participate. As an unphased trial, it offers a unique opportunity for teenagers to potentially improve their health through dietary changes.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that the DASH diet is safe for managing high blood pressure in adolescents?

Research has shown that the DASH diet is safe and effective for managing high blood pressure. Studies have found that this diet can lower cholesterol, reduce saturated fats, and decrease blood pressure. It is often recommended as one of the best diets for heart health and controlling high blood pressure.

The DASH diet has undergone testing in many clinical trials, which have not reported any major side effects. This indicates that most people can follow the diet without problems. Additionally, large studies have found that adherence to the DASH diet is linked to a lower risk of heart-related issues, supporting its safety and long-term benefits for heart health.

In summary, the DASH diet is proven to be safe and effective, making it a good choice for those looking to manage high blood pressure. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the DASH diet approach for high blood pressure because it emphasizes a comprehensive dietary change rather than relying solely on medications like ACE inhibitors or beta-blockers. Unlike standard treatments, which often focus on reducing symptoms through medication, the DASH diet targets the root causes by promoting a nutrient-rich diet filled with fruits, vegetables, and low-fat dairy. This method has the potential to improve overall cardiovascular health and provide a sustainable, lifestyle-based solution. Additionally, it offers a non-pharmacological option, reducing the risk of medication-related side effects.

What evidence suggests that the DASH diet could be effective for high blood pressure?

Research has shown that the DASH diet can help lower blood pressure. One study found that people who followed the DASH diet and reduced salt intake saw their top blood pressure number drop by an average of 7.1 points. Other studies have found that the DASH diet also lowers cholesterol and unhealthy fats, aiding in high blood pressure control. In this trial, participants in the DASH diet toolkit arm will receive the DASH diet intervention, which has proven more effective than usual care in improving blood pressure both initially and over time. This diet emphasizes fruits, vegetables, and low-fat dairy foods, which benefit heart health. ^{2 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for adolescents with high blood pressure, who may also be experiencing food insecurity. Specific eligibility details are not provided, but typically participants would need to meet certain health criteria and not have conditions that could interfere with the study.

Inclusion Criteria

I have high blood pressure.

I am between 12 and 17 years old.

Exclusion Criteria

I cannot eat by mouth.

I have high blood pressure caused by another condition.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive DASH diet intervention or standard nutrition counseling

12 weeks

Follow-up

Participants are monitored for changes in blood pressure and dietary intake

6 months

What Are the Treatments Tested in This Trial?

Interventions

• DASH-FV

Trial Overview

The trial is testing a DASH diet intervention involving home delivery of produce compared to standard care. It's set up so one group gets the special diet and another just gets advice on nutrition without additional support.

How Is the Trial Designed?

Group I: DASH diet toolkit arm Active Control 1 Intervention

A group of participants receiving DASH diet intervention

Group II: STANDARD Placebo Group 1 Intervention

Nutrition counseling only as part of standard of care

Who Is Running the Clinical Trial?

Nemours Children's Clinic

Lead Sponsor

Trials

128

Recruited

18,000+

Published Research Related to This Trial

A 2-month intervention led by a nurse practitioner for 45 overweight and obese hypertensive patients resulted in significant improvements in diet and lifestyle, as measured by standardized questionnaires.

Participants experienced an average weight loss of 3.6 pounds, indicating that the DASH diet and lifestyle changes were effective in promoting better health outcomes in this high-risk group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supporting cardiovascular risk reduction in overweight and obese hypertensive patients through DASH diet and lifestyle education by primary care nurse practitioners. Jarl, J., Tolentino, JC., James, K., et al.[2021]

The Satter House Trial of Reduced Sodium Meals (SOTRUE) showed that a low sodium meal plan for 14 days in older adults led to a reduction in seated systolic blood pressure (SBP) from 123 to 112 mmHg, indicating potential benefits for blood pressure management.

While the low sodium diet did lower SBP by 4.8 mmHg compared to a typical sodium diet, the results were not statistically significant, suggesting that further research with a larger sample size and longer duration is necessary to confirm the efficacy and safety of low sodium meals in older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effects of a Low Sodium Meal Plan on Blood Pressure in Older Adults: The SOTRUE Randomized Feasibility Trial. Juraschek, SP., Millar, CL., Foley, A., et al.[2021]

The DASH diet, which emphasizes fruits, vegetables, and low-fat dairy, has been shown to effectively lower blood pressure in individuals with prehypertension and stage I hypertension, based on findings from the DASH trial.

While the DASH diet is generally safe for most patients, caution is advised for those with chronic kidney or liver diseases, and modifications may be needed for individuals with chronic heart failure, uncontrolled diabetes, lactose intolerance, or celiac disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Dietary Approaches to Stop Hypertension (DASH) eating pattern in special populations. Tyson, CC., Nwankwo, C., Lin, PH., et al.[2021]

The DASH diet is effective in lowering blood pressure, but studies show that compliance with the diet is often suboptimal, especially in educational interventions compared to controlled feeding trials.

There is no consensus on the best method to assess compliance with the DASH diet, highlighting the need for more effective strategies to maintain adherence beyond just dietary counseling.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Compliance with the Dietary Approaches to Stop Hypertension (DASH) diet: a systematic review. Kwan, MW., Wong, MC., Wang, HH., et al.[2023]

The OmniHeart study is a randomized crossover trial involving 160 adults with prehypertension or Stage 1 hypertension, designed to compare the effects of a carbohydrate-rich diet with diets high in protein or unsaturated fat on blood pressure and cholesterol levels.

The study aims to provide insights into how different macronutrient compositions can influence cardiovascular risk factors, potentially guiding dietary recommendations for better heart health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rationale and design of the Optimal Macro-Nutrient Intake Heart Trial to Prevent Heart Disease (OMNI-Heart). Carey, VJ., Bishop, L., Charleston, J., et al.[2017]

In a study of 412 adults with pre- or stage 1 hypertension, combining a low sodium diet with the DASH diet resulted in significant reductions in systolic blood pressure (SBP), especially in individuals with higher baseline SBP levels (≥150 mm Hg), where reductions reached up to -20.8 mm Hg.

Reducing sodium intake alone also lowered SBP across all baseline levels, indicating that both dietary interventions are effective in managing blood pressure, with the most pronounced effects observed in those with higher initial blood pressure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure. Juraschek, SP., Miller, ER., Weaver, CM., et al.[2022]

The HF-DASH diet, which substitutes full-fat for low-fat dairy and reduces sugar intake, effectively lowers blood pressure similarly to the standard DASH diet while also reducing triglycerides and VLDL particle concentrations.

While both the DASH and HF-DASH diets lowered blood pressure, only the standard DASH diet significantly reduced LDL cholesterol and other harmful lipoproteins compared to a control diet, suggesting that the HF-DASH diet may be a safer alternative without compromising blood pressure benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: a randomized controlled trial. Chiu, S., Bergeron, N., Williams, PT., et al.[2023]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10551663/

DASH Diet: A Review of Its Scientifically Proven Hypertension ...

Participants following the DASH diet with low sodium intake experienced an average systolic blood pressure reduction of 7.1 mmHg in those ...

2.

ncbi.nlm.nih.gov

ncbi.nlm.nih.gov/books/NBK482514/

DASH Diet To Stop Hypertension - StatPearls - NCBI Bookshelf

The diet has been tested in several clinical trials and has been shown to lower cholesterol, saturated fats, and blood pressure.

3.

ahajournals.org

ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16156

Dietary Approaches to Stop Hypertension ...

The DASH intervention proved more effective than routine care in initial systolic BP improvement and longer term improvement in endothelial function and diet ...

4.

sciencedirect.com

sciencedirect.com/science/article/pii/S2161831322000473

Dietary Approaches to Stop Hypertension (DASH) Diet and ...

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 ...

5.

nejm.org

nejm.org/doi/full/10.1056/NEJM199704173361601

A Clinical Trial of the Effects of Dietary Patterns on Blood ...

When compared with the fruits-and-vegetables diet, the combination diet reduced systolic blood pressure by 2.7 mm Hg more (P = 0.001) and ...

6.

nhlbi.nih.gov

nhlbi.nih.gov/education/dash-eating-plan

DASH Eating Plan | NHLBI, NIH

Blood Disorders and Blood Safety ... NIH-supported DASH diet named “Best Heart-Healthy Diet” and “Best Diet for High Blood Pressure” in 2025.

7.

jamanetwork.com

jamanetwork.com/journals/jama/fullarticle/2841256

DASH-Patterned Groceries and Effects on Blood Pressure

This randomized clinical trial investigates the effect of home-delivered Dietary Approaches to Stop Hypertension (DASH) low-sodium groceries ...

8.

ahajournals.org

ahajournals.org/doi/10.1161/JAHA.122.026684

Effects of the Dietary Approaches to Stop Hypertension ...

Several population‐based studies have shown that adherence to the DASH diet is associated with a lower risk of CVD events,,, which is likely ...

9.

nejm.org

nejm.org/doi/full/10.1056/NEJM200101043440101

Effects on Blood Pressure of Reduced Dietary Sodium and ...

The DASH diet was associated with a significantly lower systolic blood pressure at each sodium level; and the difference was greater with high sodium levels ...