Association of Dietary Approaches to Stop Hypertension diet and Mediterranean diet with blood pressure in less-developed ethnic minority regions

Objective: We aimed to investigate the association of Dietary Approaches to Stop Hypertension (DASH)-style diet and Mediterranean-style diet with blood pressure in less-developed ethnic minority regions (LMERs). Design: Cross-sectional study. Setting: Dietary intakes were assessed by a validated food frequency questionnaire. Dietary quality was assessed by the DASH-style diet score and the alternative Mediterranean-style diet (aMED) score. The association between dietary quality and blood pressure was evaluated using multivariate linear regression model. We further examined those associations in subgroups of blood pressure level. Participants: A total of 81433 adults from the China Multi-Ethnic Cohort (CMEC) study were included in this study. Results: In the overall population, compared with the lowest quintile, the highest quintile of DASH-style diet score was negatively associated with systolic BP (coefficient: −2.78, 95% CI: −3.15 to −2.41; P-trend<0.001), while the highest quintile of aMED score had a weaker negative association with systolic BP (coefficient: −1.43, 95% CI: −1.81 to −1.05; P-trend<0.001). Both dietary indices also showed a weaker effect on diastolic BP (coefficient for DASH-style diet: −1.06, 95% CI: −1.30 to −0.82; coefficient for aMED: −0.43, 95% CI: −0.68 to −0.19). In the subgroup analysis, both dietary indices showed a stronger beneficial effect on systolic BP in the hypertension group than in either of the other subgroups. Conclusion: Our results indicated that the healthy diet originating from Western developed countries can also have beneficial effects on blood pressure in LEMRs. DASH-style diet may be a more appropriate recommendation than aMED as part of a dietary strategy to control blood pressure, especially in hypertensive patients.

Dietary Approaches to Stop Hypertension (DASH) diet, Mediterranean diet and blood lipid profiles in less-developed ethnic minority regions

Different from developed countries, there is a paucity of research examining how the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets relate to lipids in in less-developed ethnic minority regions (LEMRs). A total of 83,081 participants from seven ethnic groups were retrieved from the baseline data of the China Multi-Ethnic Cohort (CMEC) study, which was conducted in less-developed Southwest China between May 2018 and September 2019. Multivariable linear regression models were then used to examine the associations of the DASH and AMED scores, assessed by modified DASH score and alternative Mediterranean diet (AMED), as well as their components with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and TC/HDL-C. The DASH scores were negatively associated with TC, HDL-C and TG. Comparing the highest quintiles with the lowest DASH scores, TC decreased 0.0708 (95% CI: −0.0923 ∼ −0.0493) mmol/L, HDL-C decreased 0.0380 (95% CI: −0.0462 ∼ −0.0299) mmol/L, and TG decreased 0.0668 (95% CI: −0.0994 ∼ −0.0341) mmol/L. The AMED scores were negatively associated with TC, LDL-C and HDL-C. Comparing the highest quintiles with the lowest AMED scores, TC decreased 0.0816 (95% CI: −0.1035 ∼ −0.0597) mmol/L, LDL-C decreased 0.0297 (95% CI: −0.0477 ∼ −0.0118) mmol/L, and HDL-C decreased 0.0275 (95% CI: −0.0358 ∼ −0.0192) mmol/L. Although both the DASH diet and the Mediterranean diet were negatively associated with blood lipids, those associations showed different patterns in LEMRs, particularly for TG and HDL-C.