59 healthy, omnivorous subjects aged 25-63 years were randomly allocated to a control group, which ate an omnivorous diet for 14 weeks, or to one of two experimental groups, whose members ate an omnivorous diet for the first 2 weeks and a lacto-ovo-vegetarian diet for one of two 6-week experimental periods. Mean systolic and diastolic blood pressures did not change in the control group but fell significantly in both experimental groups during the vegetarian diet and rose significantly in the experimental group which reverted to the omnivorous diet. Adjustment of the blood-pressure changes for age, obesity, heart rate, weight change, and blood pressure before dietary change indicated a diet-related fall of some 5-6 mm Hg systolic and 2-3 mm Hg diastolic. Although the nutrient(s) causing these blood-pressure changes are unknown, the effects were apparently not mediated by changes in sodium or potassium intake.
"Evidence for these relationships has been accumulated over the last years from several lines: clinical trials, cohort studies, as well as cross-sectional studies. That plant-based dietary patterns have favourable effects on blood pressure has been convincingly demonstrated by the Dietary Approaches to Stop Hypertension (DASH) trial (Appel et al. 1997), trials on vegetarian diets (Rouse et al. 1983; Margetts et al. 1986), and a prospective cohort (Schulze et al. 2003b). Furthermore, in a recent trial over a 2-year period among men and women with the metabolic syndrome, increased consumption of fruit, vegetables, walnuts, whole grains, and olive oil significantly reduced concentrations of C-reactive protein (CRP), IL-6, IL-7, and IL-18, reduced insulin resistance, as well as improved endothelial function compared with the control group which consumed an otherwise healthy diet (,30 % fat, , 10 % saturated fat; Esposito et al. 2004). "
[Show abstract][Hide abstract] ABSTRACT: Dietary pattern analysis, which reflects the complexity of dietary intake, has received considerable attention by nutritional epidemiology. For a long time, two general approaches have been used to define these summary variables in observational studies. The exploratory approach is based only on the data of the study, whereas the hypothesis-oriented approach constructs pattern variables based on scientific evidence available before the study. Recently, a new statistical method, reduced rank regression, was applied to nutritional epidemiology that is exploratory by nature, but can use scientific evidence by focusing on disease-related dietary components or biomarkers. Several studies, both observational and clinical, suggest that dietary patterns may predict the risk of CHD and stroke. In the present review, we describe the results of these studies and the available evidence regarding the relationships between dietary patterns and risk of CVD and we discuss limitations and strengths of the statistical methods used to extract dietary patterns.
British Journal Of Nutrition 06/2006; 95(5):860-9. DOI:10.1079/BJN20061731 · 3.45 Impact Factor
"The effect of dietary patterns on blood pressure has been explored in observational epidemiologic studies and randomized controlled clinical trials. In clinical trials of vegetarian diets in which vegetable products have replaced animal products, blood pressure was reduced in normotensive and hypertensive participants  . The effect of the vegetarian diet on blood pressure reduction is believed to be associated with the increased fiber and mineral content coupled with the low fat content of these diets. "
[Show abstract][Hide abstract] ABSTRACT: The best approach to the primary prevention of hypertension is a combination of lifestyle changes: weight loss in overweight persons; increased physical activity; moderation of alcohol intake; and consumption of a diet that is higher in fruits, vegetables, and low-fat dairy products and lower in sodium content than the average American diet (Table 3). Recent randomized controlled trials have demonstrated that these lifestyle changes can be sustained over long periods of time (more than 3 years) and can have blood pressure-lowering effects as large as those seen in drug studies. Hypertension is an important preventable risk factor for cardiovascular disease, the leading cause of mortality in the United States. To achieve the Healthy People 2010 goal of reducing the proportion of adults with hypertension from 28% to 16%, concerted efforts must be directed toward primary prevention strategies. Lifestyle modifications including weight loss, increased physical activity, and dietary changes in individuals have been shown to reduce the incidence of hypertension and should be recommended for all persons and especially those with prehypertension. In addition, timely adoption of prevention strategies to reduce the incidence of hypertension and its subsequent complications in the general population may interrupt the costly cycle of hypertension and prevent the reductions in quality of life associated with this chronic disease.
Medical Clinics of North America 02/2004; 88(1):223-38. DOI:10.1016/S0025-7125(03)00126-3 · 2.61 Impact Factor
"Amongst the factors influencing BP, much attention has been paid to differences in diet. Intra-population studies have shown that not only are vegetarian diets consistently found to be associated with low BP (Sacks & Kass, 1988) and to be effective in lowering BP in both normotensive and hypertensive individuals (Rouse et al. 1983) but that an increased intake of fruits and vegetables may have a significant hypotensive effect (Appel et al. 1997), focusing attention on nutrients derived largely from these foods. Attention is currently focused on dietary Na, and particularly on Na:K as factors influencing BP (Dyer et al. 1994). "
[Show abstract][Hide abstract] ABSTRACT: Epidemiological and clinical trials suggest an inverse relationship between dietary K intake and blood pressure (BP). Most trials however have been of short duration, the dose of K was high, and the results have been conflicting. The aim of the present study was to evaluate the effect on BP of a low-dose supplementation (24 mmol/d) for an extended period. A double-blind placebo-controlled trial was conducted on fifty-nine volunteers, randomly assigned to receive 24 mmol slow-release KCl/d (n 30) or a placebo (n 29). Measures of BP, anthropometric characteristics and urine analysis for electrolytes were recorded during a 1-week baseline period. Supplementation was for 6 weeks during which BP and changes in weight were assessed and a second 24 h urine collection made. The primary outcome was the change in mean arterial pressure (MAP); systolic BP (SBP) and diastolic BP (DBP) were secondary outcomes. After 6 weeks of supplementation MAP was reduced by 7.01 (95 % CI -9.12, -4.89; P<0.001) mmHg, SBP was reduced by 7.60 (95 % CI -10.46, -4.73; P<0.001) mmHg and DBP was reduced by 6.46 (95 % CI -8.74, -4.19; P<0.001) mmHg. The reduction in MAP was positively associated with baseline urinary Na:K (P<0.034). A low daily dietary supplement of K, equivalent to the content of five portions of fresh fruits and vegetables, induced a substantial reduction in MAP, similar in effect to single-drug therapy for hypertension.
British Journal Of Nutrition 08/2003; 90(1):53-60. DOI:10.1079/BJN2003861 · 3.45 Impact Factor
Cassandre E Bénay, Mehdi Tahiri, Lawrence Lee, Evangelia Theodosopoulos, Amin Madani, Liane S Feldman, Elliot J Mitmaker
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