Suboptimal Nutritional Intake for Hypertension Control in 4 Ethnic Groups

Amgen Inc, 1 Amgen Center Dr, MS28-3A, Thousand Oaks, CA 91320-1799, USA.
Archives of internal medicine (Impact Factor: 17.33). 05/2009; 169(7):702-7. DOI: 10.1001/archinternmed.2009.17
Source: PubMed


This study compared intake of specific nutrients based on the Dietary Approaches to Stop Hypertension (DASH) guidelines for hypertension management among multiethnic middle-aged and older adults.
We conducted quantitative analysis using baseline data of a prospective cohort study of 5972 adults aged 45 to 84 years recruited between July 2000 and August 2002 who participated in the Multi-Ethnic Study of Atherosclerosis (MESA). Diet information was collected using a 120-item food frequency questionnaire. Bivariate and multivariate methods were used to evaluate associations between DASH-accordant intake of each nutrient (fat, saturated fat, cholesterol, protein, fiber, calcium, magnesium, and potassium) with ethnicity and hypertension status.
Less than 30% of MESA participants met any DASH nutrient target. DASH accordance was lowest in saturated fat intake and highest in cholesterol intake (5.3% and 29.5% of the participants, respectively). Multivariate analyses showed significant ethnic differences in DASH accordance in all nutrients but saturated fat. Compared with white participants, Chinese American participants had greater DASH accordance in cholesterol (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.13-1.67) and protein intake (2.32; 1.55-3.49) but less in total fat (0.47; 0.30-0.74), magnesium (0.58; 0.51-0.67), and potassium intake (0.40; 0.20-0.81); African Americans and Hispanics had greater DASH accordance in fiber intake (1.36; 1.13-1.62; and 2.23; 1.53-3.23, respectively) but less in calcium intake (0.44; 0.37-0.52; and 0.79; 0.68-0.91, respectively). Diagnosed and uncontrolled hypertension was associated with less DASH accordance in saturated fat (OR, 0.80; 95% CI, 0.70-0.91) and magnesium (0.80; 0.71-0.91). DASH accordance differed significantly with and without inclusion of dietary supplements in the analysis.
There is significant variation in DASH goal attainment among different ethnic groups. Assessments of nutrient intake that exclude dietary supplements may be underestimating DASH accordance.

3 Reads
  • Source
    • "The wide range of prevalence of hypokalemia may depend on dietary consumption of potassium according to the study population or ethnicity. Compared with Caucasians, Asians and African Americans tend to have lower daily potassium intake (Gao et al., 2009; Kant et al., 2007; Szeto et al., 2005). In a group of 266 Chinese PD patients, prevalence was reported as 20.3%, and hypokalemia was found to be an independent predictor of mortality, although causes of death in the hypokalemic group did not differ from those in the normokalemic group (Szeto et al., 2005). "

    Progress in Peritoneal Dialysis, 10/2011; , ISBN: 978-953-307-390-3
  • Source
    • "The underlying nutrient targets are reduced dietary fat, saturated fat and cholesterol intake and increased protein, fiber, Ca, Mg and K intake. The literature suggests that these nutrients are associated with BP control (Engberink et al., 2009; Gao et al., 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to determine the relationship between daily dietary mineral (Na, K, Ca and Mg) intake and BP in the elderly. This study was conducted on 390 elderly volunteers (≥ 65 years). Subjects were randomly selected from the general population of Ankara, Turkey. Anthropometric measurements, lipid profiles, and mean systolic and diastolic BP (SBP and DBP) of all the participants were measured. To determine the mineral intake of the participants, food consumption was measured with a 24-h dietary recall. The 49.3% of participants were found to be hypertensive, 25.1% to be pre-hypertensive and 25.6% were normotensive according to the JNC-7 Guidelines, except for daily Mg and Na intake, the energy, macronutrient and micronutrient intake of groups were not significantly different (p>0.05). A significant inverse correlation between daily Ca intake and SBP was found in the pre-hypertensive group when age and gender adjusted regression analyses were performed (B=-0.006, p<0.05). Na intake and Na/K ratio were directly associated with SBP in the hypertensive group. In conclusion, SBP was found to be most related to dietary Na and Ca intake, and Na-to-K ratio in the elderly population.
    Archives of gerontology and geriatrics 07/2011; 55(1):106-11. DOI:10.1016/j.archger.2011.06.018 · 1.85 Impact Factor
  • Source
    • "A higher dietary calcium intake reduced the risk of hypertension in women over the age of 45 in the American Women's Health Study, and a calcium intake over 1,000 mg/day lowered the risk of hypertension (multivariate relative risk = 0.87) [28]. Also, the appropriate intake levels of sodium, along with a calcium intake of 800 mg or more, reduced the hypertension risk in normotensive or non-treated hypertensive populations, to that of treated hypertensive populations, respectively [16,24]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Regional differences between large cities and rural areas are observed in the Korean National Health and Nutrition Examination Survey (KNHANES). This present study was conducted to evaluate the effect of dietary factors on hypertension risk in Korean populations, especially residents of the Chungcheong province which was not in metropolitan area, using KNHANES III. A total of 544 adults aged ≥ 19 years were placed into either the normotensive or the hypertensive group. Subject characteristics, BMI, blood pressure, and nutrient intakes were compared between the two groups using a chi-square test and t-test. We estimated odds ratios (ORs) using multiple logistic regression, adjusted for energy intake and selected covariates. There were significant differences in age, education level, alcohol consumption, and BMI between the normotensive and hypertensive groups. We found decreased ORs for the medium versus lowest tertile of calcium intake (multivariate OR = 0.43, 95% CI: 0.21-0.88), for the highest versus lowest tertile of calcium intake (multivariate OR = 0.43, 95% CI: 0.20-0.90) with significant trends in risk (P = 0.040), and for the medium versus lowest tertile of potassium intake (multivariate OR = 0.43, 95% CI: 0.20-0.89). Subjects with the highest sodium/calcium ratio had a 2.10-fold greater risk of hypertension compared to the subject with the lowest, with significant trends in risk (P = 0.002). Adequate calcium and potassium intake should be encouraged and regional differences should be considered in making a healthy plan for hypertension management.
    Nutrition research and practice 02/2011; 5(1):60-5. DOI:10.4162/nrp.2011.5.1.60 · 1.44 Impact Factor
Show more

Similar Publications


3 Reads
Available from