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Does The Dash Diet Lower Cholesterol
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Dash Diet A Diet To Avoid Hypertension
Brooke E. Wickman 1, Byambaa Enkhmaa 2, 3, Ronit Rydberg 2, Eric Romero 4, Martin Cadeiras 4, Frederick Meyers 2 and Francen Steinberg 1, 2, *
Center for Precision Medicine and Information Sciences, University of California School of Medicine, Davis, Sacramento, CA 95817, USA
Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of California School of Medicine, Davis, Sacramento, CA 95817, USA
Department of Internal Medicine, Division of Cardiovascular Medicine, School of Medicine, University of California, Davis, Sacramento, CA 95817, USA
A Dash Diet Book: The Dash Diet Action Plan
Received: 2021 October 28 / Revised: 2021 December 6 / Accepted: 2021 December 6 / Published: 2021 December 10
(This article refers to a special issue on Nutritional Optimization and Dietary Support for the Prevention and Management of Cardiovascular Disease)
Heart failure (HF) is a chronic health care burden. Effective, evidence-based interventions for the prevention and management of HF are needed to improve patient longevity, symptom control, and quality of life. Dietary Approaches to Stop Hypertension (DASH) may have beneficial effects in patients with HF. However, lack of consensus on comprehensive dietary guidelines and lack of pragmatic evidence limits the ability of healthcare organizations to implement clinical recommendations. Advances in medical nutrition therapy with precision nutritional approaches can reduce the burden of HF, improve clinical care, and meet the needs of a diverse patient population. The purpose of this review is to summarize the current evidence regarding dietary recommendations for HF, including dietary interventions for the DASH diet, and to develop initial recommendations for the implementation of the DASH diet in ambulatory HF management. Articles related to human studies were retrieved using the following search terms: Dietary Approaches to Stop Hypertension (DASH diet), dietary pattern, diet, metabolism, and heart failure. Only full-text articles written in English were included in this review. Because DASH dietary interventions are recommended, limitations of these studies include small sample sizes and lack of randomization of interventions, resulting in less robust evidence. Randomized controlled interventions are needed to provide definitive evidence for the use of the DASH diet in the treatment of HF.
Heart failure; dietary methods to control hypertension; the DASH diet; dietary pattern; metabolism; metabolomics; accurate nutrition; personal nutrition heart failure; dietary methods to control hypertension; the DASH diet; dietary pattern; metabolism; metabolomics; accurate nutrition; personal nutrition
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Approximately 6.2 million adults in the United States have heart disease (CVD) [1]. Average population improvement and overall improvement in cardiovascular disease (CVD) will increase the prevalence of HF and worsen the functional quality of life of these individuals and their caregivers. Strategies for the effective management of CF are urgently needed. Although the primary prevention of HF events is an important research topic, the scope of this study did not include HF prevention, but rather focused on the management of diagnosed HF.
HF is the final manifestation of various pathophysiological cardiac dysfunctions characterized by insufficient cardiac output to meet the metabolic demands of body tissues [2]. HF does not affect the entire population equally and is a source of health disparities and inequalities. Advances in medical management, as well as dietary and behavioral change interventions, may synergistically affect the pathophysiology and symptoms of heart failure to improve patient health outcomes and quality of life. Although fluid and sodium restriction are often recommended for patients with HF, a comprehensive nutritional plan for HF has not become the standard of care for HF.
Challenges to the successful management of HF include: (1) multiple disease etiologies with variable response to treatment regimens, (2) nutritional therapy inconsistent with patient preferences, reducing adherence to lifestyle and dietary recommendations, and (3) metabolic heterogeneity affecting individual the disease. progression. and management response. For example, HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) respond similarly to treatment. While HFrEF responds well to standard therapy, HFpEF responds less well, and new evidence-based care strategies are being tested.
Despite these challenges, there are opportunities to better understand HF and reassess long-accepted, but not individual, HF standards. Interdisciplinary research and health care teams are best positioned to monitor and interpret clinically relevant metabolic pathways and biomarkers while engaging HF patients, educators, and the community in effective HF management.
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Better ambulatory disease management can slow disease progression and improve health outcomes such as hospitalizations and mortality, making these important research targets. Regarding nutrition, individualized dietary flexibility may better meet the needs of HF patients than fluid and sodium restriction. Dietary Approaches to Stop Hypertension (DASH) is a promising combination diet that, when incorporated into the lifestyle of ambulatory HF patients, may impact HF management. This integrated nutritional approach allows for greater individualization of precision nutrition and may be beneficial in the treatment of HF in free-living patients rather than reducing nutrition [3]. Combined with behavioral modification techniques, the DASH diet may have beneficial effects on HF. Understanding the clinical efficacy of the DASH diet and its effects on metabolic biomarkers will be critical to developing a scientific evidence base for accurate dietary recommendations and as a standard of care for ambulatory HF management.
The purpose of this review is to summarize the literature related to the implementation and effectiveness of the DASH diet in the outpatient setting and to inform future nutrition research on cardiovascular health.
The literature related to the DASH diet was reviewed for human studies without time constraints. Eligible and reviewed studies included randomized controlled trials, prospective and cross-sectional studies, systematic reviews and meta-analyses. Online literature was searched using PubMed. Search terms included heart failure, Dietary Approaches to Stop Hypertension (DASH diet), diet, dietary pattern, dietary behavior, implementation science, metabolism, metabolomics, and outcomes. Combinations of search terms include, but are not limited to, dietary pattern, metabolism and heart failure, DASH diet and metabolism and heart failure, dietary pattern and heart failure, dietary patterns and heart failure and outcomes, DASH and heart failure, diet and heart failure. . A total of 85 articles were identified after the initial search, with additional search terms and criteria added as the reviewers reviewed the literature. The articles are divided by nutritional model and HF topics; DASH diet and HF; diet, metabolism and HF.
HF is a manifestation of end-stage heart disease characterized by the inability of the heart to meet the body’s metabolic demands [2]. Impaired HF oxygen kinetics lead to poor quality of life and increased HF-related morbidity and mortality [4]. Symptoms that significantly affect daily activities include shortness of breath, fatigue, and swelling. Clinical HF syndrome can occur due to various etiologies affecting the myocardium, heart valves, pericardium or blood vessels. Risk factors for HF include smoking, hypertension, obesity, diabetes or insulin resistance, and coronary heart disease.
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HF is a heterogeneous syndrome, with complex characteristics of each patient showing functional and structural biomarker changes during disease progression. HF is divided into four successive stages, where A (at risk) is at risk of HF due to pre-existing conditions; B (before HF) – asymptomatic structural heart disease; C (HF) is a symptomatic structural heart disease; and D (previous HF) is end-stage HF with prominent symptoms at rest despite therapeutic interventions. HF may also occur
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