The Efficacy of a Clinic-Based Behavioral Nutrition Intervention Emphasizing a DASH-Type Diet for Adolescents with Elevated Blood Pressure

Received 22 March 2007; received in revised form 5 July 2007; accepted 10 September 2007. published online 05 November 2007.

Objective

To examine the efficacy of a 3-month clinic-based behavioral nutrition intervention emphasizing a diet high in fruits, vegetables, and low fat dairy (DASH intervention) versus routine outpatient hospital-based nutrition care (RC) on diet and blood pressure (BP) in adolescents with elevated BP.

Study design

Fifty-seven adolescents with a clinical diagnosis of prehypertension or hypertension (systolic BP or diastolic BP, 90th to 99th percentile) were randomly assigned to DASH or RC. SBP, DBP, 3-day diet recall, weight, and height were assessed at pretreatment, post-treatment, and 3 months later (follow-up).

Results

In completer analysis, DASH versus RC had a greater decrease in SBP z scores from baseline to post-treatment (P < 0.01) and a trend for a greater decrease in SBP z scores from baseline through follow-up (P = .07). DBP z scores changed similarly for conditions from baseline through follow-up. Relative to RC, DASH had a greater increase in intake of fruits (P < .001), potassium and magnesium (P < .01), and a greater decrease in total fat (P < .05) from baseline to post-treatment. From baseline through follow-up, DASH versus RC had a greater increase in low fat dairy (P < .001).

Conclusions

The DASH intervention proved more effective than RC in improving SBP and diet quality in adolescents with elevated BP.

Abbreviations: BMI, Body mass index, BP, Blood pressure, DASH, Dietary Approaches to Stop Hypertension, DBP, Diastolic blood pressure, RC, Routine care, SBP, Systolic blood pressure

a Department of Nutritional Sciences, University of Cincinnati, Cincinnati, OH

b Children’s Hospital and Regional Medical Center, University of Washington, Department of Pediatrics-Child Health Institute, Seattle, WA

c Center for Biostatistics, University of Cincinnati, Cincinnati, OH

d Cincinnati Children’s Hypertension Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH

e Department of Pediatrics, University of Colorado School of Medicine, The Children’s Hospital, Denver, CO.

Reprint requests: Dr. Sarah C. Couch, Department of Nutritional Sciences, University of Cincinnati, Cincinnati, OH 45267-0394.

Supported by the American Heart Association Ohio Valley Affiliate (AHA 0355332B). Clinical Trials.gov Identifier: NCT00431288.

PII: S0022-3476(07)00878-5

doi:10.1016/j.jpeds.2007.09.022

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