BOSTON — Plenty of people are aware they should “eat healthier for their heart,” but what exactly does that mean? Researchers from Beth Israel Deaconess Medical Center are finally providing some heart healthy diet specifics. Their study finds that both the Dietary Approaches to Stop Hypertension (DASH) diet, and a diet rich in fruits and vegetables, cuts heart disease risk scores by about 10 percent over an eight-week period.
While focusing on fruits and vegetables can do a good enough job, researchers say the DASH diet appears to offer additional benefits for women and Black adults, especially in comparison to a Western diet. The typical Western diet contains a minimal amount of fruits and vegetables and lots of fat and sodium. The DASH diet, meanwhile, is all about lowering blood pressure and features tons of foods rich in potassium, calcium, and magnesium.
Why is research like this so important? Cardiovascular disease remains the number one cause of death in the United States, responsible for more than 800,000 deaths annually. While it’s common knowledge that healthy eating helps curb cardiovascular risk factors like hypertension and high cholesterol levels, there’s little conclusive research pointing to one specific diet for heart-conscious eaters.
“While physicians and patients rely on the extensive data available when choosing appropriate pharmacologic therapy to prevent atherosclerotic cardiovascular disease, there’s limited evidence to inform expectations for risk reductions from established lifestyle interventions,” says corresponding study author Stephen P. Juraschek, MD, PhD, a clinician-researcher in the Department of Medicine at BIDMC, in a media release. “Our study suggests that the benefits associated with these diets may vary by sex and race. While a diet rich in fruits and vegetables produced reductions in risk for woman and Black participants, the effect with the DASH diet was twice as large in women and four times as large in Black adults.”
The DASH diet is twice as beneficial for women than men
In an effort to determine the influence of different diets on an individual’s risk of atherosclerotic cardiovascular disease, study authors analyzed a dataset encompassing 459 adults between 22 and 75 years-old who participated in the original DASH trial between 1994 and 1996. That group included roughly 50 percent women and African Americans and followed one of three diets for eight weeks. The control diet was generally a Western diet, featuring lots of total fat, saturated fat, and cholesterol. The fruit and veggie diet provided more produce, but other than that, did not otherwise significantly differ from the control diet. Finally, the DASH diet also provided more fruit and vegetables, but emphasized more whole grains, lean proteins, nuts, and low-fat dairy, all while simultaneously cutting down on fat, saturated fat, cholesterol, and sugar.
That original DASH project, first published in 1997, demonstrated that among adults with elevated blood pressure and hypertension, the DASH diet not only reduced systolic blood pressure but also helped lower HDL cholesterol levels in comparison to the control diet. The fruit and vegetable diet was also able to reduce systolic blood pressure, albeit to a lesser degree, and improve HDL cholesterol levels.
When the research team compared datasets, they noted both the DASH diet and the fruit and vegetable diet lowered participants’ 10-year risk for atherosclerotic cardiovascular disease by roughly 10 percent overall. However, the effect was not consistent across all demographics; the DASH approach to eating lowered 10-year risk scores among women by nearly 13 percent, in comparison to just over six percent for men. Additionally, the DASH diet lowered the 10-year risk score by close to 14 percent among Black adults, as opposed to just three percent among non-Black adults.
“The findings could have major implications for clinical practitioners and policy makers alike,” explains first author Sun Young Jeong, MD, MPH, an internal medicine resident at BIDMC. “Cardiovascular disease is the leading cause of death in women and hypertension is also more strongly linked with heart failure and death in women than men. We also know women are less likely to receive risk factor modification therapies, such as statins, so our finding that DASH may be more efficacious among women are relevant for lifestyle counseling in this group.”
“Similarly, disparities in access to healthy foods has been a major focus of policy efforts to promote higher intake of fruits and vegetables among Black adults,” adds Juraschek, who is also an assistant professor of medicine at Harvard Medical School. “Our study suggests that the DASH dietary pattern may offer Black adults more prevention benefits than the emphasis on fruits and vegetables alone. This is particularly relevant as dietary pattern has been identified as one of the most important mediators of hypertension risk among Black adults.”
The study is published in The American Journal of Cardiology.