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The Dietary Approach to Stop Hypertension (DASH) is recommended to lower blood pressure (BP), but its effects on cardiometabolic biomarkers are unclear. A systematic review and meta-analysis of randomised controlled trials (RCT) was conducted to determine the effects of the DASH diet on cardiovascular risk factors. Medline, Embase and Scopus databases were searched from inception to December 2013. Inclusion criteria were as follows: (1) DASH diet; (2) RCT; (3) risk factors including systolic and diastolic BP and glucose, HDL, LDL, TAG and total cholesterol concentrations; (4) control group. Random-effects models were used to determine the pooled effect sizes. Meta-regression analyses were carried out to examine the association between effect sizes, baseline values of the risk factors, BMI, age, quality of trials, salt intake and study duration. A total of twenty articles reporting data for 1917 participants were included in the meta-analysis. The duration of interventions ranged from 2 to 24 weeks. The DASH diet was found to result in significant decreases in systolic BP ( - 5·2 mmHg, 95% CI - 7·0, - 3·4; P< 0·001) and diastolic BP ( - 2·6 mmHg, 95% CI - 3·5, - 1·7; P< 0·001) and in the concentrations of total cholesterol ( - 0·20 mmol/l, 95% CI - 0·31, - 0·10; P< 0·001) and LDL ( - 0·10 mmol/l, 95% CI - 0·20, - 0·01; P= 0·03). Changes in both systolic and diastolic BP were greater in participants with higher baseline BP or BMI. These changes predicted a reduction of approximately 13% in the 10-year Framingham risk score for CVD. The DASH diet improved cardiovascular risk factors and appeared to have greater beneficial effects in subjects with an increased cardiometabolic risk. The DASH diet is an effective nutritional strategy to prevent CVD.
ABSTRACT The burden of noncommunicable diseases (NCDs) continues to rise across the globe, and the risk of dying prematurely from an NCD in a low- and middle-income country (LMIC) is almost double that in a high-income country. Confronting this crisis requires a critical mass of scientists who are well versed in regional health problems and understand the cultural, social, economic, and political contexts that influence the effectiveness of interventions to address NCDs. Investing in research capacity strengthening in LMICs is critical to effectively combating disease, and local researchers are best poised to address the health challenges in their home countries given their understanding of the unique culture and context in which they are working. The Fogarty International Center of the U.S. National Institutes of Health has a set of programs focused on building individual and institutional NCD research capacity in LMICs. The Programs provide models for sustainable scientific research capacity strengthening, innovative funding mechanisms and partnership-building approaches. Investing in the training and scientific capacity of LMIC individuals and institutions not only helps foster a research culture and solidify local ownership of research, but it also ensures that the most appropriate solutions are developed, increasing the likelihood that those solutions will sustain over time. In addition, the Programs’ investigators have advanced the science across a range of NCDs and associated risk factors. This article describes key lessons and compelling cases from the Programs that can be harnessed by other health researchers and funders to further the global response to the NCD burden.
Improving the carbohydrate quality of the diet by replacing the common cereal staple white rice (WR) with brown rice (BR) could have beneficial effects on reducing the risk for diabetes and related complications. Hence we aimed to compare the effects of BR, WR, and BR with legumes (BRL) diets on 24-h glycemic and insulinemic responses among overweight Asian Indians.
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