School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
Statistical Consulting Service, School of Mathematics and Applied Statistics, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
Eur J Clin Nutr. 2018 Jun;72(6):894-903. doi: 10.1038/s41430-018-0123-0. Epub 2018 Mar 20.
BACKGROUND/OBJECTIVES: In addition to weight-loss, healthy dietary patterns and lower sodium intakes can help reduce blood pressure (BP), but individualised dietary advice may be necessary to achieve these effects. This study aimed to examine the impact of individualised dietary advice on BP in the intensive phase of a weight-loss trial.
SUBJECTS/METHODS: Secondary analysis of baseline and 3-month data from the HealthTrack randomised controlled trial (n = 211). Participants were randomly assigned to one of three dietary advice groups: general advice (control), individualised advice (intervention group, I), or intervention group supplemented with 30 g walnuts/day (IW). Resting BP and 24-h urine sodium and potassium were measured. Dietary intake was evaluated through diet history interviews.
Unadjusted SBP reduced significantly in all groups (IW and I groups P < 0.001; control group P = 0.002) and DBP in IW and I groups (P < 0.001). Compared to controls, the reductions in BP were 3-4 mmHg greater in the I and IW groups, but this only reached significance for DBP in the I group (-3.3 mmHg; P = 0.041). After controlling for age, sex, medication, weight-loss, physical activity and smoking, only the IW group showed a significant association between SBP reduction and increased urinary potassium (β = -0.101, P = 0.044), decreased sodium:potassium ratio (β = 2.446, P = 0.037) and increased consumption of seed and nut products and dishes (β = -0.108, P = 0.034).
Dietary patterns with distinctive foods and lower sodium:potassium ratios may enhance the effects of weight-loss on BP. The patterns were best achieved with individualised dietary advice and food supplements.
背景/目的：除了减肥，健康的饮食模式和减少钠的摄入也有助于降低血压（BP），但可能需要个性化的饮食建议才能达到这些效果。本研究旨在探讨在减肥试验的强化阶段，个性化饮食建议对 BP 的影响。
受试者/方法：对 HealthTrack 随机对照试验的基线和 3 个月数据的二次分析（n=211）。参与者被随机分配到以下三个饮食建议组之一：一般建议（对照组）、个性化建议（干预组，I）或干预组补充 30 克核桃/天（IW）。测量静息血压和 24 小时尿钠和钾。通过饮食史访谈评估饮食摄入。
所有组的 SBP 均显著降低（IW 和 I 组 P<0.001；对照组 P=0.002），IW 和 I 组的 DBP 也显著降低（P<0.001）。与对照组相比，I 组和 IW 组的 BP 降低幅度分别增加了 3-4mmHg，但仅在 I 组的 DBP 降低有统计学意义（-3.3mmHg；P=0.041）。在控制年龄、性别、药物、体重减轻、体力活动和吸烟后，只有 IW 组 SBP 降低与尿钾增加呈显著相关（β=-0.101，P=0.044），钠钾比降低（β=2.446，P=0.037），以及种子和坚果制品和菜肴摄入量增加（β=-0.108，P=0.034）。
具有独特食物和较低钠钾比的饮食模式可能增强减肥对 BP 的影响。这些模式最好通过个性化饮食建议和食物补充来实现。
