Effect of dietary approaches to stop hypertension (DASH) diet on adiposity indices in children with overweight and obesity: an 8-week triple-blind randomized controlled trial.

UNLABELLED

We aimed to investigate the potential effects of Dietary Approaches to Stop Hypertension (DASH) diet on adiposity indices in children with overweight and obesity. This study was a triple-blind, randomized controlled trial. Sixty girls and boys (aged 8-12 years) were randomly assigned to either DASH diet or control group, and the intervention duration was 8 weeks. Body weight (BW), height, waist circumference (WC), skinfold thickness (SFT), neck circumference (NC), body mass index (BMI), waist-to-height ratio (WHtR), body round index (BRI), and weight-adjusted waist index (WWI) were assessed before and after the intervention. The primary analysis was conducted on a per-protocol basis, including only participants who completed at least two visits and adhered to the study protocol. This approach was chosen to ensure that the results reflect the actual effects of the intervention among compliant participants. Analysis of covariance (ANCOVA) was used to compare after treatment adiposity indices between groups. Mean ± SD age and BMI of the participants was 11.8 ± 0.8 years (69% were girls) and 25.9 ± 3.52 kg/m, respectively. A total of 58 patients (n = 29 in DASH group and n = 29 in control group) who completed at least two visits and adhered to the study protocol were included in the final per-protocol analysis. Two participants (one from each group) were lost to follow-up and excluded from the analysis due to incomplete data. After 8 weeks, the DASH group had a significantly lower BW (59.5 vs. 62.6 kg), WC (84.3 vs. 85.5 cm), NC (32.9 vs. 33.3 cm), SFT (3.57 vs. 3.57 cm), BMI (25.9 vs. 25.9 kg/m), WHtR (0.55 vs. 0.56), BRI (4.57 vs. 4.75), and WWI (10.42 vs. 10.84 cm/√kg) compared with the controls (P for all < 0.01). The mean change percent of adiposity indices was higher in the control than the DASH group (P for all < 0.05); however, for the WWI, a significant reduction was observed in the DASH group.

CONCLUSION

Adherence to DASH diet may be an effective approach for obesity management in children who are overweight and obese.

TRIAL REGISTRATION

Our study was registered with IRCT.IR ( https://irct.behdasht.gov.ir ) under the identifier IRCT20240623062229N1 on 30 June 2024.

WHAT IS KNOWN

• The DASH diet is effective in improving cardiovascular health and metabolic outcomes in adults, but its impact on adiposity indices in children with overweight/obesity remains understudied. • Previous studies on the DASH diet in pediatric populations have yielded inconsistent results, with some showing  benefits in weight management and others reporting neutral effects.

WHAT IS NEW

• This first triple-blind randomized controlled trial demonstrates that an 8-week DASH diet intervention significantly reduces multiple adiposity indices (body weight, waist circumference, BMI, and novel indices like WWI and BRI) in children with overweight/obesity. • The study highlights the DASH diet's potential as a practical, non-restrictive dietary strategy for pediatric obesity management, with benefits observed even without caloric restriction.