DASH diet vs. DASH diet plus physical activity in older patients with type 2 diabetes and high blood pressure: A randomized clinical trial
Abstract
BACKGROUND AND AIMS: To evaluate the effect of lifestyle modification by adopting a DASH diet, with and without physical activity guidance, on blood pressure, glycemic control, lipid profile, weight, and body composition in older patients with type 2 diabetes mellitus (T2DM) and hypertension. METHODS AND RESULTS: For this randomized clinical trial, we recruited patients aged 60 years or older with T2DM and uncontrolled hypertension. One group (DASH) received only DASH dietary guidance, while the other group (DASHPED) received dietary guidance and encouragement to walk with a pedometer. Outcomes of interest were (1) blood pressure, (2) physical activity, (3) weight, body mass index (BMI), and body composition, and (4) biochemical variables. Measurements were taken at baseline and 16 weeks after the intervention. We included 35 patients in the analysis. At the end of the study, the DASHPED group had an mean increase in physical activity of 1721 steps/day. Both groups displayed significantly reduced weight, BMI, and waking diastolic pressures on ambulatory blood pressure monitoring after the intervention. A trend of reduced sleeping diastolic pressure was found in the DASHPED group. Changes in weight, BMI, muscle mass, body fat, waist-hip ratio, glycemic control, lipid profile, and insulin sensitivity did not differ between the groups. CONCLUSION: There was no difference in outcomes between the group that only dieted and the group that also performed increased physical activity, despite a significant increase in exercise. This reinforces the importance of dietary changes in immediate blood pressure control.
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A minimum monitoring duration of seven consecutive days is appropriate to account for day-to-day variability and provide a reliable representation of habitual behaviour, including weekday/weekend differences.
“A minimum of seven days was considered appropriate, as this duration is commonly adopted in physical activity research to account for day-to-day variability and to provide a reliable representation of habitual behaviour, including differences between weekdays and weekends [10,12,13].”
Providing a pedometer within dietary supervision produced only a modest, diastolic-limited benefit, evident solely after adjustment for baseline values.
“By contrast, providing a pedometer within dietary supervision produced only a modest, diastolic-limited benefit, evident solely after adjustment for baseline values [12].”
In the absence of such structure, the device's ability to support sustained clinical improvement may be significantly reduced.
“In the absence of such structure, the device’s ability to support sustained clinical improvement may be significantly reduced [8,12,20,31,32,35].”
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- Authors
- L. P. de Oliveira, V., de Freitas, M. M., P. de Paula, T., Gubert, M. L., Miller, M. E. P., Schuchmann, R. A., Souza, K. L. A., & Viana, L. V.
- Affiliations
- Post-Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul (BR)
- Venue
- Nutrition and Health
- Publisher
- SAGE Publications
- Published
- 2022-09-16
- Volume
- 30
- Issue
- 2
- Pages
- 389-398
- ISSN
- 0260-1060 (ISSN-L)
- 2047-945X
- OpenAlex
- W4296162118
- Cited by
- 8
- References
- 41
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 2
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition and Health (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hospital de Clínicas de Porto Alegre
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- DASH diet, type 2 diabetes, hypertension, older adults, physical activity, lifestyle modification, blood pressure control, glycemic control, weight loss, body composition, insulin sensitivity, lipid profile
- MeSH terms
- Dietary Approaches To Stop Hypertension, Aged, Blood Glucose, Blood Pressure, Body Composition, Body Weight, Diabetes Mellitus, Type 2, Female, Humans, Hypertension, Lipids, Male, Middle Aged, Exercise, Body Mass Index
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