Document Type : Original Article(s)
- Sahar Golpour-Hamedani 1
- Noushin Mohammadifard 2
- Alireza Khosravi 3
- Awat Feizi 4
- Sayyed Morteza Safavi 1
1 Food Security Research Center AND Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
2 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3 Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
4 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute AND Department of Biostatistics and Epidemiology, School of Health and Isfahan University of Medical Sciences, Isfahan, Iran
BACKGROUND: Few studies have investigated the effects of dietary approaches to stop hypertension (DASH) diet on obesity in children. The present study was conducted to examine adherence to the DASH diet in relation to obesity in children and adolescents, Isfahan, Iran. METHODS: A cross-sectional study was carried out among 456 children aged 11-18 years who were selected by random cluster sampling method. Dietary intakes were assessed using a validated Food Frequency Questionnaire (FFQ). The DASH score was constructed based on food items emphasized or minimized in the DASH diet. Anthropometric measurements were conducted based on standard protocols. General and abdominal obesity were defined based on body mass index ≥ 95th percentiles and waist: height ratio of more than 0.5, respectively. RESULTS: Higher adherence to DASH diet was inversely associated with general obesity (odds ratioT1 vs. T3 3.34, 95% confidence interval 1.28-8.75); however, after controlling for confounding factors, this association disappeared. Furthermore, higher adherence to DASH diet was negatively associated with central obesity in children, but the relation was not statistically significant. CONCLUSION: We concluded that there was an inverse nonsignificant association between adherence to DASH diet and general obesity indices after adjustment for potential confounders. Further, well-designed randomized clinical trial studies are suggested to find out the effect of DASH diet on obesity obviously.
- Salehi-Abargouei A, Akbari F, Bellissimo N, Azadbakht L. Dietary diversity score and obesity: A systematic review and meta-analysis of observational studies. Eur J Clin Nutr 2016; 70(1): 1-9.
- Najafipour H, Yousefzadeh G, Forood A, Karamouzian M, Shadkam M, Mirzazadeh A. Overweight and obesity prevalence and its predictors in a general population: A community-based study in Kerman, Iran (Kerman coronary artery diseases risk factors studies). ARYA Atheroscler 2016; 12(1): 18-27.
- Malekzadeh R, Mohamadnejad M, Merat S, Pourshams A, Etemadi A. Obesity pandemic: an Iranian perspective. Arch Iranian Med 2005; 8(1): 1-7.
- Azadbakht L, Akbari F, Esmaillzadeh A. Diet quality among Iranian adolescents needs improvement. Public Health Nutr 2015; 18(4): 615-21.
- Hajna S, Liu J, LeBlanc PJ, Faught BE, Merchant AT, Cairney J, et al. Association between body composition and conformity to the recommendations of Canada's Food Guide and the Dietary Approaches to Stop Hypertension (DASH) diet in peri-adolescence. Public Health Nutr 2012; 15(10): 1890-6.
- Hashemipour M, Soghrati M, Malekahmadi M, Soghrati M, Mirmoghtadaei P, Poursafa P, et al. Association of anthropometric indexes and cardiometabolic risk factors among obese children. ARYA Atheroscler 2009; 5(1): 39-48.
- McKinnon RA, Orleans CT, Kumanyika SK, Haire-Joshu D, Krebs-Smith SM, Finkelstein EA, et al. Considerations for an obesity policy research agenda. Am J Prev Med 2009; 36(4): 351-7.
- Perry CP, Keane E, Layte R, Fitzgerald AP, Perry IJ, Harrington JM. The use of a dietary quality score as a predictor of childhood overweight and obesity. BMC Public Health 2015; 15: 581.
- Woodruff SJ, Fryer K, Campbell T, Cole M. Associations among blood pressure, salt consumption and body weight status of students from south-western Ontario. Public Health Nutr 2014; 17(5): 1114-9.
- Fung TT, Chiuve SE, McCullough ML, Rexrode KM, Logroscino G, Hu FB. Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med 2008; 168(7): 713-20.
- Berz JP, Singer MR, Guo X, Daniels SR, Moore LL. Use of a DASH food group score to predict excess weight gain in adolescent girls in the National Growth and Health Study. Arch Pediatr Adolesc Med 2011; 165(6): 540-6.
- Sacks FM, Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, et al. A dietary approach to prevent hypertension: a review of the Dietary Approaches to Stop Hypertension (DASH) Study. Clin Cardiol 1999; 22(7 Suppl): III6-10.
- Azadbakht L, Fard NR, Karimi M, Baghaei MH, Surkan PJ, Rahimi M, et al. Effects of the Dietary Approaches to Stop Hypertension (DASH) eating plan on cardiovascular risks among type 2 diabetic patients: a randomized crossover clinical trial. Diabetes Care 2011; 34(1): 55-7.
- Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F. Beneficial effects of a dietary approaches to stop hypertension eating plan on features of the metabolic syndrome. Diabetes Care 2005; 28(12): 2823-31.
- Kelishadi R, Majdzadeh R, Motlagh ME, Heshmat R, Aminaee T, Ardalan G, et al. Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents: The Caspian-IV Study. Int J Prev Med 2012; 3(10): 699-705.
- Ghaffarpour M, Houshiar-Rad A, Kianfar H. The manual for household measures, cooking yields factors and edible portion of foods. Tehran, Iran: Nashre Olume Keshavarzy p. 213; 1999.
- Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, et al. Centers for disease control and prevention 2000 growth charts for the united states: Improvements to the 1977 national center for health statistics version. Pediatrics 2002; 109(1): 45-60.
- Esmaili H, Bahreynian M, Qorbani M, Motlagh ME, Ardalan G, Heshmat R, et al. Prevalence of general and abdominal obesity in a nationally representative sample of Iranian children and adolescents: The CASPIAN-IV study. Iran J Pediatr 2015; 25(3): e401.
- National Health Service. Measuring diet and physical activity in weight management interventions. London, UK: National Obesity Observatory; 2011.
- Folsom AR, Parker ED, Harnack LJ. Degree of concordance with DASH diet guidelines and incidence of hypertension and fatal cardiovascular disease. Am J Hypertens 2007; 20(3): 225-32.
- Barak F, Falahi E, Keshteli AH, Yazdannik A, Esmaillzadeh A. Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet in relation to obesity among Iranian female nurses. Public Health Nutr 2015; 18(4): 705-12.
- Asghari G, Yuzbashian E, Mirmiran P, Hooshmand F, Najafi R, Azizi F. Dietary approaches to stop hypertension (dash) dietary pattern is associated with reduced incidence of metabolic syndrome in children and adolescents. J Pediatr 2016; 174: 178-84.
- Gunther AL, Liese AD, Bell RA, Dabelea D, Lawrence JM, Rodriguez BL, et al. Association between the dietary approaches to hypertension diet and hypertension in youth with diabetes mellitus. Hypertension 2009; 53(1): 6-12.
- Liese AD, Bortsov A, Gunther AL, Dabelea D, Reynolds K, Standiford DA, et al. Association of DASH diet with cardiovascular risk factors in youth with diabetes mellitus: the SEARCH for Diabetes
- in Youth study. Circulation 2011; 123(13): 1410-7.
- Shin KO, Oh SY, Park HS. Empirically derived major dietary patterns and their associations with overweight in Korean preschool children. Br J Nutr 2007; 98(2): 416-21.
- Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi F. Dairy consumption is inversely associated with the prevalence of the metabolic syndrome in Tehranian adults. Am J Clin Nutr 2005; 82(3): 523-30.
- Lindstrom J, Peltonen M, Eriksson JG, Louheranta A, Fogelholm M, Uusitupa M, et al. High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study. Diabetologia 2006; 49(5): 912-20.
- Schwingshackl L, Hoffmann G. Long-term effects of low glycemic index/load vs. high glycemic index/load diets on parameters of obesity and obesity-associated risks: a systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2013; 23(8): 699-706.
- McKeown NM, Yoshida M, Shea MK, Jacques PF, Lichtenstein AH, Rogers G, et al. Whole-grain intake and cereal fiber are associated with lower abdominal adiposity in older adults. J Nutr 2009; 139(10): 1950-5.