ARYA Atherosclerosis Journal

Investigation of adherence to DASH diet components and reduction of heart failure risk in adults: A case-control study

Document Type : Original Article

Authors

Abbas Abbasi 1
Davood Shafie 2
Reza Heidari Moghaddam 3
Masoumeh Sadeghi 4
Seyyed Morteza Safavi 1

1 Department of Clinical Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

https://doi.org/10.48305/arya.2024.42670.2964
Abstract
BACKGROUND: Heart failure (HF), or congestive Heart failure (CHF), is a heart disorder with a number of symptoms caused by the heart’s inability to pump blood. Our aim in conducting this study is to investigate the adherence to dietary approaches to stop hypertension (DASH) diet components and the risk of HF in Iranian adult women and men.
METHODS: In this hospital-based, case-control study, we included 340 participants (194 men and 146 women) aged 30–70 years who were recently (less than 6 months) diagnosed with HF. In this study, there were 169 participants in the control group and 171 participants in the case group. A semi-quantitative food frequency questionnaire (FFQ) with 148 items was used to assess food intake. Multiple logistic regression statistical tests were used to evaluate the relationship between DASH score and HF.
RESULTS: After adjusting for confounding variables, the data showed that adherence to the DASH diet was associated with a reduced risk of HF. Our data show that a significant relationship was found between the consumption of fruits (OR: 0.62; 95% CI: 0.53-0.68), vegetables (OR: 0.53; 95% CI: 0.28-0.81), legumes and nuts (OR: 0.75; 95% CI: 0.65-0.68), and heart failure, but no significant relationship was found with the other components of the DASH diet and heart failure.
CONCLUSION: Findings suggest that there is an inverse relationship between adherence to the DASH-style diet and the likelihood of HF, and adherence to some components of the DASH diet was also effective in reducing the risk of HF. To obtain more complete results, it is necessary to conduct cohort studies and randomized clinical trials.

Keywords

Heart Failure
Congestive Heart Failure
Diet
DASH Diet
Cardiovascular Diseases
  1. Bytyçi I, Bajraktari Mortality in heart failure patients. Anatol J Cardiol. 2015 Jan;15(1):63-8. https://doi. org/10.5152%2Fakd.2014.5731
  2. Savarese G, Lund Global Public Health Burden of Heart Failure. Card Fail Rev. 2017 Apr;3(1):7-11. https://doi.org/10.15420/cfr.2016:25:2
  3. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/ American Heart Association Joint Committee on Clinical Practice J Am Coll Cardiol. 2022 May 3;79(17):e263-e421. https://doi.org/10.1016/j. jacc.2021.12.012
  4. Hirata K, Hyodo E, Hozumi T, Kita R, Hirose M, Sakanoue Y, et al. Usefulness of a combination of systolic function by left ventricular ejection fraction and diastolic function by E/E’ to predict prognosis in patients with heart failure. Am J Cardiol. 2009 May 1;103(9):1275-9. https://doi.org/10.1016/j. 2009.01.024
  5. Eshraghi A, Mohammadzadeh Shabestri M, Jalalyazdi M, Alizadeh Sani Z. The Correlation between Left and Right Ventricular Ejection Fractions in Patients with Ischemic Heart Disease, Documented by Cardiac Magnetic Resonance Imaging. J Cardiothorac Med. 2016; 4(1):407-10.
  6. Eskandari V, Amirzargar AA, Mahmoudi MJ, Rahnemoon Z, Rahmani F, Sadati S, et al. Gene expression and levels of IL-6 and TNFα in PBMCs

 

 

 

correlate with severity and functional class in patients with chronic heart failure. Ir J Med Sci. 2018 May;187(2):359-68. https://doi.org/10.1007/s11845- 017-1680-2

  1. Perez AL, Grodin JL, Chaikijurajai T, O’Connor C, Starling RC, Wilson Tang WH, et Interleukin-6 and Outcomes in Acute Heart Failure: An ASCEND-HF Substudy. J Card Fail. 2021 Jun;27(6):670-6. https:// doi.org/10.1016/j.cardfail.2021.01.006
  2. Szekely Y, Arbel A Review of Interleukin-1 in Heart Disease: Where Do We Stand Today? Cardiol Ther. 2018 Jun;7(1):25-44. https://doi. org/10.1007%2Fs40119-018-0104-3
  3. Panahi M, Papanikolaou A, Torabi A, Zhang JG, Khan H, Vazir A, et Immunomodulatory interventions in myocardial infarction and heart failure: a systematic review of clinical trials and meta-analysis of IL-1 inhibition. Cardiovasc Res. 2018 Sep 1;114(11):1445-
  4. https://doi.org/10.1093/cvr/cvy145
  5. Mozaffarian D, Appel LJ, Van Horn Components of a cardioprotective diet: new insights. Circulation. 2011 Jun 21;123(24):2870-91. https://doi. org/10.1161%2FCIRCULATIONAHA.110.968735
  6. Jones NRV, Forouhi NG, Khaw KT, Wareham NJ, Monsivais Accordance to the Dietary Approaches to Stop Hypertension diet pattern and cardiovascular disease in a British, population-based cohort. Eur J Epidemiol. 2018 Feb;33(2):235-44. https://doi. org/10.1007/s10654-017-0354-8
  7. Farhadnejad H, Asghari G, Mirmiran P, Azizi F. Dietary approach to stop hypertension diet and cardiovascular risk factors among 10- to 18-year-old individuals. Pediatr Obes. 2018 Apr;13(4):185-94. https://doi.org/10.1111/ijpo.12268
  8. Shoaibinobarian N, Danehchin L, Mozafarinia M, Hekmatdoost A, Eghtesad S, Masoudi S, et al. The Association between DASH Diet Adherence and Cardiovascular Risk Factors. Int J Prev Med. 2023 Feb 25;14:24. https://doi.org/10.4103%2Fijpvm. ijpvm_336_21
  9. Rodríguez-López CP, González-Torres MC, Aguilar- Salinas CA, Nájera-Medina O. DASH Diet as a Proposal for Improvement in Cellular Immunity and Its Association with Metabolic Parameters in Persons with Overweight and Obesity. Nutrients. 2021 Oct 9;13(10):3540. https://doi.org/10.3390/nu13103540
  10. Blumenthal JA, Babyak MA, Hinderliter A, Watkins LL, Craighead L, Lin et al. Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study. Arch Intern Med. 2010 Jan 25;170(2):126-35. https://doi.org/10.1001/ archinternmed.2009.470
  11. Padma DASH Diet in Preventing Hypertension.

 

ABR. 2014;8(2):94-6. https://doi.org/10.5829/idosi. abr.2014.8.2.8272

  1. Farhadnejad H, Emamat H, Teymoori F, Tangestani H, Hekmatdoost A, Mirmiran P. Role of Dietary Approaches to Stop Hypertension Diet in Risk of Metabolic Syndrome: Evidence from Observational and Interventional Studies. Int J Prev Med. 2021 Mar 10;12:24. https://doi.org/10.4103/ijpvm. ijpvm_108_20
  2. Peairs AD, Shah AS, Summer S, Hess M, Couch Effects of the dietary approaches to stop hypertension (DASH) diet on glucose variability in youth with Type 1 diabetes. Diabetes Manag (Lond). 2017;7(5):383-91.
  3. Onvani S, Haghighatdoost F, Azadbakht L. Dietary approach to stop hypertension (DASH): diet components may be related to lower prevalence of different kinds of cancer: A review on the related documents. J Res Med Sci. 2015 Jul;20(7):707-13. https://doi.org/10.4103/1735-1995.166233
  4. Mohseni R, Mohseni F, Alizadeh S, Abbasi The Association of Dietary Approaches to Stop Hypertension (DASH) Diet with the Risk of Colorectal Cancer: A Meta-Analysis of Observational Studies. Nutr Cancer. 2020;72(5):778-90. https://doi. org/10.1080/01635581.2019.1651880
  5. Chiavaroli L, Viguiliouk E, Nishi SK, Blanco Mejia S, Rahelić D, Kahleová H, et DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients. 2019 Feb 5;11(2):338. https://doi.org/10.3390/ nu11020338
  6. Ibsen DB, Levitan EB, Åkesson A, Gigante B, Wolk The DASH diet is associated with a lower risk of heart failure: a cohort study. Eur J Prev Cardiol. 2022 May 25;29(7):1114-23. https://doi.org/10.1093/eurjpc/ zwac003
  7. Asghari G, Rezazadeh A, Hosseini-Esfahani F, Mehrabi Y, Mirmiran P, Azizi Reliability, comparative validity and stability of dietary patterns derived from an FFQ in the Tehran Lipid and Glucose Study. Br J Nutr. 2012 Sep 28;108(6):1109-17. https://doi. org/10.1017/s0007114511006313
  8. 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 Arch Intern Med. 2008 Apr 14;168(7):713-20. https://doi.org/10.1001/archinte.168.7.713
  9. National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey. Available from: https://www.cdc.gov/nchs/nhanes/ htm
  10. Aadahl M, Jørgensen T. Validation of a new self- report instrument for measuring physical Med Sci Sports Exerc. 2003 Jul;35(7):1196-202. https:// doi.org/10.1249/01.mss.0000074446.02192.14

 

 

 

  1. Al Zenki S, Al Omirah H, Al Hooti S, Al Hamad N, Jackson RT, Rao A, et al. High prevalence of metabolic syndrome among Kuwaiti adults--a wake- up call for public health intervention. Int J Environ Res Public Health. 2012 May;9(5):1984-96. https:// org/10.3390%2Fijerph9051984
  2. Mahdavi A, Mohammadi H, Foshati S, Shokri Mashhadi N, Clark CCT, Moafi A, et al. Effects of the dietary approach to stop hypertension (DASH) diet on blood pressure, blood glucose, and lipid profile in adolescents with hemophilia: A randomized clinical trial. Food Sci 2021; 9(1): 145–153. https://doi. org/10.1002/fsn3.1972
  3. Campbell DASH Eating Plan: An Eating Pattern for Diabetes Management. Diabetes Spectr. 2017 May;30(2):76-81. https://doi.org/10.2337/ds16-0084
  4. Levitan EB, Wolk A, Mittleman Consistency with the DASH diet and incidence of heart failure. Arch Intern Med. 2009 May 11;169(9):851-7. https://doi. org/10.1001/archinternmed.2009.56
  5. Ibsen DB, Levitan EB, Åkesson A, Gigante B, Wolk The DASH diet is associated with a lower risk of heart failure: a cohort study. Eur J Prev Cardiol. 2022 May 25;29(7):1114-23. https://doi.org/10.1093/eurjpc/ zwac003
  6. Chiavaroli L, Viguiliouk E, Nishi SK, Blanco Mejia S, Rahelić D, Kahleová H, et DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients. 2019 Feb 5;11(2):338. https://doi.org/10.3390/ nu11020338
  7. Pirouzeh R, Heidarzadeh-Esfahani N, Morvaridzadeh M, Izadi A, Yosaee S, Potter E, et Effect of DASH diet on oxidative stress parameters: A systematic review and meta-analysis of randomized clinical trials. Diabetes Metab Syndr. 2020 Nov-Dec;14(6):2131-38. https://doi.org/10.1016/j.dsx.2020.10.031
  8. Tsutsui H, Tsuchihashi-Makaya M, Kinugawa S, Goto D, Takeshita A; JCARE-GENERAL Investigators. Characteristics and outcomes of patients with heart failure in general practices and hospitals. Circ J. 2007 Apr;71(4):449-54. https://doi.org/10.1253/ 71.449
  9. Belch JJ, Bridges AB, Scott N, Chopra M. Oxygen free radicals and congestive heart Br Heart J. 1991 May;65(5):245-8. https://doi. org/10.1136%2Fhrt.65.5.245
  10. Pang Y, Huang M, Lu J, Peng Z, Tang M, Huang P, et Global trends in research on oxidative

 

stress related to heart failure from 2012 to 2021: a bibliometric analysis and suggestion to researchers. Ann Transl Med. 2023 Jan 31;11(2):54. https://doi. org/10.21037%2Fatm-22-6573

  1. Vanreusel I, Taeymans J, Van Craenenbroeck E, Segers VFM, Van Berendoncks A, Briedé JJ, et Elevated oxidative stress in patients with congenital heart disease and the effect of cyanosis: a meta-analysis. Free Radic Res. 2023 May-Jun;57(6-12):470-86. https://doi.org/1 0.1080/10715762.2023.2284639
  2. Farías JG, Molina VM, Carrasco RA, Zepeda AB, Figueroa E, Letelier P, et Antioxidant Therapeutic Strategies for Cardiovascular Conditions Associated with Oxidative Stress. Nutrients. 2017 Sep 1;9(9):966. https://doi.org/10.3390/nu9090966
  3. Landmesser U, Drexler H. The clinical significance of endothelial Curr Opin Cardiol. 2005 Nov;20(6):547-51. https://doi.org/10.1097/01. hco.0000179821.11071.79
  4. Adamy C, Mulder P, Khouzami L, Andrieu- abadie N, Defer N, Candiani G, et al. Neutral sphingomyelinase inhibition participates to the benefts of N-acetylcysteine treatment in post- myocardial infarction failing heart rats. Circ Res. 2014; 115(5):475–77.
  5. Bourraindeloup M, Adamy C, Candiani G, Cailleret M, Bourin MC, Badoual T, et al. N-acetylcysteine treatment normalizes serum tumor necrosis factor- alpha level and hinders the progression of cardiac injury in hypertensive rats. Circulation. 2004 Oct 5;110(14):2003-9. https://doi.org/10.1161/01. 0000143630.14515.7c
  6. Alpert MA, Lavie CJ, Agrawal H, Kumar A, Kumar SA. Cardiac effects of obesity: pathophysiologic, clinical, and prognostic consequences - a review. J Cardiopulm Rehabil Prev. 2016 Jan-Feb;36(1):1-11. https://doi.org/10.1097/hcr.0000000000000147
  7. Lopez-Jimenez F, Almahmeed W, Bays H, Cuevas A, Di Angelantonio E, le Roux CW, et al. Obesity and cardiovascular disease: mechanistic insights and management A joint position paper by the World Heart Federation and World Obesity Federation. Eur J Prev Cardiol. 2022 Dec 7;29(17):2218-37. https://doi.org/10.1093/eurjpc/zwac187
  8. Jannasch F, Kröger J, Schulze MB. Dietary Patterns and Type 2 Diabetes: A Systematic Literature Review and Meta-Analysis of Prospective Studies. J Nutr. 2017 Jun;147(6):1174-82. https://doi.org/10.3945/ 116.242552
ARYA Atherosclerosis Journal
Volume 20, Issue 4
July and August 2024
Pages 38-46

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us