The Efficacy of the DASH Diet in Male Patients Who Are Obese to Reduce the Risk of Developing Hypertension

Abstract

Background: adult obese men are at risk of developing not only type 2 diabetes, but are risk of developing hypertension. The correlation of obesity and hypertension calls for a dietary approach to preventing hypertension in obese men.

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Objectives/Aims: the main objective of this study is to investigate the efficacy of and underlying mechanisms operant in the DASH diet. The other objective was to determine the effectiveness of DASH Diet in preventing and managing Hypertension in obese male adults.

Methods: the researcher conducted a systematic review and meta-analysis of studies conducted between 2009 and 2018. The research articles were obtained from Ebscohost, PubMed, Google Scholar, Medline, and Cochrane databases.

Results: the researcher found out that the DASH diet is effective in preventing and managing hypertension in men as it reduces the amount of salt, cholesterol, fat and excess carbohydrates that contribute to obesity and high blood pressure. Reducing the salt intake from 9-12 to 5-6 g/d can significantly affect the BP. However, reducing the salt intake to 3g/d would produce a long-term effect on the blood pressure and prevent hypertension in adult obese men as compared to those adult obese men who do not consume the DASH diet

Conclusions: In the adult obese men, the DASH diet can lower salt intake and provide the dietary minerals required to reduces the BP and prevent hypertension.

Implications: implication of this study includes demand for future research to establish the most precise standard for measuring the DASH efficacy, especially for the obese adults. Researchers should find effective strategies that can be used to enhance and maintain the adherence to the recommendations, and to achieve a significant reduction of HTN in adult obese males.

Future Directions: Future research should also focus on the prospective barriers to the adoption of this kind of dietary plan.

The efficacy of the DASH diet in male patients 18 years and older who are obese to reduce the risk of developing hypertension

Research problem

With the prevalence of obesity and hypertension and the significant relationship between obesity and hypertension, various approaches aimed at preventing obesity and hypertension have been explored. Currently, the Dietary Approaches to Stop Hypertension (DASH) is being explored as a potential approach for controlling obesity and high blood pressures. The DASH diet is a meal plan aimed at lowering or controlling high blood pressures, this study aims at investigating the empirical evidence that the DASH diet can lower and control hypertension among male obese adults.

Problem Statement

Obesity is a major risk factor in the development of hypertension. Obesity is increasingly become prevalent in adults and is associated with diabetes and high blood pressures. According to CDC, 39.0% of the adult's population worldwide has obesity and approximately 93.3 million adults in the US had obesity as at 2016. The other obesity-related health condition includes stroke, type 2 diabetes, and cancer. The burden of the disease is also high as the US government in 2008 spent approximately $147bilion in medical costs while the medical costs for people with obesity tend to be $1429 higher than the medical cost of those people with normal weight. The Hispanics and non-Hispanic blacks (47.0% and 46.8% respectively) had the highest age-adjusted obesity prevalence's followed by non-Hispanic whites and non-Hispanic Asians (37.9% and 12.7% respectively. On the other hand, CDC (2018) reported that the obesity was prevalent among the young adults between the age of 20-39 years (35.7%) but higher among the middle-aged adults 40-59%. Additionally, among the obese adults, hypertension is also a major health problem which makes obesity in adults and hypertensions comorbidities (CDC, 2018). In obese adults, obesity-related arterial hypertension is mainly associated with the activation of the sympathetic nervous systems, followed by the activation of the renin-angiotensin systems as well as salt retentions. There is a nexus between obesity and elevated arterial pressures, therefore, to treat obesity-related hypertension, it is important to take into consideration the role of sodium retention in arterial hypertension. The mechanism by which obesity is a sequelae of hypertension, the interaction of the obesity with cardiac restriction that also causes arterial hypertension.

The fact the DASH diet (dietary approaches, to stop hypertension) has been considered a lifelong strategy to healthy eating, makes DASH diet an important intervention strategy for preventing or treating high blood pressure. Hypertension is mainly associated with end-organ damage and increased morbidity and mortality whenever the cardiac output is affected and the systemic vascular resistance is high. Sodium m retention is influenced by end-organ damage. The DASH diet is mainly designed with the aims of reducing the sodium intake. People are also advised to increase the portion of nutrient-rich foods that can help lower blood pressure. For example potassium, calcium and magnesium are nutrients that can potentially n.

Research question:

PICO: For obese patients who are 18 years and older, how does the consumption of the DASH diet reduce the future risk of developing hypertension compared with the consumption of regular diet?

Hypothesis

H0: Among obese adults, the consumption of the DASH diet reduces the risk of developed hypertension compared to the consumption of regular diet

H1: among the obese male adults, the consumption of the DASH diet does not reduce the risk of developing hypertension compared to the consumption of regular diet

Overall objectives:

• To identify the most recent and relevant literature on this topic and make an informed assessment as to the efficacy of and underlying mechanisms operant in the DASH diet.
• To show the relevance of DASH Diet in the prevention and management of Hypertension disease.

Specific Objectives

• To establish the severity of hypertension in male adult patients who are obese.
• To explain the efficacy of the DASH diet and follow-ups for adults male with a history of obesity to prevent the risks of developing hypertension.

Background:

The DASH diet can significantly reduce the blood pressure within a short time. For example, the systolic blood pressure can drop by 7 points within one month if a patient is put under DASH diet. DASH diet can also reduce the risk of an obese adult developing arterial hypertension. Components of a DASH diet

DASH diet and sedum levels'

DASH diet puts emphasize on vegetables, fruits and all low-fat dairy foods, whole grains as well as fish, poultry, and nuts. It is important to note that the DASH diet has lower sedum version that encourages the consumption of 15090mg of sodium per days, as the goal is to reduce the amount of salt in the diet (14). To cut back on sodium, DASH diet encourages low sodium intake. Therefore, using sodium free spices instead of salt is also encouraged. When cooking snacks, salt should not be added and canned foods must be washed and rinsed because salt is soluble in water.

DASH diet make up

DASH also emphasizes the consumption of whole grains, fruits, vegetates and low-fat dairy products including fish, legumes, and nuts. Red meat is allowed but should be moderated, sweets and fats should also be taken in small amounts but cholesterol, saturated fats, and total fats are highly discouraged because they contribute in damaging the arteries as the cholesterol plaques block the blood flow in the arteries (15).

Caffeine and alcohol

Alcohol and caffeine also allowed in DASH diet but they should be taken in moderating as too much alcohol can significantly increase one's blood pressure. Caffeine can also temporarily raise the blood pressure (14)

DASH diet and weight loss

Overweight and obesity are major precursors of high blood pressures and arterial hypertension. DASH diet is aimed at managing weight through weight loss. DASH diet may not be a weight loss programs but the diet is aimed at consuming lower calories. For example, DASH diet is aligned with the 2000 calories per day goals (16). Therefore, anyone aiming to lose weight can consume less than 2000 calories per day, redoing the portions sizes and frequency.

DASH diet also lowers the uric acid levels in people suffering from hyperuricemia thereby lowering the risk of gout (16). The effect of sedum intake on high blood pressure is adequately documented and the effect of the low sound intake on the systolic and diastolic blood pressure versus the effect of the same high sodium intake on the systolic and diastolic blood pressure indicated that high sodium intakes increased the systolic blood pressures. The high sodium intake also significantly affect the plasma levels of renin, aldosterone as well as n cholesterol, high-density lipoprotein, low-density lipoprotein and the catecholamines and triglycerides. The DASH diet reduces the average sodium intake from 201mmol per days to 66mmol/day (2).

Research design and methods:

Study design:

The researchers adopted a PRISMA protocol for the systemic review and Meta-analysis. Systematic review involved answering a set of defined research question through the collection of empirical evidence from different studies based on the predefined eligibility criteria. O the other hand, the meta-analysis used the statistical methods to summarize all the results reported in the studies sampled for systematic review. The researchers conducted a search in six databases including Medline, Cochrane, Medline, EBM, and EBSCO's medical databases, ProQuest, MEDSCAPE, The National Library of Medicine (NLM), and National Center for Biotechnology Information. The researcher used the following key terms: DASH diet, hypertension, obesity, diastolic blood pressure, systolic blood pressure, commodities, and mortality.

Data collection

The search criteria for data collection was used, the researcher used a predetermined inclusion and exclusion criteria. The researchers mainly focused on randomized controlled trial design as the main inclusion criteria because randomized controlled trials are non-biased researchers whose results are transferable and generalizable. The randomized controlled trials are also chosen because the studies have followed the whole assessment process for evaluating the DASH compliances

Sampling:

The studies that were included in the Meta-analysis must have met the Inclusion criteria, the eligibility criteria include the randomized-controlled trials that involved obese male adults, and used the DASH dietary plan for obesity in adults. The other factor that was taken into consideration included Weight (kg, lbs. %), Body fat measures: (BMI and BMI change), Waist circumference, Waist-hip ratio, Weight loss maintenance and Percent reduction of excess weight because these are major predictors of obesity in male adults. On the other hand, the exclusion criteria included those studies involving Female adults, Studies involving obese children, Non-randomized controlled trials

Study variables:

Outcome/Dependent Variables:

The dependent variables include hypertension because it was the outcome being measured after the consumption of the DASH diet.

Predictor/Independent Variables:

Other Independent Variables/ Potential Confounding Variables:

The predictor variables include the DASH diet, obesity, compliances,

Measurements:

The measurements include the DASH diet score. The DASH diet scores were generated from results of a food frequency questionnaire in the NIH-AARP Diet and Health Study. The scores include indexes defined by Dixon which inviolves7 food groups,...