Table 2.
Summary of characteristics of included trials in the most recent systematic reviews and meta-analyses of controlled trials assessing the effect of the DASH dietary pattern on cardiometabolic risk factors.
| Cardiometabolic Risk Factor | Systematic Review and Meta-Analysis | Total no. of Trials | Total n | Median Sample Size (Range) | Metabolic Phenotypes: no. of Trials | Median Age, yr (Rangea) | Median Follow-up, wks (range) | Trial Design: no. of Trials | Countries: no. of Trials | Randomized: no. of Trials | Intervention: no. of Trials | Comparator: no. of Trials | Feeding/Compliance: no. of Trials | Rob: no. of Trials b |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Blood Pressure (SBP + DBP) | Siervo et al., 2015 [11] | 19 | 1, 918 | 37 (12–537) | 9 HTN: 3 PreHTN + HTN: 2 MetS: 1 GDM: 1 Norm: 1 OH, lean: 1 OB: 1 T2DM | 44.3 (30.1–59.2) | 8 (2–24) | 6 CO: 13 P | 12 USA: 4 Iran: 3 Australia | 16 Y: 3 N | 15 DASH alone: 2 weight loss DASH: 1 weight loss DASH + exercise: 1 behavioural intervention plus DASH | 10 usual diet: 2 low fat diet: 2 low antioxidant diet: 2 weight loss diet:1 behavioural intervention alone: 1 exercise alone: 1 usual GDM practice | 14 dietary advice: 4 metabolic: 1 dietary advice plus some supplemented foods | 11 U: 8 Lo |
| Total-C + LDL-C | Siervo et al., 2015 [11] | 13 | 1, 673 | 54 (12–537) | 6 HTN: 2 PreHTN + HTN: 1 GDM: 1 Norm: 1 OH, Lean: 1 OB: 1 T2DM | 48.3 (30.1–59.2) | 4 (3–24) | 6 CO: 7 P | 8 USA: 3 Australia: 2 Iran | 10 Y: 3 N | 12 DASH alone: 1 behavioural intervention plus DASH | 7 usual diet: 2 low fat diet: 2 low antioxidant diet:1 behavioural intervention alone: 1 usual GDM practice | 10 dietary advice: 2 metabolic: 1 dietary advice plus some supplemented foods | 9 U: 4 Lo |
| HDL-C | Siervo et al., 2015 [11] | 15 | 1, 749 | 54 (12–537) | 6 HTN: 2 PreHTN + HTN: 2 MetS: 1 GDM: 1 Norm: 1 OH, lean: 1 OB: 1 T2DM | 44.0 (30.1–59.2) | 8 (3–24) | 6 CO: 9 P | 8 USA: 4 Iran: 3 Australia | 12 Y: 3 N | 12 DASH alone: 2 weight loss DASH: 1 behavioural intervention plus DASH | 7 usual diet: 2 low fat diet: 2 low antioxidant diet: 2 weight loss diet:1 behavioural intervention alone: 1 usual GDM practice | 12 dietary advice: 2 metabolic: 1 dietary advice plus some supplemented foods | 11 U: 4 Lo |
| Triglycerides | Siervo et al., 2015 [11] | 14 | 1, 654 | 44 (12–537) | 5 HTN: 2 PreHTN + HTN: 2 MetS: 1 GDM: 1 Norm: 1 OH, Lean: 1 OB: 1 T2DM | 42.6 (30.1–55.6) | 6 (3–24) | 6 CO: 8 P | 8 USA: 4 Iran: 2 Australia | 11 Y: 3 N | 11 DASH alone: 2 weight loss DASH: 1 behavioural intervention plus DASH | 7 usual diet: 1 low fat diet: 2 low antioxidant diet: 2 weight loss diet:1 behavioural intervention alone: 1 usual GDM practice | 12 dietary advice: 2 metabolic | 10 U: 4 Lo |
| HbA1c | Manual conductc | 2 | 65 | 33 (31–34) | 1 GDM: 1 T2DM | 42.6 (30.1–55.0) | 6 (4–8) | 1 CO: 1P | 2 Iran | 2 Y | 2 DASH alone | 2 usual diet | 2 dietary advice | 1 U: 1 Lo |
| Blood glucose | Siervo et al., 2015 [11] | 10 | 826 | 27 (12–537) | 1 HTN: 2 PreHTN + HTN: 2 MetS: 1 GDM: 1 Norm: 1 OH, Lean: 1 OB: 1 T2DM | 40.8 (30.1–55.0) | 6 (3–24) | 5 CO: 5 P | 6 USA: 4 Iran | 8 Y: 2 N | 7 DASH alone: 2 weight loss DASH: 1 behavioural intervention plus DASH | 4 usual diet: 2 low antioxidant diet: 2 weight loss diet: 1 behavioural intervention alone: 1 usual GDM practice | 10 dietary advice | 7 U: 3 Lo |
| Fasting insulin | Shirani et al., 2013 [64] | 11 | 760 | 15 (9–266) | 2 HTN: 4 PreHTN + HTN: 1 Norm: 1 OH: 1 OH, Lean: 2 OW/OB | 44.1 (34.3–51.8) | 4 (3–24) | 6 CO: 5 P | 10 USA: 1 UK | 6 Y: 5 N | 8 DASH alone: 3 behavioural intervention plus DASH | 6 usual diet: 2 low antioxidant diet: 3 advice only | 10 dietary advice: 1 dietary advice plus some supplemented foods | 7 U: 4 Lo |
| HOMA-IR | Shirani et al., 2013 [64] | 8 | 603 | 14 (9–266) | 1 HTN: 3 PreHTN + HTN: 1 Norm: 1 OH: 1 OH, Lean: 1 OB | 39.7 (34.3–49.8) | 3.5 (3–24) | 6 CO: 2 P | 8 USA | 4 Y: 4 N | 6 DASH alone: 2 behavioural intervention plus DASH | 4 usual diet: 2 low antioxidant diet: 2 advice only | 8 dietary advice | 6 U: 2 Lo |
| Body weight | Soltani et al., 2016 [65] | 11 | 1,211 | 54 (22–476) | 5 HTN: 2 MetS: 1 PreHTN + HTN: 1 HF patients: 1 OW/OB, NAFLD: 1 OW/OB, PCOS | 48.5 (30.1–62.0) | 16 (8–52) | 0 CO: 11 P | 4 USA: 4 Iran: 2 Australia: 1 Brazil | 11 Y: 0 N | 5 DASH alone: 4 weight loss DASH: 1 behavioural intervention Plus DASH: 1 DASH + LGI | 4 weight loss: 2 low fat: 2 usual diet: 1 behavioural intervention: 1 general HF recommendations: 1 standard low sodium HTN advice | 10 dietary advice: 1 dietary advice plus some supplemented foods | 6 U: 5 Lo |
| CRP | Soltani et al., 2017 [66] | 6 | 451 | 42 (31–241) | 2 Hyperlipidemic: 1 Lean Norm + OB HTN: 1 OW/OB, NAFLD: 1 OW/OB, PCOS: 1 T2DM | 45.7 (30.1–55.0) | 8 (3–24) | 3 CO: 3 P | 3 Iran: 2 USA: 1 Canada | 16 Y: 0 N | 3 DASH alone: 2 weight loss DASH: 1 lacto-ovo vegetarian DASH | 2 weight loss: 1 usual diet: 1 usual plus fibre, potassium, magnesium: 1 healthy American: 1 Portfolio diet (plant-based with soy protein, viscous fibres and nuts) | 15 dietary advice: 1 metabolic | 3 U: 3 Lo |
A range represents the range of the mean age in the trials. b For ROB, an assessment was performed using the Cochrane Risk of Bias tool, including the evaluation of individual domains of risk of bias (sequence generation, allocation concealment, blinding of participants/personnel and outcome assessors, incomplete outcome data, selective outcome reporting). Each of the five domains was evaluated as either low, high or unclear ROB and the overall ROB category was determined based on the most selected category. c Since no published systematic review and meta-analysis was retrieved from the search, we manually conducted a systematic review and meta-analysis on the DASH dietary pattern and HbA1c (Supplemental Tables S20–21 and Supplemental Figure S3). BMI, body mass index; BP, blood pressure; CO, crossover; CRP, C-reactive protein; DASH, dietary approaches to stop hypertension; DBP, diastolic blood pressure; DM, diabetes; F, female; F/U, follow-up; GDM, gestational diabetes; HDL-C, high-density lipoprotein-cholesterol; HF, heart failure; HTN, hypertensive; HOMA-IR, Homeostatic Model Assessment of Insulin Resistance; HTN, hypertension; L, lean; Lo, Low; LDL-C, low-density lipoprotein-cholesterol; LGI, low glycemic index; M, male; meds, medication; MetS, metabolic syndrome; N, no; Norm, normotensive; NAFLD, non-alcoholic fatty liver disease; OB, obese; OH, overall healthy; OW, overweight; P, parallel; PCOS, polycystic ovarian syndrome; PreHTN, prehypertensive; ROB, Risk of Bias; SBP, systolic blood pressure; SD, standard deviation; T2DM, type 2 diabetes; Total-C, total-cholesterol; U, unclear; W, women; wks, weeks; Y, yes; yr; year.