A lower-sodium version of the DASH diet — tailored specifically for people with type 2 diabetes — can meaningfully reduce blood pressure, even in those already taking medication, according to new research from Johns Hopkins Medicine.
The modified diet, called DASH4D (DASH for Diabetes), cuts back on sodium and carbohydrates while increasing healthy fats. It’s built on the foundation of the original DASH diet, which emphasizes fruits, vegetables and low-fat dairy, but adjusts potassium levels and other nutrients to make it safer for people with diabetes and kidney concerns.
Participants in the study received all meals from the research team and cycled through four different diets over five-week periods: a high- and low-sodium version of DASH4D, and a high- and low-sodium version of a typical American diet. Most were older adults with high blood pressure already taking multiple medications.
On average, participants who ate the lower-sodium DASH4D diet saw their top blood pressure number (systolic) drop by about 5 points and the bottom number (diastolic) drop by about 2 points, compared to when they ate a typical American diet high in sodium. While those numbers may sound small, even a 5-point drop in systolic blood pressure can cut the risk of stroke by 14%, heart failure by 8%, and cardiovascular events by 6%, according to researchers.
"Most people in this study were taking more than one blood pressure medication, but we found that you can lower it further with dietary change," said corresponding author Dr. Lawrence Appel of Johns Hopkins. "Blood pressure is one of the most important numbers to control because the higher the number, the higher the risk of stroke and heart disease."
Lead author Dr. Scott Pilla added that many people with diabetes focus on blood sugar alone, but managing blood pressure is just as critical.
“The next steps,” he said, “are to get the knowledge that we gained out to people with diabetes and help them use the diet to make healthy changes.”
The study was published June 9 in JAMA Internal Medicine. It was primarily supported by the Sheikh Khalifa Stroke Institute at Johns Hopkins University School of Medicine. Additional funding came from the National Institutes of Health, including grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute. Researchers also received career development support and help from the Johns Hopkins Institute for Clinical and Translational Research.