Milling & Baking News - November 29, 2005 - 14

N U T R I T I O N

A N D

H E A L T H

Study suggests carbohydrate cuts
may boost DASH diet benefits
Continued from Page 1
that in addition to salt, potassium,
weight, alcohol and the DASH (Dietary
Approaches to Stop Hypertension)
diet, macronutrients also affect blood
pressure," they said. "The DASH diet,
as tested in this trial, can be improved.
Partial substitution of carbohydrates
with protein, about half from plant
sources, or with unsaturated fat, predominantly monounsaturated fat, has
beneficial effect on blood pressure."
While subjects on all three study diets
experienced blood pressure reductions,
the greatest reductions occurred on diets with fewer carbohydrates. Each of
the three eating regimens in the study
was described as "a healthy diet."
The study, funded by the National
Institutes of Health, was conducted by a
group of researchers led by Lawrence J.
Appel of Johns Hopkins University. Dr.
Appel was a member of the 2005 U.S. Di-

etary Guidelines advisory committee.
The researchers conducted a randomized trial comparing the effects
on blood pressure and serum lipids of
three healthful diets, each reduced in
saturated fats:
1 - A carbohydrate-rich diet, similar
to the DASH diet;
2 - A diet rich in protein with about
50% coming from plant sources; and
3 - A diet rich in unsaturated fat,
predominantly monounsaturated fat.
Carbohydrates accounted for 58% of
calories in the first diet and 48% in the
other two. Trial participants were adults
aged 30 and above and had slightly to
moderately elevated blood pressure.
Each participant was randomly assigned to one of six sequences, each
containing all three diets.
While the outcomes from the
various diets differed, the study
showed that all three, including the

carbohydrate diet, were healthful.
"Changes from baseline indicated
major benefits from all three diets,"
the researchers concluded.
Systolic (the force of blood against
the arteries when the heart beats) and
diastolic blood pressure (the force
between beats) and levels of L.D.L.
("bad") and H.D.L. ("good") cholesterol were lower on each diet. Systolic
blood pressure was lowered 8.2% on
the carbohydrate diet and 9.5% and
9.3% on the protein and unsaturated
fat diets, respectively.
The researchers estimated that the
10-year risk of coronary heart disease
was lower on each study diet by 16.1%
to 21%. They added that the protein
and unsaturated fat diets further lowered C.H.D. (coronary heart disease)
risk from the carbohydrate diet.
"Results from this trial build on
findings of our earlier research, which
documented the beneficial effects
of the DASH diet on blood pressure
and L.D.L. cholesterol levels," the
researchers said. MBN

Eye-raising differences in JAMA diets
CHICAGO - While a new study published in the Journal of the American Medical Association suggests blood pressure may be lowered
by cutting carbohydrates, the differences in the diets could offer a different prescription for improving health: cutting dessert.
According to the study (see story above, beginning on Page 1), each of the diets was "rich in fruits, vegetables, fiber, potassium and
other minerals at recommended levels."
This description suggests an apples-to-apples comparison of diets in which the DASH (Dietary Approaches to Stop Hypertension)
diet was modified with reductions in carbohydrates and increases in either protein or fats. A deeper look suggests the differences
between the three study diets are more complicated than may be suggested.
For example, intake of grains was nearly identical in the carbohydrate diet (5.3
servings per day in a 2,100 calorie diet) and the protein diet (5 servings per day).
Nutrient targets and average
Fats and oils, designated as a "use sparingly" category in the dietary guidelines,
was 71% higher in the carbohydrate diet (6 servings) than in the protein diet
daily servings of foods by diet
(3.5 servings). Desserts and sweets, another "use sparingly" category, were 84%
at 2,100 calories
higher in the carbohydrate diet (4.6 servings, equating to 1 teaspoon per serving
Diet
- a relatively modest amount) than in the protein diet (2.5 servings).
Nutrient targets
Carbohydrate Protein Fat
More broadly, while the researchers emphasized the healthfulness of
Calorie percentages
the proteins in the protein diet and fats in the fats diet, the carbohydrate
Fat
27
27
37
diet appears to have been weighted heavily toward simple carbohySaturated
6
6
6
drates such as desserts and fruits (see accompanying table).
Monounsaturated
13
13
21
Polysaturated
8
8
10
The carbohydrate diet even showed some differences with the DASH diet.
Carbohydrate
58
48
48
For instance, the desserts and sweets intake in the carbohydrate diet, at 4.6
Protein
15
25
15
servings per day, is roughly double the recommendation in DASH.
Meat
5.5
9
5.5
These differences certainly could have been a factor in the results, said Paul
Dairy
4
4
4
Thompson,
director of the Preventive Cardiology Program and of CardiovasPlant
5.5
12
5.5
cular Research at Hartford Hospital, Hartford, Conn., and a member of the
Food groups, servings per day
Grain Foods Foundation clinical advisory board.
Fruit and juices
6.6
3.8
4.8
"All three diets in this study reduced cardiovascular risk factors
Vegetables
4.4
5.4
6.3
among participants," Dr. Thompson said. "While grain servings were
Grains
5.3
5
4.3
Low-fat dairy products
1.4
2.3
1.6
similar across all three diets, the carbohydrate diet contained almost
High-fat dairy products
0.7
0.2
0.3
double the servings of fruits, juices, desserts and sweets, suggesting that
Legumes, nuts, seeds and
1.3
3
1.2
the deleterious effects of the carbohydrate diet were due to simple sugother vegetable protein
ars and not grain consumption."
Beef, pork and ham
0.9
1.1
1
The menu differences all were necessary to hit various macronutrient
Poultry
1.6
2.6
1.8
targets while keeping micronutrient intake balanced, said Janis Swain, a
Fish
1.1
1.3
1
registered dietician at Brigham and Women's Hospital in Boston. Ms. Swain,
Egg products, substitutes
0.2
1.1
0.1
one of the study's authors, was in charge of designing the menus to meet the
Desserts and sweets
4.6
2.5
1.7
nutritional targets. MBN
Fats and oils
6
3.5
12

14 / Milling & Baking News, November 29, 2005

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