The PREMIER intervention helps participants follow the dietary approaches to stop. Hypertension dietary pattern and the current dietary reference intakes recommendations
The PREMIER intervention helps participants follow the dietary approaches to stop. Hypertension dietary pattern and the current dietary reference intakes recommendations
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DOI：
10.1016/j.jada.2007.06.019
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发表时间：
2007-09-01
影响因子：
--
通讯作者：
Champagne, Catherine
中科院分区：
文献类型：
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作者：
Lin, Pao-Hwa;Appel, Lawrence J.;Champagne, Catherine
目的探讨Premier Study生活方式干预对高血压患者膳食摄入量、饮食模式依从性和膳食参考摄入量(DRI)的影响，设计一项为期18个月的多中心随机对照试验，比较两种生活方式干预方案与单纯建议组的差异。年龄在25岁或以上，体重指数在18.5到45.0之间，没有服用降压药，有高血压前期或第一阶段高血压(收缩压120到159 mm Hg，舒张压80到95 mm Hg)的个体符合条件。干预这两个积极干预计划是执行既定建议的行为生活方式干预，和既定的干预加DASH饮食模式。这两种干预措施都包括强化的团体咨询和个人咨询。对照组在随机化后接受了简短的建议会议，并在6个月的数据收集后再次接受了建议。饮食摄入量通过两次随机的24小时回顾收集，分别在基线、6个月和18个月。主要观察指标Premier研究的主要结果是6个月时收缩压的变化。本文研究的主要结果包括在每个时间点通过24小时回顾收集的饮食变量。主要结果衡量：Premier研究的主要结果是6个月时收缩压的变化。研究的主要结果包括每个时间点的24小时回顾收集的膳食变量。统计分析采用重复测量6个月和18个月的混合模型计算并比较各时间点和3个干预组之间的营养素摄入量。计算达到或达到原始DASH营养摄入量水平的参与者比例和DRI，并在三个干预组之间进行比较。P<；0.01被认为具有统计学意义。结果在既定干预和既定干预加DASH饮食模式组中，参与者都显著减少了能量、总脂肪、饱和脂肪和钠的摄入量，并且这些减少在整个研究过程中持续存在。既定干预加DASH饮食模式组的参与者增加了水果、蔬菜、乳制品以及多种维生素和矿物质的摄入量；这些增加明显大于对照组和既定干预组。大多数既定干预加DASH饮食模式组的参与者在6个月时至少达到了DRI推荐的大多数营养素的三分之二，尽管他们减少了总能量摄入量。在18个月时发生了一些但相对较小的再发。结论既定干预和既定干预加DASH饮食模式小组干预都能有效地帮助参与者遵循既定的血压控制建议。只接受建议的对照组也进行了一些行为改变，主要是减少能量和钠的摄入量。
Objective To examine the influence of the PREMIER study lifestyle interventions on dietary intakes and adherence to the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and the Dietary Reference Intakes (DRI).Design An 18-month multicenter, randomized controlled trial comparing two multicomponent lifestyle intervention programs to an advice only control group.Subjects/setting A total of 810 participants were recruited from local communities and randomized into the study. Individuals were eligible if they were aged 25 years or older, had body mass index between 18.5 and 45.0, not taking antihypertensive medication, and had prehypertension or stage 1 hypertension (systolic blood pressure 120 to 159 mm Hg and diastolic blood pressure 80 to 95 mm Hg).Intervention The two active intervention programs were a behavioral lifestyle intervention that implements established recommendations, and an established intervention plus the DASH dietary pattern. Both interventions consisted of intensive group and individual counseling sessions. The control group received a brief advice session after randomization and again after 6 months of data collection. Dietary intakes were collected by two random 24-hour recalls at baseline, 6 months, and 18 months. Main outcome measures The primary outcome of the PREMIER study was change in systolic blood pressure at 6 months. The main outcomes examined here include dietary variables collected by 24-hour recall at each time point.Main outcome measures The primary outcome of the PREMIER study was change in systolic blood pressure at 6 months. The main outcomes examined here include dietary variables collected by 24-hour recall at each time point.Statistical analyses Nutrient intakes were calculated and compared among the time points and the three intervention groups using mixed models with repeated measures at 6 and 18 months. Proportion of participants who met or achieved the original DASH nutrient intake levels and the DRIs were calculated and compared among the three intervention groups. P < 0.01 was considered statistically significant.Results Participants in both the established intervention and established intervention plus DASH dietary pattern groups substantially reduced energy, total fat, saturated fat, and sodium intake and these reductions persisted throughout the study. Established intervention plus DASH dietary pattern group participants increased intakes of fruits, vegetables, dairy, and many vitamins and minerals; these increases were significantly greater than that of the control and established intervention groups. A majority of established intervention plus DASH dietary pattern group participants achieved at least two thirds of the DRI recommendations for most nutrients at 6 months, despite their reduction in total energy intake. Some but relatively small recidivism occurred at 18 months.Conclusions Both the established intervention and established intervention plus DASH dietary pattern group intervention were effective in helping participants follow established recommendations to control blood pressure. The advice-only control group also made some behavior changes, mainly decreasing energy and sodium intake.