DASH-Sodium Trial in Adolescents

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 DESCRIPTION (provided by applicant): Antecedents of high blood pressure (BP) and dyslipidemia likely originate in childhood. Furthermore, dietary habits developed during adolescence are carried into adulthood. In order to provide evidence in support of dietary guidelines in children and retard the epidemic of BP and dyslipidemia-related morbidity in later years, we propose a carefully controlled, randomized trial to test, among adolescents, two dietary interventions: (1) the Dietary Approaches to Stop Hypertension (DASH) diet, similar to the USDA food patterns for adolescents recommended by the Dietary Guidelines for Americans, and (2) sodium reduction. To this end, we combined the leadership experience of two research groups, Larry Appel and his team who conducted the DASH studies in adults and Connie Weaver and her team from Purdue who have led multiple controlled feeding studies in adolescents. The proposed study is a randomized, 2x2 factorial isocaloric feeding study with a cross-over design that tests the effects on BP and blood lipids of (1) diet (DASH vs Usual) and (2) sodium intake (High vs Low) in a diverse sample of adolescents. Study participants (n=522: ~50% Female; ~25% White, ~25% Black, ~25% Asian, and ~25% Hispanic) will be 11 to 15 years of age with systolic BP in the upper third of the BP distribution for their sex, age and height. Each participant will receive two of the four interventions, each for 25 days, in random order as part of a summer research camp. BP and lipids will be measured at the end of each feeding period. Results of this trial will provide direct evidence of the impact of the two interventions on both blood pressure and blood lipid levels among adolescents. This information will inform dietary guidance and influence future policy development on strategies to lower blood pressure and improve lipid patterns among adolescents. Most importantly, given that the antecedents to CVD risk factors begin in adolescence and track into adulthood, intervening in adolescence has tremendous potential as a means to prevent CVD in adults.