DASH-Sodium Trial in Adolescents

 描述(申请人提供)：高血压(BP)和血脂异常的病史可能起源于儿童时期。此外，青春期养成的饮食习惯也会延续到成年。为了提供证据支持儿童饮食指南，并在以后几年延缓BP和血脂异常相关发病率的流行，我们提议进行一项谨慎对照的随机试验，以在青少年中测试两种饮食干预：(1)停止高血压(DASH)饮食的饮食方法，类似于美国农业部推荐的青少年饮食模式，以及(2)减少钠。为此，我们结合了两个研究小组的领导经验，Larry Appl和他的团队在成年人中进行了DASH研究，普渡大学的Connie Weaver和她的团队领导了多项青少年控制喂养研究。这项拟议的研究是一项随机的2x2因素等卡路里喂养研究，采用交叉设计，在不同的青少年样本中测试(1)饮食(DASH与平时)和(2)钠摄入(高与低)对血压和血脂的影响。研究参与者(n=522：约50%的女性；约25%的白人、约25%的黑人、约25%的亚裔和约25%的西班牙裔)年龄在11至15岁，其收缩压在性别、年龄和身高的血压分布的上三分之一。每位参与者将随机接受四种干预措施中的两种，每种干预为期25天，作为夏季研究夏令营的一部分。在每个喂食期结束时测量血压和血脂。这项试验的结果将为这两种干预措施对青少年血压和血脂水平的影响提供直接证据。这些信息将为饮食指导提供信息，并影响未来在青少年中降低血压和改善血脂模式战略的政策制定。最重要的是，鉴于心血管疾病危险因素的先兆开始于青春期，并一直跟踪到成年，干预青春期作为预防成人心血管疾病的手段具有巨大的潜力。

 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.