DASH Diet + Exercise + Weight-Loss Counseling

The nationally recommended DASH (Dietary Approaches to Stop Hypertension), similar to the Pritikin Eating Plan, does a great job of lowering blood pressure, particularly its 1,500-mg-of-sodium-a-day variation.
But for years scientists have asked:  Can a complete lifestyle-change program do even more?  Can DASH plus exercise specialists who develop personalized fitness routines plus registered dietitians and psychologists who coach people in effective weight-loss strategies (yes, a program like the Pritikin Longevity Center’s) get even better results?

Most definitely, asserts research published in the January 25, 2010 issue of the Archives of Internal Medicine and conducted by scientists from Duke University Medical Center.

Most common cardiovascular disease in the U.S.

It is an extremely important study for not only individual health but the nation’s economic health because chronic high blood pressure, or hypertension, is the most common cardiovascular disease in the U.S.  Scientists at Cornell University recently determined that the economic burden of hypertension in America, exceeding $50 billion annually, is higher than any other disease.  In 2009, the number of Americans with hypertension rose to 70+ million. If a complete lifestyle-change program can do a better job than DASH alone at ratcheting down soaring blood pressure and helping people shed weight (which lowers blood pressure even more), it is change we desperately need.

The study’s participants were made up of 144 men and women, average age 52, who were overweight or obese, had elevated blood pressure (systolic pressure between 130 and 159 and diastolic pressure between 85 and 99), but were not yet on anti-hypertensive medications.

They were randomly assigned to one of three groups: 1) the DASH diet alone; 2) the DASH diet in combination with an aerobic exercise program as well as group counseling sessions on weight-loss and lifestyle-change strategies; or 3) a control group – no change in diet and exercise habits.

19 pounds lost

After four months, the people in the comprehensive program (DASH + exercise + weight/lifestyle counseling) lost approximately 19 pounds on average while the other two groups lost minimal weight or gained weight.

Dramatic blood pressure improvements

Moreover, the people in the comprehensive program netted a 16-point improvement in blood pressure, which, the authors wrote, “is equivalent to the blood pressure lowering that physicians could expect from a high dose of an anti-hypertensive drug.” Previous research had found that this level of blood pressure control translated to an approximate 40% reduction in stroke risk and 25% reduction in heart attacks.

The group following just DASH showed an 11-point reduction in blood pressure; the control group, a 3-point reduction.

Decreased artery stiffness

There was more good news. Not only did the people in the comprehensive lifestyle-change group achieve dramatic reductions in blood pressure and weight, they also improved other important cardiovascular biomarkers. The research team observed benefits to the structure and function of their hearts, including decreased artery stiffness and a reduced thickening in the left ventricle of the heart.

“Tackling Obesity: Is Primary Care Up to the Challenge?”

In an accompanying editorial entitled “Tackling Obesity: Is Primary Care Up to the Challenge?“ Dr. Robert Kushner of Northwestern University Feinberg School of Medicine stated that a comprehensive lifestyle-change program involving physician counseling and the services of exercise specialists and registered dietitians is not easily implemented in a typical doctor’s office. To make matters worse, these services are not usually covered by health plans.

That’s got to change, asserts Dr. Kushner. He called for health care reform and training that would aid primary care physicians in tackling the obesity crisis. One vital reform would be coverage for nutrition and exercise coaching. Another would be coverage for scientifically-proven residential programs like the Pritikin Longevity Center.

Change is afoot. Recently enacted legislation in Congress has allowed Medicare to cover participation in programs like the Pritikin Longevity Center for people with heart disease. Adding coverage for overweight Americans before they have heart disease would be even more effective, and not just for the individual. It could save the country billions in health care costs for everything from hypertension drugs to coronary bypass surgeries to nursing home care for stroke victims.

It could, quite simply, take us from a nation in the red to a nation in the black.

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