Abstract WE439: The generalizability of the Dietary Approaches to Stop Hypertension for Diabetes (DASH4D) Diet

Abstract

Background: We recently showed that a DASH-style diet optimized for diabetes (DASH4D diet) significantly reduced blood pressure and improved glycemic control in a randomized trial of adults with type 2 diabetes. To better understand the generalizability of the DASH4D findings, we compared demographic and clinical characteristics and the baseline dietary intake of the trial participants with those of the general US adult population with type 2 diabetes. Methods: We analyzed pre-randomization data from 103 participants in the DASH4D trial. For the comparison population, we analyzed data from 546 participants from NHANES 2021-2023 who met the inclusion criteria of the DASH4D study (aged 18 years and older with type 2 diabetes, systolic blood pressure of 120 – 159 mmHg, and diastolic blood pressure of <100 mmHg). Participants with HbA1c >9 were excluded. Typical dietary intake was assessed using 24-hour dietary recall in both studies. We assessed dietary recall data along with demographic, physical and clinical characteristics in both study populations. Analyses of NHANES accounted for the complex survey design and were weighted to provide nationally representative estimates. Results: The DASH4D participants were more likely to be female, Black race, and have higher attained education, and have lower total cholesterol than US adults with diabetes. The prevalence of obesity was similar in the two populations (Table 1) . Participants in DASH4D and US adults had comparable intake of protein (17 vs.16 % of total energy intake), carbohydrates (44 vs. 45% of total energy intake), and total fat (39 vs. 38% of total energy intake) (Figure 1) . DASH4D participants consumed a higher average level of fiber (10 g per 1,000 kcal) compared to NHANES (8 g per 1,000 kcal). Both populations had similar intakes of calcium, magnesium, phosphorous and potassium (Figure 2) . Conclusion: The usual dietary intake of participants in the DASH4D trial is broadly representative of US adults with diabetes, suggesting findings from the DASH4D trial are likely generalizable to the US population with diabetes.