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Association of Dietary Approaches to Stop Hypertension diet and Mediterranean diet with blood pressure in less-developed ethnic minority regions

Abstract Objective: We aimed to investigate the associations of Dietary Approaches to Stop Hypertension (DASH)-style diet and Mediterranean-style diet with blood pressure (BP) in less-developed ethnic minority regions (LEMR). Design: Cross-sectional study. Setting: Dietary intakes were assessed by a validated FFQ. Dietary quality was assessed by the DASH-style diet score and the alternative Mediterranean-style diet (aMED) score. The association between dietary quality and BP was evaluated using multivariate linear regression model. We further examined those associations in subgroups of BP level. Participants: A total of 81 433 adults from the China Multi-Ethnic Cohort (CMEC) study were included in this study. Results: In the overall population, compared with the lowest quintile, the highest quintile of DASH-style diet score was negatively associated with systolic BP (SBP) (coefficient –2·78, 95 % CI –3·15, –2·41; P for trend < 0·001), while the highest quintile of aMED score had a weaker negative association with SBP (coefficient –1·43, 95 % CI –1·81, –1·05; P for trend < 0·001). Both dietary indices also showed a weaker effect on diastolic BP (coefficient for DASH-style diet –1·06, 95 % CI –1·30, –0·82; coefficient for aMED –0·43, 95 % CI –0·68, –0·19). In the subgroup analysis, both dietary indices showed a stronger beneficial effect on SBP in the hypertension group than in either of the other subgroups. Conclusion: Our results indicated that the healthy diet originating from Western developed countries can also have beneficial effects on BP in LEMR. DASH-style diet may be a more appropriate recommendation than aMED as part of a dietary strategy to control BP, especially in hypertensive patients.