Geoffrey W. Snyder

Comprehensive Nutrition Plan Improves Cardiovascular Risk Factors in Essential Hypertension

Increased arterial pressure is known to be influenced by a variety of nutrients. Compliance with dietary recommendations for risk reduction is often limited by the complexity of their implementation. In addition, how improvements in total diet, rather than single nutrients, influence concomitant cardiovascular risk factors has not been thoroughly explored. We assessed the effects of a nutritionally complete prepared meal program, the Campbells Center for Nutrition and Wellness plan (CCNW), compared with dietary therapy in which participants received a structured nutritional assessment and prescription and selected their own foods, in 101 women and men with mild-to-moderate hypertension. Outcome measures included blood pressure (BP), lipids and lipoproteins, glucose, glycosylated hemoglobin (HbA1c), insulin, homocysteine, nutrient intake, compliance, and quality of life. Both dietary interventions significantly lowered BP (P < .0001), while simultaneously improving the overall cardiovascular risk profile. Significantly greater benefits were observed with the CCNW plan as compared with the participant selected diet in cholesterol and LDL levels (both P < .0001), LDL:HDL (P < .001), HbA1c (P < .05), homocysteine (P < .001), total nutrient intake (P < .0001), compliance (P < .0001), and quality of life (P < .001). This study demonstrates that improving the total diet to include the full array of recommended dietary guidelines, rather than focusing on single nutrients, has significant benefits for the cardiovascular risk profile of hypertensive persons beyond BP control. Compared with typical dietary therapy, the comprehensive CCNW meal plan has significantly greater effects on multiple cardiovascular risk factors while yielding greater compliance and improved quality of life.

Concurrent Nutrient Changes with a Decrease in Dietary Sodium

Abstract Method: A 6-center randomized placebo controlled trial was instituted to assess the effect of dietary sodium on the effectiveness of isradipine in subjects with essential hypertension. After baseline evaluation, 99 hypertensive subjects were counselled to restrict dietary sodium to 60–80 mEq/day; all subjects received a comprehensive manual on a sodium-restricted diet and individual counselling by a dietitian. No advice regarding other nutrients was given. After a 4-week run-in period to assess compliance, subjects with urinary Na Results: Sodium intake was reduced by 50 mEq to 64±25 mEq. Intakes of most nutrients decreased significantly (p ; 16% decrease in calcium intake (703±342mg to 588±259mg) ; 14% in iron (14±6mg to 12±14mg); and 6% in potassium (2645±918 to 2495±851mg). Conclusion: The effect of dietary sodium restriction must be carefully weighed with a concomitant effect on other nutrients. While in reduction in total fat is beneficial, reduction in calcium, iron, and potassium intakes may offset this