Very Low Carbohydrate vs DASH Diet
Today we are discussing a recent study on different dietary strategies. This study was published in the journal Annals of Family Medicine in May 2023 titled “Comparing Very Low Carbohydrate vs DASH Diets for Overweight or Obese Adults with Hypertension and Prediabetes or Type 2 Diabetes: A Randomized Trial”. For many years now the DASH diet has been revered for its ability to help lower blood pressure. DASH actually stands for the Dietary Approaches to Stop Hypertension - pretty compelling, right? It has been shown to work in many studies. However, that doesn’t necessarily make it the best or only nutritional strategy.
In this particular study, they looked at 94 adults with triple morbidity (hypertension, prediabetes/Type 2 Diabetes, and obesity or overweight), monitored for 4 months. Randomized into groups: Very Low Carbohydrate ketogenic diet or DASH diet. Then further subdivided the two diet groups into groups with standard education and support or groups with both standard education and support plus some additional support.
Everyone got access to an online program, text messages, cookbooks, email-based coaching, and recommendations to monitor nutrition intake, weight, blood pressure, and blood sugar. Exercise and sleep routines were also encouraged. Those in the extra support groups received additional information on mindful eating, emotional eating, food-related urges, mindful responses to stress, positive emotion regulation, and gratitude.
Very Low Carbohydrate: limit carbohydrate intake to 20-35g net carbs per day, with goal of achieving nutritional ketosis as measured using urine ketone test strips.
DASH: limit sodium to under 2300 mg daily and less than 20-30% intake of calories in fat (low fat, low sodium diet)
All participants underwent assessments as baseline and at the end to include blood pressure, hemoglobin A1c, body weight, and medications prescribed and dosages needed.
Here were the results after 16 weeks for each group:
Very low carb groups had greater improvement in systolic blood pressure, hemoglobin A1c, and more weight loss.
→ Not just better systolic blood pressure, but the Very Low Carbohydrate diet groups decreased twice as much by nearly 10 points, DASH groups reduced 5 points.
→ Not just better hemoglobin A1c, but the Very Low Carbohydrate diet groups decreased by .35%, DASH groups decreased by .14%.
→ And not just better weight loss, but the Very Low Carbohydrate groups lost nearly twice as much weight: 19.14lbs vs 10.34lbs in the DASH diet groups.
→ And to top it all off, 12 of 32 on Very Low Carbohydrate who were taking blood pressure medications diet stopped or decreased their blood pressure medications during the study. Whereas only 4 of 42 on DASH diet who were taking blood pressure medications stopped or decreased their blood pressure medication. And 5 of 9 on the Very Low Carbohydrate diet who were taking blood sugar medications stopped or decreased their blood sugar medications versus 0 decrease or stop in blood sugar medications on DASH. Two people on DASH actually increased blood sugar medications.
Head to head, the very low carbohydrate vs DASH diet shows the very low carbohydrate diet wins!
Interestingly, when they looked at both diets with and without the added support on mindfulness and emotional eating - the added support did not make a statistically significant difference for either diet. So it would seem that the standard education given to all participants was adequate.
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If you like this content, be sure to check out the comparison between the ketogenic diet and the ever so popular Mediterranean Diet here.
