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Dietary starch intake of individuals and their blood pressure: the International Study of Macronutrients and Micronutrients and Blood Pressure.

ABSTRACT: Data from the Multiple Risk Factor Intervention Trial show an independent direct association between starch intake and blood pressure in American men at higher risk of coronary heart disease. Cross-sectional data from the International Study of Macronutrients and Micronutrients and Blood Pressure (INTERMAP) were used to assess relations of dietary starch intake to blood pressure in men and women from four countries.Data include 83 nutrients from four multipass 24-h dietary recalls and two timed 24-h urine collections; eight blood pressure readings; and questionnaire data, for 4680 participants aged 40-59 years from 17 population samples in Japan, People's Republic of China, United Kingdom, and United States of America.In multiple linear regression analyses--adjusted for urinary sodium, urinary potassium, consumption of alcohol, cholesterol, saturated fatty acids, polyunsaturated fatty acids, calcium, and other variables--starch intake higher by two standard deviations (14.1% kJ) was associated with systolic/diastolic blood pressure differences of -1.0/-0.9 mmHg (P = 0.09, P < 0.05). Results were similar with additional control for fiber, magnesium, or phosphorus; reduced to -0.5/-0.7 mmHg (P = 0.47, P = 0.13) with separate adjustment for vegetable protein. Findings were similar for men analyzed separately, for American men, and for American men at higher coronary heart disease risk.Our findings indicate that--if any--relations of starch intake to blood pressure are modestly inverse. Current dietary guidelines for hypertension prevention and control remain relevant.

SUBMITTER: Brown IJ

PROVIDER: S-EPMC3111912 | biostudies-other | 2009 Feb

REPOSITORIES: biostudies-other

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Dietary starch intake of individuals and their blood pressure: the International Study of Macronutrients and Micronutrients and Blood Pressure.

Brown Ian J IJ Elliott Paul P Robertson Claire E CE Chan Queenie Q Daviglus Martha L ML Dyer Alan R AR Huang Chiang-Ching CC Rodriguez Beatriz L BL Sakata Kiyomi K Ueshima Hirotsugu H Van Horn Linda L Zhao Liancheng L Stamler Jeremiah J

Journal of hypertension 20090201 2

<h4>Objective</h4>Data from the Multiple Risk Factor Intervention Trial show an independent direct association between starch intake and blood pressure in American men at higher risk of coronary heart disease. Cross-sectional data from the International Study of Macronutrients and Micronutrients and Blood Pressure (INTERMAP) were used to assess relations of dietary starch intake to blood pressure in men and women from four countries.<h4>Methods</h4>Data include 83 nutrients from four multipass 2 ...[more]

PMID: 19155780

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Project description:BackgroundAdherence to the Dietary Approaches to Stop Hypertension (DASH) diet enhances potassium intake and reduces sodium intake and blood pressure (BP), but the underlying metabolic pathways are unclear.ObjectivesAmong free-living populations, we delineated metabolic signatures associated with the DASH diet adherence, 24-hour urinary sodium and potassium excretions, and the potential metabolic pathways involved.MethodsWe used 24-hour urinary metabolic profiling by proton nuclear magnetic resonance spectroscopy to characterize the metabolic signatures associated with the DASH dietary pattern score (DASH score) and 24-hour excretion of sodium and potassium among participants in the United States (n = 2164) and United Kingdom (n = 496) enrolled in the International Study of Macro- and Micronutrients and Blood Pressure (INTERMAP). Multiple linear regression and cross-tabulation analyses were used to investigate the DASH-BP relation and its modulation by sodium and potassium. Potential pathways associated with DASH adherence, sodium and potassium excretion, and BP were identified using mediation analyses and metabolic reaction networks.ResultsAdherence to the DASH diet was associated with urinary potassium excretion (correlation coefficient, r = 0.42; P < 0.0001). In multivariable regression analyses, a 5-point higher DASH score (range, 7 to 35) was associated with a lower systolic BP by 1.35 mmHg (95% CI, -1.95 to -0.80 mmHg; P = 1.2 × 10-5); control of the model for potassium but not sodium attenuated the DASH-BP relation. Two common metabolites (hippurate and citrate) mediated the potassium-BP and DASH-BP relationships, while 5 metabolites (succinate, alanine, S-methyl cysteine sulfoxide, 4-hydroxyhippurate, and phenylacetylglutamine) were found to be specific to the DASH-BP relation.ConclusionsGreater adherence to the DASH diet is associated with lower BP and higher potassium intake across levels of sodium intake. The DASH diet recommends greater intake of fruits, vegetables, and other potassium-rich foods that may replace sodium-rich processed foods and thereby influence BP through overlapping metabolic pathways. Possible DASH-specific pathways are speculated but confirmation requires further study. INTERMAP is registered as NCT00005271 at www.clinicaltrials.gov.

Dataset Information

Dietary starch intake of individuals and their blood pressure: the International Study of Macronutrients and Micronutrients and Blood Pressure.

Publications

Dietary starch intake of individuals and their blood pressure: the International Study of Macronutrients and Micronutrients and Blood Pressure.

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