台灣化得舒飲食能改善台灣高血壓前期及第一期患者的血壓，並且也能改善 糖尿病前期患者的血糖。台灣化得舒飲食和得舒減醣飲食對於血壓、血糖、總膽 固醇與低密度膽固醇有相同的改善效果。在血壓偏高的族群中，血壓下降的程度 較血壓正常者大，並且台灣化得舒飲食對收縮壓下降較減醣得舒飲食有更好的效 果。而本試驗顯示減醣得舒飲不但與得舒飲食一樣能同時改善血壓、血糖，並且 還能降低胰島素濃度、三酸甘油酯，增加 HDL-C/TC 比值。
得舒飲食對於高血壓前期及第一期患者的收縮壓和舒張壓能夠下降-8.9/
-5.6mmHg，相當於一顆降血壓藥物的效果，因此得舒飲食原則和菜單適合向台灣 地區高血壓前期及第一期的國人推廣。對於未來研究，可以進一步探討得舒飲食 合併體重控制對於高血壓病患是否能減少用藥。
而減醣得舒飲食可以改善高血壓前期及第一期患者的血壓、糖尿病前期患者 的血糖和胰島素、並且下降兩種患者血中三酸甘油酯、上升 HDL-C/TC 比值。顯示 減醣得舒飲食能改善代謝症候群的狀況，並且配合運動，增加血糖下降的程度。
對於未來研究，可以改變本試驗使用芥花油和減少糙米飯的減糖飲食型態，而改 為以減少精製白飯為主，用黃豆及豆干取代，並且使用橄欖油增加抗氧化物，探 討減醣得舒飲食是否能更多下降血糖和胰島素。但是由於減醣得舒飲食含較多的 脂肪，是否會造成其他疾病之風險則有待評估。
過去的營養教育會給予飲食的原則或簡單菜單來一步步改善營養知識和健康。
本次研究中發現受試者在一個月的飲食介入後，有些受試者會在沖淡期改變原本 的飲食習慣，飲食型態會趨向研究中提供的飲食。或許是每次的供餐使受試者瞭 解甚麼食物份量適合自己，甚麼菜餚可以幫助健康，甚麼樣的調味比較合適。並 且養成不喝甜飲料和吃零食的習慣，潛移默化中把研究提供的飲食型態變成自己 的飲食型態。因此，對於未來的飲食介入試驗，建議使用平行試驗設計來探討飲 食對於疾病的影響，減少沖淡期中受試者行為改變等因素。另外，不論是營養教 育研究還是推廣好的飲食習慣，提供健康餐飲搭配營養知識教育或許是另外一種 可行的營養教育方式。
51
Table 3-1 Nutrient targets and actual estimates of the two experimental diets (Taiwan DASH and reduced carbohydrate DASH) at 2000 kcal.
DASH R-CHO DASH
Nutrient Target Estimate (n=9) Target Estimate (n=9) Carbohydrate (kcal%) 55 55.1 48 47.9*
Fat(kcal%) 27 26.3 32 31.7*
Saturated 7 6.7 7 6.5
Monounsatruated 8 7.5 13 13.3*
Polyunsaturated 12 12.1 12 11.6 Protein (kcal%) 18 18.6 20 20.4*
Na (mg) 2900 2885.5 2900 2936.7
K (mg) 4567 4664.7 4567 4612.6
Mg (mg) 483 507.3 483 503.4
Ca (mg) 1200 1166 1200 1218.2
Cholesterol (mg) 150 140.9 150 164.9
Fiber (g) 30 33.6 30 32.5
(* Comparison of actual estimates of the two experimental diets, P<0.05)
DASH R-CHO DASH Food group, serving no. /day Estimate (n=9) Estimate (n=9)
Cereal 10.4 8.8
Low-fat dairy products 1.2 1.2
Vegetables 6.2 6.2
Fruit and juices 4.7 3.6
Protein- rich food 7.2 8.7
Nut 1.6 2.1
Oil 5.2 6.8
Sweet 0 0
High-fat dairy products 0 0
52
Table 3-2 Nine-day cycling menus.
平日循環一 平日循環二 平日循環三 平日循環四 平日循環五 平日循環六
早餐 洋芋土司 水果全麥三明治 起司厚片 蔬菜起司三明治 鮪魚飯糰 鮭魚炭烤三角飯糰
低脂保久乳 黑芝麻豆漿 低脂保久乳 低脂保久乳 低脂保久乳 低脂保久乳
早點 水果 水果 水果 水果 水果 水果
堅果 堅果 堅果 堅果 堅果 堅果
午餐 雲南河粉 玉米飯 炒烏龍麵 糙米飯 豬肉炒飯 青醬雞肉義大利麵
芹菜蝦仁 豆腐燒肉 麻醬豆腐 紅燒鯛魚 炒豆干綠花椰 生菜沙拉
涼拌蘆筍 燙韭菜 枸杞山藥 涼拌小黃瓜 炒莧菜
涼拌四季豆 涼拌素雞 燴三絲
燙油菜
午點 水果 水果 水果 水果 水果 水果
晚餐 南瓜糙米飯 紫米飯 糙米飯 紅麴飯 黑芝麻糙米飯 紫米飯
味噌旗魚 檸香雞串 拋灑豬肉 迷迭香雞腿肉 黑胡椒豬柳 茄汁魚片
滷豆干 炒野菇 芹菜炒豆干 炒菠菜 燙地瓜葉 青江菜炒豆皮
燙菠菜 牛蒡絲 蠔油芥蘭 炒紅菜 小黃瓜炒雞丁 炒黃豆芽菜
燴三絲 炒芥菜豆干 海帶干絲 豆干炒海帶芽
晚點 水果 水果
低脂保久乳 水果 水果 水果 水果
註:本菜單使用的水果有香蕉、奇異果、芭樂、鳳梨、棗子、木瓜、小番茄、葡萄、橘子、哈密瓜
53
Table 3-2 Nine-day cycling menus (continued).
週末循環一 週末循環二 週末循環三
早餐 鐵板豬三明治 起司厚片 鮭魚炭烤三角飯糰
黑芝麻豆漿 低脂保久乳 低脂保久乳
早點 水果 水果 水果
堅果 堅果 堅果
午餐 糙米飯 糙米飯 糙米飯
寒天咖哩雞 蠔油香菇雞柳 蘑菇雞柳
炒芥藍 炒油菜 炒菠菜
午點 水果 水果 水果
晚餐 糙米飯 糙米飯 糙米飯
紅糟雞 豬肉壽喜燒 黑胡椒豬柳
炒芥菜 炒花椰菜 炒青江菜
豆干炒毛豆 咖哩皇帝豆 滷豆干
黑胡椒毛豆
晚點 水果
低脂保久乳 水果 水果
54
99.12.31~100.3.25 100.4.9~100.7.1
First stage (4 weeks) Washout (4 weeks)
Drop out (n = 3)
Drop out (n = 3)
Drop out (n = 1)
Drop out (n = 1)
Second stage (4 weeks)
DASH (n = 7) R-CHO DASH (n = 9)
R-CHO DASH
(n = 7) DASH (n = 7) R-CHO DASH
(n = 6) DASH (n = 8)
DASH (n = 10) R-CHO DASH (n = 10)
Screened (n = 217)
Phase1: Eligible participants (n = 20)
Randomly assigned Randomly assigned
Phase2: Eligible participants (n = 16)
Figure 3-1 Flow chart for recruitment and experiment.
55
Table 3-3 Baseline characteristics of the participants.
Age, mean (SD), y 45.5(9.1) 44.9(9.7) 46(8.7) 0.73
Women, No. (%) 17(47.2) 8(47.1) 9(47.4) 0.99
Weight, mean (SD), kg 67.7(10.9) 67.2(11.0) 68.2(11.0) 0.78
Body mass index, mean (SD) 24.8(3.0) 24.8(3.5) 24.9(2.6) 0.83 SBP≧130 or DBP≧85 mmHg, No. (%) 20(55.6) 9(52.9) 11(57.9) 0.77
Pre-diabetes, No. (%) 25(69.4) 14(82.4) 11(57.9) 0.11
Education 1.00
SBP, mean (SD),mmHg 125.0(10.6) 124.4(9.0) 125.6(12.1) 0.74
DBP, mean (SD),mmHg 83.6(7.4) 84.5(5.0) 82.9(9.2) 0.52
Blood glucose, mean (SD),mg/dL 106.8(16.1) 110.1(16.4) 103.8(15.7) 0.25 Urinary electrolyte excretion
Na/creatinine, mean(SD), mmol/mmol 11.5(5.0) 11.0(3.7) 11.9(5.9) 0.59 K/creatinine, mean(SD), mmol/mmol 3.0(1.2) 2.9(1.1) 3.2(1.3) 0.49 Mg/creatinine, mean(SD), mmol/mmol 0.9(0.4) 0.9(0.4) 1.0(0.4) 0.51
R-CHO
56
Table 3-4 Baseline characteristics of participants who completed two stage.
First stage Second stage P-value First stage Second stage P-value First stage Second stage P-value
Age, mean (SD), y - -
-Women, No. (%) - -
-Weight, mean (SD), kg 66.5(11.2) 65.7(11.3) 0.0008 64.9(10.8) 64.3(11.3) 0.189 68.0(11.6) 66.9(11.4) 0.0001 Body mass index, mean (SD) 24.6(3.0) 24.4(2.9) 0.0011 24.0(3.3) 23.9(3.3) 0.3874 25.2(2.7) 24.7(2.6) <0.0001 SBP≧130 or DBP≧85 mmHg, No. (%) 15(53.6) 9(32.1) 0.1052 7(53.9) 2(15.4) 0.0968 8(53.3) 7(46.7) 0.715
Pre-diabetes, No. (%) 20(71.4) 14(50.0) 0.1007 10(76.9) 7(53.8) 0.411 10(66.7) 7(46.7) 0.269
SBP, mean (SD),mmHg 124.3(11.2) 120.3(11.1) 0.0095 124.2(9.0) 117.7(8.4) 0.0116 124.4(13.1) 122.5(12.8) 0.3185 DBP, mean (SD),mmHg 83.0(7.9) 78.8(7.5) 0.0031 84.5(5.2) 77.8(5.1) 0.0066 81.6(9.6) 79.7(9.1) 0.1947 Blood glucose, mean (SD),mg/dL 106.4(15.2) 100.9(10.2) 0.0089 106.3(14.1) 99.7(8.8) 0.0555 106.4(16.5) 101.9(11.5) 0.0931 Urinary electrolyte excretion
Na/creatinine, mean(SD), mmol/mmol 12.2(4.8) 14.7(8.8) 0.1668 11.3(3.6) 12.4(6.3) 0.5871 12.9(5.7) 16.7(10.2) 0.2116 K/creatinine, mean(SD), mmol/mmol 3.0(1.3) 3.5(2.0) 0.0865 2.8(1.2) 2.9(1.6) 0.7613 3.2(1.5) 4.0(2.3) 0.0497 Mg/creatinine, mean(SD), mmol/mmol 1.0(0.4) 0.9(0.5) 0.3276 1.0(0.4) 0.8(0.3) 0.2658 1.0(0.4) 1.0(0.6) 0.8033
15(53.6) 46.8(9.0)
Participants with complete data (n=28) R-CHO DASH-->DASH (n=15)
47.9(8.4) 8(53.3) 45.5(9.8)
7(53.6)
DASH-->R-CHO DASH (n=13)
57
Table 3-5 Effect of ambient temperature and weight change on blood pressure.
Dependent variable: second stage baseline SBP
Parameter Estimate Standard Error Pr > |t|
Intercept 27.49 16.20 0.1032
First stage baseline SBP 0.79 0.13 <.0001 Temperature change -0.54 1.14 0.6401 Weight change 1.54 1.30 0.2489
sex -2.01 2.77 0.4758
Dependent variable: second stage baseline DBP
Parameter Estimate Standard Error Pr > |t|
Intercept 29.51154 11.55726 0.0178 First stage baseline DBP 0.619149 0.133464 0.0001
Temperature change -1.24516 0.842364 0.1529 Weight change 1.602463 0.955657 0.1071
sex 0.440808 2.054596 0.832
58
Table 3-6 Differences in nutrient levels between two baseline diets.
Participants who ate DASH diet in the first stage (n=13).
Before first baseline’s diet
Before second baseline’s diet Nutrient Mean
(SD) Carbohydrate (g) 279.43 280.60 (64.32) (52.88)
Ca (mg) 585.23 674.30
(478.27) (419.35) SFA (mg) 25552.64 23721.32
(10733.31) (12117.66) Cholesterol (mg) 225.33 216.46
(76.19) (92.28) MUFA (mg) 26107.01 23449.05 (9279.93) (6960.38) PUFA (mg) 18066.01 21941.52 (7897.07) (6150.09)
59
Table 3-6 Differences in nutrient levels between two baseline diets (continued).
Participants who ate reduced carbohydrate DASH diet in the first stage (n=15).
Before first baseline’s diet
Before second baseline’s diet Nutrient Mean
(SD) Carbohydrate (g) 293.05 302.16
(27.63) (42.23)
Ca (mg) 528.34 475.71
(242.33) (190.72) SFA (mg) 20766.66 18135.27
(5099.43) (4623.54) Cholesterol (mg) 232.58 232.20
(78.64) (99.63) MUFA (mg) 23172.90 23654.73
(3915.59) (9973.75) PUFA (mg) 20353.02 18038.02 (6007.56) (6045.48)
60
(*Subtracting the first baseline blood pressure values)
Figure 3-2 Mean blood pressure change from the first baseline by study phases, study stages, and the two experimental diets.
-16
DASH Reduced CHO DASH
Phase 2
4 weeks washout 4 weeks washout
Phase 1
DASH Reduce CHO DASH
Phase 1 Phase 2
4 weeks washout 4 weeks washout
61
Table 3-7 Mean blood pressure change from the first baseline by study phases, study stages, and the two experimental diets.
SBP DBP Phase1: 1st stage
0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 -5.25 2.52 -3.20 1.81 -2.20 1.86 -1.50 1.14 2 -5.15 2.05 -9.05 2.51 -5.02 2.17 -4.55 1.89 3 -7.35 2.34 -9.25 2.70 -4.80 1.47 -2.95 1.94 4 -8.65 1.96 -5.30 1.94 -6.40 1.36 -2.40 1.86 Phase1: 2nd stage
0 -0.21 2.97 -4.71 3.11 1.71 1.89 -4.43 2.39 1 -9.21 3.74 -12.57 3.86 -2.07 2.46 -11.07 3.29 2 -5.86 3.23 -10.57 3.60 2.21 1.39 -6.71 1.72 3 -7.50 2.27 -6.71 2.51 -2.21 2.59 -6.36 2.55 4 -8.21 4.02 -5.14 2.69 -0.21 2.02 -3.43 2.78 Phase2: 1st stage
0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1 -6.00 2.63 -1.89 2.27 -5.36 1.97 -2.50 1.18 2 -4.29 2.29 -5.39 2.47 -6.36 2.07 -5.50 1.87 3 -11.71 4.32 -8.11 2.86 -10.86 2.22 -6.56 1.84 4 -10.36 2.68 -10.78 1.88 -9.86 1.42 -8.00 1.21 Phase2: 2nd stage
0 -3.25 2.13 -8.75 3.19 -5.06 1.24 -9.50 3.37 1 -6.25 2.44 -11.58 3.45 -5.13 1.67 -12.83 2.87 2 -9.00 2.95 -12.92 2.43 -6.94 1.66 -13.42 1.76 3 -8.50 2.48 -13.25 2.63 -8.06 1.52 -13.42 2.79 4 -8.00 1.76 -10.58 3.70 -5.31 1.31 -8.67 3.12
62
Figure 3-3 Mean blood pressure and weight changes from baseline by the two experimental diets.
DASH Reduced CHO DASH
DASH weight Reduced CHO DASH weight
-9
DASH Reduced CHO DASH
DASH weight Reduced CHO DASH weight
63
Figure 3-4 Mean blood pressure change from baseline in DASH diet group and R-CHO DASH diet group by baseline blood pressure states (all participants).
64
Table 3-8a Mean blood pressure and weight changes from baseline by the two experimental diets (all participants). Table 3-8b Mean blood pressure and weight changes from baseline by the two experimental diets (participants with normal baseline blood pressure).
(weeks Mean Table 3-8c Mean blood pressure and weight changes from baseline by the two experimental diets (participants with abnormal baseline blood pressure).
(weeks Mean
DASH (n=27) DASH (n=27) R-CHO DASH
(n=27) DASH (n=27) R-CHO DASH
65
Figure 3-5 Mean blood pressure change from baseline in DASH diet group and R-CHO DASH diet group by baseline blood
pressure states (participants with complete data).
66
Table 3-9a Mean blood pressure and weight changes from baseline by the two experimental diets (participants with complete data).
(weeks) Mean Table 3-9b Mean blood pressure and weight changes from baseline by the two experimental diets
(participants with complete data and normal baseline blood pressure).
(weeks) Mean Table 3-9c Mean blood pressure and weight changes from baseline by the two experimental diets
(participants with complete data and abnormal baseline blood pressure).
(weeks) Mean
DASH (n=5) R-CHO DASH
(n=5) DASH (n=5) R-CHO DASH
(n=5) DASH (n=5) R-CHO DASH (n=5)
DBP weight
SBP SBP
DASH (n=28) R-CHO DASH (n=28)
SBP DBP
DASH (n=23) R-CHO DASH
(n=23) DASH (n=23) R-CHO DASH (n=23)
weight DASH (n=28) R-CHO DASH
(n=28) DASH (n=28) R-CHO DASH (n=28)
DASH (n=23) R-CHO DASH (n=23)
67
Figure 3-6 Mean blood pressure change from baseline in the first stage by the two experimental diets.
Table 3-10 Mean blood pressure and weight change from baseline by the two experimental diets (participants in the 1st stage)
(weeks) Mean DASH (n=17) R-CHO DASH
(n=19)
weight DASH (n=17) DASH (n=17) R-CHO DASH
(n=19)
DASH Reduced CHO DASH
-9
DASH Reduced CHO DASH
68
Table 3-11 Mean blood pressure change from baseline after four weeks dietary intervention by the two experimental diets.
p-value
Blood pressure, mmHg No. Mean SE p-value No. Mean SE p-value between diet
First stage 17 -9.35 1.55 < 0.0001 19 -7.89 1.47 < 0.0001 0.50
All participants 32 -7.91 1.12 < 0.0001 32 -5.13 1.28 < 0.0001 0.11
Normal blood pressure 5 -2.80 1.59 0.1522 5 -5.50 4.10 0.2501 0.56
Prehypertension and hypertension 27 -8.85 1.21 < 0.0001 27 -5.06 1.35 0.0009 0.04 Participants with complete data 28 -7.75 1.17 < 0.0001 28 -4.95 1.39 0.0009 0.12 Pre-DM and pre-HT and HT 19 -9.61 1.58 < 0.0001 16 -5.69 1.56 0.0024 0.09
First stage 17 -7.82 1.05 < 0.0001 19 -5.05 1.29 0.001 0.11
All participants 32 -4.64 0.92 0.0003 32 -2.63 1.06 0.0187 0.16
Normal blood pressure 5 -1.30 1.15 0.3203 5 -1.60 3.29 0.6523 0.93
Prehypertension and hypertension 27 -5.26 1.03 < 0.0001 27 -2.81 1.12 0.0189 0.12 Participants with complete data 28 -4.45 1.04 0.0002 28 -2.32 1.18 0.0598 0.24
Pre-DM and pre-HT and HT 19 -5.37 1.29 0.0006 16 -3.56 1.60 0.0422 0.38
Systolic
Diastolic
Mean (SE) Change From Baseline by Diet
DASH Reduced CHO DASH
69
Table 3-12a Adjusting blood pressure changes by weight and temperature change in generalized estimating equation by diet with time as categorical variable.
β p-value β p-value β p-value β p-value
Intercept 0 . 0 . 0 . 0 .
Time 4 -7.46 <.0001 -4.84 <.0001 -3.94 0.0049 -1.97 0.0704 Time 3 -7.31 <.0001 -5.58 <.0001 -5.16 0.0002 -3.20 0.0011 Time 2 -4.92 <.0001 -3.58 0.0004 -5.48 0.0002 -3.69 0.0001 Time 1 -5.73 <.0001 -2.98 0.0034 -3.26 0.017 -2.96 0.0014
Time 0 0 1 0 . 0 . 0 1
Weight change 0.58 0.44 -0.55 0.44 1.29 0.18 0.71 0.18 Temperature
change -0.35 0.62 -0.59 0.28 -0.29 0.53 -0.17 0.55
DASH Reduced CHO DASH
SBP DBP SBP DBP
Table 3-12b Adjusting blood pressure changes by weight and temperature change in generalized estimating equation by diet with time as continuous variable.
β p-value β p-value β p-value β p-value
Intercept 0 . 0 . 0 . 0 .
Time -2.10 <.0001 -1.36 <.0001 -1.07 0.0009 -0.55 0.0353 Weight change 0.42 0.5602 -0.54 0.4552 1.93 0.0273 1.28 0.0236 Temperature
change 0.06 0.9331 -0.51 0.3328 -0.19 0.6498 -0.05 0.8692
DASH Reduced CHO DASH
SBP DBP SBP DBP
70
Table 3-12c Adjusting blood pressure changes by weight and temperature change in generalized estimating equation
Dependent variable: SBP changes from baseline
Parameter Estimate Pr > |Z|
Intercept 0
-Time -1.2946 <.0001
Time*diet (DASH) -0.6379 0.1055 Time*diet (R-CHO DASH) 0 .
Weight change 1.2103 0.0342 Temperature change -0.1335 0.7453 Dependent variable: DBP changes from baseline
Parameter Estimate Pr > |Z|
Intercept 0
-Time -0.8340 0.0013
Time*diet (DASH) -0.3880 0.2852 Time*diet (R-CHO DASH) 0 . Weight change 0.2353 0.6815 Temperature change -0.3570 0.2788
71
(*Subtracting the first baseline fasting plasma glucose or fasting insulin values)
Figure 3-7 Mean fasting plasma glucose and insulin change from the first baseline by study phases, study stages, and the two experimental diets.
-14
DASH Reduced CHO DASH
Phase 1 Phase 2
4 weeks washout 4 weeks washout
-5
DASH Reduced CHO DASH
Phase 1 Phase 2
4 weeks washout 4 weeks washout
72
Table 3-13 Mean fasting plasma glucose and insulin and HOMA-IR changes from the first baseline by study phases, study stages, and the two experimental diets.
(weeks) Mean
73
Figure 3-8 Mean fasting plasma glucose and insulin and HOMA-IR changes from baseline by the two experimental diets.
-6
ΔFasting plasma glucose (mg/dl)
No. of weeks
ΔFasting plasma glucose
DASH Reduced CHO DASH
-3
DASH Reduced CHO DASH
-0.9
DASH Reduced CHO DASH
74
Table 3-14a Mean fasting plasma glucose and insulin and HOMA-IR changes from baseline by the two experimental diets (all participants).
(weeks) Mean Table 3-14b Mean fasting plasma glucose and insulin and HOMA-IR changes from baseline
by the two experimental diets (participants with normal baseline fasting plasma glucose).
(weeks) Mean Table 3-14c Mean fasting plasma glucose and insulin and HOMA-IR changes from baseline
by the two experimental diets (participants abnormal baseline fasting plasma glucose).
(weeks) Mean SE Mean SE Mean SE Mean SE Mean SE Mean SE
0 0 0 0 0 0 0 0 0 0 0 0 0
DASH (n=8) R-CHO DASH (n=11) DASH (n=8) R-CHO DASH
(n=11)
DASH (n=32) DASH (n=32)
Insulin Glucose
Insulin
DASH (n=8) R-CHO DASH (n=11)
75
Table 3-15 Mean fasting plasma glucose and insulin and HOMA-IR changes from baseline by the two experimental diets (participants with complete data)
(weeks) Mean
Table 3-16 Mean fasting plasma glucose and insulin and HOMA-IR changes from baseline by the two experimental diets (participants in the 1st stage)
(weeks) Mean
(n=19) DASH (n=17) R-CHO DASH (n=19) R-CHO DASH
(n=28) DASH (n=28) R-CHO DASH
(n=28) DASH (n=28)
Glucose
R-CHO DASH (n=19)
Glucose Insulin
DASH (n=17) DASH (n=17)
R-CHO DASH (n=28)
76
Table 3-17 Mean fasting plasma glucose and insulin and HOMA-IR change from baseline after four weeks dietary intervention by the two experimental diets.
p-value
No. Mean SE p-value No. Mean SE p-value between diet
Glucose, mg/dl
First stage 17 -6.29 2.32 0.0154 19 -5.68 1.96 0.0096 0.84
All participants 32 -3.53 1.55 0.0299 32 -3.69 1.38 0.0122 0.94
Normal fasting glucose 8 0.00 1.41 1.0000 11 -1.45 1.85 0.4501 0.57
Pre-diabetes 24 -4.71 1.97 0.03 21 -4.86 1.85 0.0146 0.96
Participants with complete data 28 -3.36 1.64 0.0505 28 -3.82 1.56 0.0213 0.85 Pre-DM and pre-HT and HT 19 -4.53 2.28 0.0621 16 -4.56 2.23 0.0713 0.99
Insulin, μU/ml
First stage 17 -2.22 0.84 0.02 19 -2.59 1.19 0.0437 0.81
All participants 32 -1.13 0.73 0.1287 32 -1.63 0.79 0.0483 0.65
Normal fasting glucose 8 -0.61 1.13 0.6031 11 -1.10 1.02 0.3081 0.76
Pre-diabetes 24 -1.31 0.90 0.1608 21 -1.91 1.10 0.0968 0.67
Participants with complete data 28 -0.90 0.76 0.2416 28 -2.00 0.84 0.0251 0.20 Pre-DM and pre-HT and HT 19 -1.61 1.12 0.1676 16 -2.02 1.40 0.1691 0.82
HOMA-IR
First stage 17 -0.85 0.33 0.0201 19 -0.89 0.42 0.0505 0.94
All participants 32 -0.46 0.25 0.0737 32 -0.55 0.27 0.0545 0.81
Normal fasting glucose 8 -0.17 0.27 0.5514 11 -0.26 0.23 0.2871 0.81
Pre-diabetes 24 -0.55 0.32 0.0943 21 -0.70 0.40 0.0954 0.77
Participants with complete data 28 -0.36 0.25 0.1651 28 -0.64 0.30 0.0440 0.36 Pre-DM and pre-HT and HT 19 -0.65 0.39 0.1154 16 -0.76 0.52 0.1652 0.87
Mean (SE) Change From Baseline by Diet
DASH Reduced CHO DASH
77
(*Subtracting the first baseline blood lipids values)
Figure 3-9 Mean blood lipids change from the first baseline by study phases, study stages, and the two experimental diets.
DASH Reduced CHO DASH
Phase Phase 2
4 weeks washout 4 weeks washout
-35
DASH Reduced CHO DASH
Phase 1 Phase 2
4 weeks washout 4 weeks washout
78
(*Subtracting the first baseline blood lipids values)
Figure 3-9 Mean blood lipids change from the first baseline by study phases, study stages, and the two experimental diets (continue).
-80
DASH Reduced CHO DASH
Phase 1 Phase 2
4 weeks washout 4 weeks washout
-10
DASH Reduced CHO DASH
Phase 1 Phase 2
4 weeks washout 4 weeks washout
79
Table 3-18 Mean blood lipids changes from the first baseline by study phases, study stages, and the two experimental diets.
(weeks) Mean
2 -21.60 8.98 -25.50 10.07 -26.90 18.48 -49.90 33.59 -1.60 0.58 -2.50 2.01 -6.60 5.64 -1.90 7.12 4 -22.30 9.18 -31.80 10.65 -27.80 24.53 -10.40 21.68 -1.90 0.90 -4.90 1.31 -8.40 4.69 -17.30 8.65 Phase1: 2nd stage
0 4.14 17.52 -2.71 10.16 -1.29 21.16 -28.14 22.73 -2.43 2.05 2.43 1.53 8.40 11.05 2.43 9.10 2 -7.29 13.58 -21.29 9.71 -12.14 16.42 -67.29 33.32 -1.86 1.24 1.43 2.38 -1.43 8.73 -7.31 10.86 4 -6.29 11.56 -31.14 10.84 7.14 22.39 -36.71 26.50 -2.00 1.56 2.57 1.78 -4.14 9.58 -24.43 6.74 Phase2: 1st stage
0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2 -23.86 6.83 -13.67 4.88 -40.29 8.82 -33.56 7.85 -3.29 2.79 -2.22 0.83 -13.43 5.06 -6.00 4.33 4 -34.29 3.98 -27.78 3.84 -36.29 20.09 -34.56 9.19 -7.14 2.99 -4.56 1.33 -22.00 4.86 -15.78 3.21 Phase2: 2nd stage
0 -16.75 8.40 -29.83 6.04 -9.38 9.02 14.33 30.08 -5.88 1.61 -3.67 5.05 -5.38 7.52 -25.00 7.59 2 -8.88 4.94 -37.33 6.30 -10.50 8.79 -27.33 16.30 -6.75 0.80 -8.83 4.96 -2.75 5.56 -21.50 4.02 4 -18.38 4.29 -46.83 9.66 23.38 38.86 -25.17 13.59 -7.25 2.32 -6.50 5.63 -12.00 7.36 -30.83 9.43
R-CHO
80
Figure 3-10 Mean blood lipids changes from baseline by the two experimental diets.
-35
DASH Reduced CHO DASH
-60
DASH Reduced CHO DASH
-4.5
DASH Reduced CHO DASH
-25
DASH Reduced CHO DASH
-0.02
DASH Reduced CHO DASH
0
DASH Reduced CHO DASH
81
Table 3-19 Mean blood lipids changes from baseline by the two experimental diets (all participants).
(weeks) Mean
2 -12.50 4.31 -17.28 4.45 -19.88 7.45 -41.41 13.17 -1.31 0.83 -2.59 0.94 -6.49 2.85 -3.76 4.11 4 -17.16 4.30 -27.16 4.28 -6.59 14.70 -22.25 8.82 -2.41 1.00 -3.31 0.96 -11.84 3.36 -16.81 4.24
(weeks) Mean SE Mean SE Mean SE Mean SE
0 0 0 0 0 0 0 0 0
2 0.0086 0.0060 0.0081 0.0077 0.0057 0.0078 0.0355 0.0130 4 0.0088 0.0055 0.0199 0.0050 -0.0057 -0.0009 -0.0009 0.0115
TG HDL-C
R-CHO DASH
(n=32) DASH (n=32) R-CHO DASH (n=32)
DASH (n=32) R-CHO DASH
(n=32) DASH (n=32)
DASH (n=32) R-CHO DASH
(n=32) DASH (n=32)
HDL-C/TC LDL-C/TC
R-CHO DASH (n=32)
DASH (n=32) R-CHO DASH (n=32) LDL-C
TC
82
Table 3-20 Mean blood lipids change from baseline after four weeks dietary intervention by the two experimental diets Mean (SE) Change From Baseline by Diet
DASH Reduced CHO DASH p-value
No. Mean SE p-value No. Mean SE p-value between diet
Cholesterol, mg/dl
Total 32 -17.16 4.30 0.0004 32 -27.16 4.28 <0.0001 0.10
HDL 32 -2.41 1.00 0.0229 32 -3.31 0.96 0.0017 0.52
LDL 32 -11.84 3.36 0.0014 32 -16.81 4.24 0.0004 0.36
HDL/TC ratio 32 0.0088 0.0055 0.1192 32 0.0199 0.0050 0.0004 0.14 LDL/TC ratio 32 -0.0057 -0.0009 0.6777 32 -0.0009 0.0115 0.9368 0.79 Triglycerides, mg/dl 32 -6.59 14.70 0.6569 32 -22.25 8.82 0.017 0.37
83
Table 3-21 Mean urinary electrolyte/ creatinine ratio change from the first baseline by study phases, study stages, and the two experimental diets
(weeks)
DASH DASH DASH R-CHO
DASH
84
Figure 3-11 Mean urinary electrolyte/ creatinine ratio changes from baseline by the two experimental diets.
-7
DASH Reduced CHO DASH
0
DASH Reduced CHO DASH
0
DASH Reduced CHO DASH
85
Table 3-22 Mean urinary electrolyte/ creatinine ratio change from baseline by the two experimental diets (all participants)
Na/Cre. K/Cre. Mg/Cre.
DASH R-CHO DASH DASH R-CHO DASH DASH R-CHO DASH
(weeks) Mean SE Mean SE Mean SE Mean SE Mean SE Mean SE
0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2 -4.48 1.40 -3.31 0.99 1.15 0.27 1.18 0.27 0.22 0.08 0.37 0.10 4 -3.99 1.37 -2.72 1.13 0.98 0.23 1.32 0.34 0.14 0.09 0.26 0.09
Table 3-23 Mean urine electrolytes change from baseline after four weeks dietary intervention by the two experimental diets
Mean(SE) Change From Baseline by Diet
DASH Reduced CHO DASH p-value
No. Mean SE p-value No. Mean SE p-value between diet
Na/creatinine, mmol/mmol 32 -3.99 1.37 0.0065 32 -2.72 1.13 0.0229 0.48 K/creatinine, mmol/mmol 32 0.98 0.23 0.0002 32 1.32 0.34 0.0006 0.42 Mg/creatinine, mmol/mmol 32 0.14 0.09 0.1401 32 0.26 0.09 0.0081 0.34
K/Na 32 0.29 0.06 <.0001 32 0.26 0.07 0.0014 0.75
Mg/Na 32 0.06 0.01 0.0004 32 0.05 0.01 0.0007 0.72
86
Table 3-24 Comparison of Taiwan and other DASH or R-CHO DASH trial.
Table 3-24 Comparison of Taiwan and other DASH or R-CHO DASH trial.