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TOPLINE
A secondary analysis of a trial found that the Dietary Approaches to Stop Hypertension for Diabetes (DASH4D) diet — a DASH-style diet tailored for diabetes — led to significant reductions in fructosamine, fasting glucose, and A1c levels compared with a diet representing typical US eating patterns among adults with type 2 diabetes (T2D). The greatest benefits for fructosamine and fasting glucose levels were observed among those with baseline A1c levels of 7% or greater.
METHODOLOGY
- Researchers conducted a secondary analysis of a controlled feeding trial to examine the effect of the DASH4D diet on glycemic biomarker levels, including fructosamine, fasting glucose, and A1c levels, among 101 adults with T2D (mean age, 67 years; 65% women).
- Participants were fed four diets in random order: DASH4D diet and comparison diet (representative of a typical American diet), each with higher (3700 mg/d at 2000 kcal) and lower (1500 mg/d at 2000 kcal) sodium levels.
- Each feeding period lasted 5 weeks and was separated by at least 1 week; caloric intake was adjusted to maintain stable body weight.
- The DASH4D diet focused on fruits, vegetables, whole grains, and low-fat dairy, whereas the comparison diet was low in fruits and vegetables and included more red meat and sugar-sweetened foods. All meals and snacks and most beverages were prepared in a metabolic kitchen.
- The primary outcome of this secondary analysis was fructosamine levels, which reflect average glycemia over approximately 2-4 weeks; secondary outcomes included fasting glucose and A1c levels.
TAKEAWAY
- Overall, 84% of participants completed all four feeding periods; adherence to the dietary intervention was approximately 96% of study days during both the DASH4D and comparison diet periods, and body weight remained stable throughout.
- Compared with the comparison diet, the DASH4D diet led to significant reductions of 5.6 µmol/L in fructosamine levels (P = .002), 4.5 mg/dL in fasting glucose levels (P = .02), and 0.09 percentage points in A1c levels (P = .04).
- In exploratory analyses, the effect of the DASH4D diet on fructosamine levels was greater among participants with higher baseline A1c levels, with mean reductions of 8.8 µmol/L among those with A1c levels of 8%-9%, 5.5 µmol/L among those with A1c levels of 7%-7.9%, and 3.7 µmol/L among those with A1c levels less than 7%. A similar trend was also observed for fasting glucose levels.
IN PRACTICE
"The DASH4D diet integrates nutritional guidance into a coherent eating plan, offering a simpler approach for patients with diabetes to follow a healthy diet that can improve glucose control," the authors wrote.
SOURCE
This study was led by Michael Fang, Johns Hopkins Bloomberg School of Public Health, Baltimore. It was published online as a brief report in Diabetes Care.
LIMITATIONS
The study excluded individuals with A1c levels > 9%. Subgroup estimates may have lacked precision due to the small number of participants with baseline A1c levels between 8% and 9%. In addition, adherence was assessed through self-reports.
DISCLOSURES
The DASH4D trial was funded primarily by the Sheikh Khalifa Stroke Institute at Johns Hopkins University School of Medicine, with additional support from the Johns Hopkins O'Brien Center to Advance Kidney Health Equity through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and from the Johns Hopkins Institute for Clinical and Translational Research through the National Center for Advancing Translational Sciences. The DASH4D-continuous glucose monitoring (DASH4D-CGM) ancillary study was funded by an NIDDK grant awarded to one author. Some authors reported receiving support or grants from various sources. Three authors are editors of Diabetes Care but had no role in reviewing or accepting the manuscript. The authors declared no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
