More than two decades ago, researchers supported by the US National Institutes of Health (NIH) developed a heart-healthy eating plan called Dietary Approaches to Stop Hypertension (DASH). The DASH diet, which gained popularity over the past 20 years, encourages eating fruits, vegetables, and whole grains while avoiding saturated fats.
Studies conducted over the years since the launch of the DASH diet have confirmed that it can help to reduce hypertension, or high blood pressure, and lead to other heart-protecting changes. Despite its undisputed health benefits, other studies have revealed that adherence to the DASH plan tends to be low, especially with the emergence of several fleetingly popular diet plans.
A new study by researchers at Brown University in the US suggests that adding mindfulness training to the DASH eating plan might help people follow the diet and reduce hypertension. Mindfulness is a focus on the present moment and being aware of what is going on inside and around you. The researchers developed a training program to teach mindfulness skills — including yoga, meditation, and self-awareness — and apply these skills toward taking steps to reduce blood pressure. Such steps include following the DASH diet, boosting physical activity, and taking blood pressure medicines.
To test the effectiveness of their program, the researchers recruited about 200 people who had elevated blood pressure (over 120/80 mm Hg). Participants were mostly college-educated (73%), and female (59%), with an average age of about 60 years. Half received enhanced usual care, which included a blood pressure device with training in how to use it, brochures about hypertension control, and doctor referrals when needed. Those in the mindfulness group were asked to engage in mindfulness practices at home for at least 45 minutes a day, six days a week. They also attended group training sessions, including weekly 2.5-hour classes.
All participants were assessed at the start of the study and six months later. DASH diet adherence was assessed via a recognized food questionnaire. Another questionnaire was used to measure participants’ interoceptive awareness — their awareness of their body’s internal signals and processes, such as hunger cues and other mind-body interactions.
Results published late last year showed that those in the mindfulness program had a significant 4.5 mm Hg reduction in blood pressure at six months compared to the control group. In their new study, the researchers also gleaned insights into the reasons why this reduction happened.
By the end of six months, the mindfulness group had a 0.32-point boost (in a 0-11 range) to their DASH diet score compared to the control group. This improvement is akin to shifting from two or three servings of vegetables a day to the recommended four or more servings. Improper diet is one of the biggest drivers of blood pressure. When the researchers focused only on the 97 participants who entered the study with poor adherence to DASH, the improvement was even greater. The mindfulness training led to a difference of 0.62 points between the training and controls.
Measures of interoceptive awareness also improved significantly in the mindfulness group compared to controls. The mindfulness group had a 0.54-point boost to their awareness scores (in a 0-5 range) over six months compared to the control group. Healthy eating habits were apparently influenced by improvements in self awareness.
The study team admitted that more additional research was needed, with more diverse participants, to determine if this type of mindfulness intervention might also be effective among other populations.
