DASH Diet Found to Yield Health Benefits in Adolescents With Hemophilia

The Dietary Approach to Stop Hypertension (DASH) diet yields beneficial health effects, reducing blood pressure, sugar, and fat, and increasing high-density lipoprotein (HDL) levels or so-called “good” cholesterol, in adolescents with hemophilia, an Iranian study reports.

The study, “Effects of the dietary approach to stop hypertension (DASH) diet on blood pressure, blood glucose, and lipid profile in adolescents with hemophilia: A randomized clinical trial,” was published in the journal Food Science & Nutrition.

Hemophilia is caused by a deficiency in blood clotting factors. The disorder is characterized by abnormally sustained bleeding, which is usually managed with medications that promote blood clotting or otherwise control bleeding. 

Hemophilia patients also have higher rates of cardiovascular and metabolic risk factors, including obesity-related complications, than the general population. Specifically, children with hemophilia have increased rates of hypertension, and blood levels of glucose (sugar) and lipids (fat) than non-affected children.

Nutrition is an important consideration in effectively managing hemophilia. However, standard hemophilia treatment does not currently include disease-specific guidelines to reduce nutrition-related cardiovascular risks.

The DASH diet has been identified as a safe and effective approach to managing blood pressure, cholesterol, and blood glucose levels in the general population. The diet emphasizes the consumption of whole grains, legumes, nuts, fruits, vegetables, low-fat dairy, and white meat while avoiding red meat and foods high in sodium.

In the study, researchers in Iran, along with a colleague in the U.K., sought to determine the impact of the DASH diet on cardiovascular and metabolic risk factors in adolescents with hemophilia.

The 10-week clinical trial (IRCT20130903014551N6) was conducted from March to June 2020, and included 40 adolescents, age 10 to 18, with hemophilia recruited from Omid Hospital in Isfahan, Iran. The study participants were male and had not used antioxidant supplements or a prescribed diet prior to the study.  

Patients were randomly assigned to the DASH diet or a control diet. The DASH group (mean age 13.8) received a diet consisting of 50%–55% carbohydrate, 27%–30% fat, and 16%–18% protein, with restricted consumption of red meat and sodium. The control group received healthy eating recommendations such as adequately chewing food before swallowing, minimizing fat and sugar consumption, avoiding fried food, and eating frequent small meals and healthy snacks. 

Because blood vitamin C levels increase on the DASH diet, its levels can be used as indicators of diet compliance. Vitamin C levels were measured at the start of the study and after 10 weeks. Study participants and their parents attended an introductory meeting and follow-up meetings at the two-, four-, six-, and eight-week mark. Parents also completed food records on the first, fifth, and 10th weeks. 

A total of seven patients withdrew from the study, three in the DASH group and four from the control group, due to medical or personal issues, or lack of adherence to the diet.

Although participants in the DASH group were in a higher weight and height percentile, the two groups showed no differences in age, body mass index percentile, or waist circumference. During the trial, the mean consumption of calories, carbohydrates, protein, and fat were also not significantly different between the groups.

Results showed that, compared to the control group, adolescents on the DASH diet had increased potassium, calcium, and vitamin C intake, as well as lower sodium consumption.

By the end of the trial, the DASH group had significantly higher blood vitamin C levels compared to both baseline (study start) and the control group, suggesting compliance with the diet. Also, compared to controls, the DASH group had a reduction in blood pressure, blood glucose and fat levels, total cholesterol, and low-density lipoprotein (LDL), which may cause cholesterol build-up in the arteries. The group also showed a significant increase in HDL, which helps remove harmful cholesterol from the blood. 

Notably, systolic blood pressure (pressure in arteries when the heart beats) but not diastolic blood pressure — pressure in the arteries in between heartbeats — was significantly decreased in the DASH group compared to controls.

“Our findings indicate that this diet can also be beneficial in adolescents with hemophilia. Indeed, our findings suggest that the DASH diet can improve blood pressure, blood glucose, and lipid profile,” the researchers wrote.

One of the study’s limitations was the inability to blind participants or researchers — in other words, making them unaware of which treatment they received.