171 EFFECTS OF THE JAPANESE-STYLE DIETARY APPROACHES TO STOP HYPERTENSION (DASH) DIET IN COMBINATION WITH COMPREHENSIVE LIFESTYLE MODIFICATION FOR JAPANESE HYPERTENSIVE PATIENTS

Background: International guidelines for hypertension recommend the Dietary Approaches to Stop Hypertension (DASH) Diet based on the evidence from the United States. The guideline Japanese Society of Hypertension 2009 (JSH2009) also recommends DASH diet as high grade evidence, but DASH diet is uncommon in Japan. Methods: Traditional DASH diet is grounded on Western-style dietary habits. That explains why DASH diet cannot come into wide use. We analyzed DASH diet precisely in terms of nutritional elements and developed the Japanese-style DASH Diet. We have guided this Japanese-style DASH Diet for around 330 hypertensive patients in combination with comprehensive lifestyle modification according to JSH2009. To evaluate adherence to DASH diet, we used DASH score based on previous studies. Results: DASH diet recommends nuts, seeds, and legumes as rich sources of magnesium, but their foods like peanut butter are not popular in Japanese food culture. We recommend soybean foods like Tohu instead of them. After guidance, 40% of patients succeeded lowering blood pressure. Their patients could get good control without medications or with fewer anti-hypertensive agents. They could accept modification because our Japanese-style DASH Diet explained not only “Restricitons“ but also “ Recommendations“ in daily foods. Conclusions: Japanese foods are getting popular in many countries and recognized healthy because of low fat, rich in vegetables, favored seafood than meat. But adjustment is needed when we use Evidence Based Medicine. It is important for appropriate lifestyle modifications to understand patient's customs, especially about foods. We introduce the first Japanese-style DASH Diet in the world.References Appel LJ, et al: A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med, 336: 1117–1124, 1997 Sacks FM, et al: Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborate Research Group. N Engl J Med, 44: 3–10, 2001