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Interventions and public health nutrition

Effect of individualised dietary advice for weight loss supplemented with walnuts on blood pressure: the HealthTrack study

European Journal of Clinical Nutritionvolume 72pages894903 (2018) | Download Citation



In addition to weight-loss, healthy dietary patterns and lower sodium intakes can help reduce blood pressure (BP), but individualised dietary advice may be necessary to achieve these effects. This study aimed to examine the impact of individualised dietary advice on BP in the intensive phase of a weight-loss trial.


Secondary analysis of baseline and 3-month data from the HealthTrack randomised controlled trial (n = 211). Participants were randomly assigned to one of three dietary advice groups: general advice (control), individualised advice (intervention group, I), or intervention group supplemented with 30 g walnuts/day (IW). Resting BP and 24-h urine sodium and potassium were measured. Dietary intake was evaluated through diet history interviews.


Unadjusted SBP reduced significantly in all groups (IW and I groups P < 0.001; control group P = 0.002) and DBP in IW and I groups (P < 0.001). Compared to controls, the reductions in BP were 3–4 mmHg greater in the I and IW groups, but this only reached significance for DBP in the I group (−3.3 mmHg; P = 0.041). After controlling for age, sex, medication, weight-loss, physical activity and smoking, only the IW group showed a significant association between SBP reduction and increased urinary potassium (β = −0.101, P = 0.044), decreased sodium:potassium ratio (β = 2.446, P = 0.037) and increased consumption of seed and nut products and dishes (β = −0.108, P = 0.034).


Dietary patterns with distinctive foods and lower sodium:potassium ratios may enhance the effects of weight-loss on BP. The patterns were best achieved with individualised dietary advice and food supplements.

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The authors would like to thank all the investigators and participants of the HealthTrack study.


HealthTrack study was primarily funded by the Illawarra Health and Medical Research Institute with additional support from the California Walnut Commission. HealthTrack study was registered on the Australian New Zealand Clinical Trials Registry, trial ID ACTRN12614000581662 (

Author contributions

LCT, KEC, EPN and MJB designed the research; RNN conducted the research; RNN and MJB performed the statistical analysis; RNN, LCT, KEC and EPN wrote the manuscript; RNN had primary responsibility for the final content. All authors read and approved the final manuscript.

Author information


  1. School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia

    • Rhoda N. Ndanuko
    • , Linda C. Tapsell
    • , Karen E. Charlton
    •  & Elizabeth P. Neale
  2. Statistical Consulting Service, School of Mathematics and Applied Statistics, University of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia

    • Marijka J. Batterham


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The authors declare that they have no conflict of interest.

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Correspondence to Rhoda N. Ndanuko.

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