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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 Nutrition volume 72, pages 894–903 (2018)Cite this article

Subjects

Abstract

Background/objectives

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.

Subjects/methods

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.

Results

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).

Conclusions

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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Acknowledgements

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

Funding

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 (www.anzctr.org.au).

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.

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Authors and Affiliations

  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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  1. Rhoda N. Ndanuko
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Correspondence to Rhoda N. Ndanuko.

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Ndanuko, R.N., Tapsell, L.C., Charlton, K.E. et al. Effect of individualised dietary advice for weight loss supplemented with walnuts on blood pressure: the HealthTrack study. Eur J Clin Nutr 72, 894–903 (2018). https://doi.org/10.1038/s41430-018-0123-0

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