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Body mass index mediates the effect of the DASH diet on hypertension: Common metabolites underlying the association

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)1-9
JournalJOURNAL OF HUMAN NUTRITION AND DIETETICS
DOIs
Accepted/In press2021
Published26 Oct 2021

Bibliographical note

Funding Information: This research was funded by the Chronic Disease Research Foundation and in part by the Wellcome Trust [Grant number: 212904/Z/18/Z]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. TwinsUK receives funding from the Wellcome Trust and by European Commission H2020 grants SYSCID (contract #733100); the National Institute for Health Research (NIHR) Clinical Research Facility and the Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London. C. M., P. L., A. N., and O. M. are funded by the CDRF. M. M. is funded by the National Institute for Health Research (NIHR)‐funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy's and St Thomas’ NHS Foundation Trust in partnership with King's College London. A. M. V. is funded by a UKRI and MRC Covid‐Rapid Response grant (MR/V027883/1) and the Nottingham NIHR Biomedical Research Centre. P. C. is founded by the European Union (H2020 contract #733100). Publisher Copyright: © 2021 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association

King's Authors

Abstract

Background

The Dietary Approaches to Stop Hypertension (DASH) diet is beneficial in reducing blood pressure; however, this may be a consequence of concurrent weight reduction. In the present study, we investigated whether body mass index (BMI) mediates the association between the DASH diet and hypertension and investigate common metabolic pathways.

Methods

We included 2424 females from the cross-sectional TwinsUK cohort, with blood pressure, BMI and dietary intake measured within 1.01 (SD = 0.68) years and serum metabolomics profiling (591 metabolites). We constructed a mediation model to test the mediation effects of BMI on the total effect of the DASH diet on hypertension. To identify a metabolite panel associated with the DASH diet and BMI, we built random forest models for each trait, and selected the common metabolic contributors using five-fold cross-validation error.

Results

We found that BMI fully mediates the association between the DASH diet and hypertension, explaining 39.1% of the variance in hypertension. We then identified a panel of six common metabolites predicting both the DASH diet and BMI with opposing effects. Interestingly, at the univariate level, the metabolites were also associated with hypertension in the same direction as BMI. The strongest feature, 1-nonadecanoyl-GPC (19:0), was positively associated with the DASH diet (β [SE] = 0.65 [0.12]) and negatively with BMI (β [SE] = −1.34 [0.12]) and hypertension (odds ratio = 0.71, 95% confidence interval = 0.6–0.84).

Conclusions

We highlight the role of BMI in the mechanisms by which the DASH diet influences hypertension and also highlight common metabolic pathways. Further studies should investigate the underlying molecular mechanisms to increase our understanding of the beneficial ways of treating hypertension.

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