title: C-Reactive Protein and Prediction of Coronary Heart Disease and Global Vascular Events in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) Inflammation Modifies the Effects of a Reduced-Fat Low-Cholesterol Diet on Lipids: Results From the DASH-Sodium Trial Beef in an Optimal Lean Diet study: effects on lipids, lipoproteins, and apolipoproteins123 A dietary approach to prevent hypertension: A review of the dietary approaches to stop hypertension (DASH) study Does the DASH diet lower blood pressure by altering peripheral vascular function? Effect of a high-fiber diet vs a fiber-supplemented diet on C-reactive protein level. The effect of a dietary portfolio compared to a DASH-type diet on blood pressure. Effect of dietary patterns on serum C-reactive protein level. The Dietary Approaches to Stop Hypertension eating plan affects C-reactive protein, coagulation abnormalities, and hepatic function tests among type 2 diabetic patients.
abstract: Background — The role of C-reactive protein ( CRP ) in predicting vascular events and response to statin therapy remains uncertain . Additional large prospect i ve studies are required . Methods and Results — Baseline CRP was related to risk over 3.2 years for primary a combined end point ( definite or suspected death from coronary heart disease , nonfatal myocardial infa rct ion , and fatal or nonfatal stroke ; n=865 events ) and secondary ( coronary heart disease events or stroke alone ) and tertiary ( stroke plus transient ischemic attack ) end points in the Prospect i ve Study of Pravastatin in the Elderly at Risk ( n=5804 men and women ; age , 70 to 82 years ) .  CRP levels were higher in subjects who had a subsequent primary end-point event compared with those who did not ( geometric mean ; 3.64 mg/L [ SD , 3.08 mg/L ] versus 3.01 mg/L [ SD , 3.05 mg/L ] ; P<0.0001 ) . CRP correlated positively with body mass index and smoking status and negatively with high-density lipoprotein cholesterol . The unadjusted hazard ratio for the primary end point was 1.48 ( 95 % CI , 1.26 to 1.74 ) in a comparison of top and bottom thirds for CRP , falling to 1.36 ( 95 % CI , 1.15 to 1.61 ) with adjustment for established predictors and body mass index . Similar results were obtained for other end points or when results were examined separately by history of vascular disease . However , baseline CRP added minimally to risk prediction beyond conventional predictors and did not relate to the magnitude of pravastatin benefit . Conclusions — Elevated CRP minimally enhances cardiovascular disease prediction beyond established vascular risk factors and does not predict response to statin therapy in elderly subjects at risk . These data suggest that CRP has limited clinical value in cardiovascular disease risk stratification or predicting response to statin therapy in elderly people Background —Inflammatory mediators regulate key aspects of lipid metabolism . We hypothesized that inflammation could diminish the cholesterol-lowering effect of a reduced-fat/low-cholesterol diet . Methods and Results —After a 2-week run-in period on a control diet ( 37 % total fat , 16 % saturated fat ) , 100 participants were r and omized to the control or DASH diet ( 27 % total fat , 6 % saturated fat ) for 12 weeks . Median C-reactive protein ( CRP ) at baseline was 2.37 mg/L ( interquartile range , 1.20 , 3.79 ) . The DASH diet , net of control , had no effect on CRP . Overall , there were significant net reductions in total ( −0.34 mmol/L ) , LDL ( −0.29 mmol/L ) , and HDL ( −0.12 mmol/L ) cholesterol from the DASH diet ( each , P < 0.001 ) and little change in triglycerides ( + 0.05 mmol/L , P = 0.21 ) . Baseline CRP was strongly associated with lipid responsiveness to the DASH diet . Total and LDL cholesterol were reduced to a greater degree in those with a “ low ” ( below median ) compared with a “ high ” ( above median ) baseline CRP ( total , −9.8 % versus −3 % ; P for interaction=0.006 ; LDL cholesterol , −11.8 % versus −3 % ; P for interaction=0.009 ) . Reductions in HDL cholesterol ( −8.8 % ) were similar in persons with low versus high CRP . Triglycerides were increased in those with a high CRP but not in those with a low CRP ( 19.8 % versus + 0 % ; P for interaction=0.019 ) . Conclusions —In this study , the presence of increased CRP was associated with less total and LDL cholesterol reduction and a greater increase in triglycerides from a reduced-fat/low-cholesterol diet . These findings document an additional mechanism by which inflammation might increase  cardiovascular disease risk Background : A Step I diet with lean beef compared with lean white meat both decrease  LDL cholesterol .  To our knowledge , no studies have evaluated a low – saturated fatty acid ( SFA ) ( < 7 % calories ) diet that contains lean beef . Objective : We studied the effect on LDL cholesterol of cholesterol-lowering diets with varying amounts of lean beef [ ie , Dietary Approaches to Stop Hypertension ( DASH ) : 28 g beef/d ; Beef in an Optimal Lean Diet ( BOLD ) : 113 g beef/d ; and Beef in an Optimal Lean Diet plus additional protein ( BOLD+ ) : 153 g beef/d ] compared with that of a healthy American diet ( HAD ) . Design : Thirty-six hypercholesterolemic participants ( with LDL-cholesterol concentrations > 2.8 mmol/L ) were r and omly assigned to consume each of the 4 diets ( HAD : 33 % total fat , 12 % SFA , 17 % protein , and 20 g beef/d ) , DASH ( 27 % total fat , 6 % SFA , 18 % protein , and 28 g beef/d ) , BOLD ( 28 % total fat , 6 % SFA , 19 % protein , and 113 g beef/d ) , and BOLD+ ( 28 % total fat , 6 % SFA , 27 % protein , and 153 g beef/d ) for 5 wk . Results : There was a decrease in total cholesterol ( TC ) and LDL-cholesterol concentrations ( P < 0.05 ) after consumption of the DASH ( −0.49 ± 0.11 and −0.37 ± 0.09 mmol/L , respectively ) , BOLD ( −0.48 ± 0.10 and −0.35 ± 0.9 mmol/L , respectively ) , and BOLD+ ( −0.50 ± 0.10 and −0.345 ± 0.09 mmol/L , respectively ) diets compared with after consumption of the HAD ( −0.22 ± 0.10 and −0.14 ± 0.10 mmol/L , respectively ) . Apolipoprotein A-I , C-III , and C-III bound to apolipoprotein A1 particles decreased after BOLD and BOLD+ diets compared with after the HAD , and there was a greater decrease in apolipoprotein B after consumption of the BOLD+ diet than after consumption of the HAD ( P < 0.05 for both ) . LDL cholesterol and TC decreased after consumption of the DASH , BOLD , and BOLD+ diets when the baseline C-reactive protein ( CRP ) concentration was < 1 mg/L ; LDL cholesterol and TC decreased when baseline CRP concentration was > 1 mg/L with the BOLD and BOLD+ diets . Conclusions : Low-SFA , heart-healthy dietary patterns that contain lean beef elicit favorable effects on cardiovascular disease ( CVD ) lipid and lipoprotein risk factors that are comparable to those elicited by a DASH dietary pattern . These results , in conjunction with the beneficial effects on apolipoprotein CVD risk factors after consumption of the BOLD and BOLD+ diets , which were greater with the BOLD+ diet , provide support for including lean beef in a heart-healthy dietary pattern . This trial was registered at clinical trials.gov as NCT00937898 Background : Population s eating mainly vegetarian diets have lower blood pressure levels than those eating omnivorous diets . Epidemiologic findings suggest that eating fruits and vegetables lowers blood pressure We tested whether lowering of blood pressure ( BP ) on the dietary approaches to stop hypertension ( DASH ) diet was associated with changes in peripheral vascular function : endothelial function , assessed by flow-mediated vasodilatation ( FMD ) of the brachial artery , and subcutaneous adipose tissue blood flow ( ATBF ) . We also assessed effects on heart rate variability ( HRV ) as a measure of autonomic control of the heart . We allocated 27 men and women to DASH diet and control groups .  We measured FMD , ATBF and HRV on fasting and after ingestion of 75 g glucose , before and after 30 days on dietary intervention , aim ing for weight maintenance . The control group did not change their diet . The DASH-diet group complied with the diet as shown by significant reductions in systolic ( P<0.001 ) and diastolic ( P=0.005 ) BP , and in plasma C-reactive protein ( P<0.01 ) , LDL-cholesterol ( P<0.01 ) and apolipoprotein B ( P=0.001 ) , a novel finding . Body weight changed by < 1 kg . There were no changes in the control group . We found no changes in FMD , or in ATBF , in the DASH-diet group , although heart rate fell ( P<0.05 ) . Glucose and insulin concentrations did not change . In this small-scale study , the DASH diet lowered BP independently of peripheral mechanisms BACKGROUND Diets high in fiber are associated with lower levels of inflammatory markers . This study examined the reduction in inflammation from a diet supplemented with fiber compared with a diet naturally high in fiber . METHODS R and omized crossover intervention trial of 2 diets , a high-fiber ( 30-g/d ) Dietary Approaches to Stop Hypertension ( DASH ) diet or fiber-supplemented diet ( 30 g/d ) , after a baseline ( regular ) diet period of 3 weeks . There were 35 participants ( 18 lean normotensive and 17 obese hypertensive individuals ) aged 18 to 49 years . RESULTS The study included 28 women and 7 men ; 16 ( 46 % ) were black , the remainder white . The mean ( SD ) fiber intake on baseline diets was 11.9 ( 0.3 ) g/d ; on the high-fiber DASH diet , 27.7 ( 0.6 ) g/d ; and on the supplemented diet , 26.3 ( 0.4 ) g/d . Overall , the mean C-reactive protein ( CRP ) level changed from 4.4 to 3.8 mg/L ( -13.7 % ; P = .046 ) in the high-fiber DASH diet group and to 3.6 mg/L ( -18.1 % ) in the fiber-supplemented diet group ( P = .03 ) . However , CRP levels decreased in the 18 lean normotensive participants in either intervention diet group ( 2.0 mg/L [ baseline ] vs 1.4 mg/L [ high-fiber DASH ] vs 1.2 mg/L [ supplemented ] ) ; P<.05 ) but did not change significantly ( 7.1 mg/L [ baseline ] vs 6.2 mg/L [ high-fiber DASH ] vs 6.5 mg/L [ supplemented ] ; P>.05 ) in obese hypertensive participants . Neither age nor race influenced the response of CRP levels to the diets . No evidence of a crossover effect was detected . CONCLUSIONS The results demonstrate that fiber intake of about 30 g/d ) from a diet naturally rich in fiber or from a supplement can reduce levels of CRP . Further research is needed to more clearly eluci date the differential effect seen in lean vs obese individuals and whether modification of dietary fiber may be helpful in modulating inflammation and its consequent cardiovascular consequences BACKGROUND AND AIM Compared to a DASH-type diet , an intensively applied dietary portfolio  reduced diastolic blood pressure at 24 weeks as a secondary outcome in a previous study . Due to the importance of strategies to reduce blood pressure , we performed an exploratory analysis pooling data from intensively and routinely applied portfolio treatments from the same study to assess the effect over time on systolic , diastolic and mean arterial pressure ( MAP ) , and the relation to sodium ( Na(+ ) ) , potassium ( K(+ ) ) , and portfolio components . METHODS AND RESULTS 241 participants with hyperlipidemia , from four academic centers across Canada were r and omized and completed either a DASH-type diet ( control n = 82 ) or a dietary portfolio that included , soy protein , viscous fibers and nuts ( n = 159 ) for 24 weeks . Fasting measures and 7-day food records were obtained at weeks 0 , 12 and 24 , with 24-h urines at weeks 0 and 24 . The dietary portfolio reduced systolic , diastolic and mean arterial blood pressure compared to the control by 2.1 mm Hg ( 95 % CI , 4.2 to -0.1 mm Hg ) ( p = 0.056 ) , 1.8 mm Hg ( CI , 3.2 to 0.4 mm Hg ) ( p = 0.013 ) and 1.9 mm Hg ( CI , 3.4 to 0.4 mm Hg ) ( p = 0.015 ) , respectively . Blood pressure reductions were small at 12 weeks and only reached significance at 24 weeks . Nuts , soy and viscous fiber all related negatively to change in mean arterial pressure ( ρ = -0.15 to -0.17 , p ≤ 0.016 ) as did urinary potassium ( ρ = -0.25 , p = 0.001 ) , while the Na(+)/K(+ ) ratio was positively associated ( ρ = 0.20 , p = 0.010 ) . CONCLUSIONS Consumption of a cholesterol-lowering dietary portfolio also decreased blood pressure by comparison with a healthy DASH-type diet . CLINICAL TRIAL REG . NO . : NCT00438425 , clinical trials.gov BACKGROUND AND AIMS C-reactive protein ( CRP ) is a marker of inflammation which has been shown in multiple prospect i ve epidemiological studies to predict the risk of cardiovascular disease and metabolic syndrome . Dietary patterns may influence the risk of diseases through the effects of CRP on inflammation . The aim of this study was to examine the relationship of dietary patterns with CRP in blood , taking into consideration gender and blood pressure . METHODS AND RESULTS The present cross-sectional analysis included 7574 participants from a large , population -based study of middle-aged Koreans . Four dietary patterns , including ' fruit ' , ' vegetable ' , ' meat ' and ' coffee ' , were derived using factor analysis . Multiple linear regressions were used to evaluate the association between dietary patterns and CRP after adjusting for age , sex , education , waist circumference , smoke status and alcohol consumption . We found that the ' vegetable ' pattern was inversely associated with CRP ( Ptrend = 0.01 ) . The adjusted mean CRP was 0.04 mg/dl lower ( 95 % CI -0.07 , -0.01 ) for subjects in the highest quartile of the ' vegetable ' pattern compared with those in the lowest quartile . This inverse association was more pronounced in men with hypertensive blood ; CRP concentrations across increasing quartile categories of the ' vegetable ' pattern score were 0.1 , 0.14 , and 0.15 mg/dl reduction compared to the 1st quartile ( the lowest quartile ) ( Ptrend = 0.04 , Plinearity = 0.02 ) . CONCLUSIONS The inverse association of the ' vegetable ' pattern with CRP was assessed , and the association appeared to be more predominant in men with hypertensive blood pressure Few studies exist regarding the effects of the Dietary Approaches to Stop Hypertension ( DASH ) diet on novel cardiovascular risk factors among type 2 diabetic patients . We evaluated the effects of the DASH eating pattern on C-reactive protein ( CRP ) level , coagulation abnormalities , and hepatic function tests in type 2 diabetic patients . In this r and omized , crossover clinical trial , 31 type 2 diabetic patients consumed a control diet or the DASH diet  for 8 wk . The DASH diet was rich in fruits , vegetables , whole grains , and low-fat dairy products and low in saturated fat , total fat , cholesterol , refined grains , and sweets , with a total of 2400 mg/d sodium . The control diet was a st and ard diet for diabetic patients .  There was a 4-wk washout between the 2 trial phases . The main outcome measures were CRP level , coagulation indices , and hepatic function tests . The mean percent change for plasma CRP level was -26.9 ± 3.5 % after the DASH diet period and -5.1 ± 3.8 % after the control diet period ( P = 0.02 ) . Decreases in both alanine aminotransferase and aspartate aminotransferase levels were greater after consuming the DASH diet compared with the control diet ( -14.8 ± 3.0 % vs -6.6 ± 3.4 % ; P = 0.001 ; -29.4 ± 3.7 % vs -5.9 ± 1.4 % ; P = 0.001 , respectively ) . The decrease in the plasma fibrinogen level during the DASH diet period ( -11.4 ± 3.6 % ) was greater than that during the control diet ( 0.5 ± 3.4 % ) ( P = 0.03 ) . Among diabetic patients , the DASH diet can play an important role in reducing inflammation , plasma levels of fibrinogen , and liver aminotransferases . Future longer term studies are recommended
target: Adherence to DASH diet is effective in improving circulating serum inflammatory biomarkers in adults , compared with usual diet ; therefore , it could be a valuable strategy to suppress inflammation process
background: BACKGROUND & AIMS Dietary approaches to stop hypertension ( DASH ) diet is associated with improved blood pressure and risk of cardiovascular diseases .
  It is proposed that DASH might also improve systemic inflammatory markers like highly sensitive C-reactive protein ( hs-CRP ) ; however , interventional studies have led to conflicting results .
  The aim of current systematic review was to summarize results of r and omized clinical trials examining the effect of DASH on inflammatory biomarkers .