DALLAS, July 11, 2022 — Blood pressure levels decreased significantly among hypertensive Chinese adults who ate heart-healthy, low-sodium traditional Chinese food for four weeks, according to new research published today in the major journal Circulation of the American Heart Association. .
The main feature of the heart-healthy Chinese diet, which was modeled on the Dietary Approach to Stop Hypertension (DASH), was reduced sodium. An unhealthy diet, especially a diet rich in sodium, is a major modifiable risk factor for high blood pressure.
“Compared to the nutritional composition of a typical Chinese diet in urban China, our heart-healthy diet of traditional Chinese cuisine cuts sodium in half, from 6000 mg per day to 3,000 mg per day, reduces fat intake and doubles dietary fiber,” said first author and co-lead study team Yanfang. Wang, PhD, a dietitian and research fellow professor at the Peking University Clinical Research Institute in Beijing, China, said it also increased protein, carbohydrates, and potassium.
According to the study, the Chinese represent more than a fifth of the world’s population. As in other parts of the world, the burden of cardiovascular disease has increased rapidly in recent decades in China. Unhealthy changes in the Chinese diet have been a major factor in the increase in cardiovascular disease.
According to the 2012 China National Nutrition Survey, consumption of healthy foods such as grains (34%), tubers and legumes (80%), vegetables and fruits (15%) decreased significantly. In contrast, consumption of meat (162%), eggs (233%) and edible oil (132%) increased significantly during the same time.
said study team leader Yangfeng Wu, MD, PhD, professor of epidemiology and science in clinical research at Peking University Clinical Research Institute in Beijing, China. “Healthy Western diets such as DASH and Mediterranean have been developed and shown to help lower blood pressure, however, as of now, no heart-healthy diet has been developed to match traditional Chinese cuisine.”
The study included 265 Chinese adults, average age 56, with systolic blood pressure equal to or greater than 130 mm Hg. Just over half of the participants were women, and nearly half were taking at least one medication for high blood pressure when the study began. Participants were recruited from Beijing, Shanghai, Guangzhou and Chengdu. These are four major cities in China, each with a corresponding regional cuisine: Shangdong, Huaiyang, Cantonese, and Szechuan, respectively.
The Chinese Heart-Healthy Diet was developed with catering organizations in those regions, and is compatible with the four regional cuisines, so that researchers can understand whether the impact of the heart-healthy diet would be applicable and sustainable for different Chinese food cultures. This can be difficult at times since traditional Chinese cuisine has a long history of using salt for cooking and preserving food over thousands of years. This is especially true in northern China, where greens were scarce in the cold climate, and people had to eat vegetables preserved in salt during the winter and spring seasons. This is why sodium intake is higher for people who live in northern China.
At the start of the study, all participants consumed their usual local diets for seven days so that new eating plans could be customized to taste and flavour. The researchers wanted the heart-healthy diet to be as close as possible to the participant’s usual diet in terms of flavour, while adjusting the dietary intake to be heart-healthy. After the first seven days of eating their usual diet, 135 adults were randomly assigned to consume the new heart-healthy Chinese diet for 28 days, and the remaining 130 participants ate meals from their usual kitchen. Depending on the group’s mission, meals were either regular or heart-healthy versions of Shangdong, Huaiyang, Cantonese, and Sichuan cuisine. Study participants and blood pressure assessors were not aware of which food group the participants were assigned to.
The researchers measured the participants’ blood pressure before and after the study, and once a week during the study. The food components of each dish were weighed to calculate the amount of nutrients per serving. Urine samples were collected to measure the amount of sodium and potassium at the beginning and end of the study. The results indicated that the blood pressure lowering effect of a healthy Chinese diet might be significant and compatible with antihypertensive drugs.
The study found:
- Participants who ate the heart-healthy Chinese diet had lower blood pressure, with systolic blood pressure (the top number) lowering an average of 10 mm Hg, and diastolic blood pressure dropping an average of 3.8 mm Hg, compared to the group that ate regularly. dishes.
- In the heart-healthy group, calorie intake increased from carbohydrates (8%) and protein (4%) and decreased from fat (11%). Consumption of fiber (14 g), potassium (1573 mg), magnesium (194 mg) and calcium (413 mg) increased, while sodium decreased (2836 mg). However, the nutrient intake of the group that ate regular meals remained virtually unchanged from the beginning to the end of the study.
- Flavor and taste preferences for the healthy Chinese diet were similar to the typical local diet, and participants ate similar amounts of food and scored their diets high in both food groups.
- The additional cost of the heart-healthy Chinese diet was about CNY 4 (equivalent to US$0.60) per day, per person, on average, compared to the usual local diet. This was considered low and generally affordable.
- The blood pressure-lowering effect was consistent among participants in the four Chinese cuisine groups for heart health.
The researchers note that these findings suggest that the heart-healthy effects of the Chinese diet, if sustained, may reduce major cardiovascular diseases by 20%. Heart failure by 28% and all causes of death by 13%.
“Health professionals should recommend a heart-healthy diet with low sodium and high potassium, fiber, vegetables and fruits as the first line of treatment for their patients with high blood pressure,” Wu said. “Since traditional Chinese food culture and cooking methods are often used wherever Chinese live, I believe a heart-healthy Chinese diet and the principles we used to develop the diet would be beneficial to Chinese Americans as well.”
American Heart Association volunteer expert Lawrence J. Abell, MD, MPH, FAHA, noted, “The results of this trial are really impressive and provide a roadmap for healthy eating for people who consume a variety of Chinese cuisines – Shangdong, Huaiyang, Cantonese or Szechuan kitchens.” Major public health efforts to “scale up” across China are justified in order to achieve population-wide reductions in blood pressure.”
Abel is the vice president of the American Heart Association’s 2021 Scientific Statement Writing Group, Dietary Guidance for Improving Cardiovascular Health. Guidelines suggest consumption of whole grains, lean proteins, plants, and a variety of fruits and vegetables; Limit salt, sugar, animal fats, processed foods, and alcohol; And to apply this directive regardless of where the food is prepared or consumed.
One limitation of the study is that the heart-healthy Chinese diet was only tested for four weeks. According to Wu, a longer study period may confirm and possibly reinforce these findings.
Co-authors are Yanfang Wang, MS, MHSc. , R. D., Ph. D.; ; Lin Feng Ph.D; Guo Zeng MS; Huilian Zhu Ph.D; Jianqin Sun, Ph.D.; Pei Gao, Ph.D. D.; Ming Li, MD; Chiang Li, MA; Zhenquan Yang, Ph.D. Huijuan Li, Ph.D.Hai Fang, Ph.D; Gaoqiang Xie, Ph.D.Pao-Hwa Lin, Ph.D. and Junxi Chen, Ph.D. The authors’ disclosures are cited in the manuscript.
The study was funded by the National Research and Development Program of the Ministry of Science and Technology of China (MOST).