Nutr Res Pract.  2015 Apr;9(2):150-157. 10.4162/nrp.2015.9.2.150.

The effects of the DASH diet education program with omega-3 fatty acid supplementation on metabolic syndrome parameters in elderly women with abdominal obesity

• Choi SH
• Choi-Kwon

• KMID: 2313823
• DOI: http://doi.org/10.4162/nrp.2015.9.2.150

Abstract

BACKGROUND/OBJECTIVES
The purpose of this study was to investigate the overall effects of a tailored Dietary Approaches to Stop Hypertension (DASH) nutritional intervention program which included omega-3 fatty acids supplementation, on dietary self-efficacy, dietary knowledge, and dietary behaviors in Korean elderly women with abdominal obesity. Furthermore, we investigated the effects of the program on metabolic syndrome parameters including the antioxidant capacities in these subjects.
SUBJECTS/METHODS
A randomized, controlled trial was conducted for 8 weeks. The experimental group (n = 21) received a weekly tailored nutritional program for 8 weeks and the control group (n = 18) received only one educational session. The clinical survey was conducted before and after the intervention period.
RESULTS
After the intervention, dietary self-efficacy (P = 0.023), frequency of fruit intake (P = 0.019), and dietary fiber intake (P = 0.044) were higher in the experimental group than in the control group. The oxidative stress (P < 0.001) was lower in the experimental group than in the control group. Moreover, low density lipoprotein (LDL) cholesterol (P = 0.023) had significantly decreased in the experimental group but not in the control group after the intervention.
CONCLUSIONS
The intervention program including omega-3 fatty acid supplementation had a positive effect on dietary self-efficacy, dietary behaviors, and oxidative stress among aged women with abdominal obesity.

Keyword

Self efficacy; nutrition; metabolic syndrome; women

MeSH Terms

Aged*
Cholesterol
Diet*
Dietary Fiber
Education*
Fatty Acids, Omega-3
Female
Fruit
Humans
Hypertension
Lipoproteins
Obesity, Abdominal*
Oxidative Stress
Self Efficacy
Cholesterol
Fatty Acids, Omega-3
Lipoproteins

Reference

1. Kwon HS, Park YM, Lee HJ, Lee JH, Choi YH, Ko SH, Lee JM, Kim SR, Kang SY, Lee WC, Ahn MS, Noh JH, Kang JM, Kim DS, Yoon KH, Cha BY, Lee KW, Kang SK, Son HY. The prevalence and clinical characteristics of the metabolic syndrome in middle-aged Korean adults. Korean J Med. 2005; 68:359–368.

2. Fisman EZ, Tenenbaum A. Adiponectin: a manifold therapeutic target for metabolic syndrome, diabetes, and coronary disease? Cardiovasc Diabetol. 2014; 13:103.

3. Lee SE, Moon JH, Ahn JH, Oh YS, Shinn SH. The association between plasma adiponectin and the components of metabolic syndrome in adults with abdominal obesity. Korean J Obes. 2007; 16:147–153.

4. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F. Beneficial effects of a Dietary Approaches to Stop Hypertension eating plan on features of the metabolic syndrome. Diabetes Care. 2005; 28:2823–2831.

5. Davis L, Stonehouse W, Loots du T, Mukuddem-Petersen J, van der Westhuizen FH, Hanekom SM, Jerling JC. The effects of high walnut and cashew nut diets on the antioxidant status of subjects with metabolic syndrome. Eur J Nutr. 2007; 46:155–164.

6. Mantzoros CS, Williams CJ, Manson JE, Meigs JB, Hu FB. Adherence to the Mediterranean dietary pattern is positively associated with plasma adiponectin concentrations in diabetic women. Am J Clin Nutr. 2006; 84:328–335.

7. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2008: Korea National Health and Nutrition Examination Survey (KNHANES IV-2). Cheongwon: Korea Centers for Disease Control and Prevention;2009.

8. Kim BH, Lee JW, Lee Y, Lee HS, Jang YA, Kim CI. Food and nutrient consumption patterns of the Korean adult population by income level-2001 National Health and Nutrition Survey. Korean J Community Nutr. 2005; 10:952–962.

9. Oh C, No JK, Kim HS. Dietary pattern classifications with nutrient intake and body composition changes in Korean elderly. Nutr Res Pract. 2014; 8:192–197.

10. Heo J, Park Y, Park HM. Dietary intake of nutrients and food in postmenopausal Korean women. J Korean Soc Menopause. 2011; 17:12–20.

11. Kabir M, Skurnik G, Naour N, Pechtner V, Meugnier E, Rome S, Quignard-Boulangé A, Vidal H, Slama G, Clément K, Guerre-Millo M, Rizkalla SW. Treatment for 2 mo with n 3 polyunsaturated fatty acids reduces adiposity and some atherogenic factors but does not improve insulin sensitivity in women with type 2 diabetes: a randomized controlled study. Am J Clin Nutr. 2007; 86:1670–1679.

12. García-Alonso FJ, Jorge-Vidal V, Ros G, Periago MJ. Effect of consumption of tomato juice enriched with n-3 polyunsaturated fatty acids on the lipid profile, antioxidant biomarker status, and cardiovascular disease risk in healthy women. Eur J Nutr. 2012; 51:415–424.

13. Ju K, So H. Effects of the nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for the patients with cardiovascular disease. J Korean Acad Nurs. 2008; 38:64–73.

14. Shenoy SF, Poston WS, Reeves RS, Kazaks AG, Holt RR, Keen CL, Chen HJ, Haddock CK, Winters BL, Khoo CS, Foreyt JP. Weight loss in individuals with metabolic syndrome given DASH diet counseling when provided a low sodium vegetable juice: a randomized controlled trial. Nutr J. 2010; 9:8.

15. Glanz K, Rimer BK, Viswanath K. Health Behavior and Health Education: Theory, Research, and Practice. 4th ed. San Francisco (CA): Jossey-Bass;2008.

16. Kwon S. Association between abdominal obesity and cardiovascular risk factors in normal-weight Korean women. Health Care Women Int. 2009; 30:447–452.

17. Jeong KH. Living to one hundred: old-age criteria and policy tasks. Health Welf Policy Forum. 2011; (180):16–27.

18. Jeong SK, Cho KH, Kim JM. The usefulness of the Korean version of modified Mini-Mental State Examination (K-mMMSE) for dementia screening in community dwelling elderly people. BMC Public Health. 2004; 4:31.

19. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977; 84:191–215.

20. Shin JH. A comparative study on obesity index, nutritional knowledge, dietary attitudes and dietary self-efficacy of home economics teachers, dietitians, and nurses in Daegu and Kyungbuk province [mater's thesis]. Daegu: Kyungpook National University;2008.

21. Kim JH. The effect of DASH (The Dietary Approaches to Stop Hypertension) diet education program on lowering blood pressure in the middle-aged women [mater's thesis]. Seoul: Seoul National University;2010.

22. Shi Z, Yuan B, Zhang C, Zhou M, Holmboe-Ottesen G. Egg consumption and the risk of diabetes in adults, Jiangsu, China. Nutrition. 2011; 27:194–198.

23. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev. 1996; 54:S59–S65.

24. The Korean Nutrition Society. Computer Aided Nutritional Analysis program version 3.0. (CAN-Pro 3.0). Seoul: The Korean Nutrition Society;2007.

25. Kim SH, Choi-Kwon S. Nutritional status among elderly Korean women and related factors. J Korean Biol Nurs Sci. 2012; 14:16–24.

26. Obarzanek E, Sacks FM, Vollmer WM, Bray GA, Miller ER 3rd, Lin PH, Karanja NM, Most-Windhauser MM, Moore TJ, Swain JF, Bales CW, Proschan MA. DASH Research Group. Effects on blood lipids of a blood pressure-lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial. Am J Clin Nutr. 2001; 74:80–89.

27. Benzie IF, Strain JJ. The ferric reducing ability of plasma (FRAP) as a measure of "antioxidant power": the FRAP assay. Anal Biochem. 1996; 239:70–76.

28. Miller DM, Aust SD. Studies of ascorbate-dependent, iron-catalyzed lipid peroxidation. Arch Biochem Biophys. 1989; 271:113–119.

29. The Korean Nutrition Society. Dietary Referecne Intakes for Koreans. 2010. Seoul: The Korean Nutrition Society.

30. Puglisi MJ, Hasty AH, Saraswathi V. The role of adipose tissue in mediating the beneficial effects of dietary fish oil. J Nutr Biochem. 2011; 22:101–108.

31. Mumford SL, Schisterman EF, Siega-Riz AM, Gaskins AJ, Wactawski-Wende J, VanderWeele TJ. Effect of dietary fiber intake on lipoprotein cholesterol levels independent of estradiol in healthy premenopausal women. Am J Epidemiol. 2011; 173:145–156.

32. Poudyal H, Panchal SK, Diwan V, Brown L. Omega-3 fatty acids and metabolic syndrome: effects and emerging mechanisms of action. Prog Lipid Res. 2011; 50:372–387.

33. Panagiotakos DB, Pitsavos C, Skoumas Y, Stefanadis C. The association between food patterns and the metabolic syndrome using principal components analysis: The ATTICA Study. J Am Diet Assoc. 2007; 107:979–987.

34. Ignarro LJ, Balestrieri ML, Napoli C. Nutrition, physical activity, and cardiovascular disease: an update. Cardiovasc Res. 2007; 73:326–340.

35. Hyun DH, Emerson SS, Jo DG, Mattson MP, de Cabo R. Calorie restriction up-regulates the plasma membrane redox system in brain cells and suppresses oxidative stress during aging. Proc Natl Acad Sci U S A. 2006; 103:19908–19912.

36. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER 3rd, Simons-Morton DG, Karanja N, Lin PH. DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001; 344:3–10.

37. Gyeongin Regional Statistics Office. Consumer price trends [Internet]. Gwacheon: Gyeongin Regional Statistics Office;2012. cited 2012 may 24. Available from: http://kostat.go.kr/office/giro/rogi_nw/2/1/index.board?bmode=read&aSeq=253933.

38. Zemel MB, Sowers JR. Salt sensitivity and systemic hypertension in the elderly. Am J Cardiol. 1988; 61:7H–12H.