DASH dietary pattern and pediatric hypertension: gender differences in the 1999–2008 United States National Health and Nutrition Examination Survey (NHANES)

Objectives The objective of this study was to assess whether adherence to the DASH (Dietary Approaches to Stop Hypertension) dietary pattern were associated with lower risk of high BP (HBP) in children and adolescents. METHODS Analyses were performed in 7330 youth (8–17 years) with 3 valid BP measurements in NHANES, 1999–2008. HBP was defined as a systolic or diastolic BP (SBP or DBP) level ≥ 90th percentile of the age‐, sex‐, and height‐specific reference level. Adherence to the DASH dietary pattern was assessed with the DASH score (based on intakes of 9 targeted food groups). Weighted analyses were performed to account for the complex survey design. RESULTS The prevalence (SE) of HBP in U.S. youth aged 8 to 17 years was 12.6% (0.6): 10.5% (0.8) in girls and 14.6% (0.9) in boys. DASH score was inversely associated with HBP. After adjusting for known risk factors, the odds ratios (ORs) across the quartiles of DASH score were 1.00 (referent), 0.81 (95% CI: 0.57, 1.15), 0.80 (95% CI: 0.57, 1.11), and 0.70 (95% CI: 0.50, 0.99) (P for trend < 0.001). There was evidence of effect modification by gender. The adjusted ORs for comparing the highest with the lowest quartiles of DASH score was 0.99 (95% CI: 0.53, 1.86; P = 0.99) in girls and 0.58 (95% CI: 0.33, 1.00; P = 0.05) in boys. CONCLUSIONS Adherence to DASH dietary pattern is inversely associated with risk of pediatric hypertension. This association might be different in boys and girls.