Practice-Based Evidence in Nutrition (PEN) Knowledge Pathway- Should the Dietary Approaches to Stop Hypertension (DASH) nutrition care plan be recommended for overweight, hypertensive children? – A review and update of the literature
Bibliographic record
Abstract
Introduction: The effectiveness of the DASH diet for adults is well documented but not well-known in children. Pediatric primary hypertension [PPH] is estimated between 1-3% in Canada and compounded by increasing obesity rates, further emphasizing the need for research in this area. Objectives: a) to update research in PPH and b) to provide RDs with evidence-based therapeutic guidelines. Methods: PEN for Healthy Weight/Obesity-Pediatric/Paediatric, along with the DASH dietary recommendations for management of hypertension in adults were first consulted. Then, a literature review using PubMed, Scopus, and Summon searches were conducted using keywords: hypertension, high blood pressure, overweight, obese*, DASH diet, dietary approaches to stop hypertension, low sodium diet, low salt diet, child*, and adolescent*. Two hundred and eight original research articles were considered. Included were: English publications (2007-2018); specific reference to the DASH diet or elements of DASH; children and adolescents between 9-21 years of age; comorbidities including obesity, diabetes, and metabolic syndrome. Excluded were: animal studies; adult studies; and the use of DASH for medical conditions differing from above. Fifteen full-text articles were obtained and included for PEN grading. Results: Eight studies (53%) demonstrated a reduction in blood pressure using the DASH diet or elements of DASH; one (6%) showed no association; three studies (20%) showed a positive benefit with sodium reduction, two (13%) did not show benefit; and one study (6%) reported that increased dairy intake was beneficial in decreasing hypertension. Conclusion: Research supporting the use of the DASH diet as a therapeutic strategy for PPH remains limited. However, there is convincing evidence that weight reduction, sodium limitation and increased servings of fruit, vegetables, and low-fat dairy may be beneficial. Significance to Dietetics: The DASH nutrition care plan may prove to be an effective tool for patients with PPH; however, DASH may not meet dietary requirements for calcium and vitamin D without RD supervision to ensure nutritional adequacy with this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.074 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.015 | 0.013 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.007 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.012 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".