Abstract
Objective
To describe the nutrient and food composition of the diets tested in the Optimal Macronutrient
Intake Trial to Prevent Heart Disease (OmniHeart).
Design
Two center, randomized, three-period crossover, controlled feeding trial that tested
the effects of three healthful diet patterns on blood pressure, serum lipid levels,
and estimated cardiovascular risk.
Subjects/setting
One hundred sixty-four participants with prehypertension and hypertension. During
the 19 weeks of feeding, participants were required to consume only food prepared
as part of the trial.
Intervention
The OmniHeart trial studied three diet patterns that differed in macronutrient composition:
a carbohydrate-rich diet similar to the Dietary Approaches to Stop Hypertension diet
(58% carbohydrate, 15% protein, and 27% fat), a higher protein diet that had 10% more
protein and 10% less carbohydrate (48% carbohydrate, 25% protein, and 27% fat), and
a higher unsaturated fat diet that had 10% more unsaturated fat and 10% less carbohydrate
(48% carbohydrate, 15% protein, and 37% fat). Each diet contained 6% saturated fat
and 100 to 200 mg cholesterol. Sodium was 2,300 mg at the 2,100 kcal energy level
and was indexed across energy levels. Calcium, magnesium, and potassium were consistent
with recommendations for the Dietary Approaches to Stop Hypertension diet and also
indexed to energy levels. Each diet pattern met the major nutrient recommendations
set by the Dietary Guidelines for Americans 2005. The 10% protein increase in the higher protein diet emphasized plant protein; however,
meat and dairy food sources were also increased somewhat. Olive oil, canola oil, and
olive oil spread were used liberally to achieve the unsaturated fat content of the
higher unsaturated fat diet. The 10% reduction in carbohydrate in the higher protein
diet and the higher unsaturated fat diet was achieved by replacing some fruits with
vegetables, reducing sweets, and using smaller portions of grain products. All three
diets reduced blood pressure, total and low-density lipoprotein cholesterol levels,
and estimated coronary heart disease risk.
Conclusions
The OmniHeart diet patterns offer substantial flexibility in macronutrient intake
that should make it easier to eat a heart-healthy diet and reduce cardiovascular disease
risk.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Academy of Nutrition and DieteticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A clinical trial of the effects of dietary patterns on blood pressure.N Engl J Med. 1997; 336: 1117-1124
- 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
- Effect of dietary sodium intake on blood lipids: Results from the DASH-sodium trial.Hypertension. 2004; 43: 393-398
- 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
- Dietary Reference Intakes For Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids.The National Academies Press, Washington, DC2002
- Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). National Heart, Lung, and Blood Institute, Bethesda, MD2002 (NIH Publication No. 02-5215)
- Nutrition and Your Health: Dietary Guidelines for Americans, 2005. 6th ed. US Government Printing Office, Washington, DC2005 (Home and Garden Bulletin No. 232)
- Should a low-fat, high-carbohydrate diet be recommended for everyone?.N Engl J Med. 1997; 337: 562-563
- Should a low-fat, high carbohydrate diet be recommended for everyone?.N Engl J Med. 1997; 337: 563-566
- Rationale and design of the Optimal Macro-Nutrient Intake Heart Trial to Prevent Heart Disease (OMNIHeart).Clin Trials. 2005; 2: 529-537
- Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: Results of the OmniHeart randomized trial.JAMA. 2005; 294: 2455-2464
- Descriptive characteristics of the dietary patterns used in the Dietary Approaches to Stop Hypertension trial.J Am Diet Assoc. 1999; 99: S19-S27
- Association between protein intake and blood pressure: The INTERMAP study.Arch Int Med. 2006; 166: 79-87
- Validation of diet composition for the Dietary Approaches to Stop Hypertension trial.J Am Diet Assoc. 1999; 99: S60-S68
- OmniHeart menus: carbohydrate, protein, unsaturated fat.(Accessed November 28, 2006)
- Pyramid Servings Database of USDA Survey Food Codes Version 1.0.(Accessed August 22, 2005)
- Data Tables: Results from USDA’s 1995 Continuing Survey of Food Intakes by Individuals and 1995 Diet and Health Knowledge Survey.([book on CD-ROM]) Continuing Survey of Food Intakes by Individuals/Diet and Health Knowledge Survey, Riverdale, MD1996
- Huxley A. The New Royal Horticultural Society Dictionary of Gardening. Stockton, New York, NY1992
- Seitan—The vegetarian wheat meat.(Accessed March 5, 2007)
- Diet and lifestyle recommendations revision 2006: A scientific statement from the American Heart Association Nutrition Committee.Circulation. 2006; 114: 82-96
- Dietary intake of 10 key nutrients for public health, United States: 1999-2000.(Accessed November 13, 2007)
- Protein.in: Messina V.K. Mangels R. Messina M. The Dietitian’s Guide to Vegetarian Diets. 2nd ed. Jones and Bartlett, Sudbury, MA2004: 69
- Olive oil and reduced need for antihypertensive medications.Arch Intern Med. 2000; 160: 837-842
- The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. US Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, Washington, DC2003 (NIH Publication No. 03-5233)
- A randomized controlled trial of a moderate fat, low-energy diet compared with a low-fat, low-energy diet for weight loss in overweight adults.Int J Obes. 2001; 25: 1503-1511
- Soy protein, isoflavones, and cardiovascular health: An American Heart Association science advisory for professionals from the Nutrition Committee.Circulation. 2006; 113: 1034-1044
Biography
J. F. Swain is a bionutrition manager, General Clinical Research Center, Brigham and Women’s Hospital, Boston, MA.
Biography
P. B. McCarron is director of Metabolic Studies, Johns Hopkins ProHealth, and L. J. Appel is a professor of medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD.
Biography
E. F. Hamilton is retired; at the time of the study, she was a senior nutrition research assistant, Brigham and Women’s Hospital, Boston, MA.
Biography
F. M. Sacks is a professor of medicine, Cardiovascular Division and Channing Laboratory Department of Nutrition, Harvard School of Public Health, Boston, MA.
Article info
Identification
Copyright
© 2008 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
