Modified DASH Diet Reduces Blood Pressure in Diabetics

A recent study from Johns Hopkins Medicine has shown that a modified version of the DASH (Dietary Approaches to Stop Hypertension) diet can lower blood pressure in individuals with type 2 diabetes. This study, published on June 9 in JAMA Internal Medicine, found that the reduced-sodium DASH4D diet was particularly effective in lowering systolic blood pressure among adults who were already using multiple antihypertensive medications.

The study aimed to test a version of the DASH diet tailored for people with type 2 diabetes. The modified diet involved reducing carbohydrates, increasing unsaturated fats and lowering potassium levels to make it safer for individuals with chronic kidney disease, a common condition among those with diabetes.

Modified DASH diet shows promise in blood pressure reduction

The DASH diet, known for being rich in fruits, vegetables and low-fat dairy products, has long been part of the standard approach to treating hypertension. However, this study is among the first to examine the impact of sodium reduction in the diet specifically for people with diabetes. The modified DASH4D diet was designed to provide similar benefits to the traditional DASH diet but with a focus on the unique needs of individuals with type 2 diabetes.

Dr. Scott Pilla, the lead author of the study and an assistant professor of medicine at Johns Hopkins University, emphasized the importance of addressing high blood pressure in diabetes management. "The goal of the study was to develop a new version of the DASH diet and see how effective it was in lowering blood pressure for people with diabetes," Pilla explained.

Clinical findings and impact

In the study, participants who consumed the low-sodium DASH4D diet saw a reduction in systolic blood pressure by about 5 points, in addition to the 10-point reduction typically observed with antihypertensive medication. This reduction was associated with a lower risk of stroke (14%), cardiovascular events (6%) and heart failure (8%).

The study's results suggest that dietary changes can complement medication in controlling blood pressure for people with diabetes, potentially leading to better long-term health outcomes. Dr. Lawrence Appel, corresponding author and professor of medicine at Johns Hopkins University, noted the importance of managing blood pressure alongside blood sugar levels in diabetes care.

Study design and participant details

The study was a randomized crossover feeding trial involving 102 participants, of whom 85 completed all diet periods. The participants, with an average age of 66, were predominantly Black (87%) and 66% were women. Most participants were using multiple antihypertensive medications. The study participants were assigned to four diet sequences: 1) DASH4D with lower sodium, 2) DASH4D with higher sodium, 3) a typical American diet with lower sodium and 4) a typical American diet with higher sodium. Each diet was followed for five weeks, with food provided to participants to maintain their weight.

Moving forward: accessibility and integration into daily life

The researchers are now focusing on making the benefits of this diet more accessible to individuals with diabetes.

"We need to make it easier for people to follow this diet in ways that are affordable and accessible to people of different cultures and with different dietary habits," Pilla said.

Reference: Pilla SJ, Yeh HC, Mitchell CM, et al. Dietary patterns, sodium reduction, and blood pressure in type 2 diabetes: the Dash4d randomized clinical trial. JAMA Intern Med. 2025. doi: 10.1001/jamainternmed.2025.1580

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