Effects of Cuisine-Based Chinese Heart-Healthy Diet in Lowering Blood Pressure Among Adults in China: Multicenter, Single-Blind, Randomized, Parallel Controlled Feeding Trial
Authors: Wang Yanfang , Feng Lin , Zeng Guo , Zhu Huilian , Sun Jianqin , Gao Pei , Yuan Jihong , Lan Xi , Li Shuyi , Zhao Yanfang , Chen Xiayan , Dong Hongli , Chen Si , Li Zhen , Zhu Yidan , Li Ming , Li Xiang , Yang Zhenquan , Li Huijuan , Fang Hai , Xie Gaoqiang , Lin Pao-Hwa , Chen Junshi , Wu Yangfeng , Wu Yangfeng , Wang Yanfang , Li Huijuan , Feng Lin , Xie Gaoqiang , Ma Wenyao , Li Jiarong , Chen Xiayan , Zhu Yidan , Xie Wuxiang , Zhu Shulan , Bai Xue , Gao Yuqing , Li Chenglong , Ma Yanjun , Hu Yiyu , Miao Ke , Zhu Shujing , Zhao Caiyun , Zhu Yunqing , Zeng Guo , Yin Wenya , Li Ming , Zhang Yiqi , Cai Congjie , Pang Xinxin , Sun Hong , Zhang Haiying , Bai Dan , Zhu Huilian , Fang Aiping , Huang Rongzhu , Luo Yun , Liu Zhaoyan , Lin Xinlei , Sun Jianqin , Zhao Yanfang , Bai Huijing , Ye Mengyao , Li Zhen , Fan Qing , Tang Jun , Xiao Fei , Wang Jianming , Zhang Yanguo , Zhang Guixiang , Chen Weiping , Zhao Weigang , Li Xiang , Tong Guangsen , Zhang Kun , Xu Bin , Zhang Ting , Yang Zhenquan , Wang Xinchi , Zhu Yunlong , Peng Jing , Zhang Haifeng , Gao Lu , Rao Shengqi , Xu Jianguo , Yang Jing , Jin Dong , Pu Ji , Zhou Juan , Tao Yuanmeihui , Jiao Yifan , Wang Zhiheng , Xu Yiying , Li Yuxin , Qiu Shi 
Published: July 2022

Background:
More than one-fifth of the world’s population consumes Chinese cuisines regularly, but no evidence-based healthy diets fitting the Chinese food culture are available for implementation.

Methods:
A multicenter, patient- and outcome assessor–blind, randomized feeding trial was conducted among 265 participants with 130 to 159 mm Hg baseline systolic blood pressure (SBP) for 4 major Chinese cuisines (Shangdong, Huaiyang, Cantonese, Szechuan). After a 7-day run-in period on a control diet matching the usual local diets, participants were randomized to continue with the control diet or the cuisine-based Chinese heart-healthy diet for another 28 days. The primary outcome was SBP, and secondary outcomes included diastolic blood pressure and food preference score. Linear regression models were used to estimate the intervention effects and adjustments for the center. The incremental cost per 1 mm Hg reduction in SBP was also calculated.

Results:

A total of 265 participants were randomized (135 on the Chinese heart-healthy diet and 130 on the control diet), with 52% women, mean age of 56.5±9.8 years, and mean SBP and diastolic blood pressure of 139.4±8.3 and 88.1±8.0 mm Hg, respectively, at baseline. The change in SBP and diastolic blood pressure from baseline to the end of the study in the control group was –5.0 (95% CI, –6.5 to –3.5) mm Hg and –2.8 (95% CI, –3.7 to –1.9) mm Hg, respectively. The net difference of change between the 2 groups in SBP and diastolic blood pressure were –10.0 (95% CI, –12.1 to –7.9) mm Hg and –3.8 (95% CI, –5.0 to –2.5) mm Hg, respectively. The effect size did not differ among cuisines (
P
for interaction=0.173). The mean food preference score was 9.5 (with 10 the best preferred) at baseline, and the net change during intervention was 0.1 (95% CI, –0.1 to 0.2;
P
=0.558). The incremental cost-effectiveness ratio per 1 mm Hg SBP reduction was CNY 0.4 (USD 0.06) per day. No difference in the number of adverse events was found between the 2 groups (
P
=0.259), and none of the adverse events was associated with the intervention.

Conclusions:
The Chinese heart-healthy diet is effective, palatable, and cost-effective in reducing blood pressure in Chinese adults with high blood pressure, with a clinically significant effect applicable across major Chinese cuisine cultures.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03882645.