Comparing Very Low-Carbohydrate vs DASH Diets for Overweight or Obese Adults With Hypertension and Prediabetes or Type 2 Diabetes: A Randomized Trial

Adults who have hypertension, prediabetes, or type 2 diabetes, as well as being overweight or obese, are at a higher risk of major health complications. Experts vary, however, on which food patterns and support methods should be advised. This study presents comparative research between two diets for overweight or obese adults with hypertension and pre-diabetes or type 2 diabetes. Specialists cannot agree on the best dietary approaches or supportive measures.
A group of 94 adults was selected from southeast Michigan with this triple multimorbidity, comparing a (VLC) diet vs a (DASH) diet, along with comparing results with and without multicomponent additional support (mindful eating, positive emotion regulation, social support, and cooking). The VLC diet resulted in better improvement in estimated mean systolic blood pressure, more improvement in glycated hemoglobin, and greater improvement in weight when compared to the DASH diet.
I have a few comments about the study. If the authors were to conduct the study again, would they use the same definition of dietary adherence? Participants were not provided food, thus dietary adherence was expected to vary more than if the experiment had been more prescriptive. I think that for persons with hypertension, the dietary approach is the best non-pharmacologic therapy option and primary intervention. Dietary adherence is important in lowering uncontrolled hypertension and hypertension-related comorbidities. I am wondering if the authors plan to conduct follow-up studies to include larger samples, and extended follow-up periods. Thank you.