Dietary Factors Associated with Hypertension in Nepal

Abstract

Hypertension is a major public health burden due to its causal association with cardiovascular disease morbidity, mortality, disability and economic costs. Diet has a major impact on hypertension. The aim of the study is to investigate the associations of diet score, dairy intake and animal protein intake with risk of hypertension in a sample of adults residing in central Nepal. This is a secondary data analysis of data collected by the University of Washington, Harvard and Shahid Gangalal National Heart Center, Nepal in 2009. Cross-sectional analyses were completed on selected variables collected during household interviews and examinations (n=200) in two regions of central Nepal: Kathmandu and Dhulikhel. Dietary information was collected via in-person interview using a food frequency questionnaire. The main models utilized logistic regression. The odds of having hypertension was 68% lower among those who eat low fat dairy daily (OR: 0.32, 95% CI: 0.07-1.29), 83% lower among those who eat 2-3 times a week (OR: 0.17, 95% CI: 0.03-0.89), 57% lower among those who eat once a week (OR:0.43, 95% CI: 0.06-2.55) and 60% lower among those who eat seldom or once a month (OR:0.40, 95% CI: 0.08-1.88) compared to those who never eat after adjusting for frequency of whole fat dairy consumption, frequency of animal protein consumption, demographic variables and traditional risk factors (p for trend=0.15). Compared to no consumption of whole fat dairy products, the odds ratio associated with daily consumption was 1.33 (95% CI: 0.38-3.38); 2-3 times per week consumption was 1.32 (95% CI: 0.08-23.37); once a week consumption was 4.08 (95% CI: 0.52-30.60) and seldom or once a month consumption was 1.85 (95% CI: 0.62-4.83) (p for trend=0.92). Compared to never consumption, the odds ratio associated with daily consumption of animal protein was 6.81 (95% CI: 0.31-150.47); 2-3 times per week consumption was 2.89 (95% CI: 0.70-11.81); once a week consumption was 1.29 (95% CI: 0.36-4.56) and seldom or once a month consumption was 1.43 (0.37- 5.45). (p for trend=0.11) The healthy eating pattern represented by diet score was non significantly protective (OR: 0.97, 95% CI: 0.93-1.02) (p for trend =0.414). In conclusion, the present study found a moderate but insignificant inverse association between low fat dairy intake and the risk of hypertension in the sample of middle and older age men and women. By contrast, whole-fat dairy intake and animal product intake was not related to the risk of hypertension. The higher diet score (representing healthy diet) was non-significantly protective for hypertension.