Effect of Dietary Fiber (Oat Bran) Supplement in Heart Rate Lowering in Patients with Hypertension: A Randomized DASH-Diet-Controlled Clinical Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Subjects
2.3. Sample Size Calculation
2.4. Intervention
2.4.1. Control Group
2.4.2. Intervention Group
2.5. Follow-Up
2.6. Outcomes
2.6.1. Primary Outcomes
2.6.2. Secondary Outcomes
Compliance to Oat Consumption
Side Effect of Dietary Fiber
Change of Medication
2.7. Measurement
2.7.1. Clinical Data and Anthropometric Measurements
2.7.2. Diet and Oat Bran Consumption Record
2.7.3. The 24 h Heart Rate
2.8. Statistical Analysis
- (1)
- Demographic, clinical data, and nutrients: First of all, the Kolmogorov–Smirov test and the Levene’s test were applied to test whether the data of different variables were normally distributed and of equal variance, respectively. The continuous variables being normally distributed were expressed as mean (M) ± standard deviation (SD), and comparisons between groups were made using the independent samples t-test if the variables were normally distributed and of equal variance; otherwise, the data of variables were expressed as median (P25, P75), and their comparisons between groups were made using the Mann–Whitney U test. For categorical variables, the data were described as the frequency (percentage), and comparisons between the two groups was conducted using the Pearson chi-squared test or Fisher’s exact test.
- (2)
- Comparisons of HR between the two groups were conducted at baseline and 3 months: if it was normally distributed, the comparison between two groups was carried out using the independent samples t-test; otherwise, the Mann–Whitney U test was used. For the changes of medication, Pearson’s chi-squared test or Fisher’s exact test was used for comparison. With respect to demographic data, clinical data, and nutrient data, analysis of covariance was applied to correct the relative biases if the comparison of variables between two groups was p < 0.1.
- (3)
- The paired t-test was used to compare the changes of HR within a group before and after intervention.
- (4)
- Intention-to-treat of HR was performed to ensure the reliability of results. A p-value of <0.05 was considered statistically significant.
3. Results
3.1. Baseline Characteristics
3.2. Dietary Fiber Intake
3.3. Effect of Dietary Fiber (Oat Bran) Supplementation on HR in Patients with Hypertension
3.3.1. 24h aveHR, 24hminHR, and 24h maxHR
3.3.2. D-aveHR, D-minHR, and D-maxHR
3.3.3. N-aveHR, N-minHR, and N-maxHR
3.4. Change of Medication
3.5. Side Effect of Dietary Fiber
4. Discussion
4.1. General Data
4.2. Compliance to Dietary Fiber Intake
4.3. Dietary Fiber on Heart Rate
4.3.1. Dietary Fiber on 24 h Heart Rates
4.3.2. Dietary Fiber on Daytime and Nighttime Heart Rates
4.4. Dietary Fiber on Medication Change
5. Conclusions
6. Limitations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | DF Group (n = 33) | Control Group (n = 30) | t/χ2/z | p | |
---|---|---|---|---|---|
x ± s/n(%)/ M(P25, P75) | x ± s/n(%)/ M(P25, P75) | ||||
Ages (years) | 40.09 ± 9.32 | 40.80 ± 10.94 | 0.736 a | 0.465 | |
Sex | Male | 26 (78.8) | 16 (53.3) | 4.582 b | 0.032 |
Female | 7 (21.2) | 14 (46.7) | |||
Marital status | Unmarried | 11 (33.3) | 5 (16.7) | 2.304 b | 0.129 |
Married | 22 (66.7) | 25 (83.3) | |||
Education | Primary school | 1 (3.0) | 0 (0.0) | 1.443 b | 0.695 |
Junior middle school | 4 (12.1) | 5 (16.7) | |||
High school/SSS | 5 (15.2) | 6 (20.0) | |||
College or higher | 23 (66.7) | 19 (63.3) | |||
Professional situation | On the job | 31 (94.0) | 25 (83.3) | 1.838 b | 0.399 |
Retired | 1 (3.0) | 3 (10.0) | |||
Job-waiting | 1 (3.0) | 2 (6.7) | |||
Medical payment | Self-funded | 3 (9.0) | 1 (3.3) | 3.938 c | 0.140 |
NRCMI | 3 (9.0) | 0(0.0) | |||
Medical insurance | 27 (81.8) | 29 (96.7) | |||
Exercise | Yes | 11 (33.3) | 12 (40.0) | 0.301 b | 0.583 |
No | 22 (66.7) | 18 (60.0) | |||
DOS(hours/day) | 6.48 (6.00, 7.63) | 6.90 (6.00, 7.50) | −0.561 d | 0.743 | |
Sleep quality | Poor | 5 (15.2) | 0(0.0) | 5.491 b | 0.064 |
Fair | 17 (51.5) | 21 (70.0) | |||
Good | 11 (33.3) | 9 (30.0) | |||
Smoke | Yes | 8 (24.2) | 7 (23.3) | 0.007 b | 0.933 |
No | 25 (75.8) | 23 (76.7) | |||
Alcohol intake | Yes | 9 (27.3) | 9 (30.0) | 0.057 b | 0.811 |
No | 24 (72.7) | 21 (70.0) | |||
BMI (kg/m2) | 24.93 ± 3.12 | 25.38 ± 4.83 | 0.436 a | 0.664 | |
WHR | 0.92 ± 0.18 | 0.96 ± 0.37 | 0.561 d | 0.743 | |
Constipation | Yes | 2 (6.1) | 3 (10.0) | 0.334 c | 0.563 |
No | 31 (93.9) | 27 (90.0) | |||
DOH (years) | 1.98 ± 3.70 | 1.67 ± 3.17 | −0.182 a | 0.856 | |
Anti-hypertensive drugs | Yes | 6 (18.2) | 10 (33.3) | 1.904 c | 0.168 |
No | 27 (81.8) | 20 (66.7) | |||
Comorbidity | Yes | 2 (6.1) | 5 (16.7) | 1.790 c | 0.181 |
No | 31 (93.9) | 25 (83.3) | |||
HR-lowing drugs | Yes | 1 | 3 | 1.284 c | 0.257 |
No | 32 | 27 | |||
SBP (mmHg) | 131.30 ± 4.80 | 137.13 ± 8.09 | 3.514 a | 0.001 * | |
DBP (mmHg) | 84.58 ± 4.72 | 85.40 ± 5.26 | 0.655 a | 0.515 | |
Complication | Yes | 0 (0.0) | 1 (3.3) | 1.118 c | 0.290 |
No | 33 (100.0) | 29 (96.7) |
Characteristic | DF Group (n = 33) | Control Group (n = 30) | t | p |
---|---|---|---|---|
x ± s/n(%) | x ± s/n(%) | |||
Total calories (kcal/day) | 1660.55 ± 386.66 | 1607.41 ± 381.21 | −0.543 | 0.589 |
Carbohydrate (g/day) | 210.66 ± 66.34 | 202.17 ± 62.18 | −0.517 | 0.607 |
Protein (g/day) | 79.17 ± 22.97 | 77.38 ± 21.74 | −0.315 | 0.754 |
Fat (g/day) | 57.66 ± 22.83 | 54.66 ± 21.49 | −0.530 | 0.598 |
Cholesterol (mg/day) | 534.67 ± 290.31 | 510.48 ± 291.59 | −0.327 | 0.745 |
Calcium (mg/day) | 563.45 ± 172.85 | 577.57 ± 261.02 | 0.254 | 0.800 |
Potassium (mg/day) | 1971.68 ± 467.21 | 1993.56 ± 663.66 | 0.153 | 0.879 |
Sodium (mg/day) | 1282.50 ± 800.98 | 1391.69 ± 878.15 | 0.514 | 0.609 |
Vitamin D (μg/day) | 3.10 ± 3.74 | 4.20 ± 5.20 | 0.962 | 0.340 |
Folic acid (μg/day) | 118.32 ± 61.78 | 124.0 ± 96.51 | 0.284 | 0.777 |
Vitamin B6 (μ/day) | 0.36 ± 0.37 | 0.24 ± 0.18 | −1.567 | 0.122 |
Magnesium (mg/day) | 296.65 ± 77.49 | 310.45 ± 115.51 | 0.558 | 0.579 |
Zinc (mg/day) | 10.18 ± 2.59 | 11.47 ± 4.51 | 1.402 | 0.166 |
Selenium (μg/day) | 52.47 ± 17.47 | 55.51 ± 27.11 | 0.215 | 0.830 |
DF (g/d) | DF Group (n = 33) | Control Group (n = 30) | t | p |
---|---|---|---|---|
x ± s/n(%) | x ± s/n(%) | |||
Baseline | 11.07 ± 3.73 | 10.66 ± 4.27 | −0.388 | 0.700 |
3 month | 21.45 ± 3.86 | 10.40 ± 3.76 | −10.75 | <0.001 * |
HR | Time | DF Group (n = 33) ± s | Control Group (n = 30) ± s | t/F | p |
---|---|---|---|---|---|
24h aveHR | Baseline | 75.15 ± 9.69 | 73.73 ± 8.21 | −0.624 | 0.535 |
3 month | 71.03 ± 9.91 | 73.00 ± 7.62 | 0.734 | 0.466 | |
t | 2.401 | 0.629 | |||
p | 0.022 * | 0.534 | |||
3 m, adjusted | 70.74 ± 1.59 | 72.70 ± 1.80 | 0.924 | 0.341 | |
MD | 4.12 ± 9.86 | 0.73 ± 6.39 | −1.600 | 0.115 | |
24hminHR | Baseline | 54.15 ± 6.51 | 55.33 ± 7.55 | 0.667 | 0.507 |
3 month | 53.88 ± 7.65 | 54.63 ± 5.39 | 0.336 | 0.738 | |
t | 0.284 | 0.639 | |||
p | 0.778 | 0.528 | |||
3 month, adjusted | 53.81 ± 1.20 | 54.47 ± 1.31 | 0.197 | 0.684 | |
MD | 0.27 ± 5.51 | 0.700 ± 6.00 | 0.295 | 0.769 | |
24h maxHR | Baseline | 103.03 ± 18.43 | 99.67 ± 13.74 | −0.822 | 0.414 |
3 month | 93.24 ± 15.26 | 98.17 ± 16.99 | 1.099 | 0.276 | |
t | 2.966 | 0.638 | |||
p | 0.006 * | 0.529 | |||
3 month, adjusted | 92.96 ± 2.93 | 96.80 ± 3.27 | 1.062 | 0.308 | |
MD | 9.79 ± 18.96 | 1.50 ± 12.88 | −2.009 | 0.049 * | |
D-aveHR | Baseline | 78.30 ± 10.53 | 76.43 ± 8.30 | −0.777 | 0.440 |
3 month | 73.30 ± 10.13 | 74.97 ± 8.08 | 0.637 | 0.527 | |
t | 2.956 | 1.239 | |||
p | 0.006 * | 0.225 | |||
3 month, adjusted | 73.17 ± 1.66 | 74.54 ± 1.93 | 0.447 | 0.507 | |
MD | 5.00 ± 9.71 | 1.46 ± 6.48 | −1.681 | 0.098 | |
D-minHR | Baseline | 60.61 ± 9.05 | 60.17 ± 8.01 | −0.203 | 0.840 |
3 month | 56.97 ± 8.01 | 57.97 ± 7.37 | 0.490 | 0.626 | |
t | 2.048 | 1.760 | |||
p | 0.049 * | 0.089 | |||
3 month, adjusted | 56.97 ± 1.45 | 57.82 ± 1.49 | 0.159 | 0.692 | |
MD | 3.64 ± 10.20 | 2.14 ± 6.95 | −0.649 | 0.518 | |
D-maxHR | Baseline | 101.76 ± 20.73 | 98.83 ± 12.31 | −0.672 | 0.504 |
3 month | 92.79 ± 15.26 | 98.17 ± 16.39 | 1.213 | 0.230 | |
t | 2.278 | 0.264 | |||
p | 0.030 * | 0.794 | |||
3 month, adjusted | 92.60 ± 2.96 | 96.72 ± 3.31 | 1.169 | 0.285 | |
MD | 8.97 ± 22.63 | 0.67 ± 13.86 | −1.735 | 0.088 | |
N-aveHR | Baseline | 61.64 ± 7.45 | 63.53 ± 8.90 | 0.920 | 0.361 |
3 month | 62.91 ± 9.48 | 63.20 ± 6.14 | 0.219 | 0.828 | |
t | −0.868 | 0.241 | |||
p | 0.392 | −0.668 | |||
3 month, adjusted | 62.87 ± 1.37 | 63.11 ± 1.54 | 0.032 | 0.859 | |
MD | −1.27 ± 8.43 | 0.33 ± 7.57 | 0.793 | 0.431 | |
N-minHR | Baseline | 53.94 ± 6.71 | 56. 83 ± 9.20 | 1.436 | 0.156 |
3 month | 54.88 ± 7.96 | 54.80 ± 6.05 | −0.024 | 0.981 | |
t | −0.866 | 1.698 | |||
p | 0.392 | 0.100 | |||
3 month, adjusted | 54.54 ± 1.25 | 55.06 ± 1.40 | 0.072 | 0.790 | |
MD | −0.94 ± 6.23 | 2.03 ± 6.56 | 1.844 | 0.070 | |
N-maxHR | Baseline | 73.58 ± 12.20 | 74.17 ± 11.91 | 0.194 | 0.847 |
3 month | 74.97 ± 14.88 | 73.97 ± 10.14 | −0.257 | 0.798 | |
t | −0.493 | 0.097 | |||
p | 0.625 | 0.923 | |||
3 month, adjusted | 75.08 ± 2.26 | 73.83 ± 2.52 | 0.108 | 0.744 | |
MD | −1.39 ± 16.23 | 0.200 ± 11.26 | 0.449 | 0.655 |
HR | Time | DF Group (n = 36) ± s | Control Group (n = 34) ± s | t | p |
---|---|---|---|---|---|
24h aveHR | Baseline | 74.97 ± 9.37 | 74.18 ± 7.99 | −0.381 | 0.704 |
3 month | 71.19 ± 9.58 | 73.53 ± 7.49 | 0.1.31 | 0.262 | |
t | 2.386 | 0.629 | |||
p | 0.023 * | 0.533 | |||
MD | 3.77 ± 9.50 | 0.65 ± 5.99 | −1.638 | 0.106 | |
24hminHR | Baseline | 54.36 ± 6.47 | 55.47 ± 7.12 | 0.683 | 0.497 |
3 month | 54.11 ± 7.53 | 54.85 ± 5.14 | 0.479 | 0.634 | |
t | 0.285 | 0.640 | |||
p | 0.778 | 0.527 | |||
MD | 0.25 ± 5.27 | 0.62 ± 5.63 | 0.282 | 0.779 | |
24h maxHR | Baseline | 102.64 ± 17.67 | 99.91 ± 13.06 | −0.731 | 0.467 |
3 month | 93.67 ± 14.67 | 98.59 ± 16.36 | 1.326 | 0.189 | |
t | 2.936 | 0.639 | |||
p | 0.006 * | 0.527 | |||
MD | 8.97 ± 18.34 | 1.32 ± 16.08 | −2.048 | 0.044 * | |
D-aveHR | Baseline | 78.08 ± 10.16 | 76.85 ± 8.08 | −0.559 | 0.578 |
3 month | 73.50 ± 9.77 | 75.56 ± 7.97 | 0.963 | 0.339 | |
t | 2.929 | 1.237 | |||
p | 0.006 * | 0.225 | |||
MD | 4.58 ± 9.38 | 1.29 ± 6.10 | −1.717 | 0.089 | |
D-minHR | Baseline | 60.61 ± 8.79 | 60.26 ± 7.63 | −0.176 | 0.861 |
3 month | 57.28 ± 7.89 | 58.32 ± 7.09 | 0.582 | 0.562 | |
t | 2.039 | 1.753 | |||
p | 0.049 * | 0.089 | |||
MD | 3.33 ± 9.81 | 1.82 ± 6.45 | −0.697 | 0.488 | |
D-maxHR | Baseline | 101.47 ± 20.73 | 99.18 ± 12.12 | −0.580 | 0.564 |
3 month | 93.25 ± 14.68 | 98.59 ± 16.36 | 1.438 | 0.155 | |
t | 2.265 | 0.264 | |||
p | 0.030 * | 0.793 | |||
MD | 8.22 ± 21.78 | 0.59 ± 12.99 | −1.768 | 0.082 | |
N-aveHR | Baseline | 61.75 ± 7.38 | 64.15 ± 8.95 | 1.226 | 0.225 |
3 month | 62.92 ± 9.26 | 63.85 ± 6.63 | 0.484 | 0.630 | |
t | −0.868 | 0.242 | |||
p | 0.391 | 0.810 | |||
MD | −1.16 ± 8.07 | 0.29 ± 7.09 | 0.803 | 0.425 | |
N-minHR | Baseline | 54.17± 6.66 | 58.09 ± 11.61 | 1.745 | 0.086 |
3 month | 55.03 ± 7.80 | 56.29 ± 9.90 | 0.596 | 0.553 | |
t | −0.866 | 1.639 | |||
p | 0.392 | 0.100 | |||
MD | −0.86 ± 5.97 | 1.79 ± 6.18 | 1828 | 0.072 | |
N-maxHR | Baseline | 73.44 ± 11.94 | 73.74 ± 11.69 | 0.103 | 0.918 |
3 month | 74.72 ± 14.47 | 73.56 ± 10.12 | −0.388 | 0.700 | |
t | −0.494 | 0.098 | |||
p | 0.624 | 0.923 | |||
MD | −1.28 ± 15.52 | −0.38 ± 10.02 | 0.456 | 0.650 |
Changes of Medication Dosage | DF Group (n = 33) | Control Group (n = 30) | χ2 | p |
---|---|---|---|---|
Reduced | 4 (12.1) | 2 (6.7) | 5.926 | 0.115 |
No change | 3 (9.1) | 7 (23.3) | ||
Increased | 3 (9.1) | 5 (16.7) | ||
Not taking medicine | 23 (69.7) | 16 (53.3) |
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Ju, Y.; Zhang, C.; Zhang, Z.; Zhu, H.; Liu, Y.; Liu, T.; Ojo, O.; Qiu, J.; Wang, X. Effect of Dietary Fiber (Oat Bran) Supplement in Heart Rate Lowering in Patients with Hypertension: A Randomized DASH-Diet-Controlled Clinical Trial. Nutrients 2022, 14, 3148. https://doi.org/10.3390/nu14153148
Ju Y, Zhang C, Zhang Z, Zhu H, Liu Y, Liu T, Ojo O, Qiu J, Wang X. Effect of Dietary Fiber (Oat Bran) Supplement in Heart Rate Lowering in Patients with Hypertension: A Randomized DASH-Diet-Controlled Clinical Trial. Nutrients. 2022; 14(15):3148. https://doi.org/10.3390/nu14153148
Chicago/Turabian StyleJu, Yang, Chenglin Zhang, Zhirong Zhang, Hongying Zhu, Yuanyuan Liu, Ting Liu, Omorogieva Ojo, Jingbo Qiu, and Xiaohua Wang. 2022. "Effect of Dietary Fiber (Oat Bran) Supplement in Heart Rate Lowering in Patients with Hypertension: A Randomized DASH-Diet-Controlled Clinical Trial" Nutrients 14, no. 15: 3148. https://doi.org/10.3390/nu14153148