{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:16:01Z","timestamp":1793650561987,"version":"4.5.1"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T00:00:00Z","timestamp":1683158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003995","name":"Natural Science Foundation of Anhui Province","doi-asserted-by":"publisher","award":["2008085MA09"],"award-info":[{"award-number":["2008085MA09"]}],"id":[{"id":"10.13039\/501100003995","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003995","name":"Natural Science Foundation of Anhui Province","doi-asserted-by":"publisher","award":["82073578"],"award-info":[{"award-number":["82073578"]}],"id":[{"id":"10.13039\/501100003995","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of Chin","doi-asserted-by":"publisher","award":["2008085MA09"],"award-info":[{"award-number":["2008085MA09"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of Chin","doi-asserted-by":"publisher","award":["82073578"],"award-info":[{"award-number":["82073578"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Several studies have demonstrated that adhering to the Dietary Approaches to Stop Hypertension (DASH) diet may result in decreased blood pressure levels and hypertension risk. This may be an effect of a reduction in central obesity. In the current study, we explored the mediation role of multiple anthropometric measurements in association with DASH score and hypertension risk, and we investigated potential common micro\/macro nutrients that react with the obesity-reduction mechanism. Our study used data from the National Health and Nutrition Examination Survey (NHANES). Important demographic variables, such as gender, race, age, marital status, education attainment, poverty income ratio, and lifestyle habits such as smoking, alcohol drinking, and physical activity were collected. Various anthropometric measurements, including weight, waist circumference, body mass index (BMI), and waist-to-height ratio (WHtR) were also obtained from the official website. The nutrient intake of 8224 adults was quantified through a combination of interviews and laboratory tests. We conducted stepwise regression to filter the most important anthropometric measurements and performed a multiple mediation analysis to test whether the selected anthropometric measurements had mediation effects on the total effect of the DASH diet on hypertension. Random forest models were conducted to identify nutrient subsets associated with the DASH score and anthropometric measurements. Finally, associations between common nutrients and DASH score, anthropometric measurements, and risk of hypertension were respectively evaluated by a logistic regression model adjusting for possible confounders. Our study revealed that BMI and WHtR acted as full mediators between DASH score and high blood pressure levels. Together, they accounted for more than 45% of the variation in hypertension. Interestingly, WHtR was found to be the strongest mediator, explaining approximate 80% of the mediating effect. Furthermore, we identified a group of three commonly consumed nutrients (sodium, potassium, and octadecatrienoic acid) that had opposing effects on DASH score and anthropometric measurements. These nutrients were also found to be associated with hypertension in the same way as BMI and WHtR in univariate regression models. The most important among these nutrients was sodium, which was negatively correlated with the DASH score (\u03b2 = \u22120.53, 95% CI = \u22120.56~\u22120.50, p &lt; 0.001) and had a positive association with BMI (\u03b2 = 0.04, 95% CI = 0.01~0.07, p = 0.02), WHtR (\u03b2 = 0.06, 95% CI = 0.03~0.09, p &lt; 0.001), and hypertension (OR = 1.09, 95% CI = 1.01~1.19, p = 0.037). Our investigation revealed that the WHtR exerts a greater mediating effect than BMI on the correlation between the DASH diet and hypertension. Notably, we identified a plausible nutrient intake pathway involving sodium, potassium, and octadecatrienoic acid. Our findings suggested that lifestyle modifications that emphasize the reduction of central obesity and the attainment of a well-balanced micro\/macro nutrient profile, such as the DASH diet, could potentially be efficacious in managing hypertension.<\/jats:p>","DOI":"10.3390\/nu15092189","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T02:08:42Z","timestamp":1683252522000},"page":"2189","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Waist-to-Height Ratio Is a Stronger Mediator in the Association between DASH Diet and Hypertension: Potential Micro\/Macro Nutrients Intake Pathways"],"prefix":"10.3390","volume":"15","author":[{"given":"Min","family":"Yuan","sequence":"first","affiliation":[{"name":"School of Public Health Administration, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health Administration, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Public Health Administration, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Zhi","sequence":"additional","affiliation":[{"name":"School of Public Health Administration, Anhui Medical University, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Zhuang","sequence":"additional","affiliation":[{"name":"School of Management, University of Science and Technology of China, Hefei 230026, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6997-5533","authenticated-orcid":false,"given":"Xu Steven","family":"Xu","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Quantitative Science, Genmab Inc., Princeton, NJ 08536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangbiao","family":"Tao","sequence":"additional","affiliation":[{"name":"School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"MOE Key Laboratory of Population Health across Life Cycle, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/s41581-019-0244-2","article-title":"The global epidemiology of hypertension","volume":"16","author":"Mills","year":"2020","journal-title":"Nat. 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