Original article Association between DASH diet (Dietary Approaches to Stop Hypertension) and hypertension in adolescents: A cross-sectional school-based study Liliana Paula Bricarello a, * , Amanda de Moura Souza b , Mariane de Almeida Alves a , Anabelle Retondario a , Ricardo Fernandes a , Erasmo Benicio Santos de Moraes Trindade c , Lúcia Andreia Zanette Ramos Zeni c , Francisco de Assis Guedes de Vasconcelos c a Postgraduate Program in Nutrition, Federal University of Santa Catarina, Florian opolis, Santa Catarina, Brazil b Institute of Study in Public Health, Federal University of Rio de Janeiro, Ilha Do Fund~ ao, Cidade Universit aria, Rio de Janeiro, 21941-598, Brazil c Professors of the Postgraduate Program in Nutrition, Federal University of Santa Catarina, Florian opolis, Santa Catarina, Brazil article info Article history: Received 16 August 2019 Accepted 9 February 2020 Keywords: Adolescents Hypertension Food Intake Dietary Approaches to Stop Hypertension DASH score Cross-sectional study summary Background & Aims: The DASH diet (Dietary Approaches to Stop Hypertension) is considered a healthy dietary pattern, and is recommended for the control of arterial hypertension (AH). However, its role in the adolescent population needs to be better investigated and clarified. The aim of this study is to identify the association between AH and the DASH diet score in a representative sample of Brazilian adolescents. Methods: A cross-sectional study using data from a national, multicenter and schoolbased probabilistic sample of 71,553 Brazilian adolescents who had their blood pressure (BP) measured and completed a 24- hour dietary recall (2013-2014). The components of the DASH score were assessed. Logistic regression models were used to evaluate the association between AH, anthropometric and sociodemographic variables, and the tertile of the DASH score. Results: Approximately 11% of the adolescents who were in the 3rd tertile of the DASH score presented AH, 18% were overweight and 9% were obese. Among the components of the score, the highest intake was sugar-sweetened beverages (92.1%), legumes and oilseeds (68.2%), red and processed meat (64.5%) and the lowest were low-fat dairy (2.2%), whole grains (11.6%) and fruits (18.1%). Sodium intake was above the maximum recommended in all tertiles. Conclusions: A small proportion of Brazilian adolescents consume foods from the DASH diet. No asso- ciations were found between this dietary pattern and AH. Strategies to increase the intake of protective foods in adolescents must be investigated as well as the potential health benefits of the standard DASH diet for this age group over time. © 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved. 1. Introduction Arterial hypertension (AH) is an important risk factor for car- diovascular diseases (CVD) [1], and it is considered the most prevalent chronic noncommunicable disease (CNCD) in all coun- tries [2]. It is estimated that the number of people with AH around the world will increase from 15 to 20% by 2025, affecting approx- imately 1.5 billion people [3]. A meta-analysis that evaluated studies with adolescents from different countries found a prevalence of AH of 11.2% for the general population. In studies that evaluated adolescents in Latin America, the combined prevalence was lower, 6.2% [4]. In Brazil, according to data from the Study of Cardiovascular Risk in Adolescents (ERICA), the prevalence of AH in schoolchildren aged was 9.6% [5]. Preventing elevated blood pressure (BP) is the most efficient way to fight hypertension, considering the difficulties and high * Corresponding author. Post-graduate Program in Nutrition, Federal University of Santa Catarina, Campus Trindade, Florian opolis, Santa Catarina, 88040-900, Brazil. E-mail address: liliana.bricarello@gmail.com (L.P. Bricarello). Contents lists available at ScienceDirect Clinical Nutrition ESPEN journal homepage: http://www.clinicalnutritionespen.com https://doi.org/10.1016/j.clnesp.2020.02.004 2405-4577/© 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved. Clinical Nutrition ESPEN xxx (xxxx) xxx Please cite this article as: Bricarello LP et al., Association between DASH diet (Dietary Approaches to Stop Hypertension) and hypertension in adolescents: A cross-sectional school-based study, Clinical Nutrition ESPEN, https://doi.org/10.1016/j.clnesp.2020.02.004