Pao-Hwa Lin

Overview:


My research interest lies generally in the area of dietary patterns and chronic diseases including hypertension using controlled feeding study and lifestyle intervention designs.

Two major controlled feeding clinical trials that I was involved in include the Dietary Approaches to Stop Hypertension (DASH) Study and the Dietary Approaches to Stop Hypertension-Sodium (DASH-Sodium) Study. In addition to being an active member for the diet committee for DASH, I also function as the chair of the diet committee for the DASH-Sodium study.  I am familiar with the development and operation of a controlled feeding study, which means the process of study design, development of questionnaire/forms for data collection/monitoring, development of quality assurance procedure, and data analysis.

I've also helped with the design and implementation of the lifestyle behavioral intervention program for the Hypertension Improvement Project (HIP), PREMIER clinical trial, Weight Loss Maintenance trial (WLM), ENCORE study, and the Cell Phone Intervention for You (CITY) trial.

Key words: Diet, controlled feeding study, mineral, blood pressure, nutrition.

Positions:

Associate Professor in Medicine

Medicine, Nephrology
School of Medicine

Member of Duke Molecular Physiology Institute

Duke Molecular Physiology Institute
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 1990

University of Texas at Austin

Grants:

Cellphone Intervention Trial for Young Adults (CITY)

Administered By
Medicine, Nephrology
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Facility and Web-based Approaches to Lifestyle Change in Resistant Hypertension

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Lifestyle, CVD Risk and Cognitive Impairment

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Identifying Strategies for Effective Weight Management in Diverse Interventions

Administered By
Medicine, Nephrology
Awarded By
University of Pittsburgh
Role
Principal Investigator
Start Date
End Date

CAPS1 and CAPS2 clinical trial

Administered By
Medicine, Nephrology
Role
Principal Investigator
Start Date
End Date

Publications:

Longer Term Effects of Diet and Exercise on Neurocognition: 1-Year Follow-up of the ENLIGHTEN Trial.

OBJECTIVES: To evaluate the longer term changes in executive functioning among participants with cardiovascular disease (CVD) risk factors and cognitive impairments with no dementia (CIND) randomized to a diet and exercise intervention. DESIGN: A 2 (Exercise) × 2 (Dietary Approaches to Stop Hypertension [DASH] eating plan) factorial randomized clinical trial. SETTING: Academic tertiary care medical center. PARTICIPANTS: Volunteer sample of 160 older sedentary adults with CIND and at least one additional CVD risk factor enrolled in the ENLIGHTEN trial between December 2011 and March 2016. INTERVENTIONS: Six months of aerobic exercise (AE), DASH diet counseling, combined AE + DASH, or health education (HE) controls. MEASUREMENTS: Neurocognitive battery recommended by the Neuropsychological Working Group for Vascular Cognitive Disorders including measures of executive function, memory, and language/verbal fluency. Secondary outcomes included the Clinical Dementia Rating-Sum of Boxes (CDR-SB), Six-Minute Walk Distance (6MWD), and CVD risk including blood pressure, body weight, and CVD medication burden. RESULTS: Despite discontinuation of lifestyle changes, participants in the exercise groups retained better executive function 1 year post-intervention (P = .041) compared with non-exercise groups, with a similar, albeit weaker, pattern in the DASH groups (P = .054), without variation over time (P's > .867). Participants in the exercise groups also achieved greater sustained improvements in 6MWD compared with non-Exercise participants (P < .001). Participants in the DASH groups exhibited lower CVD risk relative to non-DASH participants (P = .032); no differences in CVD risk were observed for participants in the Exercise groups compared with non-Exercise groups (P = .711). In post hoc analyses, the AE + DASH group had better performance on executive functioning (P < .001) and CDR-SB (P = .011) compared with HE controls. CONCLUSION: For participants with CIND and CVD risk factors, exercise for 6 months promoted better executive functioning compared with non-exercisers through 1-year post-intervention, although its clinical significance is uncertain.
Authors
Blumenthal, JA; Smith, PJ; Mabe, S; Hinderliter, A; Welsh-Bohmer, K; Browndyke, JN; Doraiswamy, PM; Lin, P-H; Kraus, WE; Burke, JR; Sherwood, A
MLA Citation
Blumenthal, James A., et al. “Longer Term Effects of Diet and Exercise on Neurocognition: 1-Year Follow-up of the ENLIGHTEN Trial..” J Am Geriatr Soc, Nov. 2019. Pubmed, doi:10.1111/jgs.16252.
URI
https://scholars.duke.edu/individual/pub1422327
PMID
31755550
Source
pubmed
Published In
Journal of the American Geriatrics Society
Published Date
DOI
10.1111/jgs.16252

Revamping the 'renal' diet: using foods to control phosphorus physiology.

Authors
Scialla, JJ; Lin, P-H
MLA Citation
Scialla, Julia J., and Pao-Hwa Lin. “Revamping the 'renal' diet: using foods to control phosphorus physiology..” Nephrol Dial Transplant, vol. 34, no. 10, Oct. 2019, pp. 1619–22. Pubmed, doi:10.1093/ndt/gfz019.
URI
https://scholars.duke.edu/individual/pub1370777
PMID
30805628
Source
pubmed
Published In
Nephrol Dial Transplant
Volume
34
Published Date
Start Page
1619
End Page
1622
DOI
10.1093/ndt/gfz019

DASH Diet and Blood Pressure Among Black Americans With and Without CKD: The Jackson Heart Study.

BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) more effectively in blacks compared to other US racial subgroups. Considering chronic kidney disease (CKD) raises BP through complex mechanisms, DASH may affect BP differently among blacks with and without CKD. We compared the association of DASH accordance to BP and prevalent hypertension among blacks with and without CKD. METHODS: Our study involved 3,135 black Americans enrolled in the Jackson Heart Study (2000-2004) with diet and office BP data. Using linear models adjusted for demographics, health behaviors, and clinical factors, we determined the association of a modified DASH score (excluding sodium intake, ranging from 0 to 8 with increasing DASH accordance) with BP. We performed tests for interaction between DASH score and CKD status. RESULTS: Among participants (mean age: 55 years; hypertension: 60%; CKD: 19%), the median DASH score was similar among participants with and without CKD (1.0 [interquartile range (IQR): 0.5-2] and 1.0 [IQR: 0.5-1.5]). CKD status modified the association of the DASH score with systolic BP (SBP) and diastolic BP (DBP; P interactions were 0.06 and <0.01). Among participants without CKD, SBP and DBP were not associated with the DASH score (-0.4 [95% confidence interval: -1.0, 0.1] mm Hg and -0.1 [-0.4, 0.2] mm Hg per one unit higher DASH score). Among participants with CKD, one unit higher DASH score was associated with lower SBP by 1.6 (0.5, 2.6) mm Hg and lower DBP by 0.9 (0.3, 1.5) mm Hg. CONCLUSIONS: Despite low DASH scores overall, better DASH accordance was associated with lower BP among Black Americans with CKD.
Authors
Tyson, CC; Davenport, CA; Lin, P-H; Scialla, JJ; Hall, R; Diamantidis, CJ; Lunyera, J; Bhavsar, N; Rebholz, CM; Pendergast, J; Boulware, LE; Svetkey, LP
MLA Citation
Tyson, Crystal C., et al. “DASH Diet and Blood Pressure Among Black Americans With and Without CKD: The Jackson Heart Study..” Am J Hypertens, vol. 32, no. 10, Sept. 2019, pp. 975–82. Pubmed, doi:10.1093/ajh/hpz090.
URI
https://scholars.duke.edu/individual/pub1393463
PMID
31187128
Source
pubmed
Published In
Am J Hypertens
Volume
32
Published Date
Start Page
975
End Page
982
DOI
10.1093/ajh/hpz090

Dietary intake and prostate cancer, continued pursuit for evidence

Authors
Lin, PH; Freedland, SJ
MLA Citation
Lin, P. H., and S. J. Freedland. “Dietary intake and prostate cancer, continued pursuit for evidence.” Translational Andrology and Urology, vol. 8, Jan. 2019, pp. S246–49. Scopus, doi:10.21037/tau.2019.01.08.
URI
https://scholars.duke.edu/individual/pub1412371
Source
scopus
Published In
Translational Andrology and Urology
Volume
8
Published Date
Start Page
S246
End Page
S249
DOI
10.21037/tau.2019.01.08

The effects of dietary patterns on quality of life: a substudy of the Dietary Approaches to Stop Hypertension trial.

Few studies have examined the effects of dietary changes, particularly modifications of whole dietary patterns, on quality of life. The Dietary Approaches to Stop Hypertension (DASH) trial compared the effects of 3 dietary patterns on blood pressure. In this substudy, we examined the effect of these diets on health-related quality of life. All DASH participants ate a control diet for 3 weeks and then were randomly assigned to continue the control diet, to a fruits and vegetables diet or to a combination diet for 8 weeks. The combination diet emphasized fruits, vegetables, and low-fat dairy products. It included whole grains, poultry, fish, and nuts, and was reduced in fats, red meat, sweets, and sugar-containing beverages. The control diet was similar to typical American intake; the fruits and vegetables diet was rich in fruits and vegetables but was otherwise similar to the control diet. Both the fruits and vegetables diet (P < .001) and the combination diet (P < .001) significantly lowered blood pressure. At the Duke University Medical Center, Durham, NC, site, participants completed the Medical Outcomes Study Short Form-36 questionnaire to assess their health-related quality of life at baseline and at the end of the dietary intervention. Eighty-three participants completed the questionnaires at both time points. In general, health-related quality of life improved in all treatment groups except for the control group in perceptions of change in health, which diminished. In the combination diet group all the subscales were improved or unchanged compared with baseline values. However, only the change in health score improved significantly (P < .05) as compared with that of the control diet group. When all the subscales were summed into a total score, the control diet was associated with mean improvement of 4.0%, the fruits and vegetables diet with 5.0%, and the combination diet with 5.9% from baseline. These data suggest that the fruits and vegetables diet and particularly the combination diet cannot only lower blood pressure, but may also improve the perception of health-related quality of life.
Authors
Plaisted, CS; Lin, PH; Ard, JD; McClure, ML; Svetkey, LP
MLA Citation
Plaisted, C. S., et al. “The effects of dietary patterns on quality of life: a substudy of the Dietary Approaches to Stop Hypertension trial..” J Am Diet Assoc, vol. 99, no. 8 Suppl, Aug. 1999, pp. S84–89. Pubmed, doi:10.1016/s0002-8223(99)00421-6.
URI
https://scholars.duke.edu/individual/pub717672
PMID
10450299
Source
pubmed
Published In
Journal of the American Dietetic Association
Volume
99
Published Date
Start Page
S84
End Page
S89
DOI
10.1016/s0002-8223(99)00421-6