Translating the Dietary Approaches to Stop Hypertension (DASH) Diet for Use in Underresourced, Urban African American Communities, 2010

Abstract

IntroductionRandomized trials have demonstrated the effectiveness of the Dietary Approaches to Stop Hypertension (DASH) program for lowering blood pressure; however, program participation has been limited in some populations. The objective of this pilot study was to test the feasibility of using a culturally modified version of DASH among African Americans in an underresourced community.MethodsThis randomized controlled pilot study recruited African Americans in 2 North Carolina neighborhoods who had high blood pressure and used fewer than 3 antihypertension medications. We offered 2 individual and 9 group DASH sessions to intervention participants and 1 individual session and printed DASH educational materials to control participants. We collected data at baseline (March 2010) and 12 weeks (June 2010).ResultsOf 152 potential participants, 25 were randomly assigned to either the intervention (n = 14) or the control (n = 11) group; 22 were women, and 21 were educated beyond high school. At baseline, mean blood pressure was 130/78 mm Hg; 19 participants used antihypertension medications, and mean body mass index was 35.9 kg/m2. Intervention participants attended 7 of 9 group sessions on average. After 12 weeks, we observed significant increases in fruit and vegetable consumption and increases in participants’ confidence in their ability to reduce salt and fat consumption and eat healthier snacks in intervention compared with control participants. We found no significant decreases in blood pressure.ConclusionImplementation of a culturally modified, community-based DASH intervention was feasible in our small sample of African Americans, which included people being treated for high blood pressure. Future studies should evaluate the long-term effect of this program in a larger sample.

The Effects of an Educational Program on Using Dietary Approach to Reduce High Blood Pressure in Khartoum State, Sudan (2015)

“…This result going with that done by (Whitt-Glover MC) in North Carolina which shows no significant changes occurred in blood pressure after 12th week of application of the DASH approach [21].…”

Preliminary Validation of the Hypertension Self‐Care Activity Level Effects (H‐SCALE) and Clinical Blood Pressure Among Patients With Hypertension

“…Another interpretation is that patients with hypertension have received messages to reduce salt consumption but their actions have yet to affect their BPs. For example, a recent study introduced DASH concepts to hypertensive African Americans, whose diet improved, but no significant changes occurred in BP . The temporal response related to short‐term or long‐term diet changes is unknown and likely influenced by many other factors beyond the scope of this study.…”

“…For example, a recent study introduced DASH concepts to hypertensive African Americans, whose diet improved, but no significant changes occurred in BP. 35 The temporal response related to short-term or long-term diet changes is unknown and likely influenced by many other factors beyond the scope of this study. A third hypothesis may be that patients with higher or uncontrolled BP may have provided socially desirable answers because they were concerned that their physician would see their responses.…”

A DASH dietary pattern and the risk of colorectal cancer in Canadian adults

“…4,11,45 This is true also for how authors define and determine adherence to a DASH diet. 28,[46][47][48] In our study, we relied on available information to define food groups and to add relevant foods to each group, including assigning equivalent serving sizes. In this regard, we may have misclassified some foods, thereby possibly misclassifying participants into an adjacent DASH score and possibly over-populating mid-range DASH scores.…”