The DASH Diet: A measure of

compliance to a structured

remedy for lowering Blood

Pressure

DHBCI DIY Assignment

By: Jason Paulson

D.I.Y. Problem: I have uncontrolled hypertension.

Tried prescriptions in the past, though discontinued use to try and treat with nutrition and exercise.

Unsuccessful, so it‟s time to try a structured, proven approach for managing hypertension.

Purpose of the study: measure compliance to DASH Diet, to help indicate likelihood of using model as a remedy in future.

Hypothesis: complying with the DASH Diet will result in significant reductions of blood pressure

Theoretical Framework Cognitive Dissonance Theory- (Festinger „57)

Two dissonant cognitions:

1) I eat too many salt-laden foods, excess salt

increases blood pressure.

2) I have HTN, I don‟t want to take BP meds.

If Unaddressed, dissonant cognitions lead to “psychological discomfort”

e.g. ”I need to start eating higher proportion of whole foods, and less processed „relatively-healthy foods‟”.

How Do I Measure DASH

Compliance? I ascribed each of the eight DASH categories with a 5-point scale designating

specific values of servings for each group (based of a 3,100kcal/day diet).

For instance, „Grains‟ Grading criteria:

Grains- (minus two points if majority are refined)

5 pts. = 10-13 more servings

4 pts. = 8-9 servings or 14-15 servings

3 pts. = 6-7 servings or >15 servings

2 pts. = 4-5 servings

1 pt. = 2-3 serving

0 pts. = 0-1 servings

BP/HR Readings &

Percentage Adherence

Day Blood

Pressure

(BP)

Heart Rate

(HR)

Percent

Adherenc

e

Regular Diet,

Day 1

139/71 62 67.5%

Regular Diet,

Day 2

135/78 60 32.5%

Regular Diet,

Day 3

141/82 74 55%

DASH Diet,

Day 1

125/73 80 77.5%

DASH Diet,

Day 2

130/69 69 75%

DASH Diet,

Day 3

133/70 68 69%

Systolic Blood Pressure

R² = 0.067

110

115

120

125

130

135

140

145

150

155

160

Reg. Diet, Day 1 SBPReg. Diet, Day 2 SBPReg Diet, Day 3 SBPDASH Diet, Day 1 SBPDASH Diet, Day 2 SBPDASH Diet, Day 3 SBP

Morning SBP

Mid-day SBP

Evening SBP

Linear (Mid-day SBP)

Did it Work?Regular Diet: (Pre-Intervention measures)

Compliance- 52%

Avg. BP- 138/77 Avg. HR- 65

DASH Diet:

Compliance- 74%

Avg. BP- 129/71 Avg. HR- 72

What I learned/

Insights Gained It‟s cheaper to follow DASH than my usual patterns

Just like the base of evidence suggests, DASH is

effective; I can manage my BP if I really apply!

Weak study design

I didn‟t factor caffeine into my scoring criteria

i.e. Ignored major confounder

Disappointments with DASH There is no distinguishing between

meat, fish, poultry, nuts, and beans.

Only one serving recommended of nuts, seeds, and

legumes.

-This discourages eating a variety of foods from this

important food group.