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Dhbci diy ppt DASH pres.
- 1. The DASH Diet:A measure of compliance to a structured remedy for lowering Blood Pressure DHBCI DIY Assignment By: Jason Paulson
- 2. D.I.Y. Problem: Ihave 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 Insightful observations pertinent to my thesis are a plus too!
- 3. Theoretical Framework CognitiveDissonance 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‟”.
- 4. How Do IMeasure 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
- 5. BP/HR Readings & PercentageAdherence 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%
- 6. Systolic Blood Pressure 160 155 150 145 140 135 130 125 MorningSBP Mid-day SBP Evening SBP Linear (Mid-day SBP) 120 115 110 Reg. Diet, Day Reg Diet,SBPDASH Diet,SBP 2 SBP 3 SBP Reg. Diet,SBPDASH Diet, Day 1 Day 1 Day 2 Day 3 SBP DASH Diet, Day
- 7. Did it Work? RegularDiet: Compliance- 52% Avg. BP- 138/77 Avg. HR- 65 DASH Diet: Compliance- 74% Avg. BP- 129/71 Avg. HR- 72
- 8. What I learned/ InsightsGained 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. Confounder ignored
- 9. 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.
Editor's Notes
- #2 For my DIY assignment I wanted to focus on behaviors that are pertinent to my thesis topic. So, because I have high blood pressure, don’t want to take pharmaceuticals, and because I know there already is a proven effective nutritional paradigm to reduce blood pressure, I chose to measure my compliance to the Dietary Approaches to Stop Hypertension (aka the DASH Diet). The main thing that provoked the focus of this assignment was because I’ve often considered trying the DASH diet, but just figured I wouldn’t properly adhere to it.
- #3 As mentioned, the problem is: I have uncontrolled hypertension.I’ve tried prescriptions in the past, though I discontinued use because I swore to myself I could manage this with nutrition and exercise.A couple years later, I’m still generally unsuccessful at keeping blood pressure at bay. With this assignment, I figured what better time than now to measure my adherence and make some relevant observations about this nutritional model that’s proven successful to lower blood pressure.
- #4 Regarding theoretical framework, The Cognitive Dissonance Theory was the primary study for me here. Just a quick recap, CDT states that any two given cognitions we have can either be consonant (in agreement) or dissonant with each other. Now, the dissonant (disagreeable) cognitions cause a “psychological discomfort” if we don’t essentially ‘reshape’ our conflicting thoughts or change a particular behavior to allow these cognitions to become consonant. My two dissonant cognitions that prompted this DIY assignment: I eat too many salt-laden foods and excess salt increases blood pressure. I have HTN, and I do NOT want to take BP medications. My biggest deterrent for never giving DASH a try in the past was the fact that I thought I wouldn’t comply. I thought it just seemed too boring, or restrictive, or perhaps I was just too stuck on my own dietary habits to break them. So, I figured what better time then now to measure the effects and my compliance to the DASH Diet?
- #5 In order to measure my average compliance of three days regular diet and three days of DASH Diet, I came up with my own grading criteria. I ascribed each of the eight DASH categories with a 5-point scale designating specific values of servings for each group. And these number of servings were based on DASH recommendations for a 3,100 kcal/day diet.I then took these values and divided by 40, to give me a “percent compliance” score. Additionally, I recorded my blood pressure with a cuff at home, three times for each of the six days: morning, mid-day (or somewhat close to it) , and evening.
- #6 Averagecompliance Regular diet – ~52%Average B.P. Reg. diet- 138/77Average H.R. -65Average adherence DASH Diet- ~74%Avg. BP Reg. Diet- 129/71Avg. HR Reg. Diet- 72
- #9 Some of the insights I gained from this experience:Ultimately, it’s cheaper (and most likely better for my BP) than my usual dietary patterns. I had a weak study design. I knew I wanted to measure my compliance to DASH, but I didn’t take the time to really think out how I would promote such dietary changes other than simply making myself more cognizant of the all the guidelines and considering them with each meal.