Translation and Validation of the Dietary Approaches to Stop Hypertension for Koreans Intervention

Abstract

Background Lifestyle modification strategies such as adoption of the Dietary Approaches to Stop Hypertension (DASH) diet are now recognized as an integral part of high blood pressure (HBP) management. Although the high prevalence of HBP among Korean Americans (KAs) is well documented, few dietary interventions have been implemented in this population, in part because of a lack of culturally relevant nutrition education guidelines. Translating and testing the efficacy of culturally relevant dietary recommendations using a well-established dietary guideline such as DASH are imperative for promoting better cardiovascular health for this high-risk cultural group. Objective The aims of this study were to systematically translate and validate a culturally modified DASH for Koreans (K-DASH) and obtain preliminary evidence of efficacy. Methods A 2-step approach of intervention translation and efficacy testing, together with close adherence to principles of community-based participatory research, was used to maximize community input. A 1-group pre-post design with 24-hour urine and 24-hour ambulatory blood pressure monitoring comparisons was used to test the initial feasibility and efficacy of the K-DASH intervention. Results A total of 28 KAs with HBP participated in a 10-week dietary intervention consisting of group education sessions and individual counseling. Both systolic blood pressure and diastolic blood pressure, as measured by ambulatory blood pressure monitoring, were significantly decreased at postintervention evaluation (systolic blood pressure, −4.5 mm Hg; diastolic blood pressure, −2.6 mm Hg; P < .05). Serum low-density lipoprotein cholesterol was significantly decreased (−7.3 mg/dL; P < .05). Serum potassium and ascorbic acid levels were also improved in the reference range. Urine potassium level was significantly increased, supporting increased fruit and vegetable consumption. Conclusion This pilot study has (a) demonstrated that a cultural adaptation of DASH using community-based participatory research methodology produced a culturally relevant and efficacious dietary intervention for the KAs with HBP and (b) provided strong preliminary evidence for the efficacy of the K-DASH intervention in reducing HBP in hypertensive KAs.

The Effects of Diet Alone or in Combination with Exercise in Patients with Prehypertension and Hypertension: a Randomized Controlled Trial

“… 8) The culturally modified DASH diet for Koreans has shown efficacy in BP lowering, as it reduced SBP by 4.5 mmHg and DBP by 2.6 mmHg. 16) As such, the Korean modified DASH diet was used as the dietary program in this study. However, implementation of the DASH diet and sodium intake reduction in the current study did not result in significant lowering of ABPM BP or office BP in the D group.…”

An Update on Nutrients and Blood Pressure

“…A pilot study, DASH for Koreans (K-DASH), developed culturally sensitive dietary guidelines by the adaptation of DASH-Na diet and demonstrated the efficacy of this K-DASH intervention in reducing HBP in Korean Americans. 95 The country-specific foods and beverages from the dietary recalls in the INTERMAP Study may provide information for developing culturally tailored dietary guidelines for management and prevention of HTN.…”

‘The Quranic Garden’: Consumption of Fruits, Vegetables, and Whole Grains from an Islamic Perspective

“…As global obesity trends and obesityrelated co-morbidities such as type 2 diabetes mellitus, hypertension, cardiovascular disease, stroke, and some cancers continue to increase unabated (Ng et al, 2014;World Health Organization, 2016b), global public policies and awareness campaigns have prompted calls from the WHO for action to reduce obesogenic environments and promote beliefs and attitudes that could support healthy dietary patterns and encourage physical activity (World Health Organization, 2016a). Recent studies have placed an emphasis on the importance of health strategies and interventions that are culturally-relevant and tailored to various respective populations and communities (Bender, Nader, Kennedy, & Gahagan, 2013;Bertran et al, 2015;James, Pobee, Oxidine, Brown, & Joshi, 2012;Kim, Song, Han, Kim, & Kim, 2013). Additionally, theoretical frameworks that incorporate aspects of faith and religion within culturally-tailored interventions have been previously proposed and continue to gain growing recognition for their potential to influence health beliefs and behaviors (Grundmann, 2014;Lancaster, Carter-Edwards, Grilo, Shen, & Schoenthaler, 2014;Opalinski, Dyess, & Grooper, 2015;Sattin et al, 2016;Yeary et al, 2015).…”