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Page: << Prev | 1 | 2 But the overall "DASH-accordance" was about 8 percent lower in the 1999-2004 group than it had been in the 1988-1994 group, Mellen found.
Certain trends emerged. "Being younger meant less DASH accordance," he said. "African-Americans were less likely to be in accord. Accordance was higher in individuals with more than a high school education, and for older individuals and those with diabetes."
Other social differences appear to play a role. "There are significant differences in the availability of healthy foods depending on where you live," Mellen said.
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Mellen also kept coming back to the doctor-patient relationship and how it is affected by methods of payment for medical care.
"Dietary counseling is not reimbursed," Mellen said. "Medicare does not reimburse for dietary counseling." It thus is easier for a physician to write a prescription for a blood pressure medication than to spend time talking to someone about good dietary habits, he said.
Dr. George Bakris, director of the hypertensive disorders unit at the University of Chicago, noted that the diet has some practical drawbacks, starting with expense.
"While the diet is certainly nutritious and gives you a balance of all the fruits and vegetables you need, if you go to the store and shop for it, it is more expensive than people appreciate," Bakris said.
The DASH diet also takes more preparation than most meals, he said. "Much of it has to be prepared, and people in this day and age are used to things that are quick," Bakris said. "In the original studies, the food was prepared for the participants. That is not for everybody."
The bottom line: Getting more people with high blood pressure to follow the DASH diet will not be easy, Bakris said. "If you can't afford it, you can't eat it," he said.
More information
Find out more about the DASH diet at the U.S National Heart, Lung and Blood Institute.
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