Disease, Nutrition, Recommendations

Cultural Challenges with the DASH Eating Plan

Heart disease is a leading cause of death in the United States contributing to over 633,000 deaths annually. Like most chronic diseases, individuals can reduce their risk of developing this condition with proper diet and exercise. When someone is at extremely high risk of developing heart disease, nutrition professions suggest a few things: exercise, stop smoking, eat nutrient dense foods and reducing sodium intake with the DASH eating plan. While these modifications are proven to reduce the risk of heart attack and stroke, the DASH eating plan can be problematic for communities of color.

DASH, or Dietary Approaches to Stop Hypertension, is a proven eating plan for lowering blood pressure without the use of medication. The reason blood pressure is so important is that it is one of many factors that contribute to heart disease. DASH recommends the following:

1. Eat fruits, vegetables, and whole grains
2. Including fat-free or low-fat dairy products
3. Consume fish, poultry, beans, nuts and vegetable oils
4. Limiting foods high in saturated fat
5. Limiting sugar-sweetened beverages and sweets

This diet is excellent for promoting a healthy diet; however, for communities of color which suffer in greater numbers from lactose intolerance DASH’s promotion of dairy products can cause discomfort. Lactose intolerance results in symptoms such as indigestion, bloating, stomach cramps, diarrhea, indigestion, flatulence and fatty stool after consuming lactose, a sugar found in dairy. The premise behind increasing dairy consumption is its higher calcium content which is associated with reducing blood pressure. The eating plan fails to acknowledge that there are other excellent sources of calcium like broccoli, calcium-fortified real fruit juices, beans, almonds, and sardines. In doing so, DASH recommends a diet that may lower hypertension, but that also makes people sick. This could diminish its credibility in communities of color. By including non-dairy sources of calcium, our healthcare systems and dietary recommendations could acknowledge and accommodate all people instead of offering a one-size-fits-all approach to health.