Adherence to the DASH diet by hypertension status in Mexican men and women: A cross-sectional study

Improving dietary patterns is a cornerstone of the non-pharmacological management of hypertension. Evidence about the adherence to healthy dietary patterns at the population level is scarce. We aimed to analyze the adherence to the Dietary Approaches to Stop Hypertension (DASH) diet among Mexican men and women by hypertension status. We used data from the 2012 Mexican National Health and Nutrition Survey (n = 2560). Using self-reported diagnosis of hypertension and blood pressure measurements, we identified participants without, with undiagnosed, and diagnosed hypertension. We calculated DASH scores (total and dietary components) based on a single 24-hour recall and analyzed differences in adherence across hypertension status using sex-specific multivariable Poisson regression models. Overall, regardless of hypertension status, adherence to the DASH score was low, with 35% of men and 38% of women with diagnosed hypertension adhering to recommended guidelines; lower adherence was observed in men (21.8%) and women (27.2%) with undiagnosed hypertension, and with no hypertension (26.8% in men, 26.3% in women). In multivariable models for men, the prevalence of adherence to the total DASH diet was 29% lower in undiagnosed adults versus adults without hypertension (RP 0.71; 95%CI 0.50,0.99). Specifically, adherence to fruits, total dairy, and animal protein was lower in undiagnosed men. Among women, the adherence to the DASH diet was similar across hypertension status in multivariable models. Mexican adults had low adherence to DASH, regardless of hypertension status. Strategies to improve adherence to DASH are needed, focusing in patients with hypertension but also as a preventive measure for the population.