title: Compliance with the Dietary Approaches to Stop Hypertension (DASH) diet: a systematic review.
abstract: BACKGROUND
  The Dietary Approaches to Stop Hypertension (DASH) diet has been recognized as effective to lower blood pressure in feeding trials, but compliance with the diet must be persistent to maximize health benefits in clinical practice. This paper reports a systematic review of the latest evidence on the method to assess DASH compliance and the corresponding patients' compliance in interventional settings.
  
  
  METHODS
  The databases including MEDLINE, EBM Reviews, EMBASE, and CINAHL Plus were searched for original research studies published in the period of January 1992-December 2012 that evaluated compliance with DASH diet. Studies written in English language, with DASH intervention, with complete documentation of the degree of DASH compliance and the assessment method used were included in this review. The search terms included: dietary approaches to stop hypertension, DASH, compliance, adherence, consistency, and concordance.
  
  
  RESULTS
  Nine studies were included. Different types of interventions were identified, ranging from feeding trial to dietary counseling. These studies differed in the assessment methods used to evaluate DASH compliance, which included objective approaches like measurement of urinary excretion, and subjective approaches like dietary intake assessment for DASH target comparison and construction of DASH scoring systems. Compliance levels were lower in educational interventions than that of the original DASH feeding trial.
  
  
  CONCLUSIONS
  To conclude, although no consensus existed regarding the best approach to assess DASH compliance, its suboptimal compliance warrants attention. This study implied a need to investigate effective approaches to sustain the DASH dietary pattern beyond counselling alone.
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Mandy Wing-Man
authors.initials: MW
authors.lastname: Kwan
authors.forename: Martin Chi-Sang
authors.initials: MC
authors.lastname: Wong
authors.forename: Harry Hao-Xiang
authors.initials: HH
authors.lastname: Wang
authors.forename: Kirin Qi-Lin
authors.initials: KQ
authors.lastname: Liu
authors.forename: Catherine Lok-Sze
authors.initials: CL
authors.lastname: Lee
authors.forename: Bryan Ping-Yen
authors.initials: BP
authors.lastname: Yan
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu
authors.forename: Sian Meryl
authors.initials: SM
authors.lastname: Griffiths
mesh_terms: D000293:Adolescent; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D004032:Diet / Q000379:methods; D004039:Diet, Sodium-Restricted / Q000379:methods; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance