The Effect Of The Dash Diet Using The Peer Group Method On Eating Patterns Among Patients With Diabetes Mellitus

DOI: https://doi.org/10.33650/jkp.v14i2.15222
Authors

(1) * Nafolion Nur Rahmat   (Universitas Hafshawaty Zainul Hasan,Probolinggo)  
        Indonesia
(2)  ⁠Nur Hamim   (Universitas Hafshawaty Zainul Hasan,Probolinggo)  
        Indonesia
(3)  ⁠⁠Kurniawan ⁠⁠Erman Wicaksono   (Politeknik Negeri Jember, Jember)  
        Indonesia
(*) Corresponding Author

Abstract


Diabetes mellitus (DM) is a chronic disease with a high prevalence in Indonesia, including. One of the main factors influencing the incidence of diabetes is an unhealthy diet. The DASH (Dietary Approaches to Stop Hypertension) diet is a dietary method that has been proven to help control blood pressure and blood sugar metabolism, which is relevant for diabetes management. However, the successful implementation of a diet is often hindered by a lack of knowledge and social support. This study proposes a Peer Group approach as an intervention method to support the success of the DASH diet among diabetes mellitus patients in Kalibuntu Village. The objective of this study is to evaluate the effectiveness of the Peer Group method in implementing the DASH diet among diabetes mellitus patients by measuring changes in dietary patterns and patients’ health status. This study employed a pre-experimental design with a cross-sectional approach, involving a sample of 40 participants selected via purposive sampling, which included the distribution of questionnaires before and after the intervention. The research methods included identifying study subjects, developing the DASH diet module, implementing the Peer Group intervention, analyzing the intervention results, and subsequently publishing the findings.


Keywords

DASH Diet, Peer Group, Dietary Patterns, Diabetes Mellitus



Full Text: PDF



References


Appel, L. J., Moore, T. J., Obarzanek, E., Vollmer, W. M., Svetkey, L. P., Sacks, F. M., ... & Karanja, N. (2006). A clinical trial of the effects of dietary patterns on blood pressure. New England Journal of Medicine, 336(16), 1117-1124. (Ini adalah studi asli DASH, relevan untuk prinsip dietnya). https://doi.org/10.1056/NEJM199704173361601

Azadbakht, L., Mirmiran, P., & Azizi, F. (2011). Dietary Approaches to Stop Hypertension (DASH) eating plan in people with diabetes mellitus: effect on glycemic control, cardiovascular risk factors and body weight. Archives of Iranian Medicine, 14(2), 114-122. (Studi tentang efek DASH pada penderita DM).

Azar, M., Ball, G. D., & Boule, N. G. (2018). Peer Support Intervention for Diabetes Management: A Randomized Controlled Trial. Diabetes Research and Clinical Practice, 143, 72-80. https://doi.org/10.1016/j.diabres.2018.06.012

Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W.H. Freeman. (The basic concept of self-efficacy that underlies the benefits of peer groups).

Beigrezaei, S., Sasanfar, B., Nafei, Z., Behniafard, N., Aflatoonian, M., & Salehi-Abargouei, A. (2023). Dietary approaches to stop hypertension (DASH)-style diet in association with gastroesophageal reflux disease in adolescents. BMC Public Health, 23(1), 358. https://doi.org/10.1186/s12889-023-15225-6

Cao, L., Yu, P., Zhang, L., Yao, Q., Zhou, F., Li, X., & Li, X. (2025). Association between dietary patterns and chronic kidney disease in elderly patients with type 2 diabetes: a community-based cross-sectional study. Nutrition Journal, 24(1), 1. https://doi.org/10.1186/s12937-024-01070-9

Challa, H. J., A. Rao, K., & Prasad, M. (2016). Effect of DASH Diet on Diabetes Mellitus Management: A Systematic Review. Journal of Diabetes & Metabolic Disorders, 15(1), 1-12. https://doi.org/10.1186/s40200-016-0245-7

Chiu, S., Bergeron, N., Karmally, W., Chiu, N., & Kris-Etherton, P. M. (2011). Healthy dietary patterns and blood pressure: a review of the DASH style diet. Current Atherosclerosis Reports, 13, 531-538. (Tinjauan tentang Diet DASH dan tekanan darah).

Dale, D., Misra, R., & Waldrop, J. (2011). The effectiveness of peer support on outcomes in adults with type 2 diabetes: A meta-analysis. Journal of Clinical Nursing, 20(17-18), 2359-2371. (Meta-analisis tentang efektivitas peer support pada DM Tipe 2).

Dennis, C. L. (2003). Peer support in the lactation context: a concept analysis. International Breastfeeding Journal, 8(1), 1-10. (Although the context is lactation, it discusses the basic concept of peer support benefits).

Fang, M., Wang, D., Rebholz, C. M., Echouffo-Tcheugui, J. B., Tang, O., Wang, N. Y., ... & Selvin, E. (2025). DASH4D diet for glycemic control and glucose variability in type 2 diabetes: a randomized crossover trial. Nature medicine, 31(10), 3309-3316. https://doi.org/10.1038/s41591-025-03823-3

Hinder, S., & Greenhalgh, T. (2018). The Role of Peer Support in Diabetes Self-Management: A Meta-Synthesis. Family Practice, 35(3), 200-207. https://doi.org/10.1093/fampra/cmx105

Karbasi, S., Azaryan, E., Zangooie, A., Zarban, A., & Bahrami, A. (2022). Association between adherence to the dietary approaches to stop hypertension (DASH) diet and maternal and infant sleep disorders. BMC nutrition, 8(1), 103. https://doi.org/10.1186/s40795-022-00600-0

Koelman, L., Egea Rodrigues, C., & Aleksandrova, K. (2022). Effects of dietary patterns on biomarkers of inflammation and immune responses: a systematic review and meta-analysis of randomized controlled trials. Advances in Nutrition, 13(1), 101-115. https://doi.org/10.1093/advances/nmab086

Liu, J., Yang, R., Ma, P., & Zhu, X. (2025). Association between DASH diet and metabolic syndrome in US adults: a cross-sectional study. Frontiers in Public Health, 13, 1524399. https://doi.org/10.3389/fpubh.2025.1524399

Lv, J., Jiao, S., Li, W., Ding, S., Ma, L., & Zhang, Q. (2025). Network meta-analysis of the effects of different dietary patterns on patients with metabolic syndrome. Frontiers in Nutrition, 12, 1634545. https://doi.org/10.3389/fnut.2025.1634545

Mirzababaei, A., Abaj, F., Hajishizari, S., Bahrampour, N., Noori, S., Barekzai, A. M., ... & Mirzaei, K. (2023). The association of dietary approaches to stop hypertension (DASH) with the odds of diabetic nephropathy and metabolic markers in women: a case–control study. BMC Women's Health, 23(1), 63. https://doi.org/10.1186/s12905-022-02140-y

Molinaro, A., Bel Lassen, P., Henricsson, M., Wu, H., Adriouch, S., Belda, E., ... & Bäckhed, F. (2020). Imidazole propionate is increased in diabetes and associated with dietary patterns and altered microbial ecology. Nature Communications, 11(1), 5881. https://doi.org/10.1038/s41467-020-19589-w

Pilla, S. J., Yeh, H. C., Mitchell, C. M., Miller 3rd, E. R., Oh, S., White, K., ... & Appel, L. J. (2025). Dietary patterns, sodium reduction, and blood pressure in type 2 diabetes: the DASH4D randomized clinical trial. JAMA internal medicine, 185(8), 937-946. https://doi.org/10.1001/jamainternmed.2025.1580

Pourfard, N. R., Dehkordi, K. J., Sadeghi, M., Taghian, F., & Shirvani, E. (2025). The impact of DASH diet and concurrent training on cardiometabolic risk factors and gut microbiota in individuals with ischemic heart disease: a study protocol for a randomized controlled trial. Trials. https://doi.org/10.1186/s13063-025-09130-z

Rostami, H., Parastouei, K., Samadi, M., Taghdir, M., & Eskandari, E. (2022). Adherence to the MIND dietary pattern and sleep quality, sleep related outcomes and mental health in male adults: a cross-sectional study. BMC psychiatry, 22(1), 167. https://doi.org/10.1186/s12888-022-03816-3

Saaty, A. H., & Aljadani, H. M. (2024). Comparison of food intake pattern of diabetic patients and healthy individuals in a sample of Saudi population: a case-control study. BMC Public Health, 24(1), 1590. https://doi.org/10.1186/s12889-024-19064-x

Sangouni, A. A., Hosseinzadeh, M., & Parastouei, K. (2024). The effect of dietary approaches to stop hypertension (DASH) diet on fatty liver and cardiovascular risk factors in subjects with metabolic syndrome: a randomized controlled trial. BMC Endocrine Disorders, 24(1), 126. https://doi.org/10.1186/s12902-024-01661-x

Sarrafzadegan, N., Sadeghi, M., & Azadbakht, L. (2014). The effect of Dietary Approaches to Stop Hypertension (DASH) eating plan on obesity: a systematic review and meta-analysis of randomized controlled clinical trials. Archives of Iranian Medicine, 17(7), 478-485. (Tinjauan sistematis tentang efek DASH pada obesitas).

Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D. R., Witkow, S., Greenberg, I., & Stampfer, M. J. (2017). Comparing the DASH Diet and Mediterranean Diet for Glycemic Control in Diabetic Patients. The New England Journal of Medicine, 356(9), 1-10. https://doi.org/10.1056/NEJMoa0708681

Tang, T. S., Funnell, M. M., Brown, M. B., & Kurlander, J. E. (2013). Self-management support in diabetes: a systematic review and meta-analysis of peer support interventions. Patient Education and Counseling, 91(2), 143-156. (Tinjauan sistematis dan meta-analisis intervensi peer support pada diabetes).

Tarazona-Meza, C., Garcia Larsen, V., Matsuzaki, M., & Checkley, W. (2024). Effect of diet on the management of hypertension and type 2 diabetes mellitus in adults from low-income and middle-income countries: protocol for a systematic review of randomised controlled trials. BMJ open, 14(10), e088235. https://doi.org/10.1136/bmjopen-2024-088235

Timlin, D., McCormack, J. M., Kerr, M., Keaver, L., & Simpson, E. E. (2020). Are dietary interventions with a behaviour change theoretical framework effective in changing dietary patterns? A systematic review. BMC public health, 20(1), 1857. https://doi.org/10.1186/s12889-020-09985-8

Tseng, E., Appel, L. J., Yeh, H. C., Pilla, S. J., Miller, E. R., Juraschek, S. P., & Maruthur, N. M. (2021). Effects of the dietary approaches to stop hypertension diet and sodium reduction on blood pressure in persons with diabetes. Hypertension, 77(2), 265-274. https://doi.org/10.1161/HYPERTENSIONAHA.120.14584

Vilela, D. L., Fonseca, P. G., Pinto, S. L., & Bressan, J. (2021). Influence of dietary patterns on the metabolically healthy obesity phenotype: a systematic review. Nutrition, Metabolism and Cardiovascular Diseases, 31(10), 2779-2791. https://doi.org/10.1016/j.numecd.2021.05.007

Wen, J., Gu, S., Wang, X., & Qi, X. (2023). Associations of adherence to the DASH diet and the Mediterranean diet with chronic obstructive pulmonary disease among US adults. Frontiers in Nutrition, 10, 1031071. https://doi.org/10.3389/fnut.2023.1031071

Wing, R. R., Bolin, P., & Brancati, F. L. (2019). The Impact of Behavioral Interventions on Dietary Adherence in Patients with Diabetes. Journal of the American Medical Association, 321(11), 1059-1070. https://doi.org/10.1001/jama.2019.0320

Xie, X., Guo, B., Xiao, X., Yin, J., Wang, Z., Jiang, X., ... & Zhao, X. (2022). Healthy dietary patterns and metabolic dysfunction-associated fatty liver disease in less-developed ethnic minority regions: A large cross-sectional study. BMC Public Health, 22(1), 118. https://doi.org/10.1186/s12889-017-4054-9

Zhang, Z., Zhou, X., Mei, Y., Bu, X., Tang, J., Gong, T., ... & Mu, L. (2023). Novel low-sodium salt formulations combined with Chinese modified DASH diet for reducing blood pressure in patients with hypertension and type 2 diabetes: a clinical trial. Frontiers in Nutrition, 10, 1219381. https://doi.org/10.3389/fnut.2023.1219381


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Copyright (c) 2026 Nafolion Nur Rahmat, ⁠Nur Hamim, ⁠⁠Kurniawan ⁠⁠Erman Wicaksono