Speaker
Stephen P. Juraschek, MD, PhD, FAHA, AHSCP-CHS
Associate Professor of Medicine
HCA Hypertension Center Director & Beth Israel Deaconess Medical Center
Keywords
Hypertension; Groceries; Diet; Grocery Access; DASH
Key Points
- Hypertension affects 55% of Black adults, more than any other demographic in the US. Diet is the most important mediator of excess hypertension risk among Black adults, and the DASH diet – which emphasizes low-sodium, heart-healthy items like fruits, vegetables, whole grains, and lean proteins – has been shown to be especially efficacious (albeit in tightly controlled settings).
- The study team sought to test whether 3 months of dietician-assisted, home-delivered, DASH-patterned grocery delivery to Black residents of communities with few grocery stores would improve their blood pressure. The comparator group received 3 $500 stipends, one every 4 weeks, for self-directed grocery shopping.
- The research team found that the intervention reduced urine sodium, systolic blood pressure, diastolic blood pressure, and LDL-cholesterol. Longer-term maintenance of these benefits will likely require sustained access to healthy groceries and nutrition counseling.
Discussion Themes
The 3.4 mmHg reduction in systolic blood pressure is more modest than the 7–10 mmHg typically expected from first-line antihypertensive drugs. Dr. Juraschek emphasized that GoFresh was a prevention cohort for adults not yet on medication.
The health benefits largely decayed after the active intervention ended. While providing food works, structural barriers to accessing healthy food remain a primary challenge. Ongoing qualitative interviews are exploring the specific barriers and facilitators that affected whether participants could maintain the DASH diet after the study ended.