Groceries

Grand Rounds January 23, 2026: DASH-Patterned Groceries Reduce Blood Pressure: Results from the GoFresh Randomized Clinical Trial (Stephen P. Juraschek, MD, PhD, FAHA, AHSCP-CHS)

Posted on by Sophia Ramirez

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.

January 21, 2026: DASH Groceries to Stop Hypertension, in This Week’s Rethinking Clinical Trials Grand Rounds

Posted on by Sophia Ramirez

In this Friday’s Rethinking Clinical Trials Grand Rounds, Stephen P. Juraschek of the Beth Israel Deaconess Medical Center will present “DASH Groceries to Stop Hypertension: Results From the GoFresh Trial.”

The Grand Rounds session will be held on Friday, January 23, 2026, at 1:00 pm eastern.

Stephen Juraschek is a physician investigator at Beth Israel Deaconess Medical Center and an associate professor at Harvard Medical School.

Join the online meeting.

Grand Rounds December 12, 2025: From Eligibility to Enrollment Without a Clinic Visit: The Eat Well Produce Prescription Trial for Patients with Diabetes at Risk of Food Insecurity (Connor Drake, PhD, MPA; Susan Spratt, MD; Abigail Rader, MS)

Posted on by Sophia Ramirez

Speakers

Connor Drake, PhD, MPA
Research Health Scientist
Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT)
Durham VA Health System HSR&D
Assistant Professor
Department of Population Health Sciences
Duke University School of Medicine

Susan Spratt, MD
Department of Medicine
Division of Endocrinology, Metabolism, and Nutrition
Department of Family Medicine and Community Health
Duke University School of Medicine

Abigail Rader, MS
PhD Candidate
Department of Population Health Sciences
Duke University School of Medicine

Keywords

Food Insecurity; Groceries; Food as Medicine; Diabetes; Cardiovascular Health; Cardiovascular Disease; Cardiometabolic Health

Key Points

  • In 2022, an estimated 12.8% of American households experienced food insecurity (FI): a lack of consistent access to safe, nutritious, or sufficient food for every person in a household to live an active, healthy life. FI is also associated with increased cardiometabolic health risk. While promising interventions to improve food security (and, by extension, cardiometabolic health) exist, methodological limitations such as a lack of pragmatic designs limit conclusions on their effectiveness.
  • The Eat Well pragmatic trial sought to better understand the real-world effectiveness of a produce prescription program when it came to improving cardiometabolic health-related outcomes and utilization patterns. They found that Eat Well did not improve outcomes among diabetic patients at risk for food insecurity. However, an affirmative outreach approach supported rapid scaling of the program.
  • Produce prescription programs may require greater duration, dose, intensity, and attention to household and implementation factors, including a focus on different at-risk groups, to improve health outcomes. Reducing cost barriers to purchasing fruits and vegetables alone may not be sufficient to improve food security – at least, not enough to improve cardiometabolic health outcomes.

Discussion Themes

Based on initial descriptive analyses, the amount spent on the card had no significant clinical effect – even among the most adherent participants.

Patients often face multiple overlapping social needs (housing, transportation, etc.), and addressing food alone may not be enough for those with the highest complexity. While the intervention was kept simple for scalability’s sake, diabetes management likely requires a more integrated, multi-sector approach that looks at factors like food, exercise, medications, education, behavioral health support, and monitoring.

Future research should identify opportunities to improve implementation, test interventions in higher-risk populations, and collect additional details on patient-reported outcomes.