Journal-based CME Course: DASH-Patterned Groceries and Effects on Blood Pressure – The GoFresh Randomized Clinical Trial

Activity ID

14667

Expires

November 9, 2028

Format Type

Journal-based

CME Credit

1

Fee

$30

CME Provider: JAMA

Description of CME Course

Importance  The Dietary Approaches to Stop Hypertension (DASH) eating plan lowered blood pressure (BP) among Black adults in a controlled environment, but to date, there are no grocery shopping strategies that replicated its health effects in a community setting.

Objective  The Groceries for Black Residents of Boston to Stop Hypertension (GoFresh) trial was conducted to determine the effects of low sodium-DASH groceries on systolic BP.

Design, Setting, and Participants  This parallel-group randomized clinical trial was conducted in Boston from August 2022 to September 2025 among Black residents of urban communities with few grocery stores, a systolic BP of 120 to less than 150 mm Hg, a diastolic BP less than 100 mm Hg, and no hypertension treatment. Data were analyzed from June through October 2025.

Interventions  Participants were randomly assigned to 12 weeks of home-delivered, DASH-patterned groceries ordered weekly with dietitian counseling without emphasizing cost or three $500 stipends every 4 weeks intended for self-directed grocery shopping.

Main Outcomes and Measures  The primary comparison was the difference in the 3-month change in model-estimated office systolic BP (based on 3 measurements over at least 2 visits) between interventions. Adherence was assessed via 24-hour urine collection. Secondary outcomes included diastolic BP, body mass index (BMI), hemoglobin A_1c levels, and low-density lipoprotein (LDL) cholesterol. Maintenance of effects was assessed 3 months after intervention cessation.

Results  Among 180 participants, (mean [SD] age, 46.1 [13.3] years; 102 female [56.7%]; 180 self-reported Black [100%]; 12 Hispanic [6.7%]), 175 individuals (97.2%) completed the primary outcome assessment. Mean (SD) baseline systolic BP and diastolic BP were 130.0 (6.7) mm Hg and 79.8 (8.1) mm Hg. At 3 months, the mean systolic BP changed −5.7 mm Hg (95% CI, −7.4, to−3.9 mm Hg) in the DASH-patterned group and −2.3 mm Hg (95% CI, −4.1 to −0.4 mm Hg) in the self-directed group (difference in changes, −3.4 mm Hg; 95% CI, −5.9 to −0.8 mm Hg; P = .009). Compared with the self-directed group, after 3 months the DASH-patterned group changed mean diastolic BP by −2.4 mm Hg (95% CI, −4.2 to −0.5 mm Hg), urine sodium level by −545 mg/24 h (95% CI, −1041 to −50 mg/24 h), and LDL cholesterol by −8.0 mg/dL (95% CI, −13.7 to −2.3 mg/dL) (to convert LDL cholesterol to millimoles per liter, multiply by 0.0259). Effects were not maintained 6 months after the intervention was initiated. No effects occurred in BMI or hemoglobin A_1c level.

Conclusions and relevance  In this study, a program of home-delivered, DASH-style groceries plus dietitian counseling decreased BP and LDL cholesterol levels beyond comparable monetary compensation. However, effects were not maintained after the intervention ended.

Trial Registration  ClinicalTrials.gov Identifier: NCT05121337

Disclaimers

1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

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