For many Americans, particularly Black adults, managing high blood pressure and cholesterol isn’t just about medication—it’s about access. A new study presented at the American College of Cardiology’s annual scientific session (ACC.26) suggests a surprisingly effective intervention: delivering groceries tailored to the DASH diet – Dietary Approaches to Stop Hypertension – directly to people’s homes. The research demonstrates that this simple act of increasing access to healthy food can yield results comparable to common blood pressure and cholesterol medications.
The study, conducted with adults facing limited access to fresh, quality food, found that those receiving DASH-aligned groceries experienced an average reduction of 7 mm Hg in systolic blood pressure over three months, compared to those receiving basic dietary advice and a general grocery allowance. Participants in the grocery delivery group saw a 7 mg/dL decrease in LDL cholesterol. These findings highlight the potential of food-based interventions to address significant health disparities, particularly within communities facing systemic barriers to healthy eating.
“We were extremely excited by the magnitude of the effects – they really go beyond what we anticipated,” said Stephen Juraschek, MD, PhD, associate professor of medicine at Harvard Medical School and associate professor of nutrition at the Harvard T.H. Chan School of Public Health, and the study’s lead author. “This study shows a real pathway for self-management in people with hypertension.”
Addressing Hypertension Disparities Through Food Access
Hypertension, or high blood pressure, disproportionately affects Black adults in the United States. According to the Centers for Disease Control and Prevention, approximately 58% of Black adults have hypertension, compared to 48% of the overall adult population. This disparity contributes to higher rates of cardiovascular disease within this population. The study focused on adults living in “food deserts”—areas with limited access to affordable, nutritious food—in the Boston area.
Previous research by Juraschek and his colleagues has already established the benefits of adhering to the DASH diet, demonstrating a nearly 14% reduction in the 10-year risk of atherosclerotic cardiovascular disease among Black adults. This new study aimed to determine if providing direct access to DASH-friendly foods could overcome the practical challenges many individuals face in adopting the diet.
How the GoFreshRx Intervention Worked
Researchers recruited 176 participants with a resting systolic blood pressure between 120 and 149 mm Hg, despite being actively treated for hypertension. The participants, with an average age of 60 and 80% female, were divided into two groups. One group received groceries delivered to their homes, selected with personalized guidance from a registered dietitian. The other group received a monthly grocery allowance and a brochure explaining the DASH diet.
The dietitians in the delivery group focused on four key principles when helping participants create grocery lists and meal plans: flavoring foods with alternatives to salt; aiming for a potassium-to-sodium ratio of two to one; limiting saturated fats to less than 7% of total calories; and following a DASH dietary pattern that also restricts processed foods and added sugars. “Each person was able to choose their own groceries for themselves and their family according to the DASH principles, with the help of a dietitian,” Juraschek explained. “We tried to keep things as general and simple as possible and allow choice, so people could come up with different combinations to meet those goals based on their food preferences.”
Significant Improvements in Blood Pressure and Cholesterol
After three months, participants receiving grocery deliveries showed a significantly greater reduction in systolic blood pressure compared to the allowance group, meeting the study’s primary endpoint. Reductions in LDL cholesterol and diastolic blood pressure were also significantly more pronounced in the delivery group. Importantly, these differences persisted even three months after the grocery deliveries and allowances ended, suggesting a lasting impact.
The study’s findings add to a growing body of evidence highlighting the powerful connection between nutrition and cardiovascular health. Researchers suggest that health insurers, urban planners, and public health practitioners should prioritize policies and programs that increase access to affordable, healthy foods to improve health outcomes and prevent heart disease. The potential for a dietary intervention to rival the effects of medication is particularly noteworthy.
“What’s exciting about a nutritional approach is that it can not only have multiple effects on blood pressure and cholesterol, but it can also be preventative in the future, without some of the side effects or interactions that you might notice with certain medications,” Juraschek noted.
Limitations and Future Research
The study was limited to a metropolitan area and lasted only three months. Whereas the home grocery delivery program proved successful in the Boston region, Juraschek acknowledged that it may not be feasible in more rural areas. Future research could explore the long-term effects of such interventions, additional outcome measures for a more comprehensive picture of cardiovascular health, and results in other high-risk populations, such as patients with diabetes or those with systolic blood pressure exceeding 150 mm Hg.
The study was funded by the National Institute on Minority Health and Health Disparities of the National Institutes of Health.
The study, “DASH-pattern Groceries Lower Blood Pressure in Treated Hypertensive Adults: Results of the GoFreshRx Randomized Controlled Trial,” was presented on March 28th and has been published simultaneously online in Natural Medicine.
This research underscores the critical role of addressing social determinants of health, such as food access, in improving cardiovascular outcomes. The potential for scalable, food-based interventions like the GoFreshRx program offers a promising avenue for reducing health disparities and promoting preventative care. Further investigation into the long-term sustainability and broader applicability of this model is warranted.
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