GoFreshRx
Home-Delivered DASH Groceries and Effects on Blood Pressure and LDL-C in Black Adults With Hypertension
Presented by Stephen Juraschek — Beth Israel Deaconess Medical Center
Subspecialty: Hypertension
Published in Nature Medicine
Key Result
Home-delivered DASH groceries reduced systolic BP by 3.4 mm Hg more than grocery stipends and LDL-C by /dL more in Black adults in food deserts. Benefits did not persist after intervention ended.
What did this trial find?
The GoFreshRx trial randomized 176 Black adults with treated hypertension living in Boston food deserts to 12 weeks of home-delivered DASH-patterned groceries with dietitian counseling or grocery stipends. The DASH grocery group had significantly greater reductions in systolic BP (~5-7 mm Hg vs ~2 mm Hg), diastolic BP, and LDL cholesterol, but benefits were not fully sustained after the intervention ended. The trial generated notable editorial commentary from Dariush Mozaffarian questioning scalability, cost-effectiveness, and dietary model, creating a meaningful interpretation debate around the "food is medicine" approach.
Why does this trial matter?
There is meaningful interpretation debate here. Mozaffarian's editorial acknowledges the trial's contribution but raises substantive concerns about population selection, dietary model, cost, and scalability — creating a real tension between the positive primary results and questions about practical relevance. The lead investigator himself acknowledged that benefits did not persist, pointing to unaddressed structural barriers. This is not purely straightforward positive coverage.
Study Design
Randomized clinical trial, 12-week intervention, single metropolitan area (Boston)
Clinical Implications
Demonstrates that structural food interventions (home-delivered DASH groceries) can meaningfully reduce cardiovascular risk factors in underserved communities. However, the lack of persistent benefit after intervention cessation highlights the need for sustained food access programs rather than time-limited interventions.
Abstract
The GoFreshRx randomized clinical trial tested whether home-delivered DASH-diet groceries could reduce blood pressure and LDL cholesterol in Black adults living in food-limited communities. The study randomized 180 participants in Boston (mean age ~46 years, systolic BP 120-150 mm Hg at baseline) to either 12 weeks of home-delivered DASH-patterned groceries with dietitian counseling or three $500 grocery stipends for self-directed shopping. Systolic blood pressure decreased by 5.7 mm Hg in the DASH group vs 2.3 mm Hg in the stipend group — a difference of 3.4 mm Hg. Diastolic blood pressure showed a 2.4 mm Hg greater reduction in the DASH group. LDL cholesterol decreased by 8 mg/dL in the DASH group vs 1.8 mg/dL with stipends. However, health benefits largely did not persist after the intervention ended, suggesting sustained access to healthy groceries and ongoing nutrition counseling may be necessary to maintain improvements.