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March 28, 2026Nature Medicine
DASH-patterned groceries and effects on blood pressure in adults treated for hypertension: the GoFreshRx randomized trial
Stephen P. JuraschekHannah ColKayla FerroRuth-Alma N. Turkson-OcranJennifer CluettRoger B. DavisKristen M. KraemerKathy McManusKenneth J. MukamalEmily AidooFredrick Larbi KwapongMarian BuduDhrumil PatilSarah NarteyJacqueline MichettiSofia AllisonManfred Mate-KoleJingyi CaoBenjamin GrobmanReva SeagerAnika L HinesEdgar R. MillerDeidra C. CrewsDea Papajorgji-TaylorStephanie L. Fitzpatrick
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Key result
Home-delivered DASH groceries and counseling lower SBP by ~5 mmHg vs a self-directed stipend.
- Difference -5.0 mmHg
- 95% CI -8.0 to -1.9
- P=0.002
- n=176
Why the study?
Although the DASH eating plan lowers blood pressure in Black adults, it had not been tested in individuals undergoing active treatment for hypertension.
Key Points
- To determine whether home-delivered groceries aligned with the Dietary Approaches to Stop Hypertension (DASH) eating plan and dietitian counseling lower blood pressure among Black adults actively treated for hypertension.
- In the GoFreshRx randomized clinical trial, 176 Black adults with systolic blood pressure (SBP) between 120 mmHg and <150 mmHg despite active hypertension treatment were enrolled.
- Participants were randomized to receive 12 weeks of weekly home-delivered DASH groceries with dietitian counseling or three US$500 stipends provided every 4 weeks.
- The primary outcome was research clinic-measured SBP at 3 months, with secondary outcomes including diastolic blood pressure (DBP) and low-density lipoprotein cholesterol (LDL-c).
- At 3 months, SBP changed by -7.0 mmHg in the DASH groceries group versus -2.0 mmHg in the self-directed group (intergroup difference: -5.0 mmHg; 95% confidence interval: -8.0 to -1.9; P = 0.002).
- Compared with the self-directed stipend group, 3 months of DASH groceries reduced DBP by -1.8 mmHg (-3.6 to -0.1) and lowered LDL-c by -7.0 mg dl.
Study Design
Type
RCT (n=176)
Randomization
randomized
Structured PICO
P
Population
Residents of Suffolk County (Boston, Chelsea, Revere, and Winthrop) with a combined population of 801,072. Primary data collection included 1,895 community survey respondents, 334 focus group participants, and 91 key informant interviews.
Main Result
Effect estimate: Difference -5.0 mmHg (95% CI -8.0 to -1.9)
Absolute Event Rate: -7% vs -2%
p-value: p=0.002
Discussion
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Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“We're very excited by the magnitude of the effects—it's really above and beyond what we anticipated. This study shows a real path forward for self-management among individuals with hypertension.”
“The trial advances the field of food is medicine by demonstrating that home-delivered DASH-patterned groceries can modestly reduce [systolic BP], [diastolic BP], and LDL cholesterol among Black adults living in food deserts.”
“We thought that some of the benefits of the nutrition changes would be maintained after the groceries were discontinued; however, the study did not address other important barriers, such as the cost of nutritious foods or access to grocery stores. Without addressing these social barriers, it may have been challenging for participants to continue eating healthier foods even after receiving counseling about the impact of diet on high BP and cholesterol.”
Implication
The 2022 MGH Community Health Needs Assessment highlights housing, economic stability, and food security as critical social determinants impacting cardiometabolic and overall health in Suffolk County.
Abstract
Although a Dietary Approaches to Stop Hypertension (DASH) eating plan has been shown to lower blood pressure (BP) in Black adults, this intervention has not been tested in individuals who were being actively treated for hypertension. In this study, we conducted a randomized clinical trial (GoFreshRx) to test whether local groceries ordered with the assistance of a dietitian to align with the DASH diet might lower BP among Black adult residents of Boston communities with few grocery stores who were being actively treated for hypertension. Individuals whose systolic blood pressure (SBP) was 120 mmHg to <150 mmHg despite active hypertension treatment were randomized either to 12 weeks of weekly home-delivered DASH groceries with dietitian counseling or to receiving three US$500 stipends every 4 weeks. The primary outcome was research clinic-measured SBP measured at 3 months. Secondary outcomes were diastolic blood pressure (DBP) and low-density lipoprotein cholesterol (LDL-c) levels. Maintenance of health effects was assessed at 3 months after the intervention. Of 176 participants (mean age 60.1 (s.d., 11.5) years; 80.7% female), 173 were available for SBP measurement at 3 months. Mean (s.d.) baseline SBP/DBP was 130.5 (7.0)/77.8 (8.9) mmHg. At 3 months, SBP changed by -7.0 mmHg in the DASH groceries group and by -2.0 mmHg in the self-directed group (intergroup difference: -5.0 mmHg; 95% confidence interval: -8.0 to -1.9; P = 0.002). Moreover, compared to the self-directed group, 3 months of DASH groceries changed DBP by -1.8 mmHg (-3.6 to -0.1) and LDL-c by -7.0 mg dl
Cite This Study
Juraschek et al. (2026) conducted an RCT in hypertension (n=176). home-delivered DASH groceries with dietitian counseling vs. three US$500 stipends every 4 weeks (self-directed group) was evaluated on research clinic-measured systolic blood pressure at 3 months (Difference -5.0 mmHg, 95% CI -8.0 to -1.9, p=0.002). 12 weeks of home-delivered DASH groceries with dietitian counseling reduced systolic blood pressure by 5.0 mmHg compared to a self-directed stipend group (95% CI: -8.0 to -1.9; P=0.002).
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