DASH-Patterned Groceries and Effects on Blood Pressure

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 A1c 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 A1c 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.