Effect of Home-Delivered DASH Groceries and Dietitian Counseling on Blood Pressure: GoFresh Randomized Clinical Trial

The findings from this late-breaking study were presented at the American Heart Association (AHA) 2025 Scientific Sessions and were simultaneously published in the November issue of Journal of American Medical Association.

Elevated blood pressure (BP) and hypertension are highly prevalent in the United States and disproportionately affect Black adults, increasing their risk of cardiovascular disease and premature mortality. The DASH diet—rich in fruits, vegetables, low-fat dairy, and lean protein, has been proven to lower BP, particularly among Black adults, by promoting a favorable potassium-to-sodium ratio in the diet. Despite its benefits, sustained adherence to the DASH diet remains challenging due to limited access to affordable healthy foods in many urban communities, often described as “food deserts.” The GoFresh trial was designed to determine whether providing home-delivered, low-sodium DASH groceries could reproduce the BP-lowering effects observed in controlled research settings when implemented in a real-world community context.

The GoFresh trial was a prospective, open-label, parallel-group randomized clinical trial conducted in Boston from August 2022 to September 2025. Researchers enrolled 180 Black adults from neighborhoods with limited grocery access.

Eligibility criteria included self-identification as African American or Black, an SBP between 120 and <150 mm Hg, a DBP <100 mm Hg, and no current pharmacologic treatment for hypertension. The mean participant age was 46.1 years, and 56.7% were females.

Participants were randomized into two 12-week intervention groups:

1. DASH-Patterned Grocery Group – Received weekly deliveries of low-sodium, DASH-patterned groceries ordered via online platforms. Participants also received weekly dietitian counseling focused on maintaining a potassium-to-sodium ratio >2.0 saturated fat level of <7% of total energy.
2. Self-Directed Shopping Group – Received three $500 stipends (distributed every four weeks) for self-directed grocery shopping and a printed DASH diet handout but no counseling or restrictions on spending.

The primary outcome was the between-group difference in the 3-month change in office-measured SBP. Secondary outcomes included changes in BMI, HbA1c levels and eGFR.

Of the 180 randomized participants, 175 (97.2%) completed the primary outcome assessment.

At 3 months, the DASH-patterned grocery group demonstrated a mean SBP reduction of −5.7 mm Hg (95% CI, −7.4 to −3.9 mm Hg), compared with −2.3 mm Hg (95% CI, −4.1 to −0.4 mm Hg) in the self-directed group. The resulting between-group difference was −3.4 mm Hg (95% CI, −5.9 to −0.8 mm Hg; P = .009), favoring the DASH grocery intervention.

The DASH group also demonstrated significantly greater reductions in diastolic blood pressure (−2.4 mm Hg; 95% CI, −4.2 to −0.5 mm Hg) and low-density lipoprotein (LDL) cholesterol (−8.0 mg/dL; 95% CI, −13.7 to −2.3 mg/dL) compared with the self-directed group.

Markers of adherence supported these findings, with a mean reduction in urine sodium of −545 mg/24 hours among participants receiving DASH groceries.

Compared with the baseline, 3-month changes in mean BMI, HbA1c levels and eGFR did not differ significantly between DASH and self-directed groups. However, during the 3-month maintenance period following cessation of grocery delivery and counseling, mean SBP in the DASH group increased by 2.4 mm Hg (95% CI, 0.8 to 4.0 mm Hg). This reversal indicated that the blood pressure improvements were not sustained after the intervention ended.

The GoFresh randomized clinical trial demonstrated that a home-delivered, DASH-style grocery program combined with dietitian counseling significantly improved blood pressure and lipid outcomes among Black adults with elevated BP, outperforming comparable monetary compensation. The trial also highlighted the practical use of online grocery platforms to enhance access to healthy foods in underserved communities.

Nonetheless, the loss of benefit following withdrawal of the intervention suggests that both sustained access to healthy groceries and ongoing nutritional support are crucial for maintaining cardiometabolic improvements. The findings emphasize that effective community-based dietary interventions require not only initial engagement but also long-term structural support to achieve lasting reductions in blood pressure and cardiovascular risk among high-risk populations.

Reference: Juraschek SP, Col H, Ferro K, et al. DASH-Patterned Groceries and Effects on Blood Pressure: The GoFresh Randomized Clinical Trial. JAMA. Published online November 09, 2025. doi:10.1001/jama.2025.21112