The GoFresh randomized trial showed that home delivery of DASH-patterned groceries improves dietary quality and lowers blood pressure in Black adults, demonstrating that removing food access barriers translates to measurable health benefit.
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.
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.
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.
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.
