TY - JOUR
T1 - A Dietary Intervention in Urban African Americans
T2 - Results of the "five Plus Nuts and Beans" Randomized Trial
AU - Miller, Edgar R.
AU - Cooper, Lisa A.
AU - Carson, Kathryn A.
AU - Wang, Nae Yuh
AU - Appel, Lawrence J.
AU - Gayles, Debra
AU - Charleston, Jeanne
AU - White, Karen
AU - You, Na
AU - Weng, Yingjie
AU - Martin-Daniels, Michelle
AU - Bates-Hopkins, Barbara
AU - Robb, Inez
AU - Franz, Whitney K.
AU - Brown, Emily L.
AU - Halbert, Jennifer P.
AU - Albert, Michael C.
AU - Dalcin, Arlene T.
AU - Yeh, Hsin Chieh
N1 - Funding Information:
This work was supported by a grant from the National Heart, Lung, and Blood Institute (P50HL0105187). The National Heart, Lung, and Blood Institute did not have a role in study design; collection, analysis, or interpretaion of the data; writing the manuscript; or the decision to submit the manuscript for publication.
Funding Information:
This work was supported by a grant from the National Heart, Lung, and Blood Institute (P50HL0105187). The National Heart, Lung, and Blood Institute did not have a role in study design; collection, analysis, or interpretaion of the data; writing the manuscript; or the decision to submit the manuscript for publication.
Publisher Copyright:
© 2016 American Journal of Preventive Medicine.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Introduction Unhealthy diets, often low in potassium, likely contribute to racial disparities in blood pressure. We tested the effectiveness of providing weekly dietary advice, assistance with selection of higher potassium grocery items, and a $30 per week food allowance on blood pressure and other outcomes in African American adults with hypertension. Design We conducted an 8-week RCT with two parallel arms between May 2012 and November 2013. Setting/participants We randomized 123 African Americans with controlled hypertension from an urban primary care clinic in Baltimore, Maryland, and implemented the trial in partnership with a community supermarket and the Baltimore City Health Department. Mean (SD) age was 58.6 (9.5) years; 71% were female; blood pressure was 131.3 (14.7)/77.2 (10.5) mmHg; BMI was 34.5 (8.2); and 28% had diabetes. Intervention Participants randomized to the active intervention group (Dietary Approaches to Stop Hypertension [DASH]-Plus) received coach-directed dietary advice and assistance with weekly online ordering and purchasing of high-potassium foods ($30/week) delivered by a community supermarket to a neighborhood library. Participants in the control group received a printed DASH diet brochure along with a debit account of equivalent value to that of the DASH-Plus group. Main outcome measures The primary outcome was blood pressure change. Analyses were conducted in January to October 2014. Results Compared with the control group, the DASH-Plus group increased self-reported consumption of fruits and vegetables (mean=1.4, 95% CI=0.7, 2.1 servings/day); estimated intake of potassium (mean=0.4, 95% CI=0.1, 0.7 grams/day); and urine potassium excretion (mean=19%, 95% CI=1%, 38%). There was no significant effect on blood pressure. Conclusions A program providing dietary advice, assistance with grocery ordering, and $30/week of high-potassium foods in African American patients with controlled hypertension in a community-based clinic did not reduce BP. However, the intervention increased consumption of fruits, vegetables, and urinary excretion of potassium.
AB - Introduction Unhealthy diets, often low in potassium, likely contribute to racial disparities in blood pressure. We tested the effectiveness of providing weekly dietary advice, assistance with selection of higher potassium grocery items, and a $30 per week food allowance on blood pressure and other outcomes in African American adults with hypertension. Design We conducted an 8-week RCT with two parallel arms between May 2012 and November 2013. Setting/participants We randomized 123 African Americans with controlled hypertension from an urban primary care clinic in Baltimore, Maryland, and implemented the trial in partnership with a community supermarket and the Baltimore City Health Department. Mean (SD) age was 58.6 (9.5) years; 71% were female; blood pressure was 131.3 (14.7)/77.2 (10.5) mmHg; BMI was 34.5 (8.2); and 28% had diabetes. Intervention Participants randomized to the active intervention group (Dietary Approaches to Stop Hypertension [DASH]-Plus) received coach-directed dietary advice and assistance with weekly online ordering and purchasing of high-potassium foods ($30/week) delivered by a community supermarket to a neighborhood library. Participants in the control group received a printed DASH diet brochure along with a debit account of equivalent value to that of the DASH-Plus group. Main outcome measures The primary outcome was blood pressure change. Analyses were conducted in January to October 2014. Results Compared with the control group, the DASH-Plus group increased self-reported consumption of fruits and vegetables (mean=1.4, 95% CI=0.7, 2.1 servings/day); estimated intake of potassium (mean=0.4, 95% CI=0.1, 0.7 grams/day); and urine potassium excretion (mean=19%, 95% CI=1%, 38%). There was no significant effect on blood pressure. Conclusions A program providing dietary advice, assistance with grocery ordering, and $30/week of high-potassium foods in African American patients with controlled hypertension in a community-based clinic did not reduce BP. However, the intervention increased consumption of fruits, vegetables, and urinary excretion of potassium.
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U2 - 10.1016/j.amepre.2015.06.010
DO - 10.1016/j.amepre.2015.06.010
M3 - Article
C2 - 26321012
AN - SCOPUS:84952630678
SN - 0749-3797
VL - 50
SP - 87
EP - 95
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 1
ER -