Individuals who received personalized nutrition education in a series of sessions conducted at their regular grocery store significantly improved their adherence to the Dietary Approaches to Stop Hypertension (DASH) diet, according to findings from the SuperWIN trial presented April 3 during ACC.22.

The trial, an innovative partnership between academic researchers and the grocery retailer Kroger, is the first to deliver a nutritional intervention in each participant's home grocery store guided by their personal food purchasing data. The academic research team led the study design and analysis, while Kroger provided in-store dietitians, clinic space, and each participant's grocery purchasing data collected by a newly issued Kroger loyalty card.

A total of 247 participants were recruited through a primary care network and were randomized into three different study groups – a control group or one of two interventional groups – after completing an initial screening and baseline data collection process. Control group participants received enhanced medical nutrition therapy in a single in-store session with a dietitian but no further nutrition education. Intervention group participants received either six additional one-on-one in-store nutrition education sessions focused on following the DASH dietary patterns, or a total of seven one-on-one in-store nutrition education sessions, plus training on tools for online shopping, free home grocery delivery, identification of healthier foods and meal planning. Each session in both intervention groups was guided by updated, individualized purchasing data that was provided to the dietitian and the participant for review.

After comparing participants' eating habits at the start of the study and three months later, researchers said that in-store nutrition education sessions significantly increased DASH adherence scores by 4.7 points on top of an enhanced standard of care group, which increased DASH scores by a baseline amount of 5.8 points alone. In addition, combining in-store nutrition education sessions with online tools and training increased DASH scores by an additional 3.8 points compared to the nutrition education sessions without the online resources-. These improvements were seen at the six-month follow-up.

"These interventions really allowed individualization of the DASH diet to each participant," said Dylan L. Steen, MD, MS, the study's lead author. "The dietitians taught participants how to eat better right within the aisles of their home grocery store. The magic is that they were not only registered dietitians, but their expertise extended to the store's inventory of products and the brands and products preferred by customers. When provided the dietary and purchasing information about each participant, they were able to use these findings to better incorporate healthy changes into each participant's lifestyle and budget."

According to Steen, the SuperWIN findings may help to address gaps between current dietary guidelines and public adherence to the recommendations. Even beyond the public-facing benefits, he also noted the unique partnership between Kroger and the research team and "the potential of research partnerships beyond the pharmaceutical, biotech and medical device industries to design and test new health care approaches and reach patients in their communities."

Clinical Topics: Cardiovascular Care Team

Keywords: ACC Annual Scientific Session, ACC22, Cardiovascular Diseases, Internet-Based Intervention, Heart Disease Risk Factors

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