A culturally tailored food-is-medicine intervention significantly reduced systolic blood pressure (SBP) in Black and Hispanic adults with hypertension, compared with those who received an equivalent amount of fresh produce without the additional supports, according to results from the THRIVE trial presented during a Late-Breaking Clinical Trial session at ACC.26 in New Orleans.

The pilot study randomized 80 adults with hypertension living in Maryland communities where it can be difficult to obtain fresh produce, half to a community co-designed multipronged intervention that included culturally aligned dietitian coaching, artificial-intelligence-optimized feedback and encouragement, and flexible produce selection from a mobile farm stand. The other half received a standard weekly bag of produce of equivalent value along with basic nutrition messages. Their mean age was 55 years, two-thirds were Black and a third were Hispanic.

At 24 weeks, participants in the intervention group saw a significantly greater reduction in SBP, which was lower by 6.8 mm Hg, on average, compared with a reduction of 0.3 mm Hg in the control group.

Participants who adhered more strongly to the DASH diet – rich in fruits, vegetables, nuts, whole grains, and lean proteins and low on sodium, added sugars and saturated fats – had a 13.3 mm Hg reduction in SBP. Researchers note this is a reduction that exceeds improvements with some hypertensive medications, although a larger study would help confirm the findings.

“It’s not enough to just tell people to change their dietary behaviors,” said Oluwabunmi Ogungbe, BSN, MPH, PhD, the study’s lead author, noting the study aimed to see how this approach can be situated within clinics and the community. “Our study demonstrates that this is feasible; we can find ways to integrate this into the health system, and we can do it in a way that truly meets people where they are.”

While the study demonstrated this intervention can be effective and feasible for making a heart-healthy diet more attainable, as a pilot study, the research is limited by its relatively small sample size, limited statistical power and geographic range. Additional larger studies could help to illuminate the broader feasibility of the approach, the appropriate length of time for the intervention to continue to yield sustained benefits, applicability in different communities and countries, relevance for particular patient groups and cost effectiveness.

Ogungbe also said that food-based interventions can complement pharmacologic therapies but are not a replacement for the use of blood pressure-lowering medications when appropriate.

Clinical Topics: Prevention, Diet, Hypertension

Keywords: ACC Annual Scientific Session, ACC26, New Orleans, Secondary Prevention, Hypertension, Blood Pressure, Diet