A Dietary Intervention in Urban African Americans: Results of the « Five Plus Nuts and Beans » Randomized Trial.

Auteur(s) :
Appel LJ., Cooper LA., Miller ER., Carson KA., Wang NY., Gayles D., Charleston JB., White K., You N., Weng Y., Martin-Daniels M., Bates-Hopkins B., Robb I., Franz WK., Brown EL., Halbert JP., Albert MC., Dalcin AT., Yeh HC.
Date :
Août, 2015
Source(s) :
American journal of preventive medicine. # p
Adresse :
Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland; Johns Hopkins Center to Eliminate Cardiovascular Health Disparities, Johns Hopkins School of Medicine, Baltimore, Maryland; The Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland. Electronic address: [email protected].

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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.

Source : Pubmed
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