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WASHINGTON -- Consumers who were taught how to shop healthier had higher DASH (Dietary Approaches to Stop Hypertension) scores, indicating increased adherence to heart-healthy foods, according to results from the randomized SuperWIN trial.

At 3 months, 100 shoppers who were given a 30-minute lecture on medical nutritional therapy and then were guided by a nutritionist through the aisles of Kroger supermarkets for six sessions raised their DASH score by an average of 8.6 points, while another group of 101 shoppers who participated in these interventions plus online shopping training achieved an average increase of 12.4 points, reported Dylan Steen, MD, of the University of Cincinnati in Ohio, at the American College of Cardiology meeting.

Even the group of 46 shoppers who only participated in the lecture (control group) achieved an average 5.8-point gain in their DASH score, Steen said in his presentation, though he noted that the group who participated in two interventions had significantly better scores than the group who participated in one (P=0.02), and the group who participated in all three had significantly better scores than the group who participated in two (P=0.01).

"SuperWIN was made possible by a unique-to-date research collaboration between our diverse academic team and a large retailer," and "demonstrated the efficacy of dietary interventions harnessing the store's physical environment, dietitians, and purchasing data," Steen said.

He noted that "pre-COVID metrics demonstrated near-perfect visit attendance, suggesting an excellent participant experience," but attendance fell to 80% after COVID emerged.

At 6 months, the scores remained higher than baseline, but Steen and colleagues observed that they were no longer statistically significantly different among groups, with a 4.4-point increase in the control group, a 6.6-point increase for those who participated in the additional guided shopping sessions, and an 8.4-point increase among those who participated in all three interventions.

While the sustainability of these interventions outside of a clinical trial remains an open question, Steen suggested that it could benefit both consumers and the businesses. He noted that supermarkets haven't been adding pharmacy services to their big-box stores due to loss of revenue. Adding nutritional/dietary services could be a win-win proposition, he said.

"If you create it, they will come," agreed discussant Eileen Handberg, PhD, ARNP, of the University of Florida in Gainesville.

She noted that the types of interventions that were employed in SuperWIN have the potential for greater change. "If you think of this in terms of primary care, little kids go shopping with their parents, so you have the ability to change behavior from children on up."

"The problem is going to be to get these services to the underserved populations," she added. "They shop at different grocery stores; there are food deserts, so trying to figure out how to get partnerships across the whole spectrum of grocery stores will be challenging."

Handberg also acknowledged that a 3-month course is not enough to significantly lower blood pressure, but "this call out to groceries to get involved in feedback to the community in a public health sort of way is an incredible opportunity. This is a huge lift, and it is really going to take a village."

SuperWIN (Supermarket and Web-Based Intervention Targeting Nutrition) included participants from a primary care network who had at least one cardiovascular risk factor, shopped regularly at Kroger supermarkets, and were willing to follow the DASH diet. Among the three groups, mean age was 56 to 57, 68% to 70% were women, 71% to 78% were white, and 28% to 39% had an annual family income of $125,000 or higher.

Steen and team also looked at changes in biometrics, including blood pressure and body mass index, and while there were improvements across the board, none of these changes achieved statistical significance.

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