There’s some evidence that healthy recipes tailored to cultural tastes, combined with a dietitian’s guidance, can help adults managing high blood pressure see significant improvements.
That’s the finding of a study presented Monday at the American College of Cardiology conference held in New Orleans. It found that a cohort of Black and Hispanic adults who stuck to the tailored Dietary Approaches to Stop Hypertension regimen saw a drop in blood pressure that was double the rate of those who used other methods.
The DASH diet program is centered on fruits and vegetables, nuts, whole grains and lean proteins, and limiting salt, sugar, saturated fats and processed foods.
“It’s not enough to just tell people to change their dietary behaviors,” said Dr. Oluwabunmi Ogungbe, assistant professor in the Johns Hopkins School of Nursing and Johns Hopkins Bloomberg School of Public Health in Baltimore and the study’s lead author.
“We asked, ‘What if we actually prescribe what they should eat, give it to them, coach them on how to prepare those foods in ways that reflect their culture and taste preferences, and then see whether they will be more likely to sustain the change going forward?’”
The participants who followed the DASH program were compared with individuals who received an equal amount of fresh produce — but no guidance on how to cook or eat it. Researchers found that those who got both the fresh produce and the guidance had the greatest benefit.
Appealing to the Taste Buds Helps
Nearly half of all U.S. adults have hypertension, which leads to heart disease, stroke, and other cardiovascular diseases. Heart disease is still the leading cause of death in the U.S. and stroke is the fourth-leading cause of death.
Both heart disease and stroke have been linked to more than one-in-four deaths in the U.S. in 2023. Almost 60% of Black American adults have high blood pressure, a rate which the American Heart Association says “is among the highest in the world.”
Black adults are also more likely to have severe cases of the disease, and it can develop when they’re younger than other populations do.
Controlling one’s diet is a well-recognized method for reducing heart disease risk, but many Americans with hypertension struggle to stick to a heart-healthy, low-sodium diet. Recently, “food-is-medicine” strategies have gained popularity but the best way to implement them have been unclear.
“We already know there is efficacy; we’re not testing something completely new. But we’re trying to see how we can situate this within clinics and the community,” Ogungbe said. “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.”
Having Guidance Led to Better Results
The researchers conducted a pilot trial with 80 Maryland adults who have hypertension, were aged 55 on average, and live in areas where it’s hard to buy fresh produce. Sixty-two percent of participants were Black. Before the trial began, researchers worked with members of the target communities to design the program and create cultural recipes that followed DASH diet guidelines.
Half of the participants were randomly assigned to participate in the food intervention portion of the study, plus a $30 bag of produce. The remaining participants received the fresh produce and general messages about nutrition, but no additional guidance.
People in the intervention group met with a dietitian every other week for one-on-one sessions to discuss meal planning and strategies to support a heart-healthy diet. The sessions were adapted to participants’ individual needs, and when possible, participants were matched with a dietitian from their own cultural background.
At the end of the 24-week trial, participants who got both the counseling and the fresh produce saw double the decrease in their systolic blood pressure, the top number in a blood pressure reading, than the other participants.
The improvement was even better for those who wove the DASH diet into their routine, which the researchers said is even greater improvement than with some blood pressure-lowering medications. But they also said a larger study would be needed to help confirm these findings.
“This information is really actionable for clinicians, because they can tell patients, your blood pressure is more likely to be lowered if you have the right support in place—the ability to access and afford healthy foods, the confidence to cook with them, culturally aligned guidance from someone who understands your background, and consistent encouragement along the way,” Ogungbe said.
For more information on heart-healthy diets visit the ACC’s CardioSmart website at https://www.cardiosmart.org/topics/healthy-living/eat-better.
