Nutrition Counseling for Hypertension Within a Grocery Store: An Example of the Patient-Centered Medical Neighborhood Model.

OBJECTIVE:To evaluate the effectiveness of nutrition counseling for patients with hypertension, provided in a grocery store setting. DESIGN:Single-arm pretest-posttest design implementing a 12-week dietary intervention. SETTING:Grocery store. PARTICIPANTS:Thirty adults with hypertension recruited from a primary care practice. INTERVENTION:Registered dietitian nutritionists provided counseling based on the Dietary Approaches to Stop Hypertension diet. MAIN OUTCOME MEASURES:Dietary intake patterns and Healthy Eating Index-2010 (HEI-2010) scores measured via food-frequency questionnaire. Change in systolic blood pressure (SBP) was a secondary outcome. ANALYSIS:Paired t tests were used to test for differences between HEI-2010 scores, intake of key food pattern components, and SBP at baseline compared with follow-up. Statistical significance was established at P ≤ .05. RESULTS:Eight HEI-2010 component scores increased significantly from baseline to follow-up (a change toward a more desirable eating pattern): total fruit, whole fruit, greens and beans, whole grains, fatty acids, refined grains, and empty calories. Sodium (P < .001), saturated fat (P < .001), discretionary solid fat (P < .001), added sugars (P = .01), and total fat (P < .001) all decreased significantly. The change in SBP was not significant. CONCLUSIONS AND IMPLICATIONS:Grocery store-based counseling for patients with hypertension may be an effective strategy to provide lifestyle counseling that is not typically available within primary care.