Grocery-store based nutrition education improves eating habits

Adults with hypertension benefit from counseling that reinforces information received from primary care providers, according to a new study published in the Journal of Nutrition Education and Behavior


Philadelphia, February 11, 2019

Hypertension affects over 60 million adults in the United States and less than half have their condition under control. A new study published in the Journal of Nutrition Education and Behavior found that grocery store−based nutrition counseling was effective in changing dietary habits of patients being treated for hypertension.

“Primary care providers face multiple barriers when delivering nutrition information to patients, including lack of training on how to provide lifestyle behavior counseling combined with lack of time to interact with the patient,” said lead author Rosanna P. Watowicz, PhD, RDN, LD, Department of Nutrition, Case Western Reserve University, Cleveland, OH, USA. “This study’s aim was to evaluate the effectiveness of a nutrition counseling program provided by a registered dietitian in the familiar setting of a grocery store.”

This study recruited patients from three primary care offices that were part of an urban academic medical center. Thirty adults aged 18–60 years diagnosed with hypertension participated. Study participants represented a diverse demographic in regard to sex, race, education, and employment.

Participants received individual counseling at one of three local grocery stores from two registered dietitians trained to provide lifestyle modification information based on the DASH (Dietary Approaches to Stop Hypertension) diet. Three counseling sessions, provided free to the patients, occurred over 12 weeks. The first visit was 60 minutes long followed by two 30–45-minute sessions. Following each session, a recap of the visit and patient’s progress towards goals were provided to the primary care provider to be included in the patient’s records.

Diet quality was assessed using the Healthy Eating Index-2010, a measure of overall diet quality compared to the Dietary Guidelines for Americans. Patients completed a food frequency questionnaire, documenting food and beverages consumed at least once during the previous three months, prior to beginning the study and at the end of the study. Blood pressure measurements were also taken.

Following the education, patients’ eating habits significantly improved in regard to total fruit, whole fruit, greens and beans, whole grains, fatty acids, refined grains, and empty calories. Sodium, saturated fat, discretionary solid fat, and total fat intake decreased significantly as well. Intake of added sugar also decreased although not to the same extent as the other categories.

Blood pressure measurements also decreased during the study, but due to the small number of participants the differences were not statistically significant. Additionally, patients reported a high level of compliance in taking their hypertension medication as prescribed during the study.

“Providing education at the grocery store offers a convenient location on a schedule with more flexibility than a primary care office and reinforces dietary changes in the environment where food decisions are made,” said Dr. Watowicz. “This strategy should be researched with other health conditions.”

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Notes for editors
The article is “Nutrition Counseling for Hypertension Within a Grocery Store: An Example of the Patient-Centered Medical Neighborhood Model,” by Rosanna P. Watowicz, PhD, RDN, LD; Randell K. Wexler, MD, MPH, FAAFP; Rick Weiss, MS; Sarah E. Anderson, PhD; Amy R. Darragh, PhD, OTR/L, FAOTA; and Christopher A. Taylor, PhD, RDN, LD, FAND (https://doi.org/10.1016/j.jneb.2018.11.011). It appears in the Journal of Nutrition Education and Behavior, volume 51, issue 2 (February 2019) published by Elsevier.

This project was supported by The Ohio State University Department of Family Medicine Crisafi-Monte Endowment Fund and The Ohio State University Food Innovation Center.

Full text of the article is available to credentialed journalists upon request; contact Eileen Leahy at +1 732 238 3628 or jnebmedia@elsevier.com to obtain copies. To schedule an interview with the authors please contact Dr. Rosanna Watowicz at +1 216 368 8875 or rpw39@case.edu.

An audio podcast featuring an interview with Dr. Rosanna Watowicz and information for journalists are located at http://www.jneb.org/content/podcast. Excerpts from the podcast may be reproduced by the media; contact Eileen Leahy to obtain permission.

About the Journal of Nutrition Education and Behavior (JNEB)
The Journal of Nutrition Education and Behavior (JNEB), the official journal of the Society for Nutrition Education and Behavior (SNEB), is a refereed, scientific periodical that serves as a resource for all professionals with an interest in nutrition education and dietary/physical activity behaviors. The purpose of JNEB is to document and disseminate original research, emerging issues, and practices relevant to nutrition education and behavior worldwide and to promote healthy, sustainable food choices. It supports the society’s efforts to disseminate innovative nutrition education strategies, and communicate information on food, nutrition, and health issues to students, professionals, policy makers, targeted audiences, and the public.

The Journal of Nutrition Education and Behavior features articles that provide new insights and useful findings related to nutrition education research, practice, and policy. The content areas of JNEB reflect the diverse interests of health, nutrition, education, Cooperative Extension, and other professionals working in areas related to nutrition education and behavior. As the Society's official journal, JNEB also includes occasional policy statements, issue perspectives, and member communications. www.jneb.org

About Elsevier
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Media contact
Eileen Leahy
Elsevier
+1 732 238 3628
jnebmedia@elsevier.com