Dietary intervention from your supermarket

The potential of dietary interventions in supermarkets in improving nutrition education and adherence was demonstrated by the positive findings from the Supermarket and Web-based Intervention Targeting Nutrition (SuperWIN) Trial presented at the ACC Scientific Sessions.

The first-of-its-kind SuperWIN results were presented by Prof. Dylan Steen (University of Cincinnati, OH, USA) [1]. SuperWIN (NCT03895580) was a randomised-controlled dietary intervention study collaboration between academic teams and the Kroger Company, the USA’s largest supermarket chain.

Included were 247 patients from the University of Cincinnati Health Primary Care with at least 1 cardiovascular risk factor: obesity, hypertension, and/or hypercholesterolaemia. After meeting with a UC Health Primary Care physician, participants completed a medical nutrition therapy visit with a Kroger Health dietitian. Eligible participants were then randomised at their preferred supermarket into 1 of the 3 study arms: (1) standard of care plus individualised, point-of-purchase nutrition education (6 visits, ‘Strategy 1’); (2) standard of care plus individualised, point-of-purchase nutrition education enhanced with online shopping technologies and training (6 visits; ‘Strategy 2’); or (3) standard of care alone [2]. Educational sessions within each store's clinic and aisles emphasised the Dietary Approaches to Stop Hypertension (DASH) diet. The primary efficacy endpoint was the mean change in DASH score from baseline to 3 months (post-intervention). Additional outcomes included blood pressure, lipids, weight, purchasing behaviour, food literacy, and intervention feedback.

The results showed a change in DASH score from baseline to 3 months of 8.6 in the Strategy 1 group, 12.4 in the Strategy 2 group, and 5.8 in the control group (Strategies 1 and 2 vs control P= 0.02; Strategy 2 vs control P=0.01; see Table). Participants in both Strategies 1 and 2 received in-aisle advice from a Kroger Health dietitian and showed better adherence to a DASH diet than the control group. Participants in the Strategy 2 cohort, who were trained on new technologies, had an even greater adherence improvement to the DASH diet than those in other cohorts. However, no significant change was observed in the secondary endpoint of systolic blood pressure from baseline to 6 months: -6.6 with Strategy 1, -5.7 with Strategy 2, and -2.8 in the control group (Strategies 1 and 2 vs control P=0.18; Strategy 2 vs control P=0.66).

Table: 3-Month results from SuperWIN [1]



In brief, participants in either strategy arm who received in-aisle education from a Kroger Health dietitian had a greater increase in their adherence to a DASH diet than the control group. Prof. Steen concluded, “The participants were taught to shop better, right in the aisles of their home stores, based on each individual’s unique tastes and needs.”

1. 
   
   1. Steen D et al. A Multisite, Randomized, Controlled Trial Of A Supermarket And Web-based Intervention Targeting Nutrition For Cardiovascular Risk Reduction. Abstract 405–16, ACC 2022, 2­–4 April, Washington DC, USA.
   2. Couch SC, et al. Am Heart J. 2022;248:21–34.

 

 

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Posted on 15 June 202213 June 2024