Remote Dietary Counseling to Promote Healthy Diet and Blood Pressure

Geisinger Clinic187 enrolled

Overview

American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines recommend lifestyle modification for patients with elevated blood pressure. While eating a Dietary Approaches to Stop Hypertension (DASH)-type diet, increasing physical activity, and weight loss have been shown to reduce blood pressure, limited resources are available in the primary care setting to help patients make these changes. In this study, the investigators will compare the efficacy of a self-guided vs. dietitian-led approach using web-based lifestyle modification tools to reduce weight, improve dietary quality, and lower blood pressure in overweight/obese adults with elevated blood pressure.

Goals that all participants will be instructed to target include: 1) weight loss \>=3% at 3 months; 2) consume a healthier dietary pattern (high in fruits, vegetables, whole grains, low-fat dairy, vegetable/fish/poultry sources of protein, healthier sources of fat, and avoid sugar and salt); 3) reduce sodium intake to \<2300 mg/d; 4) at least 180 min/wk of moderate-intensity physical activity.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

187

Conditions

Blood Pressure High Blood Pressure

Interventions

Self-Guided ApproachBEHAVIORAL

For a 12-week period, patients will be asked to access the web platform (Evolve, formerly BMIQ), review educational materials, and enter dietary information. From January 2019 to February 2021, participants used an earlier version of the platform, which was used in tandem with LoseIt (www.loseit.com), a meal-logging app that integrated with the platform. In February 2021, a platform update occurred (Evolve) where the core tenets of the program remained the same and included the dietary data entry directly on the platform.

Dietitian-led ApproachBEHAVIORAL

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * 24-hour ambulatory SBP 120-160 mmHg * BMI ≥ 25 kg/m2 * Access to a telephone * Access to a computer or smartphone with internet access * Complete dietary data entry for at least 5 out of 7 days during run-in period * Enter weight into the platform during run-in period Exclusion Criteria: * Inability to understand English * Myocardial infarction, stroke, or atherosclerotic cardiovascular disease procedure within last 6 months. * Current treatment for malignancy * Planned or previous bariatric surgery * Pregnant, breast-feeding, or planned pregnancy prior to the end of participation * Self-reported average consumption of \> 21 alcoholic beverages per week or binge drinking. * Psychiatric hospitalization in past year * Current symptoms of angina * Planning to leave the area prior to end of the study * Current participation in another clinical trial * Principal investigator discretion (i.e. concerns about safety, compliance)