Supermarket and Web-Based Intervention Targeting Nutrition (SuperWIN) for Cardiovascular Risk Reduction

Inclusion Criteria: 1. Age ≥21 to ≤75 years on the start date of the study (Day 0) 2. Speak, write, read English fluently 3. In-person outpatient visit with a UC Health primary care network (PCN) provider within the last 12 months 4. Major food planner of their household, which may include planning, purchasing, and/or preparing greater than 50% of the meals or foods consumed at home 5. Existing shopper at a study site Kroger (≥50% of grocery store food dollars spent at Kroger) with a Kroger Loyalty ID number 6. Willing to use a new individual Kroger Loyalty ID number for the duration of the study 7. Access to a home desktop or laptop computer with reliable internet access 8. Access to an email account that can be used for the duration of the study 9. Able to independently purchase and prepare food: 1. Reliable transportation to participating Kroger store 2. Ability to stand for significant periods of time to grocery shop and prepare food at home 3. Tools and equipment needed to prepare own food at home, such as a kitchen equipped with basic cooking tools (e.g. burner, pan, spatula, sink) 10. Presence of a cardiovascular risk factor(s) (at least one): 1. Hypertension (defined by one of the following): * Blood pressure measurement: systolic blood pressure (SBP) 130-189 mm Hg and/or diastolic blood pressure (DBP) 80-109 mm Hg (at Visit #1) * Current treatment with an oral medication prescribed by a physician for blood pressure lowering (defined by one of the following): 1. Beta blockers 2. Diuretics (e.g. thiazide or thiazide-like diuretics, loop diuretics, aldosterone antagonists, potassium-sparing diuretics) 3. Angiotensin-converting enzyme inhibitors 4. Angiotensin II receptor blockers 5. Direct renin inhibitors (i.e. aliskiren) 6. Calcium channel blockers (dihydropyridine and nondihydropyridine) 7. Calcium alpha2-agonist and other centrally acting drugs (e.g. clonidine) 8. Direct vasodilators (e.g. hydralazine) 2. Body-mass index (BMI) measurement ≥30 kg/m2 (at Visit #1) 3. Hypercholesterolemia (defined by one of the following): * Low density lipoprotein cholesterol (LDL-C) 130-189 mg/dl (at Visit #1) * Current treatment with a medication prescribed by a physician for hypercholesterolemia (defined by one of the following): 1. Statins 2. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors 3. Absorption inhibitors (i.e. ezetimibe) 4. Fibrates 5. High-dose niacin (≥1 g per day) 6. Bile acid sequestrants (e.g. cholestyramine) Exclusion Criteria: 1. Unwillingness or inability to modify current diet 2. Actively engaged in another dietary intervention or taking a weight-loss supplement 3. SBP ≥190 mm Hg or DBP ≥110 mm Hg (at Visit #1) 4. Low-density lipoprotein cholesterol (LDL-C) ≥190 mg/dl, triglycerides (TG) ≥600 mg/dl, or glucose ≥400 mg/dl (at Visit #1) 5. Evidence of prior diagnosis of severe chronic kidney disease (CKD) defined by electronic health record codes for dialysis, CKD Stage 4 or 5 and/or last estimated glomerular filtration rate (eGFR) ≤30 ml/min/1.732 \[based on Modification of Diet in Renal Disease (MDRD) formula\] 6. Active cancer other than non-melanoma skin cancers (i.e. basal cell carcinoma or squamous cell carcinoma) 7. Diagnosis of celiac disease, ulcerative colitis, or Crohn's disease 8. High risk for alcohol use disorder: 1. ≥21 drinks a week (men) 2. ≥14 drinks a week (women) 9. Women who are pregnant or plan to become pregnant within the next 6 months from the start of the study (Day 0) 10. Food allergies requiring a specialized diet, including allergies to dairy products, eggs, peanuts, tree nuts, soy, gluten-containing wheat and grains, fish, and shellfish 11. Previous visit at TLC for diet counseling 12. Previous use of the Kroger's online shopping platform (Kroger.com or the Kroger app) 13. Participant lives greater than 20 miles from any participating Kroger study store (defined by zip codes) 14. Women, Infants, and Children (WIC) beneficiaries in their household