Remote dietitian counseling with short-term meal delivery improves DASH diet adherence and lowers blood pressure in veterans with hypertension and obesity

Namratha Atluri; Lauren Herty; Carly Runge; Joanna Wells; Margaret Scisney-Matlock; Scott L Hummel

doi:10.1016/j.ahj.2026.107386

Remote dietitian counseling with short-term meal delivery improves DASH diet adherence and lowers blood pressure in veterans with hypertension and obesity

Am Heart J. 2026 Feb 24:107386. doi: 10.1016/j.ahj.2026.107386. Online ahead of print.

Authors

Namratha Atluri¹, Lauren Herty², Carly Runge², Joanna Wells², Margaret Scisney-Matlock³, Scott L Hummel⁴

Affiliations

¹ Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
² VA Ann Arbor Health System, Ann Arbor, MI.
³ School of Nursing, University of Michigan, Ann Arbor, MI.
⁴ Department of Internal Medicine, University of Michigan, Ann Arbor, MI; VA Ann Arbor Health System, Ann Arbor, MI. Electronic address: scothumm@med.umich.edu.

PMID: 41747920
DOI: 10.1016/j.ahj.2026.107386

Abstract

Background: Hypertension and obesity disproportionately affect veterans and contribute to cardiovascular disease. The sodium-restricted Dietary Approaches to Stop Hypertension eating pattern (DASH-SRD) reduces blood pressure (BP) and is guideline-recommended, but adherence is low in this population. We conducted a randomized trial of a remotely delivered dietary intervention to promote and sustain adoption of DASH-SRD in veterans with hypertension and obesity.

Methods: Veterans with hypertension and obesity received two weeks of home-delivered DASH-SRD meals after two weeks of ad-lib diet (Phase 1), then five telephone-delivered, dietitian-led motivational interviewing counseling sessions over four months, with or without a newly developed mobile application (Phase 2). DASH adherence (score 0-9 per 3-day food diary), clinic blood pressure (BP), and urinary sodium:potassium ratio were collected at baseline and at months one and six of Phase 2. Generalized estimating equations were used to evaluate changes in these parameters during the intervention.

Results: Sixty-one veterans (age 67±8 years, 15% female, 16% non-White) with obesity (BMI 34.4±5.2) and hypertension completed the trial. Dietary counseling session attendance was 96%. Between baseline and 6 months, DASH adherence score improved (1.8±1.6 to 2.3±1.4 points, p=0.02), BP decreased (systolic 133±17 to 128±15 mmHg, p=0.048; diastolic 73±11 to 69±12 mmHg, p=0.03), and urinary sodium:potassium ratio declined (2.6±1.1 to 1.5±0.8, p<0.001). There were no significant differences between the mobile application plus counseling and counseling-alone groups.

Conclusion: In Veterans with hypertension and obesity, a brief interval of home-delivered meals followed by telephone dietitian counseling sustainably improved DASH-SRD adherence and reduced BP.

Keywords: DASH; hypertension; metabolic syndrome; nutrition; sodium.