(EA02-07-26) Pilot Randomized Clinical Trial of Produce Prescription with Dietitian Coaching to Improve DASH Diet Adherence and Diet Quality: THRIVE Food is Medicine Trial

Name of the scientific conference where the work was recently presented: AHA EPI-Lifestyle Scientific Sessions 2026

Date on which the work was previously presented at the scientific conference listed above: March 18, 2026

Objectives: Despite the efficacy of the Dietary Approaches to Stop Hypertension (DASH) diet, adherence remains low due to barriers, including food access, affordability, and lack of tailored support. We hypothesized that a Food is Medicine intervention combining produce prescriptions with personalized dietitian coaching would improve dietary quality in high-risk populations.

Methods: THRIVE was a 24-week, 2-arm randomized pilot feasibility trial conducted among Black and Hispanic adults with hypertension living in Healthy Food Priority Areas in Maryland. Participants were randomized 1:1 to: THRIVE intervention: $30/week produce prescription via “FARMacy” market + individualized DASH-aligned dietitian coaching + adaptive bi-directional text messaging + social resource navigation, or Enhanced usual care (EUC): produce bags without coaching + social resource navigation. Primary outcome: change in DASH adherence score (0–9 scale) via 24-hour dietary recalls. Secondary outcomes: Healthy Eating Index (HEI-2015) total score and fruit/vegetable intake at 12 and 24 weeks. Analyses used paired t-tests and difference-in-differences (DiD).

Results: Among 80 randomized participants (mean age 54.5 years, 57% female, 62% Black, 34% Hispanic), both groups improved in DASH adherence at 12 weeks (THRIVE: +0.33, p=0.534; EUC: +0.68, p=0.033), with improvements sustained at 24 weeks (THRIVE: +0.78; EUC: +0.25; DiD: +0.53, p=0.452). THRIVE produced clinically meaningful HEI gains at 12 weeks (+10.63, 95% CI: 2.85–18.40, p=0.010) vs EUC (+3.61, p=0.186; DiD: +7.01, p=0.134). HEI improvements were sustained at 24 weeks in THRIVE (+6.44) vs minimal change in EUC (+0.11; DiD: +6.32, p=0.212). Vegetable intake increased significantly within the EUC group at 12 weeks (+0.63 cups, p=0.012); between-group differences in fruit and vegetable intake were not significant at either timepoint.

Conclusions: This pilot trial demonstrates the feasibility and promise of a multi-component Food is Medicine intervention to improve DASH diet adherence and overall diet quality among Black and Hispanic adults with hypertension. Preliminary results support the potential of combining produce prescriptions with personalized nutrition support.

Funding Sources: American Heart Association, Healthcare by Food Initiative