Five Plus Nuts & Beans (2010-2015)

Insufficient or poor-quality diet contributes substantially to many diseases—including diabetes, obesity, cardiovascular disease, and cancer—that disproportionately affect certain Americans. In the Five Plus Nuts and Beans Trial, we tested whether or not a diet that was designed to be palatable but featured more fruits and vegetables, potassium, vitamin C, and magnesium improved the health of community-dwelling participants.

Elevated blood pressure is an extraordinarily common and important risk factor for cardiovascular disease and stroke, particularly among African Americans. Although pharmacological treatment of hypertension substantially lowers risk for cardiovascular complications, recommendations for adoption of the DASH diet (Dietary Approaches to Stop Hypertension) are recognized as an integral part of medical management. However suboptimal diets, in part, contribute to health disparities in blood pressure control.

While unhealthy diets have many social determinants (e.g., educational attainment, literacy, income, insurance status), there is a markedly lower availability of components of the DASH diet-recommended foods (such as fresh fruits and vegetables, skim milk and whole grain foods) in predominantly African-American and lower-income neighborhoods compared with Caucasian and higher-income neighborhoods.

Outcomes

The Five Plus Nuts and Beans trial was an 8-week pilot intervention study testing the effects of incorporating components of the DASH diet into nutritional choices of low income African Americans with hypertension. Participants were provided either $30 per week of fruits, vegetables, nuts and beans plus advice from a study coach, or a $30 per week gift card to the partnered grocery store.

Although the program did not reduce blood pressure, the intervention increased consumption of fruits and vegetables, and increased urinary excretion of potassium.