Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Dec 12;10(4):e52.
doi: 10.2196/jmir.1114.

Weight, blood pressure, and dietary benefits after 12 months of a Web-based Nutrition Education Program (DASH for health): longitudinal observational study

Thomas J Moore  1 , Nour Alsabeeh, Caroline M Apovian, Megan C Murphy, Gerald A Coffman, Diana Cullum-Dugan, Mark Jenkins, Howard Cabral
Affiliations

Weight, blood pressure, and dietary benefits after 12 months of a Web-based Nutrition Education Program (DASH for health): longitudinal observational study

Thomas J Moore et al. J Med Internet Res. .

Abstract

Background: The dietary habits of Americans are creating serious health concerns, including obesity, hypertension, diabetes, cardiovascular disease, and even some types of cancer. While considerable attention has been focused on calorie reduction and weight loss, approaches are needed that will not only help the population reduce calorie intake but also consume the type of healthy, well-balanced diet that would prevent this array of medical complications.

Objective: To design an Internet-based nutrition education program and to explore its effect on weight, blood pressure, and eating habits after 12 months of participation.

Methods: We designed the DASH for Health program to provide weekly articles about healthy nutrition via the Internet. Dietary advice was based on the DASH diet (Dietary Approaches to Stop Hypertension). The program was offered as a free benefit to the employees of EMC Corporation, and 2834 employees and spouses enrolled. Enrollees voluntarily entered information about themselves on the website (food intake), and we used these self-entered data to determine if the program had any effect. Analyses were based upon the change in weight, blood pressure, and food intake between the baseline period (before the DASH program began) and the 12th month. To be included in an outcome, a subject had to have provided both a baseline and 12th-month entry.

Results: After 12 months, 735 of 2834 original enrollees (26%) were still actively using the program. For subjects who were overweight/obese (body mass index > 25; n = 151), weight change at 12 months was -4.2 lbs (95% CI: -2.2, -6.2; P < .001). For subjects with hypertension or prehypertension at baseline (n = 62), systolic blood pressure fell 6.8 mmHg at 12 months (CI: -2.6, -11.0; P < .001; n = 62). Diastolic pressure fell 2.1 mmHg (P = .16). Based upon self-entered food surveys, enrollees (n = 181) at 12 months were eating significantly more fruits, more vegetables, and fewer grain products. They also reduced consumption of carbonated beverages. Enrollees who had visited the website more often tended to have greater blood pressure and weight loss effect, suggesting that use of the DASH for Health program was at least partially responsible for the benefits we observed.

Conclusions: We have found that continued use of a nutrition education program delivered totally via the Internet, with no person-to-person contact with health professionals, is associated with significant weight loss, blood pressure lowering, and dietary improvements after 12 months. Effective programs like DASH for Health, delivered via the Internet, can provide benefit to large numbers of subjects at low cost and may help address the nutritional public health crisis.

PubMed Disclaimer

Conflict of interest statement

Dr. Moore is Chairman of e-Havior Change, LLC which owns the copyright to the DASH for Health™ program. Dr. Apovian, Ms. Murphy, Ms. Cullum-Dugan, and Mr. Coffman have received some salary support from e-Havior Change, LLC.

Figures

Figure 1
Figure 1
A view of the program’s homepage as designed for EMC Corporation employees
Figure 2
Figure 2
Pattern of website use during a 3-week baseline period and then in sequential 4-week periods for 12 months
Figure 3
Figure 3
Mean (+ /- 95% CI) systolic and diastolic blood pressure change at 12 months in high and normal blood pressure groups (the systolic change in the high blood pressure group was significant, P < .001)
See this image and copyright information in PMC

References

    1. Appel L J, Moore T J, Obarzanek E, Vollmer W M, Svetkey L P, Sacks F M, Bray G A, Vogt T M, Cutler J A, Windhauser M M, Lin P H, Karanja N. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997 Apr 17;336(16):1117–24. doi: 10.1056/NEJM199704173361601. http://content.nejm.org/cgi/pmidlookup?view=short&pmid=9099655&promo=ONF... - DOI - PubMed
    1. Sacks F M, Svetkey L P, Vollmer W M, Appel L J, Bray G A, Harsha D, Obarzanek E, Conlin P R, Miller E R, Simons-Morton D G, Karanja N, Lin P H DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001 Jan 4;344(1):3–10. doi: 10.1056/NEJM200101043440101. http://content.nejm.org/cgi/pmidlookup?view=short&pmid=11136953&promo=ON... - DOI - PubMed
    1. Fung Teresa T, Chiuve Stephanie E, McCullough Marjorie L, Rexrode Kathryn M, Logroscino Giancarlo, Hu Frank B. Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med. 2008 Apr 14;168(7):713–20. doi: 10.1001/archinte.168.7.713.168/7/713 - DOI - PubMed
    1. Bantle John P, Wylie-Rosett Judith, Albright Ann L, Apovian Caroline M, Clark Nathaniel G, Franz Marion J, Hoogwerf Byron J, Lichtenstein Alice H, Mayer-Davis Elizabeth, Mooradian Arshag D, Wheeler Madelyn L. Nutrition recommendations and interventions for diabetes--2006: a position statement of the American Diabetes Association. Diabetes Care. 2006 Sep;29(9):2140–57. doi: 10.2337/dc06-9914. http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=1693616929/9/2140 - DOI - PubMed
    1. Go Vay Liang W, Wong Debra A, Wang Yu, Butrum Ritva R, Norman Helen A, Wilkerson Luann. Diet and cancer prevention: evidence-based medicine to genomic medicine. J Nutr. 2004 Dec;134(12 Suppl):3513S–3516S. http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=15570062134/12/3513S - PubMed

Publication types