Dietary interventions may best be delivered at supermarkets, which offer convenience, accessibility, full food inventories and, increasingly, in-store registered dietitians, online shopping and delivery services. In collaboration with a large retail supermarket chain, we conducted a multisite supermarket and web-based intervention targeting nutrition trial (no. NCT03895580), randomizing participants (n = 247 (139 women and 108 men)) 2:2:1 to two levels of dietary education (Strategy 1 and Strategy 2) or an enhanced control group that included educational components beyond the routine standard of care. Both Strategies 1 and 2 included individualized, in-person, dietitian-led, purchasing data-guided interventions. Strategy 2 also included online tools for shopping, home delivery, selection of healthier purchases, meal planning and healthy recipes. The primary endpoint was change in dietary approaches to stop hypertension (DASH) score (a measure of adherence to the DASH diet) from baseline to 3 months. The primary endpoint was met because, at 3 months, the DASH score increased by 4.7 more for the combined Strategy 1 and Strategy 2 groups than for the control group (95% confidence interval (CI) (0.9, 8.5), P = 0.02). In a prespecified hierarchical test, at 3 months, DASH score increased by 3.8 more for the Strategy 2 group than for the Strategy 1 group (95% CI (0.8, 6.)9, P = 0.01). This trial demonstrates the efficacy of data-guided, supermarket-based, dietary interventions and modern online shopping tools in improving dietary quality in a free-living, community-based population. The trial also demonstrates the opportunity for academic investigators to collaborate with retailers to design and rigorously test comprehensive healthcare interventions.

饮食干预可能最好在超市提供，超市提供便利、可及、完整的食品库存，并且越来越多地提供店内注册营养师、在线购物和送货服务。我们与一家大型零售连锁超市合作，进行了多站点超市和基于网络的营养干预试验（编号 NCT03895580），随机分配参与者（n = 247（139 名女性和 108 名男性）） 2:2:1 到两个级别的饮食教育（策略 1 和策略 2）或包括超出常规护理标准的教育内容的增强控制组。策略 1 和 2 都包括个性化的、面对面的、营养师主导的、购买数据指导的干预措施。策略 2 还包括用于购物、送货上门、选择更健康的购物、膳食计划和健康食谱的在线工具。主要终点是从基线到 3 个月的饮食停止高血压方法 (DASH) 评分（一种对 DASH 饮食的依从性的衡量）的变化。达到主要终点是因为在 3 个月时，联合策略 1 和策略 2 组的 DASH 评分比对照组增加了 4.7（95% 置信区间 (CI) (0.9, 8.5)，P = 0.02）。在预先指定的分级测试中，在 3 个月时，策略 2 组的 DASH 评分比策略 1 组增加了 3.8（95% CI (0.8, 6.)9，P = 0.01 ）  。该试验证明了以数据为导向、以超市为基础的饮食干预和现代在线购物工具在改善自由生活、以社区为基础的人群的饮食质量方面的功效。该试验还展示了学术研究人员与零售商合作设计和严格测试综合医疗保健干预措施的机会。