JMIR Form Res. 2026 Oct 28;10:e106388. doi: 10.2196/106388.
ABSTRACT
BACKGROUND: The Dietary Approaches to Stop Hypertension Diet (DASH) diet supports heart health; yet, many find it difficult to follow in community settings. Mindful eating can improve adherence, but in-person programs are time-consuming and not always accessible. eHealth offers an accessible, scalable alternative that may increase engagement and compliance.
OBJECTIVE: This study assessed the feasibility of a DASH eHealth program focused on mindful eating and the preliminary changes in eating behaviors, diet quality, and health outcomes.
METHODS: Participants were recruited from a university workplace via email and flyers and randomly assigned to either a web-based DASH diet education program (Diet Only) or the Mind Your Heart (MYH) intervention. The MYH program included the same DASH curriculum plus additional mindful eating instruction, guided practice, and specific, measurable, achievable, realistic, and time frame (SMART) goal setting. Both interventions were fully asynchronous, self-guided, and lasted 6 weeks on the Desire2Learn (D2L) Brightspace platform, with no personalized coaching or counseling. Baseline and postintervention assessments involved in-person measurements of anthropometrics, blood pressure, and blood biomarkers. Participants recorded their diets electronically over 3 days using MyFitnessPal (MyFitnessPal, Inc) and completed validated questionnaires on mindful eating using the Mindful Eating Behaviors Scale (MEBS), eating behaviors using the Three-Factor Eating Questionnaire Revised 21-item (TFEQ-R21), motivation for regulated eating using the Regulated Eating Behaviors Scale (REBS), and perceived stress using the Perceived Stress Scale 10-item (PSS-10). During the intervention, automated ecological momentary assessments (EMAs) were sent electronically 3 times weekly to monitor eating behaviors in real time.
RESULTS: Thirty-seven participants (mean BMI 31.93 SD 7.25, 34/37, 91.9% female, 31/37, 83.8% White) were randomized into groups. Among the 36 who remained enrolled, the mean curriculum completion was 85.9%, SD 21.4; 31 (86.1%) completed≥60% of assigned content, and 32 (88.9%) completed at least half of the scheduled EMA prompts. Thirty-four participants attended the postintervention assessment and completed the questionnaires and the blood pressure assessment, although paired baseline and postintervention data were not available for all anthropometric measures and biomarkers. Participants reported no adverse events, and research staff observed none. Although no significant between-group differences were observed for DASH adherence, anthropometric measures, blood pressure, or cardiometabolic biomarkers, participants in the MYH group showed greater improvements than the Diet Only group in TFEQ-cognitive restraint (mean difference in change 0.39, 95% CI 0.06-0.72; Hedges g=0.81; P=.02) and REBS-controlled regulation (mean difference in change 3.59, 95% CI 0.01-7.16; Hedges g=0.68; P=.05).
CONCLUSIONS: A fully asynchronous digital mindful eating plus DASH education intervention and associated research procedures were feasible among working adults at elevated cardiovascular risk. Preliminary changes in eating behaviors suggest that mindful eating warrants further evaluation, but findings should be interpreted cautiously given the small sample and feasibility design. Larger, adequately powered randomized controlled trials are needed.
PMID:42950223 | DOI:10.2196/106388