If doctors prescribed fruits and vegetables like medicine, would people be able to improve their health through diet alone? That's the theory behind the growing number of free produce programs in the United States.
These so-called produce prescription programs set up free bundles of fruits and vegetables for participants to receive on a regular basis, deliver fresh produce to people's homes, and give them money to buy it. aims to fight heart disease and obesity-related diseases. Produce.
Carol Grand, a 63-year-old retiree from Tulsa, Oklahoma, entered one such program in late 2022 after being diagnosed with diabetes. Her doctor prescribed her medication, but she didn't want to rely on it forever, she said.
“I said, 'Well, there's no way this is how I want to live my life,'” Grand said. “If there was another option, I took it.”
Grand enrolled in FreshRx Oklahoma, a nonprofit food prescription service for people with diabetes. The year-long program sees him handing out bags of locally grown fruits and vegetables and recipes every two weeks. Participants also receive free quarterly health screenings.
Grand said her blood sugar levels have dropped to non-diabetic levels and she has lost 50 pounds.
Before joining the program, she said she regularly ate junk food because it was affordable. She said: “My eating habits were terrible, I ate anything quick and loaded with sugar.” Now, Grand said, she's making recipes like tofu and sautéed peppers.
Recent research supports the benefits of these programs. A new study presented Wednesday at the American Heart Association's Scientific Sessions in Chicago analyzed the impact of a program called Recipe4Health, which delivers 16 weekly doses of free produce to people's doorsteps in Alameda County, California. Participants also participate in group medical visits where they learn about nutrition and physical activity.
Researchers looked at the effects on about 5,300 middle-aged patients at federally qualified medical centers (clinics that see low-income, uninsured, or underinsured patients). All participants had chronic health conditions or were food insecure.
The healthcare provider submitted an electronic “prescription” to Recipe4Health.
“Prescriptions don't go to the pharmacy, they go to the farm,” said Lisa Goldman Rosas, assistant professor of epidemiology and population health at Stanford School of Medicine, who published the study.
“The fact that it comes from a provider is very powerful,” she added. She said, “Because health care providers are paying attention to diet, they are sending the message that diet is part of health.”
Researchers compared the participants' health records with those of patients at other federally qualified health centers that did not receive produce deliveries. Over a one-year period, participants significantly lowered their non-HDL cholesterol (the type that clogs your arteries) compared to other groups. Some participants also experienced a decrease in blood sugar levels.
The study found that participants not only increased their consumption of agricultural products, but also their physical activity. This study has not been peer-reviewed or published in a scientific journal. The percentage of participants who said they were food insecure (meaning they have limited access to healthy food due to lack of money or other resources) decreased from 59% to 48% . However, participation in the program did not seem to change people's blood pressure or body mass index.
A similar study conducted last year analyzed the impact of nine produce programs run by Wholesome Wave, an organization that uses private funding to support communities facing poverty and nutritional insecurity. In total, the program enrolled approximately 1,800 overweight or obese children and approximately 2,000 adults with health risk factors such as obesity, diabetes, and high blood pressure.
After meeting with a health care professional, participants received between $15 and $300 per month in the form of paper coupons or loaded onto cards to purchase produce at local farmers markets and grocery stores.
The study found that the regimen improved glycemic control, blood pressure, and body mass index in adults.
“Our findings suggest that these programs may become an important and complementary part of future clinical care,” said co-author of the analysis and instructor of health sciences at the Massachusetts Chan College of Medicine. Kurt Hager said.
A study last year estimated that if 6.5 million adults with diabetes and food insecurity were prescribed prescriptions for an average of 25 years, nearly 300,000 cases of cardiovascular disease would be prevented and healthcare costs would be saved nearly $40 billion. There is.
Produce prescriptions received renewed attention after the 2022 White House Conference on Hunger, Nutrition, and Health made improving access to nutrition services for Medicare and Medicaid beneficiaries a priority.
Historically, Hager said, such programs are “unsustainable over the long term if they rely solely on grants, foundation support, and donations, so we're currently taking steps to reduce some of these programs. “There is a huge movement towards health insurance actually starting to pay for it.”
Hager added that more states are starting to take advantage of Medicaid waivers that allow them to try out new medical services. California, Massachusetts, New Jersey, North Carolina, Oregon and Washington all approved waivers for Medicaid recipients that would allow direct access to healthy food, according to a February study.
At the same time, researchers are gathering more evidence about the benefits of agricultural formulas. A 450-person trial in Southern California found that weekly produce deliveries for six months lowered blood sugar levels in people with type 2 diabetes. Preliminary data from a New York City trial also found that families who received fresh food deliveries were more food secure and experienced less stress overall than those who did not.
“We are basically treating food as medicine, but it also has many other aspects that make parents' lives easier,” said study director Roopa Kalyanaraman Marcello.
The trial involved 250 families with children aged 2 to 8 who were overweight or obese, providing half of the families with locally grown fruits and vegetables for 24 weeks, and providing additional support for healthy eating and children. She also provided tips on eco-friendly recipes. Other families received only educational tips.
Marcello said delivery hasn't necessarily led families to eat more fruits and vegetables, as many people simply buy less produce at the store, but it has helped children eat more diverse foods. There is no doubt that this has happened.
“Infancy is the most important period for forming dietary patterns and preferences,” she said. “We wanted to intervene as early as possible.”
