Access to healthy foods improves outcomes in two studies

IIn Stockton, California, nearly 60% of the city’s 320,000 residents have prediabetes or live with diabetes. One of them is Shane Bailey, 72, a longtime resident and U.S. Coast Guard veteran. Also, the area where she lives doesn’t have a grocery store nearby and is considered a food desert, so getting healthy, affordable food can be a big challenge.

“I live in the Central Valley, where a lot of produce is grown. But in Stockton, it’s often very expensive, low quality, or both. ” said Mr. Bailey.

But thanks to Abbott and the Public Health Institute’s Health Food Rx Program, she was able to make lifestyle changes that helped manage her condition. The program was a pilot study that provided 374 people with diabetes with healthy meal kits containing fresh produce from the Stockton/San Joaquin Emergency Food Bank every other week for one year.

“Learning how to make these healthy meals was fun. It kept me busy and also improved my mental health,” Bailey said. Each box came with a recipe, and participants could take a virtual cooking class to learn how to make each meal. Her favorite meal was a chicken and green vegetable stir-fry stuffed with broccoli, kale, spinach and bok choy, tossed with warm olive oil and Asian spices.

The Food Rx program is one of two recent studies, both of which have not yet been peer-reviewed, showing the benefits of produce prescription programs as a way to improve diabetes-related health outcomes and address food insecurity. not. Supporters say food-as-medicine programs could go a long way in helping people with low incomes and chronic illnesses, especially those living in food deserts.

“Health disparities exist in communities of color, namely Latinx and Black communities, and people living in these communities tend to live in historically under-resourced areas, so the impact of diabetes is ,” said Maggie Wilkin, director of research and evaluation. She holds a PhD from the Center for Health and Nutrition at the Institute of Public Health and served as lead author of the poster presentation. Access to healthy food is one of the important tools he says to address these disparities.

Results of the Food Rx pilot study were presented Tuesday at the American Public Health Association annual meeting. Overall, hemoglobin A1c measurements (which measure average blood glucose levels over a 3-month period) significantly decreased from 9.73% to 8.93% over the year for participants whose measurements were outside the target range at baseline. According to the Centers for Disease Control and Prevention, a hemoglobin A1c level of 5.7% to 6.4% is considered prediabetic.

Researchers also found that participants’ food insecurity decreased by 10%. Additionally, participants made lifestyle changes to manage their diabetes, such as participating in more physical activity, checking their blood sugar levels daily, following a diabetes meal plan, and attending diabetes education and nutrition classes. Reported that there have been significant changes.

Bailey, who is on Medicare and receives Veterans Affairs health benefits, had hoped the program would last longer. “I would like to participate in more programs like this that are affordable and accessible,” she said.

Wilkin said involving community organizations like food banks could provide a sustainable way to continue similar programs in other cities and towns. She said the findings support policies that provide reimbursable, medically tailored diets to people with chronic illnesses. “Organizations looking to implement a produce prescription program can apply and receive funding from the U.S. Department of Agriculture’s Gus Schumacher Nutrition Incentive Program,” she said.

Payers told STAT they could cover food as a drug amid a growing body of research showing it leads to improved health outcomes.

Further south in California, in Los Angeles, Kaiser Permanente Southern California led a six-month randomized controlled trial of a produce prescription program for 450 patients receiving Medicaid.

Study participants were randomly assigned to three different groups. One was a control group that did not receive free fresh food, and the other was a high-dose intervention group and a low-dose intervention group that received free fresh food deliveries. The value of produce was adjusted to the size of participants’ households, ranging from $90 to $270 for high-dose groups and $90 to $180 for low-dose households. All participants who received free produce were also provided with a free dietary and nutrition counseling session by telephone with a registered dietitian or nutritionist.

The study results, presented earlier this week at the American Heart Association’s Scientific Sessions, showed that patients in both the high-dose and low-dose intervention groups improved their blood sugar levels and lowered their A1c by an average of 0.32 points.

Furthermore, the data showed that the state of food security and nutrition security has improved significantly. Compared to the control group, the odds of food security increased by approximately 230% and the odds of nutritional security increased by 370% for patients in both intervention groups. .

“Diet-related diseases such as obesity and diabetes are major causes of morbidity and mortality and contribute to increased health care costs,” said lead author Claudia, a researcher at Kaiser Permanente in the Southern California Institute for Research and Evaluation.・Mr. Now said. “We can provide medical care and dietary counseling, but if patients can’t afford healthy foods, they won’t be able to follow dietary and nutritional advice.”

In early 2023, the Centers for Medicare and Medicaid Services announced that states will have the opportunity to provide “alternative” services for the health-related social needs of people on Medicaid in managed care plans. , Nau points out. States are currently focusing on a variety of unmet health-related social needs, including providing nutritious prepared meals and healthy grocery and vouchers to support the health needs of enrollees. We are now able to offer alternative benefits.

Wilkin said that, in the grand scheme of things, programs like this are investments that encourage healthy habits in participants for years to come. “Providing people with the tools and resources to try new foods and create new recipes will continue beyond the program and lead to better long-term outcomes for people with diabetes,” she said. .

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