If doctors prescribed fruits and vegetables as medicine, could people improve their health with that diet alone? That’s the theory behind a growing number of programs in the United States that give out these products for free.
The goal of these programs is to combat heart problems and obesity-related diseases, whether by preparing free packages of fruits and vegetables for participants to pick up regularly, delivering packages of those fresh products to their homes, or giving people money so they can buy them.
Carol Grand, a 63-year-old retiree from Tulsa, Oklahoma, joined one of these programs in late 2022 after she was diagnosed with diabetes. Her doctor prescribed medication, she said, but the woman didn’t want to depend on it forever.
“I said to myself, ‘Well, this can’t be the way I’m going to live my life,’” Grand said. “If there was another alternative, I was going to put it to the test.”
Grand signed up for FreshRx Oklahoma, a nonprofit “prescription food” service for people with diabetes. The year-long program distributes bags of locally grown fruits and vegetables, along with recipes to cook them, every two weeks. Participants also receive free health checkups every quarter.
Grand stated that his blood sugar level dropped to non-diabetic levels and that lost 50 pounds (15 kilograms).
Before the program, he stated, I used to eat junk food because it was cheaper: “My diet was horrible: anything fast, anything loaded with sugar.” Now, Grand said, he cooks recipes like stir-fried tofu and sweet peppers.
Recent studies support the benefits of these programs. New research presented Wednesday at the American Heart Association Scientific Sessions in Chicago looked at the impact of a program called Recipe4Health, which delivers 16 weekly shipments of free products to homes in Alameda County, California. Participants also attend group medical visits where they are taught about nutrition and physical activity.
Researchers examined the effects on nearly 5,300 middle-aged patients at Federally Qualified Health Centers (clinics that serve low-income, uninsured, or underinsured people). All participants had a chronic illness or were food insecure.
Your healthcare providers submitted an electronic “prescription” to Recipe4Health.
“The prescription, instead of going to the pharmacy, goes to the farm,” explained Lisa Goldman Rosas, associate professor of Epidemiology and Population Health at Stanford School of Medicine, who presented the research.
“The fact that it comes from your healthcare provider is very significant,” he added. “It sends the message that food is part of your health because your healthcare provider cares about her.”
That it comes from your health provider is very significant. “Send the message that food is part of your health because your doctor cares about it.”
Lisa Goldman PROFESSOR OF EPIDEMIOLOGY AND POPULATION HEALTH, STANFORD SCHOOL OF MEDICINE
The researchers compared the participants’ medical records with those of patients at other federally qualified health centers that had not received product deliveries. Over the course of a year, those who participated significantly reduced their non-HDL (artery-clogging) cholesterol compared to the other group. Some participants also saw reductions in their blood sugar levels.
The participants not only increased their consumption of fruits and vegetables, but also their physical activity, according to the research, which has not been reviewed or published in a scientific journal. The percentage of participants who reported being food insecure (meaning they had limited access to healthy foods due to lack of money and other resources) decreased from 59% to 48%. However, being part of the program did not appear to change people’s blood pressure or body mass index.
A similar study last year looked at the impact of nine produce programs run by Wholesome Wave, an organization that uses private funding to help communities facing poverty and food insecurity. About 1,800 overweight or obese children and about 2,000 adults with health risk factors such as obesity, diabetes and hypertension participated in the programs.
After meeting with a health professional, participants received between $15 and $300 a month – in the form of printed vouchers or loaded onto a card – to purchase goods at a local farmers market or grocery store.
The study found that the prescriptions improved glycemic control, blood pressure and body mass index in adults.
“Our results suggest that these programs could be an important and complementary part of health care in the future,” said Kurt Hager, one of the authors of the analysis and a health sciences instructor at UMass Chan School of Medicine.
A study last year estimated that if 6.5 million adults with diabetes and food insecurity were fed fruit- and vegetable-based prescriptions for an average of 25 years, nearly 300,000 cases of cardiovascular disease could be avoided and nearly $40 billion in health savings would be saved. health costs.
Fruit- and vegetable-based recipes received renewed attention after the 2022 White House Conference on Hunger, Nutrition and Health made it a priority improve access to nutrition services for Medicare and Medicaid beneficiaries.
Historically, Hager explained, these programs have been “unsustainable in the long run if they rely solely on grants and support from foundations and donations, so there’s a really big movement right now for health insurance to start paying for some.” of these programs.”
Hager added that more states have begun to take advantage of Medicaid waivers that allow them to test new health services. According to a February study, California, Massachusetts, New Jersey, North Carolina, Oregon and Washington have approved waivers for Medicaid recipients that allow the direct provision of healthy foods.
At the same time, researchers are gathering more evidence about the benefits of produce recipes. In a trial in Southern California with 450 people, six months of weekly produce deliveries were found to lower blood sugar levels in people with type 2 diabetes. Preliminary data from a trial in the city of New York revealed that families who received home deliveries of fresh produce had more food security and less stress overall, compared to families who did not receive them.
In the New York test they participated 250 families with children ages 2 to 8 who were overweight or obese. Half of these families were given locally grown fruit and vegetables for 24 weeks, as well as advice on healthy eating and recipes for children’s meals. The other families only received educational advice.
Roopa Kalyanaraman Marcello, director of that study, explained that deliveries did not necessarily lead families to eat more fruits and vegetables, as many simply bought fewer products in the store. But they did lead children to eat a greater variety of foods.
“Early childhood is the most critical period for the formation of food patterns and preferences”, he explained. “We wanted to intervene (in that process) as soon as possible.”
