Produce prescriptions associated with improved social, medical outcomes
A diverse set of programs providing financial incentives for adults and children to consume produce led to improvements in food insecurity, self-reported health status, and glycemic and blood pressure control, according to a recent study.
Produce prescriptions were associated with significant improvements in consumption of fruits and vegetables, food security, and health status for adults and children, as well as clinically relevant improvements in HbA1c, blood pressure, and weight for adults with cardiometabolic health issues, a study found.
To examine the effects of produce prescriptions, researchers studied outcomes from 22 produce prescription locations in 12 U.S. states from 2014 to 2020. The study included 2,064 adults and 1,817 children with, or at risk for, poor cardiometabolic health who were recruited from clinics serving low-income neighborhoods.
Programs provided financial incentives to purchase fruits and vegetables at grocery stores or farmers' markets (median, $63/month; duration, 4 to 10 months). Surveys assessed food intake, food security, and self-reported health, while HbA1c, blood pressure, body mass index (BMI), and BMI z-score were measured at clinics. Results were published Aug. 29 by Circulation: Cardiovascular Quality and Outcomes.
After about six months, fruit and vegetable intake increased by 0.85 (95% CI, 0.68 to 1.02) and 0.26 (95% CI, 0.06 to 0.45) cup per day among participating adults and children, respectively. The odds of being food insecure dropped by one-third (odds ratio [OR], 0.63; 95%CI, 0.52 to 0.76), and the odds of improving one level in self-reported health status increased for adults (OR, 1.62; 95% CI, 1.30 to 2.02) and children (OR, 2.37; 95% CI 1.70 to 3.31). Among adults with an HbA1c of 6.5% or above, there was an average decline of −0.29% (95% CI, −0.42% to −0.16%). Systolic and diastolic blood pressures declined by −8.38 mm Hg (95% CI, −10.13 to −6.62 mm Hg) and −4.94 mm Hg (95% CI, −5.96 to −3.92 mm Hg), respectively, in adults with hypertension, and BMI decreased BMI decreased by −0.36 kg/m2 (95% CI, −0.64 to −0.09 kg/m2 in adults with overweight or obesity). Children's BMI z-score did not change significantly.
The study authors wrote that “produce prescriptions appear to advance nutrition security, defined as having consistent access, availability, and affordability of foods that promote well being and prevent and treat disease.”
An accompanying editorial noted that the results were important for health researchers who focus on the development and implementation of interventions to address obesity, diabetes, and related chronic conditions. “[I]investment in food-based nutrition programs and interventions, such as produce prescription programs, that provide for the purchase and intake of healthy foods, such as fruits and vegetables, holds potential to address food insecurity and improve downstream health outcomes, especially in health disparate populations at greatest risk of poor nutrition,” the editorial stated.