Food for Health: Evaluation of a Fruit and Vegetable Prescription Program on Community Health

Access to nutritionally adequate and safe food is a basic human need. Yet, food insecurity--lack of consistent, dependable access to enough food for all household members for active, healthy living--affects millions of American households. Those who experience food insecurity at rates above the national average include people from all walks of life: households with children; households with children headed by a single female, households headed by a Hispanic or black non-Hispanic person. those living in rural areas, those living in the South or Southwest US, families of enlisted military service members and veterans, college students, and seniors. Consequences of food insecurity include physical impairments related to insufficient or improper dietary intake, psychological issues related to a lack of consistent food access, and socio-familial disturbances.

Methodology: For this study, we provided a fruit and vegetable prescription and education program for food-insecure diabetics with poor blood sugar control who were patients of a primary care clinic associated with a safety net hospital in a large urban area in the southeast US. We then studied the impact of this program on certain diabetes health parameters. The study subjects were referred to this program by their primary care physician. There was a six-week series of one-hour classes that were led by a certified dietitian. Each class included, in addition to the usual didactic education, an onsite preparation of a healthy, diabetes-friendly dish composed of locally available vegetables and/or fruits, with a portion for each attendee to try. At the end of each class, each participant was given the recipe for the dish that was prepared that day, and a 20-pound bag of similar locally available vegetables and/or fruits with which to practice at home.

Analysis: Hemoglobin A1c and BMI measurements were taken before and after the intervention. Before- and after-intervention questionnaires were done to assess self-efficacy, perceived value assigned to fruit and vegetable intake, nutrition and diabetes knowledge, current fruit and vegetable consumption, and diabetes distress.

Results: Study participants, on average, showed a significant post-intervention decrease in hemoglobin A1c, a significant decrease in diabetes distress, and increases both in knowledge about diabetes and nutrition, and perceived value of fruits and vegetables for health.