‘Produce Prescriptions’ Improve Diet, Health Metrics: Study

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Aug. 30, 2023 – People who were given $63 per month to buy fruits and vegetables experienced health improvements and ate more produce, researchers from Tufts University in Boston report.

Dubbed “produce prescriptions,” the effort showed that over the course of 6 months, adults in the program increased their fruit and vegetable intake on average by 0.85 cups and children in those households averaged an increase of 0.26 cups. (For context, federal nutrition guidelines recommend 2.5 cups of vegetables per day and 2 cups of fruit per day for people on a 2,000-calorie daily diet. Most people eat less than the recommended levels.)

The authors noted that 1 in 5 deaths worldwide are attributable to a poor diet, and an estimated 300,000 annual U.S. deaths from heart disease and diabetes can be linked to poor diet. A movement called “food as medicine” seeks to improve people’s health through what they eat. Produce prescriptions with financial incentives aim to overcome what public health experts call “food insecurity,” which refers to a lack of access to sufficient food to meet a person’s basic needs.

“We have an ongoing epidemic of diet-related illness,”  researcher Kurt Hager, an an expert in food policy and nutritional epidemiology at Tufts, told  The Washington Post. “Physicians, historically, have had very few tools to improve the nutrition of their patients besides from some limited access to nutrition counseling.”

The study was published Tuesday in the journal Circulation: Cardiovascular Quality and Outcomes. The analysis looked at multiple programs that occurred over a variety of durations between 2014 and 2020. Combined, the study looked at the results for 2,064 adults and 1,817 children in 22 areas across 12 states. The participants had or were at risk for cardiometabolic problems such as insulin resistance, diabetes, non-alcoholic fatty liver disease, heart attack, or stroke. The conditions are common and considered preventable. All of the people were recruited from clinics located in low-income areas.

Participants were provided about $63 per month to buy fruits and vegetables from grocery stores or farmer’s markets, and on average people spent 73% of the amount they were given. (A 2019 report from the U.S. Department of Agriculture estimated that people needed to spend between $63 and $78 per month to eat recommended dietary levels of fruits and vegetables.)

After 6 months of receiving the financial incentive, the odds of participants being food insecure dropped by one-third. The odds of improving one level in self-reported health status for children more than doubled, and they increased for adults, as well. Adults with high blood sugar had levels decline, and overweight or obese adults experienced BMI reductions. A measure of children’s BMI did not change. 

The people in the study reported family fruit and vegetable intake and had their blood sugar levels, blood pressure, and changes in body mass index measured at clinics. Hager told the Post that the adults’ blood pressure improved by “about half that of commonly prescribed medications, which is notable for a simple change in diet.”