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Effect of an Intensive Food-as-Medicine Program on Health and Health Care Use: A Randomized Clinical Trial
Joseph Doyle1, Marcella Alsan2, Nicholas Skelley3
1Massachusetts Institute of Technology Sloan School of Management, Cambridge.
JAMA Internal Medicine
|December 26, 2023
Summary
Intensive food-as-medicine programs increased preventive health care use but did not improve glycemic control in adults with diabetes and food insecurity. Further research is needed to optimize these interventions for better health outcomes.
Area of Science:
- Clinical Medicine
- Public Health
- Nutrition Science
Background:
- Food-as-medicine programs are gaining traction, necessitating evidence-based research on their health impacts.
- Patients with type 2 diabetes and food insecurity often face challenges in managing their condition due to limited access to nutritious food.
Purpose of the Study:
- To evaluate the effectiveness of an intensive food-as-medicine program on glycemic control and healthcare utilization in patients with type 2 diabetes and food insecurity.
Main Methods:
- A stratified randomized clinical trial with a waitlist design was conducted over one year.
- Participants received either immediate access to the program or a delayed intervention, with follow-up at 6 and 12 months.
- The program included healthy groceries, dietitian consultations, and diabetes education for individuals with HbA1c levels of 8% or higher.
Main Results:
- The food-as-medicine program led to increased engagement in preventive healthcare, including more dietitian visits and higher rates of certain diabetes medications.
- No significant difference in glycemic control (HbA1c levels) was observed between the treatment and control groups at 6 months.
- Participants in the program reported improvements in their dietary habits compared to the control group.
Conclusions:
- Intensive food-as-medicine interventions can enhance preventive healthcare engagement among patients with type 2 diabetes and food insecurity.
- These programs, as implemented, did not demonstrate a significant improvement in glycemic control compared to usual care.
- Further investigation is required to develop and refine food-as-medicine strategies that effectively improve health outcomes in targeted populations.
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