Association between youth blood pressure and exposure to pediatric fruit and vegetable prescriptions

Health impacts of pediatric fruit and vegetable prescription programs (FVPPs) are unclear. This study assessed whether exposure to an FVPP that provided $15 produce prescriptions during pediatric visits was associated with differences in child diet, food security, physical activity, weight status, and blood pressure.

This cross-sectional analysis included data from caregiver-child dyads with varying levels of exposure to the FVPP. Dyads completed surveys at pediatric offices. Trained research assistants measured height and weight of children and recorded blood pressure through chart review. Causal inference analyses using propensity score adjustments compared outcomes of exposure groups.

680 dyads enrolled. Youth who received ≥1 prescription (exposed) reported greater physical activity compared to youth who received no prescriptions (unexposed). Blood pressure percentiles were lower among exposed when compared to unexposed youth (63.273 versus 75.060 for SBP; 71.472 versus 77.548 for DBP); and fewer exposed children recorded elevated blood pressure when compared to unexposed (0.141 versus 0.343 for SBP; 0.199 versus 0.344 for DBP; and 0.286 versus 0.531 overall). Similar findings were obtained using duration as a measure of exposure.

Youth exposed to the FVPP experienced greater physical activity and healthier blood pressure. Findings may indicate novel health-promoting effects of pediatric FVPPs.

When compared to youth with no exposure, youth exposed to a pediatric fruit and vegetable prescription program recorded greater physical activity and healthier blood pressure. Youth with high exposure (≥24 months) to the fruit and vegetable prescription program experienced greater physical activity and healthier blood pressure when compared to youth with low exposure (<24 months). This extends evaluation of pediatric fruit and vegetable prescription programs beyond feasibility and preliminary effectiveness to indicate potential of such programs in positively influencing physical activity and blood pressure of participating youth. Findings indicate novel health-promoting effects of pediatric fruit and vegetable prescription programs.