A recent study led by the Massachusetts Institute of Technology Sloan School of Management, Cambridge, explored the effectiveness of an intensive food-as-medicine program in managing type 2 diabetes among patients facing food insecurity.
The research, published in JAMA Internal Medicine, involved a randomized clinical trial with 349 participants, aiming to determine if access to healthy food options could improve glycemic control and influence health care usage.
Participants with type 2 diabetes and high HbA1c levels were divided into two groups.
The treatment group (170 individuals) received comprehensive support for a year, including groceries for healthy meals, dietitian consultations, health coaching, and diabetes education.
A control group (179 individuals) did not receive these benefits for the first six months.
After six months, both groups showed similar significant declines in HbA1c levels (1.5% in the treatment group and 1.3% in the control group), indicating no marked difference attributable to the program. This raises questions about other contributing factors to the observed improvements.
The program did increase engagement with preventive health care, as seen in more dietitian visits and active prescription orders in the treatment group.
However, these interventions did not lead to better glycemic control compared to usual care in the context of food insecurity.
No differences in cholesterol, triglycerides, fasting glucose, or blood pressure were noted between the groups at six or 12 months.
The lack of impact on these measures despite a healthy diet and access to medical professionals suggests that the effects of prolonged food insecurity may not be easily reversible through short-term interventions.
This study aligns with findings from the Centers for Disease Control, indicating that people experiencing food and nutrition insecurity are more likely to have diabetes.
While healthy eating is critical for managing blood sugar levels, nutritious foods are often unaffordable or inaccessible for those living in poverty, leading to reliance on processed foods.
For those with diabetes, the cost of healthy foods often competes with healthcare expenses, creating a challenging dilemma.
Although this study found no significant short-term improvements, it highlights the growing problem of food and nutrition insecurity alongside an increase in diet-related chronic diseases.
Food-as-medicine programs, including produce prescription programs and medically tailored meals, are gaining traction.
However, this study suggests that short-term dietary interventions may be insufficient for clinical change, emphasizing the need for long-term strategies to ensure food and nutrition security.
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The research findings can be found in JAMA Internal Medicine.
