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Prescriptions for fruits and vegetables linked to better heart health

Prescriptions for fruits and vegetables can lead to better heart health and food security, according to a new study published by the American Heart Association in the journal Circulation.

Patients receive electronic cards or vouchers to access free or discounted produce at retail grocery or farmers’ markets. 

Improved health and well-being 

People with a higher risk of cardiovascular disease who participated in produce prescription programs increased their consumption of fruits and vegetables, resulting in improved body mass index (BMI), blood sugar, and blood pressure levels, as well as a decrease in food insecurity.

Dr. Kurt Hager, lead author of the study and an instructor at UMass Chan Medical School, explained that produce prescription programs allow doctors to prescribe fruits and vegetables alongside medications. 

“We know that food insecurity impacts health through several important pathways, including overall dietary quality, but also through stress and anxiety, mental health, and tradeoffs between paying for food and other basic needs such as housing costs, utilities, and medications,” said Dr. Hager. 

“These results indicate produce prescriptions may lay an important foundation for improved health and well-being.”

Focus of the study

The study involved participants receiving a median of $63 per month to purchase produce at local stores and farmers markets and attending nutrition classes. 

Data was collected via questionnaires about fruit and vegetable consumption, food insecurity, and health status, and routine testing of blood pressure, weight, height, and hemoglobin A1c (HbA1c) levels at the start and end of the program. 

The study did not include a control group, comparing outcomes among participants before and after program participation instead.

Key findings

According to the results, adults reported an increase in their intake of fruits and vegetables by nearly one cup per day (0.85 cups per day), while children’s intake increased by about a quarter of a cup per day (0.26 cups per day).

Systolic blood pressure decreased by more than 8 mm Hg, and diastolic blood pressure decreased nearly 5 mm Hg among adults with high blood pressure at the start of the study.

Blood sugar, as measured by HbA1C levels, decreased by 0.29 to 0.58 percentage points among adults with diabetes. BMI improved significantly among adults with obesity, although children’s BMI did not change.

The results also showed that adults were 62% more likely, and children more than twice as likely, to report better health status by program completion.

Participants were one-third less likely to report food insecurity after completing the programs compared to beforehand.

Nutrition insecurity 

Dr. Mitchell Elkind, chief clinical science officer of the American Heart Association and a tenured professor of neurology and epidemiology at Columbia University, noted that poor nutrition and nutrition insecurity are major drivers of chronic disease globally. 

“This analysis of produce prescription programs illustrates the potential of subsidized produce prescriptions to increase consumption of nutritious fruits and vegetables, reduce food insecurity, and, hopefully, improve subjective and objective health measures,” said Dr. Elkind. 

He also highlighted the need for future research to include randomized controlled trials to offset any potential bias and more rigorously prove the benefits of produce prescription programs.

Food is Medicine Initiative

The Food is Medicine Initiative, announced in September 2022 by the American Heart Association and The Rockefeller Foundation at a White House Conference on Hunger, Nutrition, and Health, aims to ensure patients receive medical prescriptions for healthy food to help prevent and manage chronic diseases. 

A 2022 American Heart Association Policy Statement noted that poor nutrition plays a significant role in serious long-term illnesses, including cardiovascular disease and Type 2 diabetes. 

In 2019 alone, poor nutrition contributed to nearly 8 million deaths. Food insecurity is defined as the lack of equitable and stable availability, access, and affordability to foods and beverages that promote well-being and prevent and treat disease.

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