Study advocates prescribing fruits and vegetables to treat diabetes

There is little scientific evidence to suggest that a diet high in fruits and vegetables does not have wide-ranging health benefits. Now, a new study suggests that prescribing patients with type 2 diabetes could prevent 296,000 cases of cardiovascular disease and save US$39.6 billion in healthcare spending over 25 years in the US.

Using a model based on 6.5 million Americans ages 40 to 79 who have both diabetes and food insecurity as reported in three cycles of the National Health and Nutrition Examination Survey (NHANES), the simulation estimated, that a national prescription program provided free fruits and vegetables could have a significant impact on health outcomes.

The program would provide eligible diabetics with free or heavily subsidized fruit and vegetables while also attempting to address the well-studied association between type 2 diabetes and factors such as low socioeconomic status, food security and food deserts.

In addition to legumes and whole grain products, fruit and vegetables are the top recommendations for a high-fiber “diabetes diet”. Studies have shown that only one in ten Americans eats the recommended amount of fruits and vegetables each day, and this is more related to affordability and access than personal choice. And there’s a growing urge to make food recipes commonplace.

While the simulation also showed that it would cost $44.3 billion to implement, taking into account patient screening, food and nutrition education, and associated administration, it would still be cost-effective. At $18,000 per quality-adjusted life year gained, it would be on par with other preventative health interventions such as blood pressure screening and control, cholesterol screening and control, and cancer screening.

“Among the strategies that can improve Americans’ diet and diet-related health outcomes, there is growing evidence that food prescriptions are an excellent option,” says senior author Dr. Dariush Mozaffarian, cardiologist and professor of nutrition at the Friedman School. “These innovative treatments are exciting because they can not only improve health and reduce healthcare spending, but also reduce inequalities by reaching the patients who need them most.”

The analysis also found that it could potentially save an estimated $4.8 billion in lost productivity.

A previous university study examining health records in 184 countries estimated that poor diet played a role in more than 14 million cases of type 2 diabetes in 2018, accounting for around 70% of all new diagnoses of the disease worldwide made out

Meanwhile, a 2021 study found that a 15-week fresh-prescription program with low-income diabetics in Detroit resulted in significant reductions in hemoglobin A1C levels, which is critical for disease remission.

Last November, the United States Department of Agriculture (USDA) announced $59.4 million in funding for the Gus Schumacher Nutrition Incentive Program (GusNIP) Produce Prescription and Nutrition Incentive programs aimed at increasing access to improve fresh fruit and vegetables significantly.

The researcher dr. Mozaffarian is also behind Food is Medicine, a unique initiative aimed at research and programs designed to make healthcare and access to fruits and vegetables more equitable.

“A national program could be implemented by including food prescriptions as a covered health benefit, which is already being tested by several states under Section 1115 Medicaid waivers, as well as by private health care payers,” says Mozaffarian. “Our new insights help with implementation to scale and evaluate these programs across the United States.”

“These results suggest that a national product prescribing initiative could benefit all Americans and underscores the potential of ‘food is medicine’ strategies to alleviate health inequalities caused by food insecurity and diet-related diseases,” added first author Lu Wang, a postdoctoral fellow at the Friedman school.

The study was published in Journal of the American Heart Association.

Source: Tufts University

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