Lisa Goldman Rosas, PhD, MPH
Credit: Stanford Health

New research adds to the evidence supporting healthy dietary interventions to reduce cardiovascular risk.

The study, presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardio-Metabolic Science Session 2024, evaluated the effectiveness of a free weekly fruit and vegetable delivery program, demonstrating a “food-as-medicine” approach. Further analysis provides evidence of additional benefits on cardiovascular risk factors such as cholesterol levels and HbA1c. You can^{1, 2}

“We were really excited to see that providing patients with moderate amounts of locally grown produce improved indicators of food insecurity, diet, and cardiovascular health.” The study was conducted during the COVID-19 pandemic, when many of these outcomes were worsening, especially among patients treated at federally qualified health centers, which have been disproportionately affected. said senior researcher Lisa Goldman Rosas, MD, MPH. Department of Epidemiology and Population Health and School of Medicine, Stanford School of Medicine.²

Despite the onslaught of pharmacological advances in recent decades, achieving and maintaining a healthy lifestyle remains the cornerstone of the management of nearly all chronic diseases. However, as a result of suboptimal infrastructure and equity, patients in many regions, including food deserts and dense urban environments, are at a disadvantage and may face additional hurdles in their efforts to achieve optimal lifestyle management. There is a gender.³

With this in mind, Rosas and a team of colleagues sought to assess how implementing a “Food as Medicine” program impacts food insecurity and risk factors for chronic disease. This interesting program, called Recipe4Health, is implemented at four federally qualified health centers and provides 16 weekly produce deliveries with or without “behavioral pharmacy,” which is 16 group medical visits per week. “Food Pharmacy” was included.^{1, 2}

The primary outcome of interest in the analysis was the change in outcomes before and after the program, as assessed by survey data. Secondary outcomes of interest in this study included changes in cardiovascular risk factors such as lipids, BMI, blood pressure, and HbA1c, which were assessed by his EHR data. Of note, secondary outcomes were measured at the end of 12 months and compared to propensity score matched controls identified from similar clinics not participating in Recipe4Health.¹

Overall, 5,286 middle-aged adults were identified to participate in the study. The mean age of this cohort was 51.2 (SD, 13.9) years, 68% were female, 51% were Latinx, 21% were Black, and 8% were Asian American/Pacific Islander.¹

Analysis of pre- and post-program survey data showed that Recipe4Health participants experienced a significant improvement of (0.41 servings). [0.11, 0.72]p=007), physical activity (41.98 minutes per week) [22.33, 61.63]p<.001) and prevalence of food insecurity (59% vs. 48%; P <.001). Analysis of EHR data highlighted that participants experienced a statistically significant reduction in non-HDL cholesterol (-17.1 [-26.9, -7.2]p<.001) and HbA1c (-0.37%, 95% CI) [-0.65, -0.08]; p=0.01) compared to propensity score matched controls at 12 months. According to the researchers, no differences in BMI or blood pressure were observed between controls and participants.¹

The researchers found several limitations within the study that should be considered when interpreting the results. These include small sample sizes, lack of control groups for primary outcomes, and reliance on EHR data.²

“This study shows that food prescriptions accessible through medical visits have the potential to improve health outcomes for a significant portion of the U.S. population,” said Kevin Volup, MD, Mark V. Pauley Professor at Perelman College. said.Wharton School of Medicine, Director of Penn Center for Health Incentives and Behavioral Economics, Institute’s Food-Based Health Care Research Director^TM Initiative.² “Coordinated research approaches are needed to more systematically and rigorously define how effective food and medical interventions are in preventing and treating disease compared to standard medical care.”

References:

1. _{^{Rosas GL, Chen S, Xiao L, et al. Examining the effects of food as medicine on heart health. Paper presented at: American Heart Association EPI|Lifestyle Science Session 2024. March 18-21, 2024, Chicago, IL.}}
2. _{^{American Heart Association Newsroom. Free fresh food once a week improves diet, physical activity, and reduces CVD risk factors. American Heart Association. March 20, 2024. Accessed March 23, 2024. https://newsroom.heart.org/news/free-weekly-fresh-Produce-improved-diet-physical-activity-and-reduced-cvd-risk-factors.}}
3. _{^{A study by Campbell P. found that prescribing fruits and vegetables could reduce future health care spending by $40 billion. HCP live. July 14, 2023. Accessed March 23, 2024. https://www.hcplive.com/view/study-finds-prescribing-fruits-and-vegetables-could-reduce-future-healthcare-spending-by-40-billion.}}