TY - JOUR
T1 - Temporal changes in bio-behavioral and glycemic outcomes following a produce prescription program among predominantly Hispanic/Latino adults with or at risk of type 2 diabetes
AU - Sato Imuro, Sandra Emi
AU - Sabharwal, Ashutosh
AU - Conneely, Casey
AU - Glantz, Namino
AU - Bevier, Wendy
AU - Barua, Souptik
AU - Pai, Amruta
AU - Larez, Arianna
AU - Kerr, David
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2023/8
Y1 - 2023/8
N2 - In the United States (U.S.), consumption of fresh vegetables and fruits is below recommended levels. Enhancing access to nutritious food through food prescriptions has been recognized as a promising approach to combat diet-related illnesses. However, the effectiveness of this strategy at a large scale remains untested, particularly in marginalized communities where food insecurity rates and the prevalence of health conditions such as type 2 diabetes (T2D) are higher compared to the background population. This study evaluated the impact of a produce prescription program for predominantly Hispanic/Latino adults living with or at risk of T2D. A total of 303 participants enrolled in a 3-month observational cohort received 21 medically prescribed portions/week of fresh produce. A subgroup of 189 participants used continuous glucose monitoring (CGM) to assess the relationship between CGM profile changes and HbA1c level changes. For 247 participants completing the study (76% female, 84% Hispanic/Latino, 32% with T2D, age 56·6 ± 11·9 years), there was a reduction in weight (−1·1 [-1·6 to −0·6] lbs., p < 0.001), waist circumference (−0·4 [-1·0 to 0·6] cm, p = 0·007) and systolic blood pressure (SBP) for participants with baseline SBP >120 mmHg (−4·2 [-6·8 to −1·8] mmHg, p = 0·001). For participants with an HbA1c ≥ 7·0% at baseline, HbA1c fell significantly (−0·5 [-0·9 to −0·1] %, p = 0·01). There were also improvements in food security (p < 0·0001), self-reported ratings of sleep, mood, pain (all p < 0·001), and measures of depression (p < 0·0001), anxiety (p = 0·045), and stress (p = 0·002) (DASS-21). There was significant correlation (r = 0·8, p = 0·001) between HbA1c change and the change in average glucose for participants with worsening HbA1c, but not for participants with an improvement in HbA1c. In conclusion, medical prescription of fresh produce is associated with significant improvements in cardio-metabolic and psycho-social risk factors for Hispanic/Latino adults with or at risk of T2D.
AB - In the United States (U.S.), consumption of fresh vegetables and fruits is below recommended levels. Enhancing access to nutritious food through food prescriptions has been recognized as a promising approach to combat diet-related illnesses. However, the effectiveness of this strategy at a large scale remains untested, particularly in marginalized communities where food insecurity rates and the prevalence of health conditions such as type 2 diabetes (T2D) are higher compared to the background population. This study evaluated the impact of a produce prescription program for predominantly Hispanic/Latino adults living with or at risk of T2D. A total of 303 participants enrolled in a 3-month observational cohort received 21 medically prescribed portions/week of fresh produce. A subgroup of 189 participants used continuous glucose monitoring (CGM) to assess the relationship between CGM profile changes and HbA1c level changes. For 247 participants completing the study (76% female, 84% Hispanic/Latino, 32% with T2D, age 56·6 ± 11·9 years), there was a reduction in weight (−1·1 [-1·6 to −0·6] lbs., p < 0.001), waist circumference (−0·4 [-1·0 to 0·6] cm, p = 0·007) and systolic blood pressure (SBP) for participants with baseline SBP >120 mmHg (−4·2 [-6·8 to −1·8] mmHg, p = 0·001). For participants with an HbA1c ≥ 7·0% at baseline, HbA1c fell significantly (−0·5 [-0·9 to −0·1] %, p = 0·01). There were also improvements in food security (p < 0·0001), self-reported ratings of sleep, mood, pain (all p < 0·001), and measures of depression (p < 0·0001), anxiety (p = 0·045), and stress (p = 0·002) (DASS-21). There was significant correlation (r = 0·8, p = 0·001) between HbA1c change and the change in average glucose for participants with worsening HbA1c, but not for participants with an improvement in HbA1c. In conclusion, medical prescription of fresh produce is associated with significant improvements in cardio-metabolic and psycho-social risk factors for Hispanic/Latino adults with or at risk of T2D.
KW - Continuous glucose monitoring
KW - Food as medicine
KW - Hispanic/Latino adults
KW - Type 2 diabetes
UR - https://www.scopus.com/pages/publications/85166291385
UR - https://www.scopus.com/inward/citedby.url?scp=85166291385&partnerID=8YFLogxK
U2 - 10.1016/j.heliyon.2023.e18440
DO - 10.1016/j.heliyon.2023.e18440
M3 - Article
AN - SCOPUS:85166291385
SN - 2405-8440
VL - 9
JO - Heliyon
JF - Heliyon
IS - 8
M1 - e18440
ER -