New Study Investigates How Well ‘Food as Medicine’ Works for Type 2 Diabetes

Food as medicine programs aim to address chronic illness and food and health disparities by providing nutritious meals. Their prevalence is relatively new, so a recent study wanted to see how effective they currently are at helping people with diabetes. The findings show they may need a bit more work.

Research recently published in JAMA Internal Medicine investigated how intensive food-as-medicine programs worked for type 2 diabetes patients with food insecurity. The program the team tested included healthy groceries, dietician consultations, education, and health coaching. The goal of the program is to improve glycemic control. According to the findings, though, there wasn’t much of a difference in outcomes between people using the program and the control group. The researchers say that doesn’t necessarily mean such programs don’t work. They may just require more research to see how best to utilize them.

Joseph Doyle, study co-author and MIT health care economist, explains, “When you find a particular intervention doesn’t improve blood sugar, we don’t just say, we shouldn’t try at all. Our study definitely raises questions, and gives us some new answers we haven’t seen before.”

The study included 465 adults with high blood sugar, or HbA1c levels of at least 8.0. They all also had food insecurity. There was an urban and a rural site administering the program, which provided groceries for 10 healthy meals per week, along with usual diabetes care. Patients were either immediately enrolled in the program or were enrolled six months later. The group that took part during the second half of the year was considered the control group. There was follow up for up to one year.

The researchers found that throughout the first six months of the program, the enrolled group saw their HbA1c levels go down by 1.5%. However, in the control group, levels went down by a similar 1.3%.

Doyle notes that there haven’t been many clinical trials studying these programs, so he doesn’t think people should assume the programs should be written off. The findings may just provide some encouragement to fine tune them, as they do provide the benefit of getting food to people who need it.

He says, “We do know that food insecurity is problematic for people, so addressing that by itself has its own benefits, but we still need to figure out how best to improve health at the same time if it is going to be addressed through the health care system.”

Possible reasons why the numbers were similar are because people in the control group were already apt to be improving and had the benefit of engagement with a health care provider, that the benefits may be observed after more time, or that having pre-made meals rather than the ingredients may make program compliance better.

Going forward, they believe there should be more research into whether pre-made meals provide a bigger benefit.