Programs that help patients afford fruits and vegetables may improve nutrition security among people managing diabetes, according to new research conducted in Los Angeles County.
The study, published in The Annals of Family Medicine, evaluated a produce prescription program for Medicaid patients with type 2 diabetes or prediabetes. Participants received $40 per month for six months on a debit card that could be used only to purchase eligible fresh fruits and vegetables at participating grocery stores.
Researchers analyzed survey data from 1,309 participants who completed questionnaires at the beginning and end of the program. The surveys assessed nutrition security, defined as consistent access to foods that support health, as well as broader household food security.
By the end of the program, the proportion of participants considered nutrition secure increased from 23.2% to 38.7%. Food security also improved, rising from 25.2% at baseline to 42.9% at follow-up. These improvements remained statistically significant after accounting for factors such as age, income, baseline food security and fruit and vegetable consumption.
Despite these gains, most participants continued to report that healthy foods were too expensive. However, more participants said they were able to find stores that offered healthy food options by the end of the program, suggesting that financial support may help reduce some, but not all, barriers to healthier eating.
The program was implemented through a partnership between the Los Angeles County Department of Public Health and three Federally Qualified Health Centers. The authors describe the results as an early, short-term success and emphasize that the study was not designed to measure long-term health outcomes, such as changes in blood sugar control or diabetes-related complications.
Because the study used a before-and-after design without a comparison group, it cannot establish cause and effect. The findings also rely on self-reported survey data, which may not fully capture changes in diet or food purchasing behavior. Still, the results add to growing evidence that addressing cost and access within health care settings can influence patients’ ability to obtain healthier foods.
The authors note that produce prescription programs are not a replacement for broader efforts to improve food affordability and availability. Instead, they suggest such programs may serve as one component of a larger strategy to support nutrition security among populations at higher risk for diet-related disease.
This project was funded in part by the U.S. Department of Agriculture through the Gus Schumacher Nutrition Incentive Program and related COVID relief initiatives.