A clinic-led food prescription program had a positive impact on diet-related behavioural and psychosocial outcomes – and some biometric indicators – among low-income, food-insecure patients with type 2 diabetes, according to researchers with the University of Texas Health Science Centre at Houston.
Researchers recruited 40 patients with diabetes to participate in a project led by the UTH School of Public Health’s Nourish program that taught ‘A Prescription for Healthy Living’ (APHL), a culinary medicine curriculum.
The patients were also enrolled in a nine-month food prescription program through a food pantry (food bank), which gave them a twice weekly allowance of around 14 kg of fruit, vegetables, lean protein and other healthy items – free of charge – and with brief nutrition counselling by a registered dietitian.
The study group was compared to patients who received the free food prescription only, with no culinary medicine education, from the same clinic in 2019-2020.
The pilot study was led by Shreela V. Sharma, PhD, RDN, professor of epidemiology at UTHealth School of Public Health and in partnership with Harris Health System and the Houston Food Bank.
“We found that while a food prescription program alone does have a positive and clinically meaningful impact on patient diabetes outcomes, there is an even greater impact when you layer on the culinary skills and education component,” Sharma said.
Culinary medicine blends the art of cooking with the science of medicine to instil a healthy dietary pattern. The five-session APHL program demonstrated to participants that healthy food tastes good, is affordable, simple to prepare, and relevant to all cultures. These 90-minute sessions – implemented virtually due to the COVID-19 pandemic – included lessons on knife skills, counting carbohydrates, reading labels, meal planning, recipe building, repurposing leftovers, and eating away from home, among others.
Overall, APHL participants saw a significant reduction in their glycosylated haemoglobin levels over the course of the study, better controlling their diabetes. Compared to the food prescription-only group, participation in APHL also resulted in significant increases in the consumption of fruits and vegetables, frequency of cooking from scratch, and self-efficacy in meal planning and cooking. Additionally, fewer participants reported that cooking healthy food is difficult.
These findings come one year after previous focus group sessions, recently highlighted in the Journal of the Academy of Nutrition and Dietetics, revealed that patients were frustrated with mixed dietary messages from different health care providers and a lack of culturally inclusive recommendations while also expressing a desire for skills to prepare tasty and healthy food.
As food prescription and culinary medicine programs gain popularity nationwide, Sharma calls for the increased training of dietitians in culinary medicine.
“Ultimately, we would like to scale this work across Harris Health clinics and hospitals and expand it to other settings and partners as well. It’s important for us to analyse and document the impact of this solution so that hopefully, one day, insurance companies will reimburse food prescription programs,” Sharma said.