Produce prescriptions could improve health of people with diabetes, save billions, study says

A new study conducted by researchers from Tufts University’s Friedman School of Nutrition Science and Policy in Boston has shown that providing free or discounted produce and nutrition education to patients with diabetes and diet-related conditions could have significant health benefits and save billions of dollars in healthcare costs.

Over the years, nonprofit groups and public health agencies have explored the concept of a produce prescription. Now, this study simulates the potential outcomes of implementing such a program nationwide. Senior author Dr. Dariush Mozaffarian, a cardiologist and nutrition professor, emphasizes that produce prescriptions are a promising option among strategies aimed at improving Americans’ nutrition and diet-related health outcomes. He also plans to launch an initiative called “Food is Medicine.”

The simulation predicts both clinical and financial advantages of making fruits and vegetables more accessible to food-insecure diabetic patients. It estimates savings of at least $40 billion in medical expenses through nationwide reductions in heart disease.

Typically, produce prescription programs enable patients with diet-related health conditions to receive vouchers or electronic cards for free or discounted fruits and vegetables, which can be delivered to their homes or obtained from grocery stores or farmer’s markets.

This study is the first to investigate the long-term benefits of a produce prescription program. It estimates that implementing a national program for 40- to 79-year-old individuals with diabetes and food insecurity could prevent 296,000 cases of cardiovascular disease, including heart attacks and strokes.

In addition to the healthcare cost savings, the strategy could also save $4.8 billion in lost productivity costs.

The research found similar benefits across different subgroups of Americans, including insurance type, race, and ethnicity. This suggests that a national produce prescription initiative could benefit all Americans and potentially address health inequities caused by food and nutrition insecurity and diet-related diseases.

To conduct the simulation, the Friedman School team analyzed studies from 20 smaller-scale initiatives and nationally representative datasets. They assumed that all American adults aged 40 to 79 with diabetes and food insecurity would increase their daily fruit and vegetable consumption by an average of 0.8 servings, equivalent to one small apple. The simulation also considered anticipated reductions in blood pressure and body mass index.

Mozaffarian suggests that a national program could be implemented by including produce prescriptions as a covered healthcare benefit. Some states are already piloting this approach under Medicaid section 1115 waivers, and private healthcare payers are also exploring it. The study’s findings provide valuable insights for scaling up and evaluating these programs across the United States.