708-P: Medical Prescriptions of Fresh Vegetables Improve Clinical and Psychosocial Outcomes for Adults with or at Risk of Type 2 Diabetes (T2D)

Abstract

For adults with T2D, food insecurity and low socio-economic status are major barriers to accessing nutritious food, leading to compensatory consumption of foods harmful to health. In particular, consumption of fresh vegetables is well below recommended levels in the United States. The aim of this project was to examine the health impact of improving access to fresh vegetables through the use of medical prescriptions for organic vegetables for adults with or at risk of T2D (ADA Risk Calculator). Over 12 weeks (and after obtaining informed consent), participants provided baseline clinical information and then received weekly medical prescriptions of 21 servings of locally sourced organic vegetables at three community based distribution centers in Santa Barbara, CA, after which baseline measurements were repeated. No additional structured nutrition education was provided. Overall, 145 adults (74% Hispanic/Latino, aged 53 [42-62] years (median [IQ range]), 78% female, with (31%) or at risk of T2D have been enrolled. At entry, 62% were food insecure which reduced to 37% after 12 weeks (p<0.0001) associated with lowering of systolic blood pressure (SBP) (-2.5 [95%CI: -4.8 to -0.2] mmHg, p=0.035) which was greater for those with an initial SBP >130 mmHg (-6.8 [95%CI: -11.7, -1.9] mmHg, p=0.005), and a reduction in waist circumference (0.9 [95%CI -1.6 to -0.2] cm, p=0.002). The change in waist circumference was also significant with baseline high-risk values of >88 cm (p=0.02) for women and >102 cm (p=0.02) for men. Median weight also fell slightly (-0.45 kg, p=0.04). For participants with a baseline HbA1c >7.0%, this reduced significantly (-0.6 [95% CI -1.2 to -0.05] %, p=0.01). Overall self-reported sleep quality, mood and pain (100 mm visual analogue scales) also improved (all p<0.001). Medical prescriptions of organic vegetables are associated with measurable clinical and psychosocial benefits for adults with or at risk of T2D. Disclosure M.A. Kujan: None. N.M. Glantz: Research Support; Self; Abbott, Eli Lilly and Company. C. Conneely: None. V. Chen: None. D. Kerr: Advisory Panel; Self; Novo Nordisk A/S, Sanofi-Aventis. Research Support; Self; Eli Lilly and Company. Stock/Shareholder; Self; Glooko, Inc. Funding U.S. Department of Agriculture (2018-01793)