Abstract 21: Examining the Impact of Food as Medicine on Heart Health

Abstract

Introduction: The recent White House Conference on Hunger, Nutrition, and Health in October 2022 made it a national priority to address food and nutrition insecurity and reduce inequities in nutrition-related chronic conditions such as heart diease. ‘Food as Medicine’ is increasing implemented to address the dual challenge of food/nutrition insecurity and chronic disease. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited rigorous evidence of the impact of Food as Medicine on heart health. Methods: We examined the effectiveness of Recipe4Health, a Food as Medicine program, for improving food insecurity and indicators of heart health among patients who accessed care in Federally Qualified Health Centers (FQHCs). Recipe4Health was implemented in 4 FQHCs and included a ‘Food Farmacy’ that provided 16 weekly deliveries of produce with or without a ‘Behavioral Pharmacy’ which was 16 weekly group medical visits. We examined pre/post changes over 4 months in outcomes assessed by surveys (e.g., produce intake, physical activity, food insecurity). We also compared outcomes (e.g., lipids, Body Mass Index [BMI], blood pressure [BP], HbA1c) in the Electronic Health Record (EHR) between Recipe4Health patients and controls over 12 months. Control patients were identified using propensity score matching with patients from similar clinics that had not implemented Recipe4Health. We used linear mixed effects models with repeated measures, adjusting for baseline of each outcome. Results: Study participants (n=5,286) were middle-aged (mean age 51.2 SD [13.9]) primarily women (68%), and from diverse racial/ethnic backgrounds with 51% Latinx, 21% Black, and 8% Asian American/Pacific Islander. Based on pre/post surveys, Recipe4Health participants significantly increased their produce consumption (0.41 servings [0.11, 0.72], p=007) and physical activity (41.98 minutes/week [22.33, 61.63], p<.001). Recipe4Health participants also experienced statistically significant improvements in food insecurity with 59% reporting food insecurity at baseline and 48% reporting food security at follow-up (p<.001). Based on EHR data, Recipe4Health participants significantly decreased their non-HDL cholesterol (-17.1 [-26.9, -7.2], p<.001) and HbA1c (-0.37%, 95% CI [-0.65, -0.08]; p=0.01) compared to propensity score-matched controls at 12 months. There were no notable differences between participants and controls with respect to BMI or BP. Conclusion: This analysis from participants in the R4H program adds important data to the literature regarding Food as Medicine. Recipe4Health, a Food as Medicine program, was effective for improving some indicators of heart health including produce consumption, physical activity, non-HDL cholesterol, and HbA1c.