‘Food as medicine’ works – but how to best get people the healthy meals? – Buffalo News

Researchers already know access to nutritious food can make a huge difference to the health of people in food-challenged situations, like older adults who are homebound or living on fixed incomes.

That’s why many health experts support “food as medicine” programs that prescribe free fresh produce to help people treat or prevent health problems associated with poor diet.

The problem is: just like with prescription drugs, not everyone finds it easy to get or take the medicine.

That’s especially an issue for some areas of Buffalo that have higher levels of poverty and hunger than the rest of the state and nation due to decades of racial segregation and neglect of its least privileged communities.

Food insecurity and health disparities among Buffalo’s minority and low-income communities have taken center stage since May 14, 2022, when a white supremacist shooter killed 10 Black people at the Tops Markets on Buffalo’s East Side. The hate crime added hunger to the trauma by closing the main supermarket serving 90,000 mostly Black and low-income people in that neighborhood.

The University at Buffalo and its Jacobs School of Medicine and Biomedical Sciences have sharpened their focus on food inequity and food as medicine in an effort to address the health disparities that result in shorter lifespans and higher incidence of preventable diseases among Black and brown residents of Buffalo.

Now two UB researchers are embarking on a study to explore the best ways to get fresh fruits and vegetables into the diets of those who struggle with good nutrition.

Lucia Leone and Dr. Jill Tirabassi want to know why some programs offering weekly fruits and vegetables to at-risk groups have had so few takers or see participation slack off over time.

“We know fresh food makes people healthier, but we don’t know the best way to provide the produce,” said Leone, associate professor in the Department of Community Health and Health Behavior at UB’s School of Public Health and Health Professions.

“What are the barriers? Is there a stigma? Why don’t some people participate?” she asked.

Leone and Tirabassi, a clinical assistant professor in the Department of Family Medicine at UB Jacobs, just received a $400,000 grant from the American Heart Association to explore those questions.

They are the primary investigators on an AHA study that will look at three food prescription approaches and track participants to gain information on the best way to get healthy food on the tables of food insecure people, in this case adults over age 65.

They plan to recruit 75 patients of Erie County Medical Center to try the three approaches in groups of 25 over 18 months starting this summer, Leone said.

One group will get a weekly credit redeemable at Massachusetts Avenue Project’s mobile produce markets.

Another group will have fresh produce boxes delivered to their homes via FreshFix, a local food delivery company co-founded by Leone.

The third will have medically tailored meal kits, with recipes and ingredients to cook at home ala the HelloFresh or Blue Apron model, delivered each week.

Leone and Tirabassi said the food will be curated to meet dietary restrictions, like diabetes or food allergies, for each patient. Each participant will receive $20 to $30 of fresh produce, or 21 servings of fruits and veggies per week, and give feedback on their experience.

The research is needed now more than ever as New York State ushers in a Medicaid waiver program that was approved by the federal Centers for Medicare & Medicaid Services earlier this year, Leone said.

The waivers allow Medicaid funding to be used to cover food as medicine prescriptions, among other benefits like nutrition and diabetes prevention classes, for the next three years, and can be extended if they are shown to improve health outcomes and reduce hospitalizations.

Leone said she’s thankful the state took a big step for preventive care for food insecure people, but she’s worried that if not well executed, the concept of allowing health insurance to cover better nutrition won’t get enough buy-in to prove its worth.

“My biggest fear is that Medicaid will run this as a pilot program and end up saying it doesn’t work because we don’t know how to properly implement it,” she said.

Tirabassi said the food as medicine approach is expected to advance rapidly as other states have joined New York in submitting Medicaid waivers. While the UB team looks at food prescription programs for seniors, other AHA-funded research will focus on people with health conditions like diabetes and high blood pressure.

“It’s essential that we are able to quickly develop best practices for ensuring food prescription programs are successful at reaching the people who need them,” Leone said. “This research will help practitioners looking to design food prescription programs for their communities understand what works and what doesn’t.”

The UB team will focus on the successes and challenges of implementing food as medicine programs for older people “who face unique barriers with food and nutrition access,” Tirabassi said.

“Older adults often have multiple chronic health conditions, have experienced life course changes like losing a spouse, or are on a fixed income. Many people in this age group also have mobility and transportation challenges.”

The researchers will survey participants each week to gauge whether they use the vouchers or food they receive and weigh the benefits and drawbacks of each method. A community advisory board also will be set up to help oversee the project and gain insight into participants’ individual experiences and how they affect their ability to participate in the programs.

“For example, do they struggle with using smartphone apps and websites to customize the food they receive?” Tirabassi said. “We will be aggregating our data with other AHA-funded grantees to put out recommended best practices for achieving good results.”