The Effect of Food is Medicine Interventions on Diabetes-related Health Outcomes Among Low-income and Food-insecure Individuals: A Systematic Review and Meta-analysis

• Published in: Canadian journal of diabetes 2023-03, Vol.47 (2), p.143-152
• Main Authors: Gao, Yueying, Yang, Adalia, Zurbau, Andreea, Gucciardi, Enza
• Format: Article
• Language: English
• Subjects: diabetes; Diabetes Mellitus; diabète; Eating; faible revenu; food insecurity; Fruit; Glycated Hemoglobin; Humans; insécurité alimentaire; low income; medically tailored meals; Outcome Assessment, Health Care; prescriptions de fruits et de légumes; produce prescriptions; repas médicalement adaptés; revue de littérature systématique; systematic literature review
• ISSN: 1499-2671; 2352-3840
• DOI: 10.1016/j.jcjd.2022.11.001

In this study, we aim to review the current evidence of Food is Medicine interventions on diabetes outcomes among low-income or food-insecure individuals. Seven databases were searched from January 1, 2000 to October 26, 2021 for full-text articles written in English. The studies included experimental studies of any duration and design which addressed the effect of Food is Medicine interventions on fruit and vegetable (F&V) intake and glycated hemoglobin (A1C) levels among low-income or food-insecure populations with prediabetes or diabetes of any age group. Only direction of effect of interventions on F&V intake were ascertained due to high variability in outcome measurement. A1C results were pooled using generic inverse variance with a fixed-effects model. Heterogeneity was assessed using Cochran’s Q and quantified by I2. Sixteen studies were included. Five of the 8 studies reported a significant increase in F&V intake. Seven of the 14 studies reported a significant decrease in A1C levels. A meta-analysis of 5 randomized controlled trials (n=843) resulted in clinically meaningful reductions in A1C compared with control (mean difference, −0.47%; 95% confidence interval, −0.66 to −0.29, I2=88%, p