January 19, 2018

A new study led by researchers at The University of North Carolina at Chapel Hill and North Carolina State University will provide a weekly allotment of locally grown vegetables to low-income, high-risk patients at The UNC Family Medicine Center and will connect the patients with existing nutrition education programs.

Dr. Alice Ammerman

Dr. Alice Ammerman

Dr. Dana Neutze

Dr. Dana Neutze

Dr. Lindsey Haynes_Maslow

Dr. L. Haynes_Maslow

Co-principal investigators of the project are Alice Ammerman, DrPH, Mildred Kaufman Distinguished Professor of nutrition at the UNC Gillings School of Global Public Health and director of the UNC Center for Health Promotion and Disease Prevention; Dana Neutze, MD, PhD, assistant professor of family medicine and associate medical director of the Family Medicine Center in the UNC School of Medicine; and Lindsey Haynes-Maslow, MHA, PhD, Gillings School alumna in health policy and management, assistant professor and extension specialist in N.C. State University’s Department of Youth, Family and Community Services, and adjunct assistant professor of nutrition at the Gillings School.

Collaborators on the project are Amy Lanou, PhD, professor and chair of the health and wellness department at UNC-Asheville, and Benjamin Aiken, MSPH, MD, physician and medical director at Mission Health, in Asheville, and Gillings School alumnus.

Researchers will track changes in patient diet and biometric measures, as well as the impact on farmers—the revenue and risks associated with the program.

“We’re excited about this opportunity to explore the intersection between health care and the food system,” said Ammerman. “The grant offers a great opportunity for collaboration within UNC-Chapel Hill and across the UNC system (including with N.C. State University and University of North Carolina at Asheville) to work with community partners and patients within the UNC Health Care System. The funding provided by the UNC General Administration fosters collaboration across these campuses.”

“Food and health care are often seen as two separate, distinct issues, but this study seeks to explore how they are one inter-connected issue,” said Haynes-Maslow.

Those enrolled will take a six-week nutrition education course taught by N.C. State’s Supplemental Nutrition Assistance Program Education (SNAP-Ed) staff. During the course and over the subsequent 17 weeks, enrollees will receive free, locally grown vegetables from Maple Spring Gardens in Cedar Grove, N.C.

The 23-week community-supported agriculture (CSA) initiative is valued at $641 per participant and will act as incentive to participate.
The study will examine participants’ biometric data, such as blood pressure and blood sugar, before and after the program, as well as patient-reported outcomes related to self-efficacy obtaining and eating fruits and vegetables.

The importance of the study is twofold in North Carolina. Studies estimate that healthier diets might prevent $71 billion per year in medical costs, lost productivity and premature deaths associated with poor diet. North Carolina communities, particularly in rural areas, face the dual challenge of high rates of chronic disease (obesity, heart disease, stroke, diabetes and cancer) and economic decline.

North Carolina is also one of the top 10 agricultural states in the country, with agricultural businesses accounting for almost 20 percent of the state’s gross domestic product. However, the state also ranks high in its rate of farm loss, particularly among smaller farms.

“I often see the impact a poor diet has upon the health of my patients,” said co-principal investigator Neutze. “This project could be a game-changer in the health of low-income individuals. Additionally, the partnership brings business to rural communities and helps support our farming community.”

“I am excited to move forward the idea of food as medicine,” said Ken Dawson, owner and general manager of Maple Spring Gardens, the farm supplying the produce for the CSA boxes.

Dawson has been running the farm for 35 years.

“This is a great project because, one, we can sell more produce, but two, to be involved with this whole concept makes good sense in terms of peoples’ health, and in terms of economic health. If there’s any way I can be involved with making that happen, I want to be involved.”

The study is modeled after successful programs in other states. In 2012, the nonprofit organization DC Greens partnered with Unity Health Care clinic and five farmers markets to offer the FVRx (prescription for fruits and veggies) program.

Survey results found that 53 percent of children reduced their body mass index during participation in the program—and more than $40,000 of produce was sold through the program by local farmers. Detroit Health piloted a similar FRx program for low-income families, with positive results.

However, these programs lacked rigorous evaluation. While other iterations of vegetable prescription programs relied primarily on self-reported outcomes, this study actually will track biometric measures. In addition, researchers will examine the economic impact on farmers.

Ideally, the program could expand its scope to other research institutions and across North Carolina, even partnering with health-insurance providers to bring programs such as this one to more low-income individuals across the state.

A version of this article appeared originally on the UNC School of Medicine website


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