• Lisa G Rosas, Steven Chen, Lan Xiao, Mike Baiocchi, Elliot Ng, Benjamin O Emmert-Aronson, Wei-Ting Chen, Ariana Thompson-Lastad, Erica Martinez, Josselyn Perez, Eric Melendez, Elizabeth Markle, Marcela D Radtke, and June Tester.
• Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA; Department of Medicine, Stanford University, Palo Alto, CA. Electronic address: lgrosas@stanford.edu.
• Am J Prev Med. 2024 Nov 2.

IntroductionFood as Medicine is increasingly recognized as an important strategy for addressing the related challenges of food insecurity and nutrition-related chronic conditions. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited evidence to understand the effectiveness of Food as Medicine.MethodsRecipe4Health, a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a 'Food Farmacy' (16 weekly produce home deliveries) alone or in combination with a 'Behavioral Pharmacy' (16 weekly group visits). A quasi-experimental study with pre/post surveys (4 months) and propensity score matched controls for Electronic Health Record (EHR) outcomes over 12 months was conducted. Participants were 2,643 Recipe4Health patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023-2024.ResultsThere was a significant increase in produce consumption from baseline to four months (0.41 servings/day [0.11, 0.72], p=0.007) in the Food Farmacy in combination with Behavioral Pharmacy. Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone (-17.1 mg/dl[-26.9, -7.2], p<0.001) and in combination with Behavioral Pharmacy (-17 mg/dl [-28.3, -5.8], p=0.003) at 12 months. Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months (-0.37%, 95% CI [-0.65, -0.08]; p=0.01), but not the Food Farmacy with Behavioral Pharmacy.ConclusionsRecipe4Health resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.Copyright © 2024. Published by Elsevier Inc.

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