Rosas Lisa G, Chen Steven, Xiao Lan, Baiocchi Mike, Ng Elliot, Emmert-Aronson Benjamin O, Chen Wei-Ting, Thompson-Lastad Ariana, Martinez Erica, Perez Josselyn, Melendez Eric, Markle Elizabeth, Radtke Marcela D, Tester June
Department of Epidemiology and Population Health, Stanford University, Palo Alto, California; Department of Medicine, Stanford University, Palo Alto, California.
Alameda County Health, San Leandro, California.
Am J Prev Med. 2025 Feb;68(2):377-390. doi: 10.1016/j.amepre.2024.10.020. Epub 2024 Nov 2.
Food 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.
Recipe4Health (R4H), 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 outcomes over 12 months was conducted. Participants were 2,643 R4H patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023 to 2024.
There was a significant increase in produce consumption from baseline to 4 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.
R4H resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.
“食物即药物”日益被视为应对粮食不安全和营养相关慢性病等相关挑战的一项重要策略。“食物即药物”指的是将基于食物的营养干预措施融入医疗保健中以预防和治疗疾病。然而，关于“食物即药物”有效性的证据有限。
Recipe4Health（R4H）是一项全面的“食物即药物”计划，在加利福尼亚州的4家联邦合格健康中心针对粮食不安全和/或营养相关慢性病患者实施。患者由医疗服务提供者转介至“食物药房”（每周16次家庭农产品配送），单独或与“行为药房”（每周16次小组就诊）联合。开展了一项准实验研究，进行前后调查（4个月），并对12个月电子健康记录结果进行倾向得分匹配对照。参与者为2020年1月至2022年12月期间确定的2643名R4H患者和2643名对照；数据于2023年至2024年进行分析。
“食物药房”与“行为药房”联合组从基线到4个月时农产品消费量显著增加（0.41份/天[0.11, 0.72]，p = 0.007）。与对照组相比，单独的“食物药房”在12个月时非高密度脂蛋白胆固醇有所改善（-17.1mg/dL[-26.9, -7.2]，p<0.001），“食物药房”与“行为药房”联合组也有所改善（-17mg/dL[-28.3, -5.8]，p = 0.003）。与对照组相比，单独的“食物药房”在12个月时糖化血红蛋白显著降低（-0.37%，95%置信区间[-0.65, -0.08]；p = 0.01），但“食物药房”与“行为药房”联合组未降低。
R4H导致饮食改善以及多项临床健康指标改善，如非高密度脂蛋白胆固醇和糖化血红蛋白。
