Brubacher Laura Jane, Little Matthew, Grewal Ashmita, Stringer Eleah, Richter Abby, Dodd Warren
School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
School of Public Health and Social Policy, University of Victoria, HSD 202d, 3800 Finnerty Rd, Victoria, BC, V8P 5C2, Canada.
BMC Prim Care. 2025 Jul 2;26(1):208. doi: 10.1186/s12875-025-02907-w.
Food insecurity is linked with suboptimal diet and comprises an important risk factor for nutrition-related chronic diseases. Fresh food prescription programs are designed to improve access to healthy foods, but there is limited evidence on the impacts of such programs in the Canadian context. The objective of this mixed methods study was to assess changes in food security, fruit and vegetable intake, and health among adult participants of a fresh food prescribing program in Guelph, Ontario, Canada.
A total of 57 adult participants who were experiencing food insecurity and had ≥ 1 cardio-metabolic condition or micronutrient deficiency received fresh food prescriptions from their healthcare practitioner, which included a nutrition and cooking information package and weekly vouchers ($10 per person in household) for an online produce market for 52 consecutive weeks. Pre-, mid-, and post-intervention surveys, blood pressure measurements, and clinical bloodwork were collected to assess food security, fruit and vegetable intake, self-reported health, and blood biomarkers of cardio-metabolic and nutritional health. We used a single-arm repeated-measures evaluation and paired t-tests and Fisher's exact tests to assess changes. Linear regression models were used to assess factors associated with change in fruit and vegetable intake. Semi-structured interviews were conducted with participants to expand on survey findings. Qualitative data were analyzed thematically using an inductive constant comparative approach.
Forty-nine participants completed post-intervention data collection. The proportion of participants experiencing severe food insecurity decreased after the intervention from 38.1% to 23.8%. Intake of fruit, orange vegetables, and 'other' vegetables increased during the intervention (p < 0.05). Mean triglyceride, fasting insulin, and ascorbic acid levels improved (p < 0.05). More severe food insecurity and lower fruit and vegetable intake at baseline, as well as more frequent interaction with healthcare providers, were associated with a greater increase in fruit and vegetable intake from pre- to post-intervention (p < 0.05). In interviews, participants reported that the program increased access to fresh fruits and vegetables, improved mental and physical health, provided social connections, and reduced financial stress.
Fresh food prescription programs may improve food security and increase fruit and vegetable intake, but further research is needed to determine their long-term health impacts.
粮食不安全与不良饮食有关，是营养相关慢性病的一个重要风险因素。新鲜食品处方计划旨在改善健康食品的获取，但在加拿大背景下，关于此类计划影响的证据有限。这项混合方法研究的目的是评估加拿大安大略省圭尔夫市一个新鲜食品处方计划的成年参与者在粮食安全、水果和蔬菜摄入量以及健康方面的变化。
共有57名经历粮食不安全且患有≥1种心血管代谢疾病或微量营养素缺乏症的成年参与者从他们的医疗保健从业者那里获得了新鲜食品处方，其中包括一份营养和烹饪信息包以及连续52周每周用于在线农产品市场的代金券（每户每人10加元）。收集干预前、干预中期和干预后的调查问卷、血压测量值和临床血液检查结果，以评估粮食安全、水果和蔬菜摄入量、自我报告的健康状况以及心血管代谢和营养健康的血液生物标志物。我们使用单臂重复测量评估以及配对t检验和费舍尔精确检验来评估变化。线性回归模型用于评估与水果和蔬菜摄入量变化相关的因素。对参与者进行了半结构化访谈，以扩展调查结果。定性数据采用归纳性持续比较方法进行主题分析。
49名参与者完成了干预后的数据收集。干预后，经历严重粮食不安全的参与者比例从38.1%降至23.8%。干预期间，水果、橙色蔬菜和“其他”蔬菜的摄入量增加（p<0.05）。平均甘油三酯、空腹胰岛素和抗坏血酸水平有所改善（p<0.05）。基线时更严重 的粮食不安全、更低的水果和蔬菜摄入量，以及与医疗保健提供者更频繁的互动，与干预前后水果和蔬菜摄入量的更大增加相关（p<0.05）。在访谈中，参与者报告说该计划增加了新鲜水果和蔬菜的获取机会，改善了身心健康，提供了社会联系，并减轻了经济压力。
新鲜食品处方计划可能会改善粮食安全并增加水果和蔬菜摄入量，但需要进一步研究以确定其对健康的长期影响。
