Can food banks improve health outcomes among diabetics?
“Eat food. Not too much. Mostly plants,” journalist and author Michael Pollan wrote in “Food Rules.” While it’s a simple mantra, it’s not as easily put into practice especially among food-insecure families who don’t know where their next meal is coming from, much less whether that next meal will include fresh fruits and vegetables. The struggle of paying for bills and other financial challenges can take priority while diet takes a back seat.
Compounding the issue of food insecurity is the prevalence of diabetes. Diabetes affects 29.1 million people in the U.S. In Michigan, an estimated 10 percent of adults 18 years and older were diagnosed with diabetes in 2014; the state ranked 22nd in the country in diabetes prevalence among adults, according to the Michigan Department of Health and Human Services. The city of Detroit has some of the highest rates in the country for chronic disease, ranking second among 500 cities, according to the Centers for Disease Control and Prevention 500 Cities Project.
Because food is so critical to health outcomes, Gleaners Community Food Bank is committed to understanding the impact of our work on the tens of thousands of hungry individuals and families we serve. Our Household Impact Model, with its focus on nutrition and health, is helping us fine-tune our current programs and develop new ones that reach our hungry neighbors with wholesome, healthful food choices.
One exciting opportunity to learn about the impact of our work on health is the Feeding America Intervention Trial for Health Diabetes Mellitus, or FAITH-DM national study. Gleaners was one of three food banks in the country chosen to participate in this two-year research project, funded by the Laura and John Arnold Foundation in collaboration with Feeding America, the Urban Institute and the University of California (San Francisco).
To implement the study locally, Gleaners partnered with eight metro Detroit organizations, including the Capuchins, with whom we have enjoyed a longtime relationship. The Detroit-based Capuchin Services Center’s pantry — which resembles a small grocery store where families can get food packages full of meat, fresh fruits and vegetables, and bread to feed a family of four for a week — sees between 16,000 and 18,000 people a month, and out of those thousands of people about 6,000 have diabetes, says Denise Johnson, the center’s emergency assistance department manager. The pantry serves a diverse population, but she’s noticed African-Americans make up a majority of those living with diabetes followed by Hispanic clients.
Research shows that people who are low income and food insecure have an increased risk for developing diet-related chronic diseases such as type 2 diabetes. Inadequate and inconsistent access to diabetes-appropriate food can be a factor in the link between food insecurity and poor glycemic control among adults with diabetes, according to Feeding America, a nationwide network of 200 food banks that fights hunger in the U.S.
The FAITH-DM research trial, which ended in October 2017, explored to what extent food bank-based interventions can improve glycemic control for patients who have uncontrolled type 2 diabetes and how effective that intervention was on improving other diabetes outcomes. It entailed screening for diabetes, distributing diabetes-appropriate food, referring clients who lacked access to health care, and providing diabetes self-management education.
The project followed about 180 participants in metro Detroit (half received the resources and education while the other half served as the control group). Over the course of six months, participants received food boxes twice a month, two educational events in months 1 and 2, and monthly drop-in sessions. The contents of the food box varied, but it always included four pounds of vegetables and two pounds of fresh fruit as well as leaner protein options such as turkey, eggs and beans as well as dairy and grains.
Gleaners will use the results as “as a jumping-off point for discussion with health care partners on how we can provide complementary support to food-insecure individuals who are also struggling with managing a chronic disease,” says Sarah Mills, director of wellness and nutrition education at Gleaners. “The results of the study will give us an idea of the ways that food pantries can play a role in improving food security and also the role of providing foods and education that support health and disease management or prevention. Food pantries are often a place where people have built relationships and feel a sense of community, so it can also be a great place to engage people in a different way and encourage connections with health care providers.”
At the Capuchin Services Center, about 66 participants enrolled in the project. Johnson says she noticed improved well being among some of the clients who stayed in the program, often hearing comments of “I feel better” as a result of having increased access to fresh fruits and vegetables. Education and raising awareness of the disease are important in managing diabetes, she says, because oftentimes people think even though they know someone with it they don’t think it will happen to them. More education would help people learn “how you yourself can be the one to handle” the disease, she says.
The national results, based on a survey of 720 clients across the country, will be announced in early 2018.
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Members of the editorial and news staff of The Detroit News were not involved in the creation of this content.