Feasibility and Effects of a Produce Prescription Program (PRx) in People With Type 2 Diabetes and Low Socioeconomic Status: A Randomised Controlled Pilot Trial
Top Things to Know
A produce prescription model that combined food provision with nutrition education, cooking support, and dietitian counseling was feasible, highly acceptable, and achieved strong participant engagement among adults with type 2 diabetes and low socioeconomic status.
Direct provision of healthy foods may improve fruit and vegetable intake and support modest improvements in weight-related outcomes and physical quality of life, even when glycemic benefits are not immediately apparent.
Larger, adequately powered studies are needed to determine whether these dietary and anthropometric improvements translate into meaningful improvements in HbA1c, cardiometabolic outcomes, and long-term diabetes management.
Summary of Conclusion/Findings
This randomized controlled pilot trial evaluated a 3-month produce prescription (PRx) program among 35 adults with type 2 diabetes and low socioeconomic status in Rotterdam, Netherlands, making it the first European RCT of a PRx intervention in this population. Participants in the intervention group received weekly plant-based food boxes, cooking workshops, nutrition education, and dietitian support, with high adherence (91% of food boxes collected) and strong satisfaction ratings (4.3-4.7 out of 5 across program components). Compared with usual care, the PRx group had significantly greater increases in vegetable intake (mean difference [MD] 85.2 g/day, 95% CI 3.2 to 167.1) and fruit intake (MD 142.8 g/day, 95% CI 8.0 to 277.7) after 3 months, along with improvements in physical quality of life (MD 7.1 points, 95% CI 0.4 to 13.8). Exploratory analyses also favored the PRx group for weight and body mass index (BMI), with several dietary and anthropometric improvements appearing to persist through 6-month follow-up. However, no clear between-group differences were observed for hemoglobin A1c (HbA1c), fasting glucose, lipids, blood pressure, or other glycemic outcomes.