MIT study looks at a healthy diet's effect on Type 2 diabetes
A new MIT study attempts to determine the value of “food-as-medicine” programs to treat diabetes using improved nutrition.
The study, co-authored by MIT health care economist Joseph Doyle of the MIT Sloan School of Management, tracks participants in a program that provides healthy meals in order to address diabetes and food insecurity at the same time, according to a news release.
The experiment focused on Type 2 diabetes, the most common form, according to the release.
The program involved people with high blood sugar levels, in this case an HbA1c hemoglobin level of 8 or more. Participants in the clinical trial who were given food to make 10 nutritious meals per week saw their hemoglobin A1c levels fall by 1.5 percentage points over six months, according to the release.
Trial participants who were not given any food had their HbA1c levels fall by 1.3 percentage points over the same time; this suggests the program’s relative effects were limited and that providers need to keep refining such interventions, the release said.
“We found that when people gained access to [get food from] the program, their blood sugar did fall, but the control group had an almost identical drop,” Doyle, the Erwin H. Schell Professor of Management at MIT Sloan, said in the release.
Given that these kinds of efforts have barely been studied through clinical trials, Doyle said he does not want one study to be the last word and hopes it spurs more research to find methods that will have a large impact, the release said.
Additionally, programs like this also help people who lack access to healthy food in the first place by dealing with their food insecurity.
“We do know that food insecurity is problematic for people, so addressing that by itself has its own benefits, but we still need to figure out how best to improve health at the same time if it is going to be addressed through the health care system,” Doyle said.
The paper, “The Effect of an Intensive Food-as-Medicine Program on Health and Health Care Use: A Randomized Clinical Trial,” is published in the JAMA Internal Medicine peer-reviewed medical journal.
To conduct the study, researchers partnered with a large health care provider in the mid-Atlantic region that has developed food-as-medicine programs, according to the release. The study took place from 2019 through 2022, with a year of follow-up testing beyond that.
People in the study’s treatment group were given food for 10 healthy meals per week for their families over a six-month period and had opportunities to consult with a nutritionist and nurses as well. Participants from both the treatment and control groups underwent periodic blood testing, the release said.
Adherence to the program was high. Ultimately, however, the reduction in blood sugar levels experienced by people in the treatment group was only marginally bigger than that of people in the control group, according to the release.
Those results leave Doyle and his co-authors seeking to explain why the food intervention didn’t have a bigger relative impact. In the first place, he notes, there could be some basic reversion to the mean in play — some people in the control group with high blood sugar levels were likely to improve even without being enrolled in the program, he said in the release.
“If you examine people on a bad health trajectory, many will naturally improve as they take steps to move away from this danger zone, such as moderate changes in diet and exercise,” Doyle said.
Moreover, because the healthy eating program was developed by a health care provider staying engaged with all the participants, people in the control group may have still benefitted from medical engagement and thus fared better than a control group without such health care access, the release said.
Doyle said he would like to see more research about food-as-medicine programs aiming at diabetes, especially if such programs evolve and try to some different formats and features.
“When you find a particular intervention doesn’t improve blood sugar, we don’t just say, we shouldn’t try at all,” Doyle said in the release. “Our study definitely raises questions and gives us some new answers we haven’t seen before.”
Support for the study came from the Robert Wood Johnson Foundation; the Abdul Latif Jameel Poverty Action Lab (J-PAL); and the MIT Sloan Health Systems Initiative.
