Do food-is-medicine programs work long term? Study links weekly groceries to lower blood pressure

Adults who received weekly plant-based grocery packages through a community health center's food pantry for nearly three years saw reductions in diastolic blood pressure, body weight and body mass index that grew larger the more packages they received, according to a new study led by Mass General Brigham researchers.

The study, published in Preventing Chronic Disease, analyzed before-and-after health data from 68 adults who received an average of 97 food packages over an average of 2.7 years through the food pantry at Mass General Brigham Revere Community Health Center in Revere, Massachusetts.

Researchers estimated that every 100 food packages received was associated with a 3.21 mmHg reduction in diastolic blood pressure, a 2.6 kg reduction in weight and a 1.04 kg/m2 reduction in BMI.

The findings address a gap in the evidence for food is medicine programs, which have mostly been studied over weeks to months rather than years, according to the researchers.

"Our results suggest that plant-based food interventions are promising and, in the future, should focus on longer duration for improving cardiovascular and metabolic health," said senior author Lauren Fiechtner, MD, MPH, division chief of pediatric gastroenterology, hepatology and nutrition at Mass General Brigham for Children and senior health and research advisor at the Greater Boston Food Bank.

Blood pressure gains, but no change in A1c

Among participants with elevated blood pressure at baseline, the program was also associated with reductions in systolic blood pressure. However, researchers found no significant improvements in hemoglobin A1c across participants.

Because the analysis compared participants' health measures before and after they began receiving food, the findings reflect associations between the number of packages received and changes in health outcomes rather than proof of cause and effect.

How the program worked

The food packages were designed by a dietitian based on the USDA 2020 Dietary Guidelines and included fresh fruits and vegetables, canned beans, nut butter and whole grains sourced from the Greater Boston Food Bank and other food access organizations.

Each package contained enough food for three meals per day for each household member for one week. Patients were invited to receive the packages weekly with no end date.

The study is tied to a longstanding collaboration between the Revere health center and the Greater Boston Food Bank, which has provided nearly 379,000 pounds of food to the clinic so far this year, according to Mass General Brigham.

"This paper has the potential to change the conversation about Food Is Medicine interventions," said first author Jacob Mirsky, MD, MA, a primary care physician at Mass General Brigham Revere Community Health Center and medical director for the food pantry. "We are boldly advocating for high potency interventions that focus on frequent, high quality, high quantity food packages over long periods of time so that patients have the greatest chance of benefiting."

Food is medicine moves closer to the exam room

Food is medicine programs, an umbrella term that typically includes produce prescriptions, medically tailored groceries and medically tailored meals, have drawn growing interest from health systems, payers and policymakers as a way to address diet-related chronic disease and food insecurity at the same time.

Much of that interest centers on primary care, where physicians are often the first to identify patients struggling with hypertension, obesity or type 2 diabetes alongside barriers to affording healthy food. Many practices now screen patients for food insecurity and other social needs as part of routine visits, and some health systems have built on-site pantries or referral partnerships with local food banks to close the loop after a positive screen.

A recurring challenge has been the evidence base. Many existing studies of food-based interventions have been small, short in duration or lacking comparison groups, making it difficult to show payers that the programs produce durable clinical benefits worth reimbursing. Researchers and advocates have called for longer, more rigorous trials that measure hard clinical endpoints and identify which program designs — including how much food is provided and for how long — produce meaningful results.

That question of dose and duration is increasingly important as states and insurers experiment with covering food-based interventions. Program designs vary widely, from short-term vouchers to months of home-delivered meals, and there is little consensus on what intensity is needed to move clinical measures such as blood pressure or weight.

For practicing physicians, the growing body of research reinforces the role of nutrition in managing cardiometabolic disease, while also highlighting practical questions about how to connect patients with sustained access to healthy food rather than one-time assistance.