Tighter Integration with Clinical Care may be Needed to Improve Health Outcomes for Clients with Diabetes
Feeding America, the nation’s largest hunger-relief organization with 200 member food banks, concluded a two-year, randomized controlled research trial to help low-income Americans better manage and control type 2 diabetes. The study, which was recently published in the American Journal of Public Health, concluded that food banks can significantly improve food security and dietary intake for people served. After six months, study participants in the intervention group had significant improvements in food security, fruit and vegetable intake, food stability, and tradeoffs between food and diabetes management supplies.
The clinical trial—named the Feeding America Intervention Trial for Health—Diabetes Mellitus (FAITH-DM)—took place between 2015 and 2017 at three Feeding America member food banks: the Houston Food Bank in Texas, The Alameda County Community Food Bank in Oakland, California and Gleaner’s Community Food Bank of Southeastern Michigan in Detroit. Feeding America partnered with the Center for Vulnerable Populations at the University of California, San Francisco (UCSF), and the Urban Institute to conduct the trial.
The goal of the trial was to determine the effectiveness of a food bank-based intervention in improving blood sugar control and other outcomes for clients living with uncontrolled type 2 diabetes. Although there were no significant differences in clinical outcomes related to diabetes between the two groups at six months, there was one exception: intervention group participants who fully engaged in all project components did experience significant improvements in HbA1c (a measure of long-term blood sugar control) levels compared to less engaged participants.
“The results of FAITH-DM reinforce Feeding America’s strategic focus on increasing access to nutritious foods and improving diet quality for the people we serve,” said Carol Medlin, Chief Impact Officer at Feeding America. “With a network of 200 food banks across the country, we are in a unique position to address hunger and improve the health and well-being of the 46 million people who turn to us for help.”
Dr. Hilary Seligman, senior medical advisor at Feeding America and associate professor of medicine at UCSF, was the Principal Investigator for the study. Dr. Seligman is one of the nation’s foremost experts on the health implications of food insecurity. Her work focuses on the intersection between food insecurity and health, particularly on the prevention and management of chronic disease.
“This is the first rigorously conducted study of which we are aware that demonstrates food banks improve food security,” said Dr. Seligman. “But in order to also improve health outcomes for people facing food insecurity, we need to better integrate the work of food banks, healthcare, and other organizations addressing social health determinants. Feeding America is committed to developing those partnerships and the evidence for what is effective.”
More than 30 million Americans have diabetes and research shows that individuals who are low income and food insecure have an increased risk of developing diet-sensitive chronic diseases, like type 2 diabetes, and are at higher risk for poor management of these chronic diseases. Moreover, Feeding America’s report Hunger in America 2014 found that a third of households that receive assistance from food banks had at least one member with diabetes.
The trial builds on the results from a previous observational study conducted by Feeding America between 2011 and 2014. The findings of that study were published in the November 2015 issue of Health Affairs.
The components of the six-month FAITH-DM intervention were:
- Screening adults at community food distributions for diabetes and monitoring of blood sugar control
- Distributing diabetes-appropriate food, amounting to enough food to meet approximately 25% of a household’s monthly food needs
- Referring clients who lacked a usual source of medical care to local primary care providers
- Providing formal diabetes self-management education and support
Funding for the trial was provided by Feeding America, the Laura and John Arnold Foundation, the Urban Institute via a Robert Wood Johnson Foundation grant, National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, and Centers for Disease Control and Prevention.
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About Feeding America
Feeding America® is the largest hunger-relief organization in the United States. Through a network of 200 food banks and 60,000 food pantries and meal programs, we provide meals to more than 40 million people each year. Feeding America also supports programs that prevent food waste and improve food security among the people we serve; educates the public about the problem of hunger; and advocates for legislation that protects people from going hungry. Visit www.feedingamerica.org, find us on Facebook or follow us on Twitter.