How healthy meal kits helped fight diabetes in one California city

A1C is used to diagnose diabetes. An A1C of 6.5% is considered the threshold for diabetes, according to the U.S. Centers for Disease Control and Prevention; 5.7% to 6.4% is considered pre-diabetic.

Overall, all participants reported a less dramatic drop, from 8.35% to 8.0%. 

Participants also reported improvements in self-managing their diabetes — doing more physical activity, checking blood sugar daily, following diabetes meal plans and going to diabetes education or nutrition classes.

“It helped me be aware of foods I wasn’t accustomed to eating,” said Shane Bailey, a 72-year-old Stockton resident who has had diabetes for about 10 years and participated in the study. “So I learned to eat kale, squash, quinoa … It was very helpful and educational.”

The findings are the latest in what’s called the “food as medicine” movement, the idea that nutrition plays a major role in people’s overall health. Many U.S. cities including San Francisco run programs that provide free or low-cost healthy food, or offer vouchers to buy produce, in efforts to help residents manage common chronic conditions like diabetes and heart disease.

The study’s findings support policies to have health insurers cover “food as medicine” programs, said Maggie Wilkin, director of research and evaluation for the Public Health Institute’s Center for Wellness and Nutrition, who led the study. Such programs include “food prescriptions” and “medically tailored meals,” where people get healthy foods to help manage specific medical conditions.

The study included about 450 adults in Stockton who had been diagnosed with Type 1 and Type 2 diabetes, mostly Type 2, who were patients at a community health clinic in Stockton. Type 2 diabetes used to be known as adult-onset diabetes, but it has become more common in children and teens. It’s linked to physical inactivity, obesity, diet and genes.

Researchers chose Stockton because it has one of the highest rates of diabetes and pre-diabetes in California, with a combined 60% of residents having one or the other. Participants got one free meal kit delivered to their home every other week, for one year. Each delivery contained ingredients to cook one meal valued at about $40, plus additional pantry items like beans, rice and nuts. The boxes came with recipes, and participants could join a Zoom cooking class to learn how to make each meal.