Study seeks to understand the impact of food insecurity on our health

"Let food be thy medicine and medicine be thy food." — Hippocrates

This astute statement made more than 2,000 years ago by the founder of modern medicine has been proven through research. We now know that healthy eating can help prevent and treat chronic diseases, such as heart disease and diabetes.

But for some Canadians, there can be financial barriers to accessing the recommended amount of healthy food, putting them at higher risk of these deadly diseases. UCalgary researcher and dietitian Dr. Dana Olstad, PhD, says food insecurity is one of the biggest barriers to good health.

“Healthy foods, like fruit and vegetables, often cost more than less healthy choices. So families who are food insecure often end up having really poor diets,” says Olstad, an assistant professor in the Department of Community Health Sciences at the Cumming School of Medicine (CSM) and a member of the Libin Cardiovascular Institute and the O’Brien Institute for Public Health.

According to Household Food Insecurity in Canada 2017-2018, a report published at the University of Toronto, almost 13 per cent of Canadian households experience food insecurity each year, making healthy diets out of reach for 4.4 million Canadians. Some groups, such as patients with Type 2 diabetes, are at particular risk when they have a poor diet.

“Food insecurity can be life-threatening for people with Type 2 diabetes because they need to eat healthy foods to control their blood sugars,” says Olstad. “If they can’t afford those foods, they will require more health-care interventions.”

These interventions can be costly. Type 2 diabetes costs the Alberta health care system $2.7 billion per year. Olstad says ensuring individuals with Type 2 diabetes can obtain healthy food will improve their health and may save the Alberta health-care system up to $25 million per year.

Study looks at healthy food 'prescription'

She and fellow UCalgary researchers Dr. David Campbell, MD, PhD, a diabetes specialist and researcher, Dr. Eldon Spackman, PhD, a health economist, and Dr. Reed Beall, PhD, a population health researcher, are teaming up to make a difference for food insecure Albertans. Their study will examine whether a subsidized healthy food prescription program can improve glycemic control and reduce health-care costs for this patient group. The team recently received funding from Alberta Blue Cross and through PRIHS, Partnership for Research and Innovation in the Health System, which is a grant program administered by Alberta Innovates and Alberta Health Services.

The study will involve 400 participants with Type 2 diabetes from several rural and urban communities in Alberta who are also food insecure. Participants will receive information about healthy eating, (a healthy food prescription), and half will also receive a subsidy of $45 per month for each household member for six months. They will be able to choose and purchase healthy foods at supermarkets. Previous research has shown subsidies as small as $3.65 per month can significantly improve diet quality and improve blood sugar levels and other measures of health.

Researchers will monitor patients, measuring their blood sugar levels, blood pressure and other clinical results, to study the impact of the program on short and longer-term health and health-care costs.

“Normally we wait for people to get sick and treat them in the health-care system, but we want to eliminate food insecurity in the first place,” says Olstad. “This is a small amount of money to invest to stop people from needing to access health-care services.”

Olstad is excited about the study, noting it is the first of its kind in Canada. It requires numerous partnerships, including with local supermarkets and primary health clinics, who will help identify those eligible for participation.

“The subsidized healthy food prescription program will mobilize and unite multiple sectors to improve the health of the participants, bridging primary care, population health, social services and industry,” says Olstad. “The benefits will extend to all household members, including children.”

Recruitment for this study will begin in the new year.

David Campbell is an assistant professor in the Departments of Medicine, Community Health Sciences and Cardiac Sciences at the CSM and a member of the O'Brien Institute for Public Health and Libin Cardiovascular Institute.

Reed Beall is an assistant professor in the Department of Community Health Sciences at the CSM and a member of the O'Brien Institute for Public Health.

Eldon Spackman is an associate professor in the Department of Community Health Sciences at the CSM and a member of the O'Brien Institute for Public Health.