The Oakland Meals Financial institution examine goals to look at the results of weight loss plan on diabetes
When the cost of his insulin got so high he could no longer afford it, Ben Goss thought he might be able to control his diabetes through diet and exercise.
At 77 years old and with a limited retirement income, he would search several food banks in Oakland for fruits and vegetables and other healthy items every week. But he knew he was not doing well. He became drowsy walking around his neighborhood and had trouble concentrating on finger weaving, a hobby he picked up after he retired.
One day when he went to a grocery bank at Fruitvale BART Station and got a free blood sugar check – a test that would tell him how serious his diabetes had become – Goss immediately accepted.
He wasn’t shocked to find his numbers were alarmingly high. What surprised him, however, was the next offer from the grocery bank employee: Would he like free boxes of healthier groceries for six months?
“Milk, eggs, kiwi. Very nice kiwi, ”said Goss on Friday, remembering the contents of his latest box. “I’m mainly looking for vegetables. You can get good fruit and vegetables at Safeway, but you pay for them. “
The study he participated in and which the Alameda County Community Food Bank was involved in examines whether convenient access to nutritious foods can help improve the health of patients with diabetes. Scientists from UCSF and a handful of other institutions are working with Feeding America, a national network of food banks, on the study in three urban areas, including Oakland.
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Their work reflects a trend of public health researchers focusing on food banks and similar organizations. What they are studying is the concept of food as medicine – that healthy eating and easy access to nutritious foods are critical components in maintaining overall health.
“Diet is really a cornerstone of diabetes management,” said Dr. Hilary Seligman, a food insecurity and health expert who works at UCSF and San Francisco General Hospital, and leads the study at the Alameda County Food Bank.
“I can spend 15 minutes of a 15-minute visit on good nutritional advice and I will feel very good,” she said. “But if this patient leaves and has no money to do the things I asked him to do, I’ve wasted my time and your time.”
A collaboration between food banks and traditional health clinics makes sense, said Seligman. Food banks could be an important entry point for improving health in low-income communities, which often suffer disproportionately from diseases such as diabetes and heart problems.
Leah Millis / The Chronicle
Research has shown that food insecurity – inconsistent access to enough healthy food – leads to poorer health outcomes in many diseases. The reasons go beyond the simple benefits of good nutrition: people who are unsure can prioritize food over prescription medication, meaning they’ll skip blood pressure medication or insulin to keep the fridge stocked until the end of the month. Hunger also increases stress, which can lead to problems of its own.
A UCSF study found that people with HIV struggling with hunger do not take their medications as consistently and tend to have higher viral loads, meaning there are more viruses in the blood than people who have easy access to food. They are more likely to need to visit the emergency room or be hospitalized.
Helping these patients by giving them nutritious food seems like an obvious way to improve their health, but there is actually little scientific evidence. That’s why studies like that of the Alameda County Food Bank and others across the Bay Area are needed, researchers say.
“You feel good about it, you see people’s faces light up,” said Mark Ryle, executive director of Project Open Hand, which has provided free meals and groceries to people living with HIV for 31 years. “But while we knew in our hearts that we were making a difference, the data might say it was very marginal.”
In 2014, Project Open Hand started a study with UCSF scientists to prove that what they were doing not only felt good, but produced objective, low-cost results. The agency provided 100 percent daily nutritional needs to about 60 people with HIV, diabetes, or both. The results of the study will be released in the coming months, but the scientists say they saw improvements in drug adherence and other health behaviors.
Anecdotally, the study appeared to reduce stress related to food insecurity.
Leah Millis / The Chronicle
“Several customers had only eaten one meal a day. They were so happy to eat three or more times a day, ”said Kim Madsen, director of nutrition at Project Open Hand. “I’ve heard several times, ‘Can this be a lifelong study? ‘
“It was really hard to finish,” she added. The Open Hand project finally started a second, larger study that is currently being carried out.
The Alameda County study is still taking part with the hope that by the end of this month about 150 people will be enrolled in the East Bay and about 540 people nationwide.
In the study, participants are given a box of products and staple groceries every other week that are supposed to provide about a quarter of the groceries for their household. The boxes, assembled at the Alameda County Community Food Bank’s main office near Oakland Airport, contain groceries tailored to meet the needs of diabetics with an emphasis on seasonal fruits and vegetables.
For a week, these were kale, tomatoes, cauliflower, nectarines and oranges as well as oatmeal, sugar-free pasta sauces, ground chicken and basics such as whole grain bread and cooking oils. Participants will also receive recipes to help them prepare items they may be less familiar with.
The study is divided into two arms: both groups receive the boxes for six months, but one group also has access to courses in topics such as nutrition, diabetes control, and stress relief. All participants have their blood sugar levels recorded at regular intervals and are monitored for a year after they stop eating.
“We see this (study) as a natural extension of who we are and what we want to be in the community and what role we want to play in preventing hunger,” said Kate Cheyne, the food bank’s research manager.
“We know that a lot of people struggle each month and make difficult decisions about food, rent, supplies, and medicine,” she said. “People were very grateful that this food was available and wondered what we were up to in the future.”
Goss isn’t worried about losing his box after graduation, although it was a great convenience, he said.
Before joining the study, he sometimes had to visit two or three grocery banks in the East Bay to get the products he needed, and he still complemented the items with trips to grocery stores. When the study ends, he’ll have to reconfigure his budget to buy milk, brown rice, and other healthy foods.
At least his insulin is done for now. He switched health care to the Veterans Benefits Administration, which covers his drug bills. Since his diabetes is treated much better, he feels more inspired to eat well and take care of himself, he said. He has also resumed his finger weaving.
“I can concentrate again,” said Goss one afternoon. His fingers curled around the brightly colored thread as he sat in the Alameda County grocery bank office, waiting for his box of produce. He hoped there were sweet potatoes.
“My wife doesn’t like her,” he said. “But I can do a lot with sweet potatoes.”
Erin Allday is a contributor to the San Francisco Chronicle. Email: [email protected] Twitter: @erinallday