I feel like I’m being a bit of a stick in the mud, but I’m not sure that I’m onboard with this new fruit and vegetable prescription initiative in New York. Naturally, I’m all for people consuming more fruits and vegetables. I’m just not sure that this is the way to go about getting people to eat more fruit and veg. Nor am I convinced that this is the ideal way to target people.
Doctors are giving out vouchers for fresh produce at a hospital in an area that has a high level of poverty and a low-level of fresh produce consumption (according to the article I linked to, as many as 5 out of 10 people in the area consume no fruit or vegetables in a given day!). These doctors are giving the vouchers to obese patients as they are at greater risk of developing diseases such as type 2 diabetes, cardiovascular disease, and certain cancers. The theory is that this will prevent the development of many of these diseases in these individuals. This is where I see the first problems with this strategy. In an area that is highly impoverished it seems unfair to give these vouchers solely to obese patients. Surely there is a high level of malnutrition amongst the normal, over-, and under-weight population as well considering the fact that insufficient income is the number one factor contributing to food insecurity. Wouldn’t it be better to give these vouchers out to all patients, or at least those earning less than a predetermined income level? Weight is not the best barometer of health and I’m fairly certain that people at all weights and income levels could do with eating more vegetables.
Another concern of mine is that many people won’t have the means, ability, or inclination to prepare fresh produce. Similar to the saying, you can lead a horse to water but you can’t make him drink. It’s all fine and well to tell people “go, get yourselves some fresh vegetables”. It’s another thing entirely for them to actually procure the vegetables and then prepare them in a healthy manner. Anyone who’s ever worked in a food bank can tell you that clients will often pass over fresh produce (there can be a number of reasons for this but it’s often because they’re unfamiliar with the foods and don’t know what to do with them).
My final concern is that this program is likely to have little to no effect on the “obesity epidemic”. Yes, increasing access to fresh nutritious foods is a lovely gesture but it does nothing to combat the obesogenic environment in which we live. We need to overhaul our entire food system and societal structure if we want to make any serious headway with curbing obesity.
This initiative reminds me of the one started in Edmonton by doctors who were (are?) prescribing exercise to their patients. I would still love to see an initiative that saw prescription of dietitian services to patients and not just obese patients. The dietitian could help the patients to figure out ways to improve their dietary habits that would work for them. They could also provide education on nutrition and food preparation and perhaps at this point the patients could be provided with vouchers for fruits and vegetables. It’s obviously not going to put an end to the obesity epidemic but it’s something that could be relatively easily implemented while we fight to change the current food environment.