Doctors write a prescription for fresh produce
July 23rd, 2012
10:00 AM ET
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Bad cholesterol, depression, high blood pressure; these are all conditions that often prompt a trip to the pharmacy. But now, physicians are administering a different treatment entirely: produce. Doctors at select clinics across the country are writing some obese patients "prescriptions" for fruits and vegetables.

The Fruit and Vegetable Prescription Program provides daily $1 subsidies to buy produce at local farmers markets. FVRx, as it is also known, is funded through Wholesome Wave, a non-profit organization which operates from private donations. Each member of a family gets the $1 prescription so, for example, a family of five would end up getting $35 per week to spend on fresh fruits and vegetables.

Janet Lopez is a cashier at a sporting goods store and lives in Washington, D.C. with her two children, brother and mother. She and her family are part of the Unity Health Care clinic's prescription program and have been buying the subsidized produce since May. She said they all have been eating more fruits and vegetables because of the program.

“It is an encouragement because now I actually see that my kids love all of this stuff and before I couldn’t get it because it wasn’t cheap. Not only that but I also didn’t know how healthy it actually is,” Lopez said.

In addition to subsidies, FVRx has patients meet with their physicians to check up on their health including their height, weight, blood pressure and body mass index. The program also offers exercise and cooking classes.

“A lot of kids are picking up on how to eat vegetables and realizing they’re not actually yucky, it’s actually, ‘Oh, it’s delicious,’ because they’re learning to cook it themselves,” Lopez said.

And organizers said they use this family oriented approach because even if the whole family isn’t obese, they don’t want one member of the family eating fruits and vegetables while the rest just keep eating junk.

“When we look at these types of health interventions they’re really most successful if the entire family can make a lifestyle change rather than cherry picking who in the family can eat more fruits and vegetables while the rest of the people sit at the table and eat instant rice with a can of condensed soup stirred in,” said Michel Nischan, CEO of Wholesome Wave.

The program exists at twelve sites in seven states and the District of Columbia. It started in 2010 and has already helped over 1000 people buy healthier food.

The program targets areas where fresh produce may not be readily available or is too expensive for impoverished families. The high price ends up being a double bind; people don’t buy the produce because the price is so high and stores don’t buy large quantities of produce because people don’t buy as much, thus increasing the price.

“Fruit and vegetable producers don’t receive any subsidies right now. It’s corn, cotton, rice, wheat and soy. So fruits and vegetables, the things we’re supposed to be eating five servings a day of are the foods that receive little to no government support,” Nischan said.

Nischan said this program ultimately produces a savings for the health care system because he believes if people eat more healthily, they’re less likely to suffer from chronic conditions. Healthy food costs less than the medicine and treatment they would require in the future.

“If you advise somebody to change to see a nutritionist to change their diet, they skip the nutritionist visit. You don’t see them again for two years until their feet hurt really bad and they’ve been vomiting for three weeks and they can’t understand because they don’t have the flu and they go back to find they have Type-II Diabetes for over a year,” Nischan said. “Now we can give them free drugs because our society won’t allow someone to die (but) the drugs are more expensive than the food.”

Though the program in D.C. is new, people like Lopez are already noticing a difference in their lives. "I feel more energetic," she said. "I don’t feel as tired anymore and I see the same thing in my kids.”

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  5. John Smith

    This issue is generally controlled by employers. Employers set short work breaks so its often junk or fast food or nothing at all during work. Long hours also eat into meal preparation time outside work. So US diet (and what restaurant serve) and lack of exercise all stem from employers demand for time. If we elect healthcare providers are lawmakers – maybe we will get those laws for 4 on + 2 of + 4 off work day with CRIMINAL enforcement directly on management.

    They could also require cities planning to include gym-restaurant complex near major employers and downtown such that you could order healthy food – exercise while its prepared – eat and return to work. Heh 2 lunches would also require mandatory staggered start and end times for work days unless the whole town shuts down for 2 hours.

    Until then most the people enjoying healthy eating for more than brief periods are very privileged folk. Often they are spending $$$ for restaurant food available only if you live in the right health conscious neighborhoods/cities like SF. Or somehow someone in the family has 4-8 hours a day to prepare 3 meals per day from fresh materials.

    March 9, 2013 at 4:18 am |
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    August 5, 2012 at 12:56 am |
  7. ldean50

    Hurray. seven dollars a week for each individual will get them 3 avacados. That'll fix it.

    July 24, 2012 at 1:01 pm |
    • Sanchit

      Actually, A pound of carrots is about 0.78, a head of lettuce is approximately 1.00, Cucumbers are often 0.33 each (3 for 1.00) and tomatoes are about .79 for a pound. (That would be 2.90 to make salad that would be able to feed at least four for .72) Most consumers are not smart about using their food dollar and do not understand how to identify the healthier, less expensive food items. The problem is most people want convenience and do not want or know how to prepare healthier foods.

      July 25, 2012 at 10:41 am |
  8. Shannon Underwood


    July 24, 2012 at 12:30 pm |
  9. Sanchit

    I am a Registered Dietitian in a hospital, I work with obese patients, people with Diabetes, High Blood Pressure, Cholesterol issues, daily. I can tell you first hand, over the 25 years I have worked in this community, there is definately a need for programs like this and those who are most ill and in need would be well-served by such a program. I advise patients to eat more fruits and vegetable and ask them to include them daily. I can say that cost is definately a factor for most of them. On the opposite side of the spectrum, as Food Service Director, I am responsible for menu planning and supervising meal prep for our cafeteria and patients. We adopted a 'lower fat' menu in 2010 and though employees were initially very opposed, they have adapted to the changes and we are selling out of salad bar, healthy vegetables and lower fat options. I have had several employees advise me that they have lost weight or improved their blood sugars while eating two meals a day with us. Food is a very personal decision and nobody wants to be told what to eat. But, if consumers do not become more aware of their health on their own , our health care system will really be in trouble trying to deal with multiple health issues of those who refuse to change their diet.

    July 24, 2012 at 12:08 pm |
  10. Hypatia

    Yeah, but buying the produce they 'prescribe' will cost 250% more than normal, with 245% of that going into the insurance companies pockets.

    July 24, 2012 at 11:42 am |
  11. Barbara

    For those who say they eat healthy (fruits and veggies) but are not losing weight...then it is portion sizes... I can not eat most fruit or veggies because I need to be on a low fiber diet. You would think I would gain weight! But I have lost weight and I didn't really need to. I eat every two hours a fistful of food. Now I do cook which limits the amount of processed food but portion control is the solution. Read the Portion Teller.

    July 24, 2012 at 10:20 am |
    • Tom, Tom, The Piper's Son

      100% correct

      July 24, 2012 at 10:49 am |
    • Lee

      lol @ 36% claiming healthy eating habits... :rolleyes:

      July 24, 2012 at 10:53 am |
  12. awildsuccess

    lots of awesome posts here. I just finished speaking at the annual North American Vegetarian Society conference – there are some MDs coming onto the bandwagon and, yes, subsidizing is a step in the right direction. What I see in my practice is that few people are willing to really face their emotions – easier to stuff the feelings and stuff their face. I did it for most my life, so speak from experience.

    Changed my habits, released 55 lbs, anger, depression, debilitating arthritis. Now I teach yoga (MDs thought my spine would fuse into one piece) and coach others to transform their lives.

    It's about choices and habits and mindset.

    July 24, 2012 at 10:13 am |
    • Tom, Tom, The Piper's Son

      >It's about choices and habits and mindset.<

      Agreed, however it has nothing to do with being a veg-head.

      July 24, 2012 at 10:41 am |
  13. Smarter Than You

    Here's the thing:

    Last year I was 39, 5'4" and 225 lbs. I was working my way toward diabetes like many. I rarely ate healthy...mostly processed foods like most Americans today. I used to say that eating healthy is out of my price-range. Then I switched to a plant-based diet last October. Not only did I lose 70 lbs., but I now have a clean bill of health, AND MY GROCERY BILL HAS BEEN CUT IN HALF.
    Yes, that's right....EATING HEALTHY IS CHEAPER THAN EATING CRAP. I have the receipts to prove it.
    Now, I know all you combatants out there are going to tell me that my bill was smaller because I stopped buying expensive, chemically-injected, processed meats. All I'll say is this: Isn't that what we're talking about is eating healthier?
    Also, to those who are going to wonder where the protein comes from now: research "vegetables with protein"'ll notice almost all veggies contain protein. Go figure.

    July 24, 2012 at 7:02 am |
    • awildsuccess

      SMARTERTHANYOU – I'd love to talk to you – I lecture about changing to a plant-based diet and lack hard evidence that it's cheaper – this would help so many people – happy to keep it anonymous, if you prefer. Please contact me sharon at wildsuccess dot us ~ thanks!

      July 24, 2012 at 9:56 am |
    • Tom, Tom, The Piper's Son

      @Smarter Than You
      Actually.. eating heather is only cheaper if your diet consisted primarily of fast food (eating out) and it’s exaggerated prices prior to your change in diet. Secondly there are different types of protein and while it is possible to live solely on a plant based diet, it ether nether optimum or efficient. Your weight losslikely had as much to do with a change in mind set as anything else. I and many, many others are not veg-heads and SHOCK are not disgustingly obese slugs. There is much more to health than just eating veggies. You also have to be active and watch portion sizes. I’m glad it worked for you.. but you are just as ignorant as you used to be.

      July 24, 2012 at 10:49 am |
    • Scott Harrington

      For Smarter Than You - plant based can be cheap - especially if you include beans and lentils in your diet - I totally agree. To Tom Tom the Pipers Son - the good thing about plant based diets is that you can litterally gorge yourself and see the pounds come off .... Becuase the vegetables are not calorie dense. You just have to watch your oil intake - that is why I prescribe it to my patients.
      Dr. Scott Harrington, board Certified Family Physician

      July 24, 2012 at 12:34 pm |
  14. John La Puma MD (@johnlapuma)

    This sort of program is exactly what is needed for a lot of reasons.

    It offers a beginning, small step solution to people who cannot access fresh produce, for whatever reason.
    It directly equates what you eat with what health conditions you have (and eventually, how you feel because of them). Many people, especially men, don't really believe that.
    And it is chef-driven, and is about flavor too.

    When I was in medical school, I got 4 hours of nutrition education; in cooking school, I got 2 hours.

    Medical students want to learn about cooking (Dr Roizen and I taught the first such US medical school class, in 2003), but the medical school curriculum is a very competitive place. There, like in the farm bill, there is very little money for vegetables. So chefs are, rightfully, filling the gap. And so, I think, will health coaches.

    Food really is the best medicine, but it takes a commitment to a healthy lifestyle to want to use it that way, stay energetic and get well. Kudos to Chef Nischan.

    July 24, 2012 at 12:16 am |
  15. eroteme

    I recently had an appointment with my cardiologist. I checked in at the reception desk, there were three young ladies there, all three 30 to 40 pounds overweight. I sat in the reception area for a while until 'my' cardiologist's nurse came to fetch me. She was about 30 pounds overweight. When I saw 'my' cardiologist he told me I should lose five pounds. Now I ask you, is this fair?

    July 23, 2012 at 7:37 pm |
    • Dr. Phil

      Maybe you should lose 25 lbs. and get a better attitude.

      July 23, 2012 at 7:40 pm |
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        July 24, 2012 at 8:37 am |
      • Yvonne Hunter-Wickens

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        July 24, 2012 at 9:46 am |
      • Hypatia

        j a c k a s s

        July 24, 2012 at 11:43 am |
  16. Ugh

    Every time I read an article that begins with something along the lines of "Overweight people need to include more fruit and vegetables in their diet", I dismiss the article instantly. While I'm sure there are many overweight and obese individuals that eat nothing but processed foods daily, there are many more out there that incoporate lots of raw fruit and veg into their diet. But despite regular exercise and a healthy diet, they are still overweight. And yet no one wants to acknowledge that, for many people, being overweight is due to genetics.

    The majority of people I know that are of healthy weights eat nothing but processed foods, and don't want to go to their doctor because they realize that they probably have diabetes and don't want to be bothered with taking medicine to control it.

    I appreciate this article its opening sentence listing medical conditions that are (usually) directly related to food intake, rather than stating that all overweight people are such due to a diet low in unprocessed foods.

    July 23, 2012 at 6:41 pm |
    • Lynn

      I've heard the genetics excuse at least a thousand times. Amazingly, that one person in the family takes steps to improve their health, really works for it, and suddenly the genetics excuse is down the toilet. It comes down to how bad you want it.

      July 23, 2012 at 11:34 pm |
    • The_Mick

      I'm overweight – though slowly dropping it (30 lbs lost) – and let me tell you about the reason people mistakenly think it's genetics. First of all, note that you cannot gain weight unless you consume more calories than you burn. It's been proven impossible. Secondly, when people get way out of shape, their bodies slow down on the production of fat handling enzymes and transport chemicals. Consequently, when they do exercise, they burn almost totally carbs. It takes weeks of regular exercise to reverse that situation and get the fat handling body biochemistry back in action. Any diets that claim more than a couple pounds per week loss are counting on your body losing so of the extra water that often occurs during a change in diet.

      July 24, 2012 at 1:17 am |
    • Smarter Than You

      Hey Ugh –
      So, back in the early 1900's up to about the 50's, when the vast majority of Americans were in great physical shape and the few who were obese were likely seniors who lost motivation to live healthy....until the 60's when more processed "food" began to be marketed, was it genetics then too? There is no evidence to support your theory. In the 1920's, the average American diet contained about 80% fresh vegetables. There was no obesity epidemic then. Nowadays it's more like 10-20% vegetables at best – rarely fresh, about 50% animal protien, and virtually entirely processed. Still think it's genetics? You keep telling yourself that.

      July 24, 2012 at 6:45 am |
    • Shannon Underwood

      It's all a delicate balance. I come from a family of people with weight issues. I could sit back accept it and blame it on genetics...Instead I incorporate self responsibility, and determination to succeed. I changed the things I eat and move more. While I am still over weight, I have lost 82lbs and will continue my journey to a fit healthy body. I will not surrender to the genetic bulge. It sounds to me like you have a sensitivity to the subject of weight, take charge of your body, be the leader of your body and show it the path to success. I wish you success and good health.

      July 24, 2012 at 1:33 pm |
  17. eroteme

    How about doing away with our present food stamps and replace them with vegetable/fruit stamps. People now on food stamps would howl along with many others.

    July 23, 2012 at 4:27 pm |
  18. Anne

    I recently told my dr that I am going to control my cholesterol through diet. He is skeptical. I don't have the test results yet but am more engergetic and have lost weight. My experience with medical professionals is that they are often not up on more natural remedies and nutrition.

    July 23, 2012 at 3:03 pm |
    • Howard

      They're up on the latest health trends. They just don't want to lose patients.

      July 23, 2012 at 3:50 pm |
    • HMG-CoA

      That is because your version of high cholesterol may not be fully diet related, but related to your specific cholesterol synthesis homeostasis as genetically predetermined. Good luck with your clinical trial, if you do not obtain the desired results maybe then listen to your doctor

      July 23, 2012 at 4:16 pm |
    • Regina

      You are right! Also, raising your HDL (over 59) and as much as possible thereafter through good nutrition, offsets total high cholesterol, which often runs in families.

      July 23, 2012 at 4:48 pm |
  19. Veggie Lover

    This is a great idea! It's time more physicans get on the plant-eating wagon. An ounce of prevention, y'all!

    July 23, 2012 at 2:14 pm |
  20. Taxpayer

    I am sick of the "poor" working the system. When will you help the people who pay for all these programs? Get real. You can't make people care and you can't make people be healthy. They have to have a desire to actually make a change. Programs like this only benefit a few and those who take advantage of the system.
    It is a joke saying that healthy food is too expensive. Have you ever heard of a shopping the weekly sales. When the products are in season they are cheap. So buy up and freeze or can. How do you think the pioneers lived? They would plan ahead and store up for the winter. And stop shopping at farmers markets. Most are nothing but a joke. They buy older product from stores and then mark up the price to sell you in a parking lot. Shop around, start price matching, start watching the ads. Take responsibility for your own actions and quit depending on the government to give it all to you.

    July 23, 2012 at 1:17 pm |
    • JellyBean

      It says the program is funded from "Wholesome Wave, a non-profit organization which operates from private donations."

      July 23, 2012 at 1:24 pm |
    • student

      I can understand where your frustration comes from, but you'd have to be foolish to say 'healthy food' isn't too expensive. It is certainly more expensive than shopping for the processed foods they throw in your face at every grocery store. The bottom line is you can stretch your dollars much further on the processed foods versus the produce and organic options. Canned foods are cheap, but most are packed with enough sodium to equal out to a total days intake. It's all about education. You can choose how our money can be spent-on these programs that offer a small stipend for fresh produce, or on their medical bills and medications that will stem from a poor diet.

      July 23, 2012 at 2:15 pm |
    • amber

      any farmers market i've ever been to has fresh locally produced goods. there may be some "resellers" but to tell someone to skip the farmers market entirely makes your whole post void in my opinion. if you live in the midwest like I do and you see a table full of bananas and peaches at the farmers market, realize they are "resellers" and ask them what they can do if you buy a flat or case of some produce that looks good. I regularly buy pears, mangoes, etc for pennies on the dollar and freeze, can, or share with family and friends.

      July 23, 2012 at 7:58 pm |
    • Ludwig

      Taxpayer, I'm not sure where you live but in my area the farmers markets all have local farmers selling their own produce. Occasionally they will bring in items like peaches from the south or berries from the north, but in general everything is grown right here. The prices are competitive and the quality beats most of the supermarket stuff hands down. I agree that eating healthy is not expensive, but many people come from backgrounds where they have never been exposed to good eating habits or good quality produce. I would much rather spend my tax dollars on preventative things like this than pay for emergency room visits down the line.

      July 23, 2012 at 11:57 pm |
    • Jennifer Haydu

      Wow Taxpayer! You sure sound like one angry and frustrated human! Remember that no matter how healthy you eat, if you walk around every day pumping all those stress hormones through your system, you will end up with disease and ill health anyway.
      Now, if you slow down and review the article about the produce prescription program, you may notice that it is NOT funded by taxpayer dollars, but by private donations. Pay attention. So you can rest assured that it is not your money being spent. Rather this is a program funded by people in the community, freely offering to help others get access to fresh food, and develop new lifestyle habits. Like you said, no one can force you to be healthy (or generous, compassionate, etc) but you can be educated and offered different choices through community support. The government is not giving anything to "poor" people in this program. This is about communities taking responsibility for each other, not just looking out for themselves.
      As for your tirade about Farmers Markets, I must ask what markets you are referring to? In my community on the central coast of California, we have several Farmers Markets that I frequent. I happen to know several of the Farmers personally, and i have visited many of their farms. I know first hand how hard they and their staff work to produce their crops, and what it takes to get them to the markets. Maybe you have a few poorly run markets in your area, (and I know of a few myself) but to make those sweeping statements about Farmers Markets in general just illustrates ignorance. Perhaps traveling outside your bubble to connect with some of the hard working farmers who depend on these markets for their livelihood would shift your view.
      Taking personal responsibility includes educating yourself about where your food comes from, who and how it is grown, how it affects the land, and how your consumption patterns feed into that cycle. It is a little more complex than looking for sales and stocking up.
      Remember too that changing patterns takes time and support. It is more than simple individual choices. To pretend that larger systems related to taxes, urban sprawl, subsidies, agribusiness etc don't affect how people eat is naive at best. Giving people some modest funding to buy fresh produce is ONE drop in a what needs to be a waterfall, but it contributes to a larger shift in creating sustainable food systems and healthy, compassionate, connected communities.
      Some day, when you are in trouble, in need of help, and someone reaches out to you, I hope you will be humbled, and gracefully accept the help.

      July 24, 2012 at 2:45 am |
      • Shannon Underwood

        Thank You for your words. It is nice to hear a voice of reason ring clear. I was beginning to think people had turned cold heartless and selfish. I'm so glad we share the same planet

        July 24, 2012 at 1:01 pm |
    • Shannon Underwood

      Hey Taxpayer or is it Tightwad, hold that money a little closer to your heart. Take it with you in your coffin and see if you can buy your way into Heaven. What good does your money do you if your heart is filled with anger and hatred. Maybe some good nutrician would improve your outlook. I realize there will always be a few people who take advantage, but there are many who work and only suppliment their income with food stamps. and when their situation improves they become self sufficiant. It's people like you who stink up the world with your bitterness. Grow some compassion, will you?

      July 24, 2012 at 12:53 pm |
  21. a slozomby

    i dont think the fda has authorized vegetables for that use.

    July 23, 2012 at 12:24 pm |
    • amy

      Hahaha good one!!!!

      July 23, 2012 at 4:17 pm |
  22. Hypatia

    Meanwhile, while doctors keep adjusting their halos, has anyone ever taken the time to check out what they're serving in hospitals. Disgusting!

    July 23, 2012 at 11:19 am |
    • lwg

      Yes, but it's not really the doctor's fault. I had two operations last year (knee and hip replacements), and was appalled by the high fat, high salt, low veggie meals I was served the first two days. So I talked to a hospital nutritionist about it, and learned a couple of things. First, green veggies contain a lot of vitamin K, which interferes with blood thinners (often given after surgery to avoid blood clots). So they are out. Second, with some exceptions, they really want patients to eat (this isn't the time to go on a limited calorie diet), and so they serve what they think people eat at home. I also learned that I could order "off the menu," so had a lot of chicken sandwiches on whole wheat along with lots of fruit.

      July 23, 2012 at 12:04 pm |
    • Phange

      Doctors have about as much say as to what hospitals serve for food as you have a say in what vacation your company's CEO takes.

      July 23, 2012 at 12:15 pm |
    • Der

      That's why hospitals don't get 5-star or Michelin ratings genious.

      July 23, 2012 at 12:23 pm |
      • Bean

        I hope you were kidding there, GENIUS.

        July 24, 2012 at 1:12 am |
  23. Dr. B

    @Kristin: the article states that it's $1/day, per family member. So that's $7/week X the number of family members you have. For a family of 5, that's $35 a week.

    July 23, 2012 at 10:31 am |
    • Dr. B

      But I agree with the rest of your statement. :-)

      July 23, 2012 at 10:32 am |
  24. Marion Taylor

    Great article Greg! This program sounds a lot like the city health initiatives aimed at alleviating food deserts, where access to fresh produce is limited, thanks for the read!

    July 23, 2012 at 10:02 am |
  25. Kristin

    That's nice, but in my area $1 would only buy a single tomato or pepper, or maybe 2 apples at the local farmer's market or grocery's an improvement, but definitely not enough. The gov't needs to stop subsidizing corn, wheat and soy and start subsidizing fruits and veggies. That's the only way to make the cost of junk go up and the cost of healthy food go down. There's a reason why the poorest are also the fattest in this country.

    July 23, 2012 at 9:49 am |
    • awildsuccess

      agree with you AND people need to start growing some of their own food. Anybody, anywhere can grow tomatoes and some greens and some sprouts – and these are ridiculously cheap to grow.

      July 24, 2012 at 10:10 am |
      • Irony

        Don't tell me what to do and go p!ss uppa rope.

        July 24, 2012 at 10:40 am |
  26. Sarah

    This sounds Amazing I hope that they come to my area!

    July 23, 2012 at 3:30 am |
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