Researchers used computer models to predict what would happen if the U.S. gave free fresh fruits and vegetables to people with diabetes who struggle to afford food. They looked at data from 20 different programs across all 50 states and found that this approach could prevent thousands of heart attacks and strokes while actually saving money for most states’ health systems. In 43 states, the programs would cost less than they save in medical bills. The benefits were biggest in states with more eligible people, like California, while smaller states like Wyoming would still see improvements.

The Quick Take

  • What they studied: Whether giving free fresh produce to people with diabetes and low income would improve their health and save money for the healthcare system
  • Who participated: Computer simulation of 693,000 adults in California down to 7,000 in Wyoming, ages 40-79, who have both diabetes and food insecurity (difficulty affording food). The study used real data from 20 existing produce prescription programs
  • Key finding: Over 10 years, free produce programs could prevent between 9,240 heart attacks and strokes in Texas down to 94 in Alaska, and would save money in 43 out of 50 states. New York could save $345 million while California might spend $155 million more—but still gain health benefits worth the cost
  • What it means for you: If you have diabetes and struggle to buy healthy food, a produce prescription program could help you eat better, control your blood sugar, and reduce your risk of heart disease. For most states, this would actually cost less than treating these diseases later. However, this is a prediction based on computer models, not yet proven in real life across all states

The Research Details

Researchers didn’t run a new experiment. Instead, they used a computer model—think of it like a very detailed video game that simulates what happens to thousands of people over time. They fed the model real information from 20 produce prescription programs that already exist, plus state-by-state data about how many people have diabetes and food insecurity, how much healthcare costs in each state, and how much fresh produce helps control diabetes.

The model predicted outcomes for two time periods: 5 years and 10 years into the future. For each state, they calculated how many heart attacks and strokes could be prevented, how many years of healthy life people would gain, and how much money the healthcare system would save or spend. They also ran the model thousands of times with slightly different numbers each time to see how confident they could be in their predictions.

This type of study is important because it lets researchers predict the real-world impact of a program before spending billions of dollars to implement it everywhere. Since every state is different—with different numbers of eligible people, different healthcare costs, and different insurance systems—this state-by-state approach shows which states would benefit most. It also helps policymakers decide if a program is worth the investment

The study used data from 20 real produce prescription programs, which is a solid foundation. The researchers included uncertainty ranges in their predictions, showing they understand these are estimates, not guarantees. However, this is a computer prediction, not real-world proof. The actual results could differ depending on how well programs are run, how many people actually participate, and whether people stick with eating more produce long-term

What the Results Show

The computer model predicted that over 10 years, produce prescription programs could prevent thousands of cardiovascular events (heart attacks and strokes) across the country. Texas would see the biggest benefit with about 9,240 prevented events, while smaller states like Alaska would see about 94 prevented events. These numbers came with uncertainty ranges—meaning the actual number could be higher or lower.

The programs would also help people live longer, healthier lives. Across all states, people could gain between 92 and 9,990 quality-adjusted life-years (a measure that combines how long you live with how healthy you are during that time). Again, larger states like California would see bigger total benefits than smaller states.

From a money perspective, the results were very positive. In 43 out of 50 states, the programs would actually save money for the healthcare system. New York would save the most—about $345 million over 10 years. Even in the 7 states where programs would cost more money upfront, they would still be considered ‘cost-effective,’ meaning the health benefits gained would be worth the extra spending. All 50 states fell below the $150,000-per-quality-adjusted-life-year threshold that experts consider reasonable value.

The study found important differences based on insurance type. Medicare beneficiaries (people 65+) were most likely to benefit financially from produce programs, followed by Medicaid recipients (lower-income individuals), and then people with private insurance. This makes sense because older adults and lower-income people have more diet-related diseases that produce can help prevent. The same patterns held true when looking at just the 5-year timeframe, suggesting benefits appear relatively quickly

Earlier, smaller studies had shown that produce prescription programs improve diet quality and help control blood sugar in people with diabetes. This research builds on those findings by showing that these individual health improvements could add up to major public health benefits across entire states. It also confirms what researchers suspected: that programs targeting people with both diabetes and food insecurity would be especially valuable, since these people face the biggest health risks and have the most to gain from better nutrition

This study is based on computer predictions, not real-world results. The actual outcomes could differ based on how well programs are implemented, how many eligible people actually enroll, and whether people maintain healthy eating habits long-term. The study assumed that the benefits seen in the 20 programs studied would apply everywhere, but different communities might have different results. Additionally, the model didn’t account for other factors that might affect success, like transportation to stores or cooking skills. The study also focused only on people with both diabetes and food insecurity, so results might not apply to people with diabetes who can afford food

The Bottom Line

If you have diabetes and struggle to afford fresh produce, ask your doctor about produce prescription programs in your area. These programs appear to help control blood sugar and reduce heart disease risk (moderate confidence based on existing program data). For policymakers: the evidence suggests implementing produce prescriptions in all 50 states would likely improve health and save money in most states, making it a reasonable public health investment (moderate-to-high confidence, though based on computer models rather than real-world proof)

This research is most relevant for: (1) Adults with diabetes who have difficulty affording healthy food; (2) State and federal policymakers deciding whether to fund produce prescription programs; (3) Insurance companies (Medicaid, Medicare, private insurers) evaluating coverage; (4) Healthcare providers treating patients with diabetes and food insecurity. People with diabetes who can afford fresh produce may still benefit from these programs, but the study specifically looked at those with food insecurity. People without diabetes should not assume these programs would help them without additional research

Based on the model, health improvements could start appearing within 1-2 years as people improve their diet and blood sugar control. The biggest financial savings would likely take 5-10 years to accumulate as fewer people develop heart disease and strokes. Individual results vary—some people might see improvements in weeks, while others might take months

Want to Apply This Research?

  • Track daily servings of fresh fruits and vegetables (goal: 5+ servings per day) and weekly blood sugar readings if you have diabetes. Note any changes in energy levels, weight, or how you feel. This creates a personal record to compare against the study’s predictions
  • If enrolled in a produce prescription program, use the app to: (1) Log what produce you received and what you cooked with it; (2) Set reminders to use produce before it spoils; (3) Track which fruits and vegetables you prefer and which recipes work best; (4) Monitor how your blood sugar responds to increased produce intake
  • Over 3-6 months, track whether your blood sugar readings improve and whether you’re consistently eating more produce. Share this data with your doctor to see if the program is working for you personally. After 6-12 months, reassess whether the program is sustainable and whether you’ve noticed improvements in energy, weight, or overall health

This study is a computer simulation predicting what might happen if produce prescription programs were implemented nationwide—it is not proof that these programs will definitely work in all situations. Results are based on data from 20 existing programs and may vary by location, individual circumstances, and program quality. If you have diabetes or food insecurity, consult with your doctor or a registered dietitian before making major dietary changes. This information should not replace professional medical advice. Insurance coverage for produce prescriptions varies by state and plan—check with your specific insurance provider about availability and eligibility