The effect of food access on type 2 diabetes control in patients of a New Orleans, Louisiana, clinic

Decoding Diabetes Nutritional Guidelines for Physicians in Underserved American Populations

“…In medical (healthcare) deserts [19], this is challenging due the low number of healthcare resources, including personnel (e.g., dietitians, certified diabetes educators, and physicians) and lack of built environments (e.g., hospitals, gyms, and walking parks) [20]. Moreover, many rural areas are also food deserts (where there is limited access to fresh foods due to the lack of grocery stores or their high cost and socioeconomic status [21,22]). Furthermore, intensive lifestyle interventions, such as those based on the Look AHEAD trial [23], known to be effective at reducing weight, require a multitude of resources and are not feasible in medical and food deserts.…”

“…The lack of accessibility to fresh foods and other health disparities play a prominent role in how well patients can manage their diabetes. Additionally, foods that contribute to type 2 diabetes are much more affordable and available in food deserts as compared to fresh foods [6,21]. This makes it difficult to implement a healthy diet based on guidelines and poses a significant challenge for the rural physician.…”

“…The core concept is to improve carbohydrate quality (more whole grains and less refined grains) to help improve glycemia. Rural physicians must assess what foods the patient has access to and suggest an eating pattern that works best with their situation [21]. A simpler approach may be to utilize the ADA Diabetes Plate Method; resources available in [82].…”

Primordial prevention: Reducing consumption of sugar-sweetened beverages in racial/ethnic populations

“…Access to food retailers is a key social determinant of health and increasing availability of fresh food is an effective strategy in promoting healthy dietary behaviors [82] . A New Orleans study determined individuals who live in food deserts have a 14 % difference in glycemic control compared to the general population with T2D [83] . Food insecurity is also disproportionately noted within NHB and Hispanic/Latino populations while reduced food security is associated with higher reports of CVD [84] , [85] , [86] .…”