Publication Date

Fall 2019

Degree Type


Degree Name

Master of Science (MS)


Nutrition, Food Science and Packaging


John Gieng


Body mass index, Community health, Food insecurity, Food pharmacy, HbA1c, Type 2 diabetes

Subject Areas

Nutrition; Public health; Health sciences


Food insecurity is defined as a lack of access to enough food for a healthy lifestyle and has been found to lead to higher prevalence of type 2 diabetes (T2DM). In recognition of this relationship, many safety-net clinics and food banks have introduced “food pharmacies.” The term “food pharmacy” may be used to describe a treatment model that focuses on provision of disease-specific, medically appropriate food. This observational study examined data from a food pharmacy in the San Francisco Bay Area to determine if program participation improved clinical measures of T2DM status or risk, namely glycated hemoglobin (HbA1c), fasting blood glucose (FBG), and body mass index (BMI). Analysis found a significant inverse correlation between program participation and BMI at 24 months after enrollment. At 24 months, individuals who participated above the median rate had significantly lower BMIs than those below the median rate. Conversely, there was no correlation found between participation and HbA1c, despite significant decreases in mean HbA1c from baseline at 18 months in subgroup analysis. In conclusion, participating in existing San Francisco Bay Area food pharmacies does not appear to improve T2DM clinical markers, aside from BMI. A modification of the food pharmacy treatment model should be considered if public programs want to effectively target T2DM in food insecure individuals.