---
title: "Medically Tailored Groceries Reduced HbA1c and Improved Food and Nutrition Security in Medicaid Pa"
id: "pubmed-42478360"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42478360"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42478360/"
doi: "10.1161/CIRCULATIONAHA.125.077982"
published_at: "2026-08-18T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Medically Tailored Groceries Reduced HbA1c and Improved Food and Nutrition Security in Medicaid Pa
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42478360
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42478360/)
- **DOI:** [10.1161/CIRCULATIONAHA.125.077982](https://doi.org/10.1161%2FCIRCULATIONAHA.125.077982)
- **Published At:** 2026-08-18T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- A randomized controlled trial enrolled 460 Medicaid-insured adults with type 2 diabetes and elevated hemoglobin A1c (HbA1c) in southern California between November 2021 and July 2022. - Participants had at least two HbA1c measurements ≥7.5% in the prior year and were randomized 1:1:1 to usual care (N=153), lower-dose medically tailored groceries (MTG) (N=153), or higher-dose MTG (N=154) for 6 months. - MTG consisted of weekly home deliveries of healthy produce scaled to household size (lower dose $100–$170/month; higher dose $135–$210/month) plus matched recipes and telenutrition counseling. - The prespecified primary comparison combined both MTG arms versus control with the primary outcome of change in **HbA1c** at 6 months. - Baseline characteristics: mean age 59.2 years, 64.8% women, 85.2% Hispanic ethnicity, 58% reported food insecurity, and mean baseline **HbA1c** 9.40% (SD 1.53). - Intervention engagement: 83.3% reported eating most or all provided food; 21.5% participated in telenutrition counseling. - Primary outcome: mean HbA1c declined by 0.66 points in the MTG groups vs 0.25 points in control, yielding a treatment difference of -0.40 points (95% CI, -0.73 to -0.08; P = 0.016). - No meaningful dose-response: higher-dose and lower-dose MTG produced similar HbA1c reductions. - MTG significantly increased odds of achieving **food security** (OR 2.12; 95% CI, 1.13–3.99; P = 0.020) and **nutrition security** (OR 3.65; 95% CI, 1.84–7.25; P < 0.001). - Hypertension and body mass index did not change significantly over the trial period. - Findings remained consistent across prespecified subgroups (sex, education, baseline food security, baseline nutrition security, baseline HbA1c) and after adjustment for demographics, baseline insecurity, self-reported health, comorbidities, and medication changes. - Conclusion: In a racially/ethnically diverse, Medicaid-insured population with type 2 diabetes, provision of **medically tailored groceries** lowered **HbA1c** and improved **food and nutrition security** over 6 months. - Trial registration: ClinicalTrials.gov NCT05407376.
## Clinical Analysis & Structured Key Points
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Epub 2026 Jul 21. # Effects of a "Food Is Medicine" Intervention on Glucose Control Among Medicaid-Insured Patients With Type 2 Diabetes: A Randomized Controlled Trial [Claudia Nau](https://pubmed.ncbi.nlm.nih.gov/?term=Nau+C&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Jason H Y Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+JHY&cauthor_id=42478360)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-2 "The George Institute for Global Health and School of Population Health, the University of New South Wales, Sydney Australia \(J.H.Y.W.\)."), [Bing Han](https://pubmed.ncbi.nlm.nih.gov/?term=Han+B&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Mina Habib](https://pubmed.ncbi.nlm.nih.gov/?term=Habib+M&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Xia Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+X&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Ariadna Padilla](https://pubmed.ncbi.nlm.nih.gov/?term=Padilla+A&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Casey Nelson](https://pubmed.ncbi.nlm.nih.gov/?term=Nelson+C&cauthor_id=42478360)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-3 "Kaiser Permanente J. Tyson School of Medicine, Pasadena, CA \(C.N.\)."), [Ceping Chao](https://pubmed.ncbi.nlm.nih.gov/?term=Chao+C&cauthor_id=42478360)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-4 "Kaiser Permanente Southern California, Medical Group Kaiser Permanente National Office of Community Health, Pasadena, CA \(C.C., P.S.\)."), [Pamela Schwartz](https://pubmed.ncbi.nlm.nih.gov/?term=Schwartz+P&cauthor_id=42478360)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-4 "Kaiser Permanente Southern California, Medical Group Kaiser Permanente National Office of Community Health, Pasadena, CA \(C.C., P.S.\)."), [Dariush Mozaffarian](https://pubmed.ncbi.nlm.nih.gov/?term=Mozaffarian+D&cauthor_id=42478360)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#full-view-affiliation-5 "Food is Medicine Institute, Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA \(D.M.\).") Affiliations Expand ### Affiliations * 1 Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA (C.N., B.H., M.H., X.L., A.P.). * 2 The George Institute for Global Health and School of Population Health, the University of New South Wales, Sydney Australia (J.H.Y.W.). * 3 Kaiser Permanente J. Tyson School of Medicine, Pasadena, CA (C.N.). * 4 Kaiser Permanente Southern California, Medical Group Kaiser Permanente National Office of Community Health, Pasadena, CA (C.C., P.S.). * 5 Food is Medicine Institute, Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA (D.M.). * PMID: **42478360** * DOI: [ 10.1161/CIRCULATIONAHA.125.077982 ](https://doi.org/10.1161/circulationaha.125.077982) Item in Clipboard Randomized Controlled Trial # Effects of a "Food Is Medicine" Intervention on Glucose Control Among Medicaid-Insured Patients With Type 2 Diabetes: A Randomized Controlled Trial Claudia Nau et al. Circulation. 2026. Show details Display options Display options Format Abstract PubMed PMID Circulation Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Circulation%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Circulation%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42478360/) . 2026 Aug 18;154(7):624-635. doi: 10.1161/CIRCULATIONAHA.125.077982. Epub 2026 Jul 21. ### Authors [Claudia Nau](https://pubmed.ncbi.nlm.nih.gov/?term=Nau+C&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Jason H Y Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+JHY&cauthor_id=42478360)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-2 "The George Institute for Global Health and School of Population Health, the University of New South Wales, Sydney Australia \(J.H.Y.W.\)."), [Bing Han](https://pubmed.ncbi.nlm.nih.gov/?term=Han+B&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Mina Habib](https://pubmed.ncbi.nlm.nih.gov/?term=Habib+M&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Xia Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+X&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Ariadna Padilla](https://pubmed.ncbi.nlm.nih.gov/?term=Padilla+A&cauthor_id=42478360)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-1 "Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA \(C.N., B.H., M.H., X.L., A.P.\)."), [Casey Nelson](https://pubmed.ncbi.nlm.nih.gov/?term=Nelson+C&cauthor_id=42478360)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-3 "Kaiser Permanente J. Tyson School of Medicine, Pasadena, CA \(C.N.\)."), [Ceping Chao](https://pubmed.ncbi.nlm.nih.gov/?term=Chao+C&cauthor_id=42478360)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-4 "Kaiser Permanente Southern California, Medical Group Kaiser Permanente National Office of Community Health, Pasadena, CA \(C.C., P.S.\)."), [Pamela Schwartz](https://pubmed.ncbi.nlm.nih.gov/?term=Schwartz+P&cauthor_id=42478360)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-4 "Kaiser Permanente Southern California, Medical Group Kaiser Permanente National Office of Community Health, Pasadena, CA \(C.C., P.S.\)."), [Dariush Mozaffarian](https://pubmed.ncbi.nlm.nih.gov/?term=Mozaffarian+D&cauthor_id=42478360)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42478360/#short-view-affiliation-5 "Food is Medicine Institute, Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA \(D.M.\).") ### Affiliations * 1 Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA (C.N., B.H., M.H., X.L., A.P.). * 2 The George Institute for Global Health and School of Population Health, the University of New South Wales, Sydney Australia (J.H.Y.W.). * 3 Kaiser Permanente J. Tyson School of Medicine, Pasadena, CA (C.N.). * 4 Kaiser Permanente Southern California, Medical Group Kaiser Permanente National Office of Community Health, Pasadena, CA (C.C., P.S.). * 5 Food is Medicine Institute, Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA (D.M.). * PMID: **42478360** * DOI: [ 10.1161/CIRCULATIONAHA.125.077982 ](https://doi.org/10.1161/circulationaha.125.077982) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Although medically tailored groceries (MTG) hold promise to improve food and nutrition security and health among patients with diet-related illnesses and social needs, few randomized trials have been performed. **Methods:** We enrolled 460 Medicaid-insured adults with type 2 diabetes and elevated hemoglobin A1c (HbA1c) between November 2021 and July 2022 in a randomized controlled trial of MTG in southern California. Eligibility was based on at least 2 HbA1c measurements ≥7.5% in the past year. Participants were randomized 1:1:1 to usual-care (N=153), lower-dose MTG (N=153), or higher-dose MTG (N=154) for 6 months, with the prespecified primary assessment comparing the combined MTG groups with control. MTG was provided as weekly home deliveries of healthy produce, scaled to household size ($100 to $170 per month for the lower dose and $135 to $210 per month for the higher dose), along with matched recipes and telenutrition counseling. The primary outcome was a change in HbA1c at 6 months. Secondary outcomes included changes in food security and nutrition security, measured by surveys, and hypertension and body mass index, measured during clinical care encounters; evaluation of dose-response comparing the lower-dose and higher-dose arms; and effects in key population subgroups. **Results:** At baseline, mean (SD) age was 59.2 (13.2) years, 284 (64.8%) were women, 373 (85.2%) reported Hispanic ethnicity, 254 (58%) reported food insecurity, and mean (SD) HbA1c was 9.40 (1.53). Among intervention participants, 244 (83.3%) reported eating most or all food provided, and 63 (21.5%) engaged in telenutrition counseling. Compared with baseline, HbA1c declined by 0.66 points in the intervention and 0.25 points in the control group, a treatment difference of -0.40 points (95% CI, -0.73, -0.08; _P_ =0.016). Higher-dose and lower-dose MTG produced similar reductions. Odds of food security and nutrition security increased by 2.12 (95% CI, 1.13, 3.99; _P_ =0.020) and 3.65 (95% CI, 1.84, 7.25; _P_ <0.001), respectively. Hypertension and body mass index did not significantly change. Results were consistent in prespecified subgroup analyses by sex, education, baseline food security, baseline nutrition security, and baseline HbA1c level. Findings were similar in analyses adjusting for baseline demographics, food insecurity, nutrition insecurity, self-reported health, comorbidities, and medication changes. **Conclusions:** In this randomized trial among Medicaid-insured, racially/ethnically diverse patients with type 2 diabetes, MTG lowered HbA1c and improved food and nutrition security. **Registration:** URL: https://www.clinicaltrials.gov; Unique identifier: [NCT05407376](http://clinicaltrials.gov/show/NCT05407376 "See in ClinicalTrials.gov"). **Keywords:** Food Is Medicine; diabetes; health care; health equity; nutrition; treatment. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement C.N. reports research funding from the National Institutes of Health. J.W. reports research funding to conduct Food is Medicine–related research from the International Fresh Produce Association, Costa, Fresh Produce Group, Pinata Farms, Perfection Fresh, One Harvest, and Hort Innovation. D.M. reports research funding from the National Institutes of Health, Kaiser Permanente Fund at the East Bay Community Foundation, National Association of Chain Drug Stores Foundation, Google Health, and The Rockefeller Foundation; serving on scientific advisory boards for Branch Venture Partners, Brightseed, Calibrate, Instacart Health, January Inc., and WndrHLTH; scientific consulting for Amazon Health and Google Health; and chapter royalties from UpToDate. The other authors report no conflicts of interest. The study was conceived by D.M., J.W., and P.S. and designed by C.N., D.M., and J.W. Data were collected by C.N., A.P., and X.L. and analyzed by B.H. and M.H. Data analysis was reviewed and interpreted by B.H., C.N., D.M., J.W., and P.S. The article was drafted by C.N., D.M., J.W., and B.H. Project administration was provided by C.C. and A.P. Critical input and revision to the article were provided by all authors, and all authors read and approved the final version. ## Similar articles * [ Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas. ](https://pubmed.ncbi.nlm.nih.gov/36321557/) Crider K, Williams J, Qi YP, Gutman J, Yeung L, Mai C, Finkelstain J, Mehta S, Pons-Duran C, Menéndez C, Moraleda C, Rogers L, Daniels K, Green P.Crider K, et al.Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217.Cochrane Database Syst Rev. 2022.Update in: [Cochrane Database Syst Rev. 2026 Feb 18;2:CD014217. doi: 10.1002/14651858.CD014217.pub2.](https://pubmed.ncbi.nlm.nih.gov/41705996/)PMID: 36321557Free PMC article.Updated. * [ Behavioral and Pharmacotherapy Weight Los
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