Abstract
BACKGROUND/OBJECTIVES: The high cost of healthy foods makes it difficult for people with a low income to manage diabetes. This study examined the effects of a monthly grocery voucher on the dietary intake, assessed through the Canadian Diet History Questionnaire III, of diabetes patients facing food or financial insecurity. We also assessed the impact on levels of hemoglobin A1c, beta-carotene, and ascorbic acid. METHODS: Participants were randomly selected from a larger clinical trial and completed the survey at 6-month follow-up. RESULTS: Voucher recipients consumed more whole fruit (mean difference in daily servings, MD 0.8; 95% CI [0.1, 1.6]) and fewer refined grains (MD -1.0; 95% CI [-1.9, -0.1]). For other food groups, the confidence intervals for the difference included null effect. Mean HEFI-2019 score was 51.7 out of 80, with voucher recipients averaging 52.4 vs. 51.0 for controls (MD 1.4; 95% CI [-3.6, 6.1]). The voucher group showed a slight HbA1c decrease (MD -0.4; 95% CI [-1.4, 0.5]). CONCLUSIONS: A voucher providing access to healthy foods for people with diabetes or prediabetes slightly increased intake of fruits and decreased intake of refined grains. Larger interventional studies are needed to determine the effects of vouchers on dietary intake among this population.