Medically Tailored Meals for Type 2 Diabetes and Heart Disease: An Australian Trial of a ‘Food is Medicine’ Intervention

Diet-related diseases in Australia impose an immense disease burden and disproportionately impact disadvantaged communities, causing more death and disability than tobacco, alcohol, and illegal drug use combined. There are millions of Australians with type 2 diabetes (T2D), who are at particularly high risk of developing other chronic diseases. Yet, while nutrition is a driver and treatment for T2D, accessing and preparing nutritious meals can be challenging for many individuals.

While initial evidence for medically tailored meals (MTM) programs is promising, most of the evidence generated to date has been through small-scale, non-randomized studies in the USA. It is unclear if MTM programs could be similarly acceptable, feasible, and effective in other healthcare systems and populations such as in Australia. Therefore, we are conducting a randomized controlled trial that will determine the effect of MTM on glycated hemoglobin (HbA1c, %) and other key clinical outcomes in participants with T2D and ongoing hyperglycemia who experience difficulties accessing and eating nutritious food in Australia.

This study is a two-arm parallel trial (goal n = 212) with individuals recruited from hospital diabetes centers and general practices in Sydney, Australia. Individuals will be randomized in a 1:1 ratio to a MTM intervention group or a control group. Over 26 weeks, the intervention group will be prescribed 20 MTM and 300g unsalted nuts delivered by meal providers every two weeks and provided up to 3 sessions with an accredited dietitian to support behavior change. Controls will continue with their usual care. The primary outcome is glycated hemoglobin (HbA1c, %) and secondary outcomes include differences in blood pressure, blood lipids, and weight, all measured at 26 weeks.

Aim One

To test whether provision of MTM is a feasible and effective way of improving T2D management among individuals with type 2 diabetes and ongoing hyperglycemia who experience difficulties accessing and eating nutritious food in Australia.