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Session to outline nutrition interventions that work

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3 minutes


Nutrition is a key element in diabetes prevention and treatment. The problem isn’t knowing what to do in terms of dietary habits, but how to help people actually do it.

Grace E. Shearrer, PhD
Grace E. Shearrer, PhD

“We have known for decades that type 2 diabetes is related to over or poor nutrition,” said Grace E. Shearrer, PhD, Assistant Professor of Human Nutrition and Food at the University of Wyoming. “But it turns out that stopping over nutrition or poor nutrition is a lot harder than eating into it.”

Dr. Shearrer will discuss gamifying nutrition as one of three novel approaches to be presented during The Future of Diabetes Nutrition Interventions—Innovation in Practice on Sunday, June 23, from 3:15 p.m. – 4:15 p.m. ET in Room W415B, the Valencia Ballroom, of the Orange County Convention Center. For registered meeting participants, the session also will be livestreamed on the virtual meeting platform and will be available on-demand following the 84th Scientific Sessions.

Telling people what to eat and what not to eat seldom changes eating behavior.

“Palatable foods engage our reward systems,” Dr. Shearrer said. “So instead of pushing against the reward system in the brain, what if we use it to our advantage? Gamification taps into our endogenous rewards systems to redirect behaviors. A lot of providers fumble with behavioral interventions with kids. Gamification gives them a tool—games—that teens already know and respond to. It’s one more way to encourage behavior change.”

Elise Mitchell, MS, MPH
Elise Mitchell, MS, MPH

Gamification is just one approach to integrating social determinants of health into nutrition intervention. Another approach is to issue produce prescriptions for patients who need help accessing or affording fruits and vegetables.

In this approach, providers identify patients experiencing food insecurity and who have a qualifying condition such as diabetes, then write a prescription for fresh produce. The prescription goes to a community-based partner organization with funding to fill the prescription through participating sites like grocery stores, farmers markets, and community-supported agriculture providers. Organizations may provide Supplemental Nutrition Assistant Programs (SNAP) enrollment and other food assistance.

“This Food Is Medicine program has taken off nationally through the Gus Schumacher Nutrition Incentive Program,” said Elise Mitchell, MS, MPH, Project Manager for Produce Prescription Programs at the Center for Nutrition and Health Impact. “We are working on a study, supported by an ADA translational award, to collect data from intervention and control groups nationally to understand the impact of these produce prescriptions across the United States on diabetes outcomes. Community-based nutrition support can be a powerful tool for improving health.”

Mitchell will discuss how produce prescriptions can help achieve a sustainable impact on individuals and communities.

Different communities face different challenges. Some areas may be food deserts. Transportation problems can make it difficult to get to grocery stores. Not everyone has access to a fully stocked kitchen or adequate cooking skills. Medical nutrition therapy from a registered dietician nutritionist, like any other therapy, must be tailored to individual needs.

Sarah A. Stoltz, PhD, MS, RDN, CDCES
Sarah A. Stoltz, PhD, MS, RDN, CDCES

“Diabetes is impacted by all aspects of life,” said Sarah A. Stoltz, PhD, MS, RDN, CDCES, Assistant Professor of Food Science and Human Nutrition at Colorado State University. “Social drivers of health, things like housing insecurity, financial instability, and food insecurity, are getting more attention. If someone with diabetes is living in a food insecure household, all the education in the world might not move the needle on improving their outcomes. Coupling nutrition education with a resource to mitigate food insecurity makes sense.”

The key is working with communities to understand unique local needs and create local solutions, said Dr. Stoltz, who will discuss multilevel interventions to improve type 2 diabetes outcomes. Working with American Indian and Alaska Native communities, she has found that local communities are well aware of their local nutrition needs and often have solutions.

“The solution isn’t going to look the same across any two communities, but communities often know what the solution should look like in their own space,” she said.

Get On-Demand Access to the Scientific Sessions


There is still time to register for on-demand access to learn about the latest advances in diabetes research, prevention, and care presented at the 84th Scientific Sessions. Select session recordings will be available through Aug. 26.