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(PTFS18-04-26) Changes in Diet Quality Associated With a Medically Tailored Grocery Intervention Among Adults With Type 2 Diabetes and Low Food Security

Monday, July 27, 2026
2:42 PM - 2:46 PM ET
Location: Prince George's Hall B-E (The Hub) - Poster Theater 2 / Poster Board Number: PT2-4
Disclosure(s):
Emily D. Martin, MS, RDN: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: To examine changes in diet quality and the food group drivers of those changes among food insecure adults with type 2 diabetes (T2D) in a pilot randomized controlled trial (RCT) of a medically tailored grocery (MTG) intervention.

Methods: Food insecure patients with T2D were recruited from a federally qualified health center and randomized to the 6-month MTG intervention or waitlist control. The intervention included biweekly pickup of produce and shelf-stable foods, dietitian led nutrition and diabetes self-management education. Two non-consecutive 24-hour diet recalls were collected at baseline and 6 months (Nutrition Data System for Research) to calculate Healthy Eating Index-2020 (HEI) scores. Adjusted between-group differences in 6-month HEI were estimated using analysis of covariance (covariates: cohort, age, sex, baseline HEI). What We Eat in America categories were used to group top food-level contributors to HEI component scores.

Results: Of the 71 enrolled participants, 48 (27 intervention; 21 control) completed baseline and 6-month assessments and were included in analyses. Participants were largely Hispanic (89%) and female (63%); mean age was 58 ± 9 years, HbA1c 8.2 ± 1.6%, and 93% reported food insecurity at baseline. Mean overall HEI scores were 66.9 ± 14.6 (intervention) and 60.6 ± 14.6 (control) at baseline and 66.6 ± 13.8 vs 57.0 ± 14.4 at 6 months. Adjusted 6-month HEI was higher in the intervention group (mean difference, 7.3 points; 95% CI: -0.77 to 15.30; p=0.075), driven by a higher Dairy component score (mean difference, 2.5 points; 95% CI: 0.66 to 4.35;
p=0.009) reported by intervention participants. The primary Dairy contributors were ‘Fluid Milk’ (intervention) and ‘Grain-based Mixed Dishes’ (control) at 6 months. Whole Grains and Sodium components also trended higher in the intervention group (+1.52 ounce-equivalents and +1.95 points; p=0.08 and 0.086): key contributors were quick breads (corn tortillas) and mixed dishes, respectively.

Conclusions: Intervention participants maintained diet quality at 6 months, with higher dairy intake and trends toward increased whole grains and less sodium, while diet quality declined in controls. Findings suggest that a MTG program may support improvements in diet quality, but larger trials are needed.

Funding Sources: NIDDK