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The Big Idea

How do you help patients with heart disease and diabetes access good nutrition?


With a healthy prescription from the Food Pharmacy.

Marianna Wetherill, an assistant professor and registered dietitian at OU-Tulsa, carries a box of healthy meal choices for Anthony Tibbs, a client of the Food Pharmacy and Tisdale Specialty Clinics. Tulsa World

Seven years ago, John Zentner walked into an OU clinic and was given a month to live. Thirty more days to hold his wife and hug his 16-year-old daughter wasn’t enough, but health statistics for people living on Tulsa’s north side were not encouraging.  Those, like Zentner, fighting heart disease, diabetes, high blood pressure, high blood sugar and high cholesterol died much younger than patients on Tulsa’s more affluent south side. 

Zentner was referred to the Food Pharmacy, housed in Tulsa’s OU Physicians Family Medicine Clinic, 1111 S. St. Louis Ave. When Zentner picked up his first “prescription” – a box filled with fruits, vegetables and foods low in sodium, but high in nutrients and fiber – his blood sugar was over 300, more than twice the recommended number. Today, that number has stabilized at 120, and Zentner is advancing his health progress as one of 50 patients who now have access to heart-friendly foods and resources through the Food Pharmacy. He has lost weight and is down to two insulin shots a day. 

“As far as my condition now, I can see myself living well past 75,” he says. “I want to be here. It’s a struggle, but it is worth it.”  

A team from the OU-TU School of Community Medicine, the College of Public Health, and the Office for Research Development and Scholarly Activity recognized that uninsured patients in the Tulsa area needed access to healthy foods. The Food Pharmacy was created in July 2016 as a partnership between OU-Tulsa and the Community Food Bank of Eastern Oklahoma, with additional funding from Blue Cross and Blue Shield of Oklahoma. 

“The remedy seemed as though it was pretty simple,” says Marianna Wetherill, an assistant professor and registered dietitian who co-created the Food Pharmacy. 

If we don't meet their needs through charitable feeding programs, there is no other option for them.
Marianna Wetherill

“It was just providing space within the clinic to help those patients who needed access to healthier foods; to address their food insecurity and also give them affordable examples of what they could be buying with their own resources.”

 The Food Pharmacy operates Tuesday afternoons as part of the Bedlam Longitudinal Clinic for uninsured patients with multiple chronic illnesses. The teaching clinic is a regular provider of health care for these patients, so when they come for medical appointments, they can receive food assistance and nutrition education all in one trip.

“This sends the message that the provider feels it’s important for the patient to eat in a healthy way,” Wetherill says.

Thirty-six percent of food-insecure individuals do not qualify for any federal food assistance program, such as SNAP, according to Map the Meal Gap, and a food pharmacy helps fill this critical void. 

Co-creator of OU's Food Pharmacy and Assistant Professor Marianna Wetherill. Photo provided

“If we don’t meet their needs through charitable feeding programs, there is no other option for them,” Wetherill says.

Wetherill and her team, Heather McIntosh, research statistician, and Danielle Prado, staff assistant, work to identify eligible participants, follow up with existing patients and prepare food boxes. Boxes are nutritionally tailored for patients, including those with diabetes, hypertension, heart disease and obesity.

Participants receive one box of shelf-stable food and two bags of fresh produce per household every month. One box costs the program about $26, but thanks to the buying power of the community food bank, patients are able to receive about twice as much food as they could purchase retail. Contents of the box include dry beans and low-sodium canned beans, which are rich in potassium and magnesium, and important to diets because of their soluble and insoluble fiber. Low-sodium vegetable juice, which helps lower blood pressure, is included because some participants have transportation issues or do not live near a grocery store with affordable fruits and vegetables. 

Also included are whole grains, canned fatty fish like salmon, dried fruit, nuts, green or black tea and anti-inflammatory spices like turmeric, garlic powder, cumin and cinnamon. Boxes also include recipe cards with meal ideas like homemade black bean burgers and beans and rice.

 The program offers rolling recruitment allowing patients to join at any time. Its goal is to serve 80 unduplicated patients in its first year. Seventy percent of the Food Pharmacy’s participants have reported having to choose between buying food or medicine in the past year. Wetherill tries to follow each patient for at least six months to evaluate the program’s impact on their health and food security. The evaluation process includes reviewing lab work and changes in weight and blood pressure. Participants complete a monthly survey answering questions about the food they are consuming and their food security status. Results are evaluated to see if eating behaviors and statuses are improving.

“[There’s a] big need for providers to be willing and able to collaborate with local food banks and food assistance programs to link patients with foods they need, especially when serving patients with nutrition-related chronic diseases,” Wetherill says. 

“A lot of the clinical problems we wrestle with during the medical encounter often may be fundamentally driven by the person’s inability to have adequate food supplies. So if we don’t address the fundamental causes, we’re not going to see quality outcomes for patients.”

As for Zentner, he’s eating his way to better health.

“Learning about food itself and how it affects your body, that is most important,” he says.

Rachel Weaver Smith is a freelance writer living in Tulsa.

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