{"id":44754,"date":"2023-01-20T18:44:26","date_gmt":"2023-01-20T18:44:26","guid":{"rendered":"http:\/\/www.brandon.ddtest.info\/multisite-test\/comprehensive-food-nutrition-program-aims-to-combat-disparities-in-diabetes-treatments\/"},"modified":"2023-01-20T18:44:26","modified_gmt":"2023-01-20T18:44:26","slug":"comprehensive-food-nutrition-program-aims-to-combat-disparities-in-diabetes-treatments","status":"publish","type":"post","link":"http:\/\/www.brandon.ddtest.info\/multisite-test\/comprehensive-food-nutrition-program-aims-to-combat-disparities-in-diabetes-treatments\/","title":{"rendered":"Comprehensive food nutrition program aims to combat disparities in diabetes treatments"},"content":{"rendered":"<p> \n<\/p>\n<div>\n<h4 id=\"h-by-rachel-crumpler\"><strong>By Rachel Crumpler<\/strong><\/h4>\n<p>Health care providers have traditionally written prescriptions for medications, for exercise, for therapy, even for relaxation for their patients. So to combat obesity and poor nutrition, why not give patients a prescription to help them eat better?<\/p>\n<p>Such <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9518562\/\" target=\"_blank\" rel=\"noreferrer noopener\">food prescriptions<\/a> \u2014 delivered to patients in the form of vouchers that can help patients get access to more fresh fruits and vegetables \u2014 are becoming increasingly popular across the U.S.<\/p>\n<p>Lauren Sastre, a professor in the Department of Nutrition Science at East Carolina University, saw the promise of food prescription programs in fall 2018 when she started researching their implementation. While she considered them helpful, Sastre didn\u2019t think they went far enough in breaking down barriers to getting healthy food.\u00a0<\/p>\n<p>For one, she said, transportation issues persist \u2014 especially in rural areas. Additionally, the amounts of fresh food offered aren\u2019t often substantial enough to meet nutrition recommendations. For example, in some cases the allotted funds would only cover the cost of a tomato and a cucumber.\u00a0<\/p>\n<p>Sastre wanted to create a more robust produce prescription program \u2014 to operate longer, to provide more food and to offer more educational support.\u00a0<\/p>\n<p>\u201cIf you don\u2019t have access to healthy food, you can\u2019t eat well, period,\u201d Sastre said. \u201cSo that\u2019s step one. But there needs to be more than step one. We don\u2019t have Home Ec anymore. We\u2019re not teaching people how to prepare things from scratch. The idea that people are going to take this produce home and cook it and eat it \u2014 there has to be some level of support in place for that.\u201d<\/p>\n<aside class=\"scaip scaip-1    \">\n<aside id=\"block-30\" class=\"widget_block clearfix\">\n<\/aside>\n<\/aside>\n<p>Last year, Sastre launched a comprehensive nutrition program called <a href=\"https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/FreshStartPromotionalFlyer.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Fresh Start<\/a>, serving low-income, uninsured patients with diabetes living in Eastern North Carolina.\u00a0<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><amp-img width=\"780\" height=\"585\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=780%2C585&amp;ssl=1\" alt=\"One woman in white chef jacket sautees asparagus in a pan while another woman in a white chef jacket watches.\" class=\"wp-image-45638 amp-wp-enforced-sizes i-amphtml-layout-intrinsic i-amphtml-layout-size-defined\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?w=2560&amp;ssl=1 2560w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=280%2C210&amp;ssl=1 280w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=450%2C338&amp;ssl=1 450w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=150%2C113&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=1536%2C1152&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=2048%2C1536&amp;ssl=1 2048w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=1200%2C900&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=200%2C150&amp;ssl=1 200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=1568%2C1176&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=600%2C450&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?w=2340&amp;ssl=1 2340w\" sizes=\"(max-width: 780px) 100vw, 780px\" layout=\"intrinsic\" disable-inline-width=\"\" i-amphtml-layout=\"intrinsic\"><i-amphtml-sizer slot=\"i-amphtml-svc\" class=\"i-amphtml-sizer\"><img alt=\"\" aria-hidden=\"true\" class=\"i-amphtml-intrinsic-sizer\" role=\"presentation\" src=\"data:image\/svg+xml;base64,PHN2ZyBoZWlnaHQ9IjU4NSIgd2lkdGg9Ijc4MCIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIiB2ZXJzaW9uPSIxLjEiLz4=\"\/><\/i-amphtml-sizer><noscript><img decoding=\"async\" loading=\"lazy\" width=\"780\" height=\"585\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=780%2C585&amp;ssl=1\" alt=\"One woman in white chef jacket sautees asparagus in a pan while another woman in a white chef jacket watches.\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?w=2560&amp;ssl=1 2560w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=280%2C210&amp;ssl=1 280w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=450%2C338&amp;ssl=1 450w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=150%2C113&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=1536%2C1152&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=2048%2C1536&amp;ssl=1 2048w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=1200%2C900&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=200%2C150&amp;ssl=1 200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=1568%2C1176&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?resize=600%2C450&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg?w=2340&amp;ssl=1 2340w\" sizes=\"(max-width: 780px) 100vw, 780px\"\/><\/noscript><\/amp-img><figcaption class=\"wp-element-caption\">Lauren Sastre, director of the Fresh Start program, sautees asparagus in a large pan. Patients with diabetes observe and help her complete the steps needed to cook a healthy asparagus frittata.  Participants learn how to prepare a vegetable in three different ways and are provided with recipes at each group class. <span class=\"image-credit\"><span class=\"credit-label-wrapper\">Credit:<\/span> Rachel Crumpler<\/span><\/figcaption><\/figure>\n<\/div>\n<p>Fresh Start offers nine in-person group classes from January to May. The classes include education on diabetes management, demonstrations of simple at-home physical exercises, and on-site cooking and taste-testing of the prepared food. Participants attending class leave with fresh produce and healthy recipes. One-on-one health coaching, conducted by trained ECU students, is also provided over the phone to help patients set attainable lifestyle goals.\u00a0<\/p>\n<p>None of these elements is groundbreaking by itself, Sastre said. It\u2019s the combination that\u2019s significant.<\/p>\n<p>\u201cI\u2019ve never seen a program that has them all offered at the same time and \u2026 intentionally integrated,\u201d she said. \u201cOur cooking aligns with the food we know we\u2019re giving out. Our health coaches touch base with their patients and see how they\u2019re working with that food and if they have questions or want more recipe ideas.\u201d<\/p>\n<p>The elements together create a synergy, Sastre said, that maximizes health improvements. Patients gain access, confidence and support to create real behavioral and lifestyle changes needed to manage their diabetes.<\/p>\n<aside class=\"scaip scaip-2    \">\n<aside id=\"block-31\" class=\"widget_block clearfix\">\n<\/aside>\n<\/aside>\n<div class=\"is-vertical is-layout-flex wp-container-4 wp-block-group has-dark-gray-color has-secondary-background-color has-text-color has-background\">\n<p class=\"has-primary-color has-text-color\"><strong>Diabetes in North Carolina<\/strong><\/p>\n<ul>\n<li>In North Carolina, about 12.4 percent of adults have diabetes, outpacing the national rate of <a href=\"https:\/\/www.americashealthrankings.org\/explore\/annual\/measure\/Diabetes\/state\/NC\" target=\"_blank\" rel=\"noreferrer noopener\">10.9 percent<\/a>, according to the annual America\u2019s Health Rankings database<\/li>\n<li>Nearly 244,000 people are estimated to have diabetes but don\u2019t yet know they have it<\/li>\n<li>Every year, an estimated 73,032 people in North Carolina are diagnosed with diabetes<\/li>\n<\/ul>\n<p class=\"has-small-font-size\"><em><a href=\"https:\/\/diabetes.org\/sites\/default\/files\/2022-01\/ADV_2021_State_Fact_sheets_all_rev_1.27_NC.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Data from the American Diabetes Association<\/a><\/em><\/p>\n<\/div>\n<h4><strong>Expensive disease<\/strong><\/h4>\n<p>Funded by a three-year, $365,000 grant from The Duke Endowment, Sastre partnered with the <a href=\"https:\/\/ncafcc.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">North Carolina Association of Free and Charitable Clinics<\/a> to offer Fresh Start to low-income, uninsured patients with diabetes at several clinics in the eastern part of the state.<\/p>\n<p>April Cook, CEO of the North Carolina Association of Free and Charitable Clinics, said diabetes is prevalent among patients at its 71 member clinics across the state. She said about 40 percent of the total patients served have diabetes.<\/p>\n<p>People with low incomes suffer disproportionately from diet-related chronic diseases, such as diabetes, and have fewer resources to manage their diseases. <a href=\"https:\/\/health.gov\/sites\/default\/files\/2022-01\/NCCC%20Report%20to%20Congress.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Food insecurity is recognized as a common risk factor<\/a> for developing type 2 diabetes (which used to be known as \u201cadult onset diabetes\u201d) and is a contributor to socioeconomic, racial and ethnic disparities in diabetes outcomes.<\/p>\n<p>Cook said patients served at free and charitable clinics are often newly diagnosed or will get diagnosed with diabetes there for the first time. She said many patients come in with <a href=\"https:\/\/www.cdc.gov\/diabetes\/managing\/managing-blood-sugar\/a1c.html#:~:text=Diagnosing%20Prediabetes%20or%20Diabetes&amp;text=A%20normal%20A1C%20level%20is,6.5%25%20or%20more%20indicates%20diabetes.\" target=\"_blank\" rel=\"noreferrer noopener\">glycemic levels<\/a>, a measurement known as hemoglobin A1C, as high as 15 percent, when the normal level should be below 5.7 percent. The A1C measurement reflects a person\u2019s blood sugar measurements over time.\u00a0<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><amp-img width=\"780\" height=\"585\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=780%2C585&amp;ssl=1\" alt=\"A church hall full of over 30 people seated at three different tables learning nutrition information about diabetes\" class=\"wp-image-45636 amp-wp-enforced-sizes i-amphtml-layout-intrinsic i-amphtml-layout-size-defined\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?w=2560&amp;ssl=1 2560w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=280%2C210&amp;ssl=1 280w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=450%2C338&amp;ssl=1 450w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=150%2C113&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=1536%2C1152&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=2048%2C1536&amp;ssl=1 2048w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=1200%2C900&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=200%2C150&amp;ssl=1 200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=1568%2C1176&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=600%2C450&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?w=2340&amp;ssl=1 2340w\" sizes=\"(max-width: 780px) 100vw, 780px\" layout=\"intrinsic\" disable-inline-width=\"\" i-amphtml-layout=\"intrinsic\"><i-amphtml-sizer slot=\"i-amphtml-svc\" class=\"i-amphtml-sizer\"><img alt=\"\" aria-hidden=\"true\" class=\"i-amphtml-intrinsic-sizer\" role=\"presentation\" src=\"data:image\/svg+xml;base64,PHN2ZyBoZWlnaHQ9IjU4NSIgd2lkdGg9Ijc4MCIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIiB2ZXJzaW9uPSIxLjEiLz4=\"\/><\/i-amphtml-sizer><noscript><img decoding=\"async\" loading=\"lazy\" width=\"780\" height=\"585\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=780%2C585&amp;ssl=1\" alt=\"A church hall full of over 30 people seated at three different tables learning nutrition information about diabetes\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?w=2560&amp;ssl=1 2560w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=280%2C210&amp;ssl=1 280w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=450%2C338&amp;ssl=1 450w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=150%2C113&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=1536%2C1152&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=2048%2C1536&amp;ssl=1 2048w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=1200%2C900&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=200%2C150&amp;ssl=1 200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=1568%2C1176&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?resize=600%2C450&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg?w=2340&amp;ssl=1 2340w\" sizes=\"(max-width: 780px) 100vw, 780px\"\/><\/noscript><\/amp-img><figcaption class=\"wp-element-caption\">Over 20  low-income, uninsured patients with diabetes from the WATCH Clinic in Goldsboro attended Fresh Start\u2019s first group class of the year on Jan. 10.  During this class, participants learned more about managing diabetes, a series of easy exercises they can complete from their couch and how to cook asparagus three different ways.  <span class=\"image-credit\"><span class=\"credit-label-wrapper\">Credit:<\/span> Rachel Crumpler<\/span><\/figcaption><\/figure>\n<\/div>\n<p>Living for a long time with high blood sugar levels has <a href=\"https:\/\/www.cdc.gov\/diabetes\/library\/features\/prevent-complications.html#:~:text=Heart%20disease%20and%20stroke%3A%20People,Clouding%20of%20the%20lens%20(cataract)\" target=\"_blank\" rel=\"noreferrer noopener\">major health implications<\/a>, including loss of eyesight, kidney disease and nerve damage.<\/p>\n<aside class=\"scaip scaip-3    \">\n<aside id=\"block-32\" class=\"widget_block clearfix\">\n<\/aside>\n<\/aside>\n<p>Diabetes is an expensive chronic disease. People with diabetes pay approximately <a href=\"https:\/\/diabetes.org\/sites\/default\/files\/2022-01\/ADV_2021_State_Fact_sheets_all_rev_1.27_NC.pdf\">2.3 times more<\/a> in medical expenses than those who do not have the disease, according to the <a href=\"https:\/\/diabetes.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">American Diabetes Association<\/a>. The organization estimates that diagnosed diabetes costs North Carolina about <a href=\"https:\/\/diabetes.org\/sites\/default\/files\/2022-01\/ADV_2021_State_Fact_sheets_all_rev_1.27_NC.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">$10.6 billion<\/a> each year \u2014 a combination of direct medical costs and indirect costs from lost productivity.<\/p>\n<p>Cook said patients often don\u2019t realize how bad they feel until they start making improvements. But making those improvements comes with extra challenges for low-income patient populations. One of the best ways to control blood glucose level is to eat healthier, but that is more expensive.<\/p>\n<p>\u201cIt\u2019s really sad to think that you want to provide the best that you can for your family and your children \u2014 and knowing that the things that are more nutritious, healthier, are out of reach for you,\u201d Cook said, noting that\u2019s the reality for many folks.<\/p>\n<p>Kelli Corbett, lead nurse practitioner at <a href=\"https:\/\/www.watchwayne.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">Wayne Action Teams for Community Health<\/a> clinic in Wayne County, said she always advises her patients to shop on the perimeter of the grocery store where the fresh, unprocessed options are. She consistently hears that it\u2019s a struggle. One patient told her they could only afford to eat peanut butter and jelly sandwiches until their next check.\u00a0<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-large\"><amp-img width=\"338\" height=\"450\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2.jpg?resize=338%2C450&amp;ssl=1\" alt=\"A woman in a mask and apron places lemon slices on top of asparagus in a tin dish. They are making a healthy dish for someone wish diabetes.\" class=\"wp-image-45634 amp-wp-enforced-sizes i-amphtml-layout-intrinsic i-amphtml-layout-size-defined\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=338%2C450&amp;ssl=1 338w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=225%2C300&amp;ssl=1 225w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=113%2C150&amp;ssl=1 113w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=768%2C1024&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=1152%2C1536&amp;ssl=1 1152w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=1536%2C2048&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=900%2C1200&amp;ssl=1 900w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=600%2C800&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=300%2C400&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=150%2C200&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=1200%2C1600&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=1568%2C2091&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=400%2C533&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?w=1920&amp;ssl=1 1920w\" sizes=\"(max-width: 338px) 100vw, 338px\" layout=\"intrinsic\" disable-inline-width=\"\" i-amphtml-layout=\"intrinsic\"><i-amphtml-sizer slot=\"i-amphtml-svc\" class=\"i-amphtml-sizer\"><img alt=\"\" aria-hidden=\"true\" class=\"i-amphtml-intrinsic-sizer\" role=\"presentation\" src=\"data:image\/svg+xml;base64,PHN2ZyBoZWlnaHQ9IjQ1MCIgd2lkdGg9IjMzOCIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIiB2ZXJzaW9uPSIxLjEiLz4=\"\/><\/i-amphtml-sizer><noscript><img decoding=\"async\" loading=\"lazy\" width=\"338\" height=\"450\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2.jpg?resize=338%2C450&amp;ssl=1\" alt=\"A woman in a mask and apron places lemon slices on top of asparagus in a tin dish. They are making a healthy dish for someone wish diabetes.\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=338%2C450&amp;ssl=1 338w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=225%2C300&amp;ssl=1 225w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=113%2C150&amp;ssl=1 113w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=768%2C1024&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=1152%2C1536&amp;ssl=1 1152w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=1536%2C2048&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=900%2C1200&amp;ssl=1 900w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=600%2C800&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=300%2C400&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=150%2C200&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=1200%2C1600&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=1568%2C2091&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?resize=400%2C533&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-scaled.jpg?w=1920&amp;ssl=1 1920w\" sizes=\"(max-width: 338px) 100vw, 338px\"\/><\/noscript><\/amp-img><figcaption class=\"wp-element-caption\">A Fresh Start program participant helps prepare lemon-roasted asparagus. Many participants commented that they had never thought to pair asparagus with lemon before. <span class=\"image-credit\"><span class=\"credit-label-wrapper\">Credit:<\/span> Rachel Crumpler<\/span><\/figcaption><\/figure>\n<\/div>\n<p>Cook said the grant-funded partnership with Sastre is a game-changer for the clinics\u2019 patients in providing healthy food as well as education and cooking skills. What patients learn can then be\u00a0 shared with other members of their households and families, helping to create systemic change.<\/p>\n<p>\u201cYou can throw money at it through medicine all you want,\u201d Cook said. \u201cBut if you don\u2019t start addressing the social determinants that surround someone\u2019s health, it\u2019s not as easy to have an impact.\u201d<\/p>\n<h4><strong>\u2018There\u2019s sights. There\u2019s smells.\u2019<\/strong><\/h4>\n<p>In its first year, Fresh Start served 56 patients from two clinics with diabetes.\u00a0<\/p>\n<p>The researchers saw <a href=\"https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/APHA-Poster-Fresh-Start.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">results<\/a>, even in the few months of the program. Patients\u2019 levels of hemoglobin A1C decreased by an average 1.21 percent. For those who attended at least four group classes, blood sugar levels decreased even further, by an average of 1.87 percent. Food literacy also improved.<\/p>\n<p>This year, the program is planning to triple its scope, expanding to serve around 150 patients at five clinics in Eastern North Carolina.\u00a0<\/p>\n<p>Ramon Harmon, deputy director of the <a href=\"https:\/\/ncafcc.org\/our-clinics\/albemarle-hospital-foundation-community-care-clinic\/\" target=\"_blank\" rel=\"noreferrer noopener\">Albemarle Hospital Foundation Community Care Clinic<\/a> in Elizabeth City, said patients that participated enjoyed the hands-on approach Fresh Start offers.\u00a0<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><amp-img width=\"780\" height=\"520\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=780%2C520&amp;ssl=1\" alt=\"A group of people seated in chairs with their hands in the air participating in a light arm exercise to help manage their diabetes\" class=\"wp-image-45643 amp-wp-enforced-sizes i-amphtml-layout-intrinsic i-amphtml-layout-size-defined\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?w=1773&amp;ssl=1 1773w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=280%2C187&amp;ssl=1 280w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=450%2C300&amp;ssl=1 450w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=150%2C100&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=1536%2C1024&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=1200%2C800&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=1568%2C1045&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=400%2C267&amp;ssl=1 400w\" sizes=\"(max-width: 780px) 100vw, 780px\" layout=\"intrinsic\" disable-inline-width=\"\" i-amphtml-layout=\"intrinsic\"><i-amphtml-sizer slot=\"i-amphtml-svc\" class=\"i-amphtml-sizer\"><img alt=\"\" aria-hidden=\"true\" class=\"i-amphtml-intrinsic-sizer\" role=\"presentation\" src=\"data:image\/svg+xml;base64,PHN2ZyBoZWlnaHQ9IjUyMCIgd2lkdGg9Ijc4MCIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIiB2ZXJzaW9uPSIxLjEiLz4=\"\/><\/i-amphtml-sizer><noscript><img decoding=\"async\" loading=\"lazy\" width=\"780\" height=\"520\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=780%2C520&amp;ssl=1\" alt=\"A group of people seated in chairs with their hands in the air participating in a light arm exercise to help manage their diabetes\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?w=1773&amp;ssl=1 1773w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=280%2C187&amp;ssl=1 280w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=450%2C300&amp;ssl=1 450w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=150%2C100&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=1536%2C1024&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=1200%2C800&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=1568%2C1045&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg?resize=400%2C267&amp;ssl=1 400w\" sizes=\"(max-width: 780px) 100vw, 780px\"\/><\/noscript><\/amp-img><figcaption class=\"wp-element-caption\">Patients from the Elizabeth City free and charitable clinic follow along with physical exercises they can perform at home during a Fresh Start group class last year. <span class=\"image-credit\"><span class=\"credit-label-wrapper\">Credit:<\/span> Photo courtesy of Fresh Start<\/span><\/figcaption><\/figure>\n<\/div>\n<p>\u201cAll the education that we provide in the health care arena is somebody standing up talking to a patient that\u2019s sitting down, and we\u2019re just lecturing them essentially,\u201d Harmon said. \u201cMaybe about 50 percent of that is actually received by the patient.<\/p>\n<p>\u201cWith the Fresh Start program, it\u2019s interactive. The patients get up. They move. There\u2019s a cooking demonstration. There\u2019s sights. There\u2019s smells.\u201d<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-large\"><amp-img width=\"338\" height=\"450\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2.jpg?resize=338%2C450&amp;ssl=1\" alt=\"A woman in a white chef jacket cutting cooked asparagus on a yellow cutting board\" class=\"wp-image-45637 amp-wp-enforced-sizes i-amphtml-layout-intrinsic i-amphtml-layout-size-defined\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=338%2C450&amp;ssl=1 338w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=225%2C300&amp;ssl=1 225w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=113%2C150&amp;ssl=1 113w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=768%2C1024&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=1152%2C1536&amp;ssl=1 1152w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=1536%2C2048&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=900%2C1200&amp;ssl=1 900w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=600%2C800&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=300%2C400&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=150%2C200&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=1200%2C1600&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=1568%2C2091&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=400%2C533&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?w=1920&amp;ssl=1 1920w\" sizes=\"(max-width: 338px) 100vw, 338px\" layout=\"intrinsic\" disable-inline-width=\"\" i-amphtml-layout=\"intrinsic\"><i-amphtml-sizer slot=\"i-amphtml-svc\" class=\"i-amphtml-sizer\"><img alt=\"\" aria-hidden=\"true\" class=\"i-amphtml-intrinsic-sizer\" role=\"presentation\" src=\"data:image\/svg+xml;base64,PHN2ZyBoZWlnaHQ9IjQ1MCIgd2lkdGg9IjMzOCIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIiB2ZXJzaW9uPSIxLjEiLz4=\"\/><\/i-amphtml-sizer><noscript><img decoding=\"async\" loading=\"lazy\" width=\"338\" height=\"450\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2.jpg?resize=338%2C450&amp;ssl=1\" alt=\"A woman in a white chef jacket cutting cooked asparagus on a yellow cutting board\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=338%2C450&amp;ssl=1 338w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=225%2C300&amp;ssl=1 225w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=113%2C150&amp;ssl=1 113w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=768%2C1024&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=1152%2C1536&amp;ssl=1 1152w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=1536%2C2048&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=900%2C1200&amp;ssl=1 900w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=600%2C800&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=300%2C400&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=150%2C200&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=1200%2C1600&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=1568%2C2091&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?resize=400%2C533&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-scaled.jpg?w=1920&amp;ssl=1 1920w\" sizes=\"(max-width: 338px) 100vw, 338px\"\/><\/noscript><\/amp-img><figcaption class=\"wp-element-caption\">Lauren Sastre cuts cooked lemon roasted asparagus into smaller bites and serves it to participants to taste test. <span class=\"image-credit\"><span class=\"credit-label-wrapper\">Credit:<\/span> Rachel Crumpler<\/span><\/figcaption><\/figure>\n<\/div>\n<p>A main appeal of participating in the program is the ability to taste food at the end of class, he said. Patients like the immediate feedback of determining whether it\u2019s a vegetable they like and would consider including in their diet.\u00a0<\/p>\n<p>\u201cBeing able to show them that you can add vegetables into things \u2014 you can season them, you can make them taste better than what they seem \u2014 is very cool, and [so is] seeing them get excited about it,\u201d said Brooke Gillespie, a senior at ECU who helped with recipe development last year and is now serving as program coordinator.<\/p>\n<p>Last year, after taste testing, Sastre said kale \u2014 participants\u2019 least familiar vegetable \u2014 turned out to be their favorite.<\/p>\n<aside class=\"scaip scaip-6    \">\n<aside id=\"gform_widget-5\" class=\"gform_widget clearfix\">\n<h5 class=\"adtitle\">Sign up for our Newsletter<\/h5>\n<div class=\"gf_browser_safari gf_browser_iphone gform_wrapper gravity-theme\" id=\"gform_wrapper_1\">\n<form method=\"post\" enctype=\"multipart\/form-data\" id=\"gform_1\" action-xhr=\"https:\/\/www.northcarolinahealthnews.org\/wp-admin\/admin-ajax.php?action=gravity_form_submission\" target=\"_top\">\n<p>\n\t<template type=\"amp-mustache\"><br \/>\n\t\tThere is a mistake in the form!<br \/>\n\t\t{{#verifyErrors}}{{message}}{{\/verifyErrors}}<br \/>\n\t<\/template>\n<\/p>\n<p>\n\t<template type=\"amp-mustache\"><br \/>\n\t\tSubmitting\u2026<br \/>\n\t<\/template>\n<\/p>\n<p>\n<template type=\"amp-mustache\"><br \/>\n\t{{#confirmation}}<br \/>\n\t\t{{{confirmation}}}<br \/>\n\t{{\/confirmation}}<br \/>\n\t{{^confirmation}}<br \/>\n\t\tForm successfully submitted.<br \/>\n\t{{\/confirmation}}<br \/>\n<\/template>\n<\/p>\n<div submit-error=\"\">\n\t<template type=\"amp-mustache\"><br \/>\n\t\t{{#errors}}<\/p>\n<p>{{#label}}{{label}}: {{\/label}}{{message}}<\/p>\n<p>\t\t{{\/errors}}<br \/>\n\t\t{{^errors}}<\/p>\n<p>Something went wrong. Please try again later.<\/p>\n<p>\t\t{{\/errors}}<br \/>\n\t<\/template>\n<\/div>\n<p data-amp-original-style=\"display: none !important;\" class=\"amp-wp-3e2e7c3\"><label>\u0394<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"\/><\/label><\/p>\n<\/form><\/div>\n<\/aside>\n<\/aside>\n<p>In addition to exposing patients to new foods, Fresh Start is making an intentional effort to tailor some recipes and educational materials to the cultural preferences of its Latino patients. For example, a handout on how much sugar is in drinks will include Mexican sodas and juices found in a typical Latino store.<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"alignright size-medium\"><amp-img width=\"225\" height=\"300\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2.jpg?resize=225%2C300&amp;ssl=1\" alt=\"\" class=\"wp-image-45641 amp-wp-enforced-sizes i-amphtml-layout-intrinsic i-amphtml-layout-size-defined\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=225%2C300&amp;ssl=1 225w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=338%2C450&amp;ssl=1 338w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=113%2C150&amp;ssl=1 113w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=768%2C1024&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=1152%2C1536&amp;ssl=1 1152w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=1536%2C2048&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=900%2C1200&amp;ssl=1 900w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=600%2C800&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=300%2C400&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=150%2C200&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=1200%2C1600&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=1568%2C2091&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=400%2C533&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?w=1920&amp;ssl=1 1920w\" sizes=\"(max-width: 225px) 100vw, 225px\" layout=\"intrinsic\" disable-inline-width=\"\" i-amphtml-layout=\"intrinsic\"><i-amphtml-sizer slot=\"i-amphtml-svc\" class=\"i-amphtml-sizer\"><img alt=\"\" aria-hidden=\"true\" class=\"i-amphtml-intrinsic-sizer\" role=\"presentation\" src=\"data:image\/svg+xml;base64,PHN2ZyBoZWlnaHQ9IjMwMCIgd2lkdGg9IjIyNSIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIiB2ZXJzaW9uPSIxLjEiLz4=\"\/><\/i-amphtml-sizer><noscript><img decoding=\"async\" loading=\"lazy\" width=\"225\" height=\"300\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2.jpg?resize=225%2C300&amp;ssl=1\" alt=\"\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=225%2C300&amp;ssl=1 225w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=338%2C450&amp;ssl=1 338w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=113%2C150&amp;ssl=1 113w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=768%2C1024&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=1152%2C1536&amp;ssl=1 1152w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=1536%2C2048&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=900%2C1200&amp;ssl=1 900w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=600%2C800&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=300%2C400&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=150%2C200&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=1200%2C1600&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=1568%2C2091&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?resize=400%2C533&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-scaled.jpg?w=1920&amp;ssl=1 1920w\" sizes=\"(max-width: 225px) 100vw, 225px\"\/><\/noscript><\/amp-img><figcaption class=\"wp-element-caption\">Asparagus frittata was a new recipe that many patients never considered making. After tasting, the dish was a big hit among participants. <span class=\"image-credit\"><span class=\"credit-label-wrapper\">Credit:<\/span> Rachel Crumpler<\/span><\/figcaption><\/figure>\n<\/div>\n<p>Additionally, there\u2019s been positive feedback about health coaching.\u00a0<\/p>\n<p>Sarah Elliott, a junior studying nutrition at ECU, served as a health coach last year, engaging in weekly phone calls with two patients.\u00a0<\/p>\n<p>On the calls, she helped patients set physical activity and diet goals and checked in on their progress. For example, one of her patients started out drinking three regular soft drinks a day, but she slowly cut the number and switched to diet soft drinks by the end of the program.<\/p>\n<p>\u201cPatients shared that that kind of one-on-one, consistent support was something they hadn\u2019t received before, and that was the piece that helped them stay motivated and stay on their goals,\u201d Elliott said. \u201cBehavior change is really hard without that \u2014 someone holding you accountable and checking in and doing it in a compassionate way.\u201d\u00a0<\/p>\n<p>By the end of the monthslong Fresh Start program, progression is noticeable in patients.\u00a0<\/p>\n<p>Sastre recalls one patient with consistently elevated blood sugar who was starting to lose his eyesight at the beginning of the program. By the end, he expressed how much better he could see \u2014 a result of the diet changes he implemented from the program.\u00a0<\/p>\n<div class=\"is-layout-constrained wp-block-group has-secondary-background-color has-background\">\n<div class=\"wp-block-group__inner-container\">\n<p class=\"has-primary-color has-text-color\"><strong>Where Fresh Start produce comes from<\/strong><\/p>\n<p>Fresh Start\u2019s food prescription program relies on donated, un-sold local produce. This is possible through Fresh Start\u2019s partnership with the <a href=\"https:\/\/endhunger.org\/\">Society of St. Andrew<\/a>, an organization that works with farmers to collect fresh produce they are unable to sell and then distribute it to groups in the community that help people who are food insecure.<\/p>\n<p>Michael Binger, regional director for North Carolina and South Carolina at the Society of St. Andrew, said when he gets a call from a farmer donating produce in Eastern North Carolina, he calls Fresh Start, which sends volunteers to harvest the fields. Most of the produce is sourced from 10 farms and then transported and distributed to patients during the next group class.\u00a0<\/p>\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><amp-img width=\"450\" height=\"338\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2.jpg?resize=450%2C338&amp;ssl=1\" alt=\"A cooler full of fresh collards and cabbage\" class=\"wp-image-45635 amp-wp-enforced-sizes i-amphtml-layout-intrinsic i-amphtml-layout-size-defined\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=450%2C338&amp;ssl=1 450w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=280%2C210&amp;ssl=1 280w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=150%2C113&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=1536%2C1152&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=2048%2C1536&amp;ssl=1 2048w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=1200%2C900&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=200%2C150&amp;ssl=1 200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=1568%2C1176&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=600%2C450&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?w=2340&amp;ssl=1 2340w\" sizes=\"(max-width: 450px) 100vw, 450px\" layout=\"intrinsic\" disable-inline-width=\"\" i-amphtml-layout=\"intrinsic\"><i-amphtml-sizer slot=\"i-amphtml-svc\" class=\"i-amphtml-sizer\"><img alt=\"\" aria-hidden=\"true\" class=\"i-amphtml-intrinsic-sizer\" role=\"presentation\" src=\"data:image\/svg+xml;base64,PHN2ZyBoZWlnaHQ9IjMzOCIgd2lkdGg9IjQ1MCIgeG1sbnM9Imh0dHA6Ly93d3cudzMub3JnLzIwMDAvc3ZnIiB2ZXJzaW9uPSIxLjEiLz4=\"\/><\/i-amphtml-sizer><noscript><img decoding=\"async\" loading=\"lazy\" width=\"450\" height=\"338\" src=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2.jpg?resize=450%2C338&amp;ssl=1\" alt=\"A cooler full of fresh collards and cabbage\" srcset=\"https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=450%2C338&amp;ssl=1 450w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=280%2C210&amp;ssl=1 280w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=150%2C113&amp;ssl=1 150w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=1536%2C1152&amp;ssl=1 1536w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=2048%2C1536&amp;ssl=1 2048w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=1200%2C900&amp;ssl=1 1200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=800%2C600&amp;ssl=1 800w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=400%2C300&amp;ssl=1 400w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=200%2C150&amp;ssl=1 200w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=1568%2C1176&amp;ssl=1 1568w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?resize=600%2C450&amp;ssl=1 600w, https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-scaled.jpg?w=2340&amp;ssl=1 2340w\" sizes=\"(max-width: 450px) 100vw, 450px\"\/><\/noscript><\/amp-img><figcaption class=\"wp-element-caption\">A cooler full of fresh collards and cabbage harvested from fields in Eastern North Carolina. The produce was distributed to patients. <span class=\"image-credit\"><span class=\"credit-label-wrapper\">Credit:<\/span> Rachel Crumpler<\/span><\/figcaption><\/figure>\n<\/div>\n<p>He said farmers receive a national farm tax credit for food donations \u2014 roughly half the fair market value.\u00a0<\/p>\n<p>Fresh Start recovered more than 2,000 pounds of produce last year from North Carolina fields. The Society of St. Andrew will connect Fresh Start with more produce this year to accommodate the increased patient volume, and Binger said obtaining the larger amount of food\u00a0won\u2019t be a problem.\u00a0<\/p>\n<p>Binger said there\u2019s an abundance of healthy, edible food that never makes it out of the fields every year. The issue is often getting produce from where it is to the people who need it.<\/p>\n<\/div>\n<\/div>\n<section id=\"republication_tracker_tool-4\" class=\"below-content widget republication_tracker_tool\">\n<div class=\"license\">\n<p><button on=\"tap:republication-tracker-tool-modal\" name=\"Republish This Story\" id=\"cc-btn\" class=\"republication-tracker-tool-button\">Republish This Story<\/button><\/p>\n<p><a class=\"license\" rel=\"noreferrer license noopener\" target=\"_blank\" href=\"http:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/\"><amp-img alt=\"Creative Commons License\" src=\"https:\/\/www.northcarolinahealthnews.org\/wp-content\/plugins\/republication-tracker-tool\/assets\/img\/creative-commons-sharing.png\" width=\"88\" height=\"31\" class=\"amp-wp-enforced-sizes amp-wp-27d0abf i-amphtml-layout-intrinsic i-amphtml-layout-size-defined\" layout=\"intrinsic\" data-amp-original-style=\"border-width:0\" i-amphtml-layout=\"intrinsic\"><i-amphtml-sizer slot=\"i-amphtml-svc\" class=\"i-amphtml-sizer\"><img alt=\"\" aria-hidden=\"true\" class=\"i-amphtml-intrinsic-sizer\" role=\"presentation\" src=\"data:image\/svg+xml;base64,PHN2ZyBoZWlnaHQ9IjMxIiB3aWR0aD0iODgiIHhtbG5zPSJodHRwOi8vd3d3LnczLm9yZy8yMDAwL3N2ZyIgdmVyc2lvbj0iMS4xIi8+\"\/><\/i-amphtml-sizer><noscript><img loading=\"lazy\" alt=\"Creative Commons License\" src=\"https:\/\/www.northcarolinahealthnews.org\/wp-content\/plugins\/republication-tracker-tool\/assets\/img\/creative-commons-sharing.png\" width=\"88\" height=\"31\"\/><\/noscript><\/amp-img><\/a><\/p>\n<\/div>\n<div class=\"message\">\n<p>Republish our articles for free, online or in print, under a Creative Commons license.<\/p>\n<\/div>\n<\/section>\n<p>\t\t\t\t\t<amp-lightbox id=\"republication-tracker-tool-modal\" layout=\"nodisplay\" role=\"dialog\" aria-modal=\"true\" class=\"i-amphtml-layout-nodisplay\" hidden=\"hidden\" i-amphtml-layout=\"nodisplay\"><\/p>\n<div id=\"republication-tracker-tool-modal-content\">\n<p><span class=\"screen-reader-text\">Close window<\/span> <span aria-hidden=\"true\">X<\/span><\/p>\n<h2>Republish this article<\/h2>\n<div class=\"cc-policy\">You are free to use NC Health News content under the following conditions:<\/p>\n<ul>&#13;<\/p>\n<li>You can copy and paste this html tracking code into articles of ours that you use, this little snippet of code allows us to track how many people read our story.<\/li>\n<p>&#13;<\/p>\n<li>Please do not reprint our stories without our bylines, and please include a live link to NC Health News under the byline, like this:<strong>By Jane Doe<\/strong><a href=\"http:\/\/www.northcarolinahealthnews.org\">North Carolina Health News<\/a><\/li>\n<p>&#13;<\/p>\n<li>Finally, at the bottom of the story (whether web or print), please include the text:North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org. (on the web, this can be hyperlinked)<\/li>\n<p>&#13;\n<\/ul>\n<\/div>\n<div class=\"article-info\">\n<p class=\"byline\">by Rachel Crumpler, North Carolina Health News <br \/>January 19, 2023<\/p>\n<\/div>\n<p><textarea readonly=\"readonly\" id=\"republication-tracker-tool-shareable-content\" rows=\"5\">&lt;h1&gt;Comprehensive food nutrition program aims to combat disparities in diabetes treatments&lt;\/h1&gt;<br \/>\n&lt;p class=&#8221;byline&#8221;&gt;by Rachel Crumpler, North Carolina Health News &lt;br \/&gt;January 19, 2023&lt;\/p&gt;<br \/>\n &lt;br \/&gt;<br \/>\n&lt;h4 id=&#8221;h-by-rachel-crumpler&#8221;&gt;&lt;strong&gt;By Rachel Crumpler&lt;\/strong&gt;&lt;\/h4&gt;<br \/>\n&lt;p&gt;Health care providers have traditionally written prescriptions for medications, for exercise, for therapy, even for relaxation for their patients. So to combat obesity and poor nutrition, why not give patients a prescription to help them eat better?&lt;\/p&gt;<br \/>\n&lt;p&gt;Such &lt;a href=&#8221;https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9518562\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;food prescriptions&lt;\/a&gt; \u2014 delivered to patients in the form of vouchers that can help patients get access to more fresh fruits and vegetables \u2014 are becoming increasingly popular across the U.S.&lt;\/p&gt;<br \/>\n&lt;p&gt;Lauren Sastre, a professor in the Department of Nutrition Science at East Carolina University, saw the promise of food prescription programs in fall 2018 when she started researching their implementation. While she considered them helpful, Sastre didn\u2019t think they went far enough in breaking down barriers to getting healthy food.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;For one, she said, transportation issues persist \u2014 especially in rural areas. Additionally, the amounts of fresh food offered aren\u2019t often substantial enough to meet nutrition recommendations. For example, in some cases the allotted funds would only cover the cost of a tomato and a cucumber.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;Sastre wanted to create a more robust produce prescription program \u2014 to operate longer, to provide more food and to offer more educational support.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;\u201cIf you don&#8217;t have access to healthy food, you can\u2019t eat well, period,\u201d Sastre said. \u201cSo that\u2019s step one. But there needs to be more than step one. We don\u2019t have Home Ec anymore. We\u2019re not teaching people how to prepare things from scratch. The idea that people are going to take this produce home and cook it and eat it \u2014 there has to be some level of support in place for that.\u201d&lt;\/p&gt;<br \/>\n&lt;p&gt;Last year, Sastre launched a comprehensive nutrition program called &lt;a href=&#8221;https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/FreshStartPromotionalFlyer.pdf&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;Fresh Start&lt;\/a&gt;, serving low-income, uninsured patients with diabetes living in Eastern North Carolina.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;figure class=&#8221;wp-block-image aligncenter size-full&#8221;&gt;&lt;img src=&#8221;https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3267-2-scaled.jpg&#8221; alt=&#8221;One woman in white chef jacket sautees asparagus in a pan while another woman in a white chef jacket watches.&#8221; class=&#8221;wp-image-45638&#8243; \/&gt;&lt;figcaption class=&#8221;wp-element-caption&#8221;&gt;Lauren Sastre, director of the Fresh Start program, sautees asparagus in a large pan. Patients with diabetes observe and help her complete the steps needed to cook a healthy asparagus frittata.  Participants learn how to prepare a vegetable in three different ways and are provided with recipes at each group class.&lt;\/figcaption&gt;&lt;\/figure&gt;<br \/>\n&lt;p&gt;Fresh Start offers nine in-person group classes from January to May. The classes include education on diabetes management, demonstrations of simple at-home physical exercises, and on-site cooking and taste-testing of the prepared food. Participants attending class leave with fresh produce and healthy recipes. One-on-one health coaching, conducted by trained ECU students, is also provided over the phone to help patients set attainable lifestyle goals.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;None of these elements is groundbreaking by itself, Sastre said. It\u2019s the combination that\u2019s significant.&lt;\/p&gt;<br \/>\n&lt;p&gt;\u201cI\u2019ve never seen a program that has them all offered at the same time and \u2026 intentionally integrated,&#8221; she said. \u201cOur cooking aligns with the food we know we\u2019re giving out. Our health coaches touch base with their patients and see how they\u2019re working with that food and if they have questions or want more recipe ideas.\u201d&lt;\/p&gt;<br \/>\n&lt;p&gt;The elements together create a synergy, Sastre said, that maximizes health improvements. Patients gain access, confidence and support to create real behavioral and lifestyle changes needed to manage their diabetes.&lt;\/p&gt;<br \/>\n&lt;div class=&#8221;wp-block-group has-dark-gray-color has-secondary-background-color has-text-color has-background&#8221;&gt;<br \/>\n&lt;p class=&#8221;has-primary-color has-text-color&#8221;&gt;&lt;strong&gt;Diabetes in North Carolina&lt;\/strong&gt;&lt;\/p&gt;<br \/>\n&lt;ul&gt;<br \/>\n&lt;li&gt;In North Carolina, about 12.4 percent of adults have diabetes, outpacing the national rate of &lt;a href=&#8221;https:\/\/www.americashealthrankings.org\/explore\/annual\/measure\/Diabetes\/state\/NC&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;10.9 percent&lt;\/a&gt;, according to the annual America\u2019s Health Rankings database&lt;\/li&gt;<br \/>\n&lt;li&gt;Nearly 244,000 people are estimated to have diabetes but don\u2019t yet know they have it&lt;\/li&gt;<br \/>\n&lt;li&gt;Every year, an estimated 73,032 people in North Carolina are diagnosed with diabetes&lt;\/li&gt;<br \/>\n&lt;\/ul&gt;<br \/>\n&lt;p class=&#8221;has-small-font-size&#8221;&gt;&lt;em&gt;&lt;a href=&#8221;https:\/\/diabetes.org\/sites\/default\/files\/2022-01\/ADV_2021_State_Fact_sheets_all_rev_1.27_NC.pdf&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;Data from the American Diabetes Association&lt;\/a&gt;&lt;\/em&gt;&lt;\/p&gt;<br \/>\n&lt;\/p&gt;&lt;\/div&gt;<br \/>\n&lt;h4&gt;&lt;strong&gt;Expensive disease&lt;\/strong&gt;&lt;\/h4&gt;<br \/>\n&lt;p&gt;Funded by a three-year, $365,000 grant from The Duke Endowment, Sastre partnered with the &lt;a href=&#8221;https:\/\/ncafcc.org\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;North Carolina Association of Free and Charitable Clinics&lt;\/a&gt; to offer Fresh Start to low-income, uninsured patients with diabetes at several clinics in the eastern part of the state.&lt;\/p&gt;<br \/>\n&lt;p&gt;April Cook, CEO of the North Carolina Association of Free and Charitable Clinics, said diabetes is prevalent among patients at its 71 member clinics across the state. She said about 40 percent of the total patients served have diabetes.&lt;\/p&gt;<br \/>\n&lt;p&gt;People with low incomes suffer disproportionately from diet-related chronic diseases, such as diabetes, and have fewer resources to manage their diseases. &lt;a href=&#8221;https:\/\/health.gov\/sites\/default\/files\/2022-01\/NCCC%20Report%20to%20Congress.pdf&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;Food insecurity is recognized as a common risk factor&lt;\/a&gt; for developing type 2 diabetes (which used to be known as \u201cadult onset diabetes\u201d) and is a contributor to socioeconomic, racial and ethnic disparities in diabetes outcomes.&lt;\/p&gt;<br \/>\n&lt;p&gt;Cook said patients served at free and charitable clinics are often newly diagnosed or will get diagnosed with diabetes there for the first time. She said many patients come in with &lt;a href=&#8221;https:\/\/www.cdc.gov\/diabetes\/managing\/managing-blood-sugar\/a1c.html#:~:text=Diagnosing%20Prediabetes%20or%20Diabetes&amp;amp;text=A%20normal%20A1C%20level%20is,6.5%25%20or%20more%20indicates%20diabetes.&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;glycemic levels&lt;\/a&gt;, a measurement known as hemoglobin A1C, as high as 15 percent, when the normal level should be below 5.7 percent. The A1C measurement reflects a person\u2019s blood sugar measurements over time.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;figure class=&#8221;wp-block-image aligncenter size-full&#8221;&gt;&lt;img src=&#8221;https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3228-2-scaled.jpg&#8221; alt=&#8221;A church hall full of over 30 people seated at three different tables learning nutrition information about diabetes&#8221; class=&#8221;wp-image-45636&#8243; \/&gt;&lt;figcaption class=&#8221;wp-element-caption&#8221;&gt;Over 20  low-income, uninsured patients with diabetes from the WATCH Clinic in Goldsboro attended Fresh Start&#8217;s first group class of the year on Jan. 10.  During this class, participants learned more about managing diabetes, a series of easy exercises they can complete from their couch and how to cook asparagus three different ways. &lt;\/figcaption&gt;&lt;\/figure&gt;<br \/>\n&lt;p&gt;Living for a long time with high blood sugar levels has &lt;a href=&#8221;https:\/\/www.cdc.gov\/diabetes\/library\/features\/prevent-complications.html#:~:text=Heart%20disease%20and%20stroke%3A%20People,Clouding%20of%20the%20lens%20(cataract)&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;major health implications&lt;\/a&gt;, including loss of eyesight, kidney disease and nerve damage.&lt;\/p&gt;<br \/>\n&lt;p&gt;Diabetes is an expensive chronic disease. People with diabetes pay approximately &lt;a href=&#8221;https:\/\/diabetes.org\/sites\/default\/files\/2022-01\/ADV_2021_State_Fact_sheets_all_rev_1.27_NC.pdf&#8221;&gt;2.3 times more&lt;\/a&gt; in medical expenses than those who do not have the disease, according to the &lt;a href=&#8221;https:\/\/diabetes.org\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;American Diabetes Association&lt;\/a&gt;. The organization estimates that diagnosed diabetes costs North Carolina about &lt;a href=&#8221;https:\/\/diabetes.org\/sites\/default\/files\/2022-01\/ADV_2021_State_Fact_sheets_all_rev_1.27_NC.pdf&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;$10.6 billion&lt;\/a&gt; each year \u2014 a combination of direct medical costs and indirect costs from lost productivity.&lt;\/p&gt;<br \/>\n&lt;div class=&#8221;wp-block-group has-secondary-background-color has-background&#8221;&gt; &lt;\/div&gt;<br \/>\n&lt;p&gt;Cook said patients often don\u2019t realize how bad they feel until they start making improvements. But making those improvements comes with extra challenges for low-income patient populations. One of the best ways to control blood glucose level is to eat healthier, but that is more expensive.&lt;\/p&gt;<br \/>\n&lt;p&gt;\u201cIt&#8217;s really sad to think that you want to provide the best that you can for your family and your children \u2014 and knowing that the things that are more nutritious, healthier, are out of reach for you,\u201d Cook said, noting that\u2019s the reality for many folks.&lt;\/p&gt;<br \/>\n&lt;p&gt;Kelli Corbett, lead nurse practitioner at &lt;a href=&#8221;https:\/\/www.watchwayne.org\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;Wayne Action Teams for Community Health&lt;\/a&gt; clinic in Wayne County, said she always advises her patients to shop on the perimeter of the grocery store where the fresh, unprocessed options are. She consistently hears that it\u2019s a struggle. One patient told her they could only afford to eat peanut butter and jelly sandwiches until their next check.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;figure class=&#8221;wp-block-image alignright size-large&#8221;&gt;&lt;img src=&#8221;https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3240-2-338&#215;450.jpg&#8221; alt=&#8221;A woman in a mask and apron places lemon slices on top of asparagus in a tin dish. They are making a healthy dish for someone wish diabetes.&#8221; class=&#8221;wp-image-45634&#8243; \/&gt;&lt;figcaption class=&#8221;wp-element-caption&#8221;&gt;A Fresh Start program participant helps prepare lemon-roasted asparagus. Many participants commented that they had never thought to pair asparagus with lemon before.&lt;\/figcaption&gt;&lt;\/figure&gt;<br \/>\n&lt;p&gt;Cook said the grant-funded partnership with Sastre is a game-changer for the clinics\u2019 patients in providing healthy food as well as education and cooking skills. What patients learn can then be&amp;nbsp; shared with other members of their households and families, helping to create systemic change.&lt;\/p&gt;<br \/>\n&lt;p&gt;\u201cYou can throw money at it through medicine all you want,\u201d Cook said. \u201cBut if you don&#8217;t start addressing the social determinants that surround someone\u2019s health, it\u2019s not as easy to have an impact.\u201d&lt;\/p&gt;<br \/>\n&lt;h4&gt;&lt;strong&gt;\u2018There\u2019s sights. There\u2019s smells.\u2019&lt;\/strong&gt;&lt;\/h4&gt;<br \/>\n&lt;p&gt;In its first year, Fresh Start served 56 patients from two clinics with diabetes.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;The researchers saw &lt;a href=&#8221;https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/APHA-Poster-Fresh-Start.pdf&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;results&lt;\/a&gt;, even in the few months of the program. Patients\u2019 levels of hemoglobin A1C decreased by an average 1.21 percent. For those who attended at least four group classes, blood sugar levels decreased even further, by an average of 1.87 percent. Food literacy also improved.&lt;\/p&gt;<br \/>\n&lt;p&gt;This year, the program is planning to triple its scope, expanding to serve around 150 patients at five clinics in Eastern North Carolina.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;div class=&#8221;wp-block-group has-secondary-background-color has-background&#8221;&gt;<br \/>\n&lt;p class=&#8221;has-primary-color has-text-color&#8221;&gt;&lt;strong&gt;Clinics served&lt;\/strong&gt;&lt;\/p&gt;<br \/>\n&lt;ul&gt;<br \/>\n&lt;li&gt;&lt;a href=&#8221;https:\/\/www.watchwayne.org\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;WATCH Clinic&lt;\/a&gt; in Goldsboro&lt;\/li&gt;<br \/>\n&lt;li&gt;&lt;a href=&#8221;https:\/\/www.merciclinic.org\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;MERCI Clinic&lt;\/a&gt; in New Bern&lt;\/li&gt;<br \/>\n&lt;li&gt;&lt;a href=&#8221;https:\/\/www.hopeclinic.net\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;Hope Clinic&lt;\/a&gt; in Bayboro&amp;nbsp;&lt;\/li&gt;<br \/>\n&lt;li&gt;&lt;a href=&#8221;https:\/\/ncafcc.org\/our-clinics\/albemarle-hospital-foundation-community-care-clinic\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;The Albemarle Hospital Foundation Community Care Clinic&lt;\/a&gt; in Elizabeth City&amp;nbsp;&lt;\/li&gt;<br \/>\n&lt;li&gt;&lt;a href=&#8221;https:\/\/www.dareclinic.org\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;Community Care Clinic of Dare&lt;\/a&gt; in Nags Head&lt;\/li&gt;<br \/>\n&lt;\/ul&gt;&lt;\/div&gt;<br \/>\n&lt;p&gt;Ramon Harmon, deputy director of the &lt;a href=&#8221;https:\/\/ncafcc.org\/our-clinics\/albemarle-hospital-foundation-community-care-clinic\/&#8221; target=&#8221;_blank&#8221; rel=&#8221;noreferrer noopener&#8221;&gt;Albemarle Hospital Foundation Community Care Clinic&lt;\/a&gt; in Elizabeth City, said patients that participated enjoyed the hands-on approach Fresh Start offers.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;figure class=&#8221;wp-block-image aligncenter size-full&#8221;&gt;&lt;img src=&#8221;https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/Fresh-Start-Group-Physical-Activity-2022.jpg&#8221; alt=&#8221;A group of people seated in chairs with their hands in the air participating in a light arm exercise to help manage their diabetes&#8221; class=&#8221;wp-image-45643&#8243; \/&gt;&lt;figcaption class=&#8221;wp-element-caption&#8221;&gt;Patients from the Elizabeth City free and charitable clinic follow along with physical exercises they can perform at home during a Fresh Start group class last year.&lt;\/figcaption&gt;&lt;\/figure&gt;<br \/>\n&lt;p&gt;\u201cAll the education that we provide in the health care arena is somebody standing up talking to a patient that&#8217;s sitting down, and we\u2019re just lecturing them essentially,\u201d Harmon said. \u201cMaybe about 50 percent of that is actually received by the patient.&lt;\/p&gt;<br \/>\n&lt;p&gt;\u201cWith the Fresh Start program, it\u2019s interactive. The patients get up. They move. There\u2019s a cooking demonstration. There\u2019s sights. There\u2019s smells.\u201d&lt;\/p&gt;<br \/>\n&lt;figure class=&#8221;wp-block-image alignright size-large&#8221;&gt;&lt;img src=&#8221;https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3279-2-338&#215;450.jpg&#8221; alt=&#8221;A woman in a white chef jacket cutting cooked asparagus on a yellow cutting board&#8221; class=&#8221;wp-image-45637&#8243; \/&gt;&lt;figcaption class=&#8221;wp-element-caption&#8221;&gt;Lauren Sastre cuts cooked lemon roasted asparagus into smaller bites and serves it to participants to taste test.&lt;\/figcaption&gt;&lt;\/figure&gt;<br \/>\n&lt;p&gt;A main appeal of participating in the program is the ability to taste food at the end of class, he said. Patients like the immediate feedback of determining whether it\u2019s a vegetable they like and would consider including in their diet.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;\u201cBeing able to show them that you can add vegetables into things \u2014 you can season them, you can make them taste better than what they seem \u2014 is very cool, and [so is] seeing them get excited about it,\u201d said Brooke Gillespie, a senior at ECU who helped with recipe development last year and is now serving as program coordinator.&lt;\/p&gt;<br \/>\n&lt;p&gt;Last year, after taste testing, Sastre said kale \u2014 participants\u2019 least familiar vegetable \u2014 turned out to be their favorite.&lt;\/p&gt;<br \/>\n&lt;p&gt;In addition to exposing patients to new foods, Fresh Start is making an intentional effort to tailor some recipes and educational materials to the cultural preferences of its Latino patients. For example, a handout on how much sugar is in drinks will include Mexican sodas and juices found in a typical Latino store.&lt;\/p&gt;<br \/>\n&lt;figure class=&#8221;wp-block-image alignright size-medium&#8221;&gt;&lt;img src=&#8221;https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3281-2-225&#215;300.jpg&#8221; alt=&#8221;&#8221; class=&#8221;wp-image-45641&#8243; \/&gt;&lt;figcaption class=&#8221;wp-element-caption&#8221;&gt;Asparagus frittata was a new recipe that many patients never considered making. After tasting, the dish was a big hit among participants.&lt;\/figcaption&gt;&lt;\/figure&gt;<br \/>\n&lt;p&gt;Additionally, there\u2019s been positive feedback about health coaching.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;Sarah Elliott, a junior studying nutrition at ECU, served as a health coach last year, engaging in weekly phone calls with two patients.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;On the calls, she helped patients set physical activity and diet goals and checked in on their progress. For example, one of her patients started out drinking three regular soft drinks a day, but she slowly cut the number and switched to diet soft drinks by the end of the program.&lt;\/p&gt;<br \/>\n&lt;p&gt;\u201cPatients shared that that kind of one-on-one, consistent support was something they hadn&#8217;t received before, and that was the piece that helped them stay motivated and stay on their goals,\u201d Elliott said. \u201cBehavior change is really hard without that \u2014 someone holding you accountable and checking in and doing it in a compassionate way.\u201d&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;By the end of the monthslong Fresh Start program, progression is noticeable in patients.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;Sastre recalls one patient with consistently elevated blood sugar who was starting to lose his eyesight at the beginning of the program. By the end, he expressed how much better he could see \u2014 a result of the diet changes he implemented from the program.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;div class=&#8221;wp-block-group has-secondary-background-color has-background&#8221;&gt;<br \/>\n&lt;p class=&#8221;has-primary-color has-text-color&#8221;&gt;&lt;strong&gt;Where Fresh Start produce comes from&lt;\/strong&gt;&lt;\/p&gt;<br \/>\n&lt;p&gt;Fresh Start\u2019s food prescription program relies on donated, un-sold local produce. This is possible through Fresh Start\u2019s partnership with the &lt;a href=&#8221;https:\/\/endhunger.org\/&#8221;&gt;Society of St. Andrew&lt;\/a&gt;, an organization that works with farmers to collect fresh produce they are unable to sell and then distribute it to groups in the community that help people who are food insecure.&lt;\/p&gt;<br \/>\n&lt;p&gt;Michael Binger, regional director for North Carolina and South Carolina at the Society of St. Andrew, said when he gets a call from a farmer donating produce in Eastern North Carolina, he calls Fresh Start, which sends volunteers to harvest the fields. Most of the produce is sourced from 10 farms and then transported and distributed to patients during the next group class.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;figure class=&#8221;wp-block-image aligncenter size-large&#8221;&gt;&lt;img src=&#8221;https:\/\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2023\/01\/IMG_3227-2-450&#215;338.jpg&#8221; alt=&#8221;A cooler full of fresh collards and cabbage&#8221; class=&#8221;wp-image-45635&#8243; \/&gt;&lt;figcaption class=&#8221;wp-element-caption&#8221;&gt;A cooler full of fresh collards and cabbage harvested from fields in Eastern North Carolina. The produce was distributed to patients.&lt;\/figcaption&gt;&lt;\/figure&gt;<br \/>\n&lt;p&gt;He said farmers receive a national farm tax credit for food donations \u2014 roughly half the fair market value.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;Fresh Start recovered more than 2,000 pounds of produce last year from North Carolina fields. The Society of St. Andrew will connect Fresh Start with more produce this year to accommodate the increased patient volume, and Binger said obtaining the larger amount of food&amp;nbsp;won\u2019t be a problem.&amp;nbsp;&lt;\/p&gt;<br \/>\n&lt;p&gt;Binger said there\u2019s an abundance of healthy, edible food that never makes it out of the fields every year. The issue is often getting produce from where it is to the people who need it.&lt;\/p&gt;<br \/>\n&lt;\/p&gt;&lt;\/div&gt;<\/p>\n<p>This &lt;a target=&#8221;_blank&#8221; href=&#8221;https:\/\/www.northcarolinahealthnews.org\/2023\/01\/19\/comprehensive-food-nutrition-program-aims-to-combat-disparities-in-diabetes-treatments\/&#8221;&gt;article&lt;\/a&gt; first appeared on &lt;a target=&#8221;_blank&#8221; href=&#8221;https:\/\/www.northcarolinahealthnews.org&#8221;&gt;North Carolina Health News&lt;\/a&gt; and is republished here under a Creative Commons license.&lt;img src=&#8221;https:\/\/i0.wp.com\/www.northcarolinahealthnews.org\/wp-content\/uploads\/2021\/10\/cropped-favicon02.jpg?fit=150%2C150&amp;amp;ssl=1&#8243; style=&#8221;width:1em;height:1em;margin-left:10px;&#8221;&gt;&lt;img id=&#8221;republication-tracker-tool-source&#8221; src=&#8221;https:\/\/www.northcarolinahealthnews.org\/?republication-pixel=true&amp;post=45647&amp;ga=UA-28368570-1&#8243; style=&#8221;width:1px;height:1px;&#8221;&gt;<\/p>\n<p><\/textarea><\/div>\n<p>1\t\t\t\t\t<\/amp-lightbox>\n\t\t\t\t\t<\/div>\n\n<br \/><a href=\"https:\/\/news.google.com\/__i\/rss\/rd\/articles\/CBMiigFodHRwczovL3d3dy5ub3J0aGNhcm9saW5haGVhbHRobmV3cy5vcmcvMjAyMy8wMS8xOS9jb21wcmVoZW5zaXZlLWZvb2QtbnV0cml0aW9uLXByb2dyYW0tYWltcy10by1jb21iYXQtZGlzcGFyaXRpZXMtaW4tZGlhYmV0ZXMtdHJlYXRtZW50cy_SAYoBaHR0cHM6Ly93d3cubm9ydGhjYXJvbGluYWhlYWx0aG5ld3Mub3JnLzIwMjMvMDEvMTkvY29tcHJlaGVuc2l2ZS1mb29kLW51dHJpdGlvbi1wcm9ncmFtLWFpbXMtdG8tY29tYmF0LWRpc3Bhcml0aWVzLWluLWRpYWJldGVzLXRyZWF0bWVudHMv?oc=5\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Rachel Crumpler Health care providers have traditionally written prescriptions for medications, for exercise, for therapy, even for relaxation for their patients. So to combat obesity and poor nutrition, why not give patients a prescription to help them eat better? Such food prescriptions \u2014 delivered to patients in the form of vouchers that can help &hellip;<\/p>\n","protected":false},"author":1,"featured_media":44755,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[161],"tags":[],"_links":{"self":[{"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/posts\/44754"}],"collection":[{"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/comments?post=44754"}],"version-history":[{"count":0,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/posts\/44754\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/media\/44755"}],"wp:attachment":[{"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/media?parent=44754"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/categories?post=44754"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.brandon.ddtest.info\/multisite-test\/wp-json\/wp\/v2\/tags?post=44754"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}