Why vegetables and museum visits could soon come by prescription

This article was first published on 4 August 2021. It was updated on 28 July 2023.

Fruit bowl or cookie jar? Which one do you reach for when those hunger pangs strike?

We all know we should be eating more fresh fruit and vegetables but the rise in obesity and the staggering rate of deaths from cardiovascular disease are proof that we don't, or are unable to make the right food choices frequently enough.

There are complex reasons for millions of people not getting enough fresh fruit and veg. The cost of living crisis has pushed millions more people into food insecurity and diet-related conditions such as diabetes can limit options for healthy food.

Research published in the Journal of the American Heart Association suggests providing fresh fruit and vegetables on prescription could lead to significant health improvements for people living with diabetes, and a dramatic reduction in healthcare costs.

The study looked into the potential benefits of introducing produce prescriptions for 6.5 million people in the US afflicted by diabetes and food insecurity. The researchers found that; "produce prescription programs implemented nationally for US adults aged 40 to 79 years with diabetes and food insecurity could prevent 292,000 cardiovascular disease events, gain 260,000 quality‐adjusted life‐years, and save $39.6 billion in health care costs and $4.8 billion in productivity costs over a lifetime".

Other parts of the world are also considering allowing doctors to prescribe healthy food. In a review of the role of food in the nation’s health, the UK National Food Strategy says fresh produce prescriptions could bolster existing efforts to encourage people to eat less salt and sugar.

A so-called "sugar tax", and other pricing mechanisms aimed to make less healthy food more expensive, could have more profound effects on lower-income households, which are more likely to consume them, the report argues.

During the COVID-19 pandemic, vulnerable people with elevated health risks and the less affluent ate nearly a whole portion of fruit and vegetable less each day, the report found. Children – particularly from poorer backgrounds – reported eating more snacks and junk food.

Among its recommendations, the report suggests expanding current free school meals to cover holiday periods, and a trial programme whereby GPs can prescribe fruit and vegetables to less affluent families “suffering, or at risk of suffering, from diet-related illness.”

Although there are no firm plans in the UK for doctors to start handing out prescriptions for peas, carrots or even an apple a day, there are already other innovative treatments being recommended in consulting rooms all over the world.

New research is exploring new ways to improve food security. For example, space technologies have a, perhaps unexpected, role to play, finds a World Economic Forum and McKinsey report.

"Examples of satellite technology driving value for agriculture are already visible," the report's authors write. "Growers today are using aerial and satellite insights to reduce herbicide, fertilizer and water use, and governments are employing satellites to address food security, verify conditional subsidies and reduce food waste."

Exposure to nature has been shown to offer a range of health benefits, both as a preventative measure and as a treatment. Since 2018, doctors in Shetland, the Scottish archipelago in the Northern Atlantic, have been able to prescribe getting outdoors in nature to treat a range of ailments and illnesses.

High blood pressure, anxiety and stress, heart disease, and mental illness can all be helped by a month-by-month calendar of things to do in the great outdoors.

Suggestions for the month of August include “turn o’er a rock and see what you see”, “make a seggie boat (fold the leaves of a yellow iris) – if you don’t know how, ask an amenable older Shetlander”, or “listen and copy a bird sound – try ‘talking’ to a bird.”

The economic and social cost of mental health has grown in the UK to reach around $165 billion a year over the past decade, according to the Centre for Mental Health.

Encouraging people to benefit from the natural world could become a normal course of action for doctors.

In December 2020, the UK government announced seven places around the country that would trial ‘green prescribing’ for two years - sharing in a pot of $8 million.

Activities include walking, cycling, community gardening and food-growing projects, and conservation projects like tree planting. Supported visits to local green spaces, waterways and the coast could also reduce isolation and loneliness, the government said.

In May 2021 this year, the UK’s Mental Health Foundation joined forces with the Wildfowl & Wetlands Trust (WWT) to kickstart a ‘blue prescribing’ programme, which see doctors prescribing visits to water-based nature facilities.

In Canada, some patients have been advised by their doctor to immerse themselves in culture. A visit to the Montreal Museum of Fine Arts is now on the prescription books following a collaboration between the museum and a consortium of doctors, Médecins Francophones du Canada.

The museum also has an impressive online collection to cater to the needs of those who can’t get to the museum itself.

And from September 2022, psychiatrists in one of Brussel's largest hospitals can offer 'museum prescriptions', reports the Guardian. These take the form of a free visit with a handful of friends of family members to one of the city's cultural highlights.

While in the UK, ‘bibliotherapy’ has long been used as a way to help patients and doctors in Bristol prescribe self-help books which patients can collect from the library.