Tuesday, June 18, 2013
BY ERIN RHODA Staff Writer
SKOWHEGAN -- When 20-year-old Angel Quattrone went to Skowhegan Family Medicine for the first check-up of her unborn baby, she was in for a surprise.
Her physician, Dr. Michael Lambke, examined Quattrone and the fetus. And he talked about vegetables.
They weren't just any vegetables, but free ones from the Skowhegan Farmers' Market.
After signing some paperwork, Quattrone left the doctor's office with a free $10 prescription for the building blocks of good health: fruits and vegetables.
The family practice -- which is integrated into Redington-Fairview General Hospital -- is undergoing the first project of its kind in Maine: giving a $10 veggie voucher to pregnant women each time they come for their doctor's visit.
Because the voucher is only redeemable for fruits and veggies at the Skowhegan Farmers' Market, it benefits local farmers as well as both the baby and expecting mother, according to Lambke, the lead physician on the veggie prescription project. Participating women receive a total of about 14 vouchers during and after delivery.
"I love fruits and vegetables anyway, so they've definitely helped," said Quattrone, of Skowhegan, who is about three months pregnant with her first child. She said she likes going to the farmers' market for local products, because "I know they're fresh, and I know where they came from."
The prescription program started this fall and will target up to 150 women in Somerset County during the next year. It's funded with $5,000 from Wholesome Wave, an organization based in Connecticut that works to decrease health care costs by providing families with local fruits and vegetables.
"The reality is fruits and vegetables are expensive, and that is a huge barrier. Many people want to make that change, but don't," Lambke said.
In addition to providing health benefits, the project's aim is to produce data on how healthy foods affect specific outcomes such as weight gain, the number of women having cesarean sections, and how many complications arise such as gestational diabetes, eclampsia or preeclampsia. Lambke will compare the findings with up to 10 years of historical control data.
Lambke acknowledged the study won't generate enough data to accurately say, for example, that the rate of gestational diabetes cases was reduced by the extra healthy food. But he hopes to be able to measure an overall decrease in complications, weight and number of women having C-sections. (Some research shows that obesity drives increases in C-section rates).
While people know that eating lots of fruits and vegetables improves nutrition, there are few concrete studies proving the direct benefits. "There really isn't any Grade A evidence, and that's the best as we know it," Lambke said.
Lambke's study, which involves four other doctors handing out veggie prescriptions, isn't big enough and won't last long enough to create as much data as is needed for a Grade A study, he said. But maybe it will prompt others to pick up where he leaves off.
"What we're trying to do is just generate a little bit of information that can help to spur the conversation, can provide some background, so other people can start taking this to people who are making day-to-day policy decisions right now," he said.
Legislation is one of the main reasons why having hard statistics about nutrition is important.
While the government subsidizes wheat, corn and soy production -- allowing for inexpensive junk food -- it doesn't subsidize fruits and vegetables, often making them too expensive for the people who need them most, he said.
"It's not about individual failings. This isn't about you and I really wanting to eat fat and unhealthy things. We've created a society that makes it very hard not to do those things," he said.
Ideally, he said, policies would be applied to reduce the costs of fruits and vegetables, or the prescription program would be picked up by an insurance company or supermarket.
"That's my little dream, that maybe Hannaford . . . would look at this and go, 'Wow, I want their business,'" he said.
"It's really, 'Let's start changing the culture around the mom and make sure, whether or not she's obese, she has a healthy nutrition during pregnancy.' That will have an impact on that child as we work to change the culture around the child," he said.
The Skowhegan Farmers' Market is open from 11 a.m. to 1 p.m., the first and third Saturdays of the month, near the new Somerset Grist Mill in the municipal parking lot.
Erin Rhoda -- 474-9534