ST. LOUIS — Prescribing medicine helps doctors respond to heart disease. Now, researchers here are studying if prescribing fruits and vegetables might help prevent it.

The new Washington University study, called NutriConnect, examines if increasing access to healthy food can create lasting, positive lifestyle changes for people at risk for heart disease — the leading cause of death in St. Louis city, county and Missouri.

“A lot of times, people’s health revolves around medical health. But the social determinants of health play as much of a role in people’s overall health,” said Jing Li, leader of the study at Washington University and associate professor of medicine. “I want to build something in the community that will last.”

And while not entirely novel, produce prescriptions are “not exactly standard” practice yet, said Brent Ling, program director at the National Produce Prescription Coalition. They’re a way to “enable patients to access healthy foods,” even if they do not live close to stores that offer fresh produce.

“Patients have lost over 50 pounds, and some have reversed their diabetes” said Ling, of other produce prescription programs. “It has really broad applicability.”

NutriConnect is a collaborative effort between BJC Health, which recruits participants from its hospitals, Schnucks and the Washington University research team, Li said.

Researchers began seeking participants in April. They have 40 and are looking to enroll another 200 people who are both at risk for heart disease and experiencing nutrition insecurity, which is like food insecurity but specifically refers to the lack of access to nutritious foods.

Participants will receive prescriptions — just like a prescription you would get from a doctor for medication— but these will be filled by the grocery store rather than the pharmacy. Schnucks will fill participants’ “produce prescription” through coupons or free grocery delivery for six months.

The food included through NutriConnect was selected by a community focus group to account for different tastes, cooking levels and the culture of food in participants’ homes.

“A lot of times, there are traditions in it — it’s a part of people’s roots,” Li said.

“For example: I love butternut squash. It’s healthy and tasty, but multiple community members said it was hard to prepare and takes time to cook,” she said. “So it’s not the right food for this study.”

Consumer choice is a key component of the study. Coupons for in-store shopping are for specific kinds of foods — say, apples — but the participant chooses the variety, like a Honeycrisp or a Red Delicious. Those who want free delivery will receive a pre-selected order of healthy foods from Schnucks, Li said.

The study isn’t limited to fresh produce. Coupons and deliveries will contain foods that are nutritionally dense and low in saturated fats, Li said.

“Our team is focusing not just on produce, but also other healthy foods — fresh, frozen or canned,” she said.

Study participants are also asked to enroll in Schnucks’ Healthier Habits program, which uses an orange “Dietitians Pick” label to “guide customers to nutrient-dense options in support of building a healthier shopping cart,” said Allison Primo, Schnucks’ manager of health and wellness strategy, in an email.

Schnucks participated in a similar study in 2023. Produce prescriptions were given to folks experiencing food insecurity and one of three chronic diseases: hypertension, diabetes or high cholesterol, according to Primo.

“We saw this group increase their produce purchasing not only during the intervention, but also four months post-intervention,” she said.

The study is part of a large effort through the American Health Association to show that food is medicine through its Health Care by Food initiative, said Mitchell Elkind, the association’s chief clinical science officer.

“In order for this to really work at scale, we need to provide more evidence in terms of cost and healthcare outcomes,” Elkind said. “We think that there’s a great opportunity here.”

The research team will collect data, and ultimately, determine if these dietary tools lead to lasting changes in participants’ lives.

“Philosophically, this is exactly what we need right now,” said Whitney Linsenmeyer, director of St. Louis University’s Didactic Program in Dietetics. “We know what is healthy for people, there’s no controversy there. But how do we get people to eat fruits and veggies? That’s a much harder question to answer, and in this study, they are looking at what works for people.”