A new study based in Seattle shows a small financial grant can boost people’s intake of fresh produce.

By Jackson Bartelt

New evidence suggests that, for residents of Seattle struggling to get enough fresh produce, a small financial boost each month may be just what’s needed to tip the scales.

Chronic diet-related disease rates continue to climb with no sign of slowing, while adherence to the Dietary Guidelines for Americans is extremely low. In fact, nearly 90% of Americans do not adhere to recommended fruit and vegetable intake. Recently, the “food is medicine” movement has become a prominent approach within nutrition and public health to combat this reality.

A team of researchers at the University of Washington led by Melissa Knox, an expert of health and nutrition policy, investigated one such initiative published in August 2025 in the Journal of the American Medical Association. The program, “Fresh Bucks,” provides a novel $40 monthly subsidy to Seattleites to be used on fruits and vegetables only. The results showed that Fresh Bucks significantly improved both access to nutritious food and the rate of consuming fruits and vegetables. The group placed on the waitlist, who served as the comparison group, experienced worse outcomes in both measures. These results suggest that food is medicine programs, such as a small cash injection for healthy foods, can favorably improve people’s diet. 

“Think about the different dimensions of food access. It’s not just financial, but are you actually able to get to the place where you can purchase?” said Knox. Recognizing this, the Fresh Bucks program allows funds to be used at major food retailers, not just farmers markets as previous programs have required. Better yet, all residents below a certain income range were eligible, not just SNAP enrollees, and no spending match was required. “All of those things are going to make it just a lot easier for you to use the benefit.” Knox said.

Real-world considerations may have influenced the results. 

“A lot of people in our study were above 60 (years old), a lot lived alone,” Knox said. This could hint at either more free time to redeem benefits or greater difficulty getting to the grocery store. Income level, race/ethnicity, and spoken language all changed how participants responded to being given the benefit. However, the team simply couldn’t explore every influence on the data, and some unpredictedbehavioral patterns may have influenced the outcomes.

For example, participants might have used the Fresh Bucks only to augment what they ate. “They’re not changing their diet,” Knox said. “ They’re just doing what they always did, continuing to buy ultra processed foods.” Still, the $40 benefit, on average, improved fruit and veggie intake and food insecurity, despite potential behavioral interactions. 

Myra Woodworth-Hobbs, a nutrition science professor and researcher at Emory University, notes:  “It’s difficult to know if they were getting any closer to the federal [Dietary Guidelines for Americans] recommendations.” For instance, while the team measured fruit and vegetable intake, the study lacked measures such as the Healthy Eating Index score, a measure of quality of diet, to assess how the rest of the diet may have changed.

Studies conducted outside of the lab do make it harder to tease apart the results. However, this doesn’t invalidate the findings of the study. Rather, it points to the strength of the Fresh Bucks initiative, showing a tangible benefit to participants despite facing practical challenges.

“Every study has things we wish we knew more about,” said Woodworth-Hobbs, “but this study was very cleverly designed.”

Food is medicine approaches, such as in this study, expand nutrition research to examine practical strategies for underserved and impoverished communities. Knox outlined various other food is medicine strategies including regulation of ultra-processed foods, taxation on consumers or suppliers, leveraging the GusNIP program, and many more common-sense methods of getting Americans in line with the Dietary Guidelines.

However, she says “if I could do anything at all, I would say expand SNAP benefits. More money for more people and add a Fresh Bucks type incentive.”

“Our mayor just announced a big push to fund a bunch of expansions of Fresh Bucks, and they want to push the amount up to $60,” Knox said with excitement, outlining her team’s projects already underway to examine the unanswered questions about the Fresh Bucks program and how to improve the health of her community.