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Leading Types of Food Is Medicine Programs, Interventions
As the food is medicine philosophy takes hold, organizations should consider which food is medicine programs are best for their patients.
Food is medicine is an emerging philosophy in healthcare that acknowledges the link between diet, food security, and disease.
Defined by the Academy of Nutrition and Dietetics Foundation, food is medicine “is a reaffirmation that food and nutrition play a role in sustaining health, preventing disease, and as a therapy for those with conditions or in situations responsive to changes in their diet.”
This is not the same as food security, a key social determinant of health. While food security focuses on whether an individual has enough to eat, food is medicine focuses on the nutritional value of food and how highly nutritious foods can help prevent or manage an illness.
To be clear, some concepts of food security and food is medicine have become intertwined. Many organizations working on addressing food security have begun to address the importance of accessing nutritious foods instead of connecting folks in need with the cheapest, and often less healthy, options. It may not be helpful to address food insecurity with junk food or fast food options, some experts have posited.
Even still, food is medicine is a wholly distinct philosophy that looks at the way healthcare providers can use food and diet to prevent, treat, or manage an illness. An individual may qualify for a food is medicine intervention without being food insecure, emphasizing the focus on nutrition in these strategies.
Why Use Food Is Medicine Interventions?
Currently, food is medicine interventions are primarily being used to treat diet-related illnesses, or illnesses caused by poor diet. Per figures from the CDC, poor diet is common in the US. Nine in 10 Americans consume too much sodium, one in six pregnant people have low iron, and three in four infants are not breastfed exclusively in the first six months of life.
The need for food is medicine interventions is urgent, according to the Rockefeller Foundation, which has provided produce prescription programs for around 28,000 people nationwide as of 2023. The US spends $1.1 trillion on diet-related illnesses such as overweight and obesity, heart disease and stroke, type 2 diabetes, and even some cancers. Looking at overweight and obesity alone, CDC said the US spends $173 billion annually on treatment.
Overall, 500,000 deaths are caused by poor diet in the US, the Rockefeller Foundation added.
Food is medicine interventions can be varied, and selecting the right one will depend on the individual patient’s needs and resources, as well as organization resources.
Medically Tailored Meals
Medically tailored meals (MTMs) first emerged during the HIV/AIDs crisis by community health workers, according to the Food Is Medicine Coalition. MTMs were designed to help stave off some of the side effects of HIV/AIDs and bring some dignity to patients’ lives, but when effective treatments for the virus finally emerged, industry professionals expanded MTM use to other disease states.
“Medically tailored meals are delivered to individuals living with severe illness through a referral from a medical professional or healthcare plan,” the Food Is Medicine Coalition says on its website. “Meal plans are tailored to the medical needs of the recipient by a Registered Dietitian Nutritionist (RDN), and are designed to improve health outcomes, lower cost of care and increase patient satisfaction.”
MTMs must adhere to certain clinical standards usually decided upon by RDNs.
Food Prescriptions
Food, and particularly produce, prescriptions are ways to connect low-income families with nutritious foods, which are often costlier than unhealthy foods.
“A Produce Prescription (PRx) Program is a medical treatment or preventative service for eligible patients due to diet-related health risks or conditions, food insecurity, or other documented challenges in access to nutritious foods, and are referred by a healthcare provider or health insurance plan,” says the National Produce Prescription Collaborative, which advocates for adding PRx to insurance benefits.
Individuals receiving a PRx should be able to fill the prescription at food retailers that are local to them to help overcome cost-related barriers to a nutritious diet.
Nutrition Education
Food is medicine requires more than just access to nutritious foods; it requires patient activation and empowerment through education. Healthcare providers often provide nutrition education and even cooking classes to supplement their food is medicine interventions so that enrollees can make their own diet-related decisions.
Similar to shared decision-making and other types of patient engagement strategies, nutrition education should ideally help patients make a behavior change that is sustainable. Stronger patient empowerment may also increase adherence to diet changes.
Farm-to-Table Programs
Farm-to-table programs mean that healthcare organizations facilitate patients gaining access to farm-fresh produce. These organizations are building community health partnerships with local farms to enable this, or else getting creative about building out farm and garden space.
For example, Boston Medical Center has a rooftop farm that grows food the hospital uses to feed its hospitalized patients and as part of its preventive pantry.
Considerations for Food Is Medicine Programs
Healthcare providers beginning a food is medicine program should assess both the organization’s resources—food-to-table won’t work for an organization without access to farm-fresh produce—as well as a patient’s resources and preferences.
Moreover, it will be critical to consider cultural competency when introducing a food is medicine intervention to a patient. Learning about and accepting cultural norms around food and diet preferences, and then accommodating those factors when creating a diet-related intervention, will increase the odds of adherence and lasting change in patients.