MGH Brigham’s Food Is Medicine Program Cut Childhood BMI

Food is medicine might be emerging as more than healthcare’s latest social determinants of health buzzword.

A new study out of Mass General Brigham showed that providing plant-based food packages to families experiencing food insecurity helped improve body mass index (BMI) in kids ages 2 to 18.

Food is medicine refers to the philosophy that a healthy diet can help prevent or manage chronic diseases. As opposed to food security, which refers to whether an individual has enough food to eat, food is medicine accounts for the nutritional value of food and how that can influence an individual’s well-being.

Examples of food is medicine programs include produce prescriptions or medically tailored meals. According to the Rockefeller Foundation, food is medicine programs “use healthy, food-based interventions to help prevent, manage, and treat chronic diet-related illnesses.”

This latest study, published in Preventing Chronic Disease, zeroed in on childhood obesity, which often co-occurs with family food insecurity, according to Lauren Fiechtner, MD, MPH, the director of the Pediatric Nutrition Center at Mass General for Children and Health and Research Advisor at The Greater Boston Food Bank.

“Children in families with food insecurity are frequently skipping meals or skipping food for a whole day because their family does not have enough money for food,” Fiechtner, who was the study’s senior author, said in a statement. “One way for parents to stretch a tight food budget and make sure their children are at least eating something is to buy the cheapest foods available, which are often not nutritious and contribute to obesity and other health problems.”

In particular, the researchers looked at the effect of prescribing plant-based food packages to families visiting the MGH Revere Food Pantry. Using EHR data, the researchers were able to track the change in BMI for kids in those families between January 2021 and February 2022, revealing that increasing access to nutritious foods, not just food in general, helped improve outcomes.

Among the 107 kids in families receiving the food packages for whom the researchers had data, the researchers observed an eight percentage-point decrease in obesity rates (defined as a BMI at or above the 85th percentile). At the study’s baseline, 57 percent of kids ages 2 to 18 were considered obese, compared to 49 percent at the study’s conclusion.

On an individual level, the researchers saw improvement in BMI of 1.08 kg/m2 or more.

That change in BMI could be explained by access to the food packages. After all, the data showed that kids from families who received more plant-based food packages saw greater improvement in BMI.

Families received an average of 27 packages over the course of the study, or around one per month; but for every increase in the number of food packages a child’s family received, the child saw a modest improvement in BMI, potentially indicating that increased access to nutritious food made a difference in outcomes.

These findings are critical because they demonstrate a return on non-traditional healthcare interventions like the MGH Revere Food Pantry. These types of healthcare-sponsored social goods can impact clinical outcomes and are key for ensuring equity.

“It’s important to encourage healthy eating habits during childhood to help prevent co-morbidities associated with obesity later in life, but many families to do not have access to expensive healthy foods, such as produce,” Fiechtner explained. “Food pantries like MGH Revere that can provide families with healthy foods are a huge help in making sure that kids have a long, healthy future and have the best cardiovascular and metabolic health possible from a young age.”

The researchers also reflected on the important timing of this program. During the pandemic, household food insecurity increased by 55 percent, and it affected 42 percent of households with children. At the same time, childhood obesity rates rose from 19.3 percent in August 2019 to 22.4 percent in 2020.

"For dozens of families, the MGH Revere Food Pantry was a literal lifeline during the pandemic by providing free weekly packages of healthy food for the entire household,” said study co-author Jacob Mirsky, MD, MA, DipABLM, medical director of the MGH Revere Food Pantry, said in a press release.

This program will ideally have impacts that expand into the future. Allison Wu, MD, MPH, the study’s first author and an attending physician in Pediatric Gastroenterology, Hepatology & Nutrition at Boston Children’s Hospital, noted that the MGH Revere Food Pantry Program was essential to connecting families to nutritious foods in the moment, but it also has the potential to educate kids about how to make healthy food choices as they grow.

“There was an immediate value to providing these food packages to support families during the pandemic, but we also enabled families and children to make healthier food choices, which we know is important to introduce when children are young,” Wu, also a research collaborator and former research fellow in the Harvard-Wide Pediatric Health Services Research Program, said in a statement. “This kind of support is not only important for their BMI in childhood, but also in informing how they choose foods and influencing what foods their families are prepfor them to promote overall health.”