Food is Medicine Institute urges US healthcare system to recognize the power of good nutrition

17 Jan 2024 --- Among rising healthcare spending, food insecurity and diet-related diseases, the US Food Is Medicine (FIM) Institute calls to implement FIM interventions across federal, regional and local levels to increase population-wide nutrition security, health equity and wellness. Such programs integrate food-based nutritional interventions into healthcare. 

The institute explains that the practice includes programs to provide relevant or tailored nutrition to patients, free or at a discount, to support disease management, prevention or optimal health linked to the healthcare system as part of a treatment plan. 

Nutrition Insight discusses FIM’s potential and research gaps with Ronit Ridberg, research assistant professor at the Food is Medicine Institute of the Friedman School of Nutrition Science and Policy at Tufts University in Boston, US. 

“Poor nutrition, including insufficient consumption of fruits and vegetables, is the leading cause of America’s health burdens and disparities. The good news is the alternative is also true — we can use healthy food to treat and prevent some of our most prevalent chronic conditions,” says Ridberg. 

“Understanding this particular role of food in our overall well-being is at the foundation of many FIM programs, including medically tailored meals and produce prescriptions.” 

Advancing FIM
The institute at Tufts University envisions a world that recognizes the consumption of nutritious food as a fundamental component of health and healthcare. It aims for all people and communities to have the knowledge, resources and support to achieve optimal health and health equity through nourishing food. 

“The FIM Institute is a first-of-its-kind, cross-university collaborative,” underscores Ridberg, “to advance FIM research, training, patient care and community and policy engagement.” 

“Our goal is to serve as a catalyst to drive change, improve health, reduce health disparities, and create a more equitable and resilient healthcare system that recognizes the power of nourishing food.”

FIM practices range from prevention to treatment. Focusing more on prevention includes population-level healthy food policies and programs, nutrition security programs — such as school meals, the Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children program — and produce prescription programs that offer patients free or discounted produce. 

The institute estimates that healthcare spending and lost productivity from suboptimal diets cost the economy US$1.1 trillion annually.The treatment side includes medically tailored groceries and medically tailored meals, which provide home-delivered nutritious meals customized for patients with severe chronic conditions and daily living limitations. 

The institute suggests vital policy solutions to advance FIM in the US, such as providing medically tailored meals and produce prescription programs, leveraging SNAP more effectively, allowing Medicaid programs to test and scale FIM programs and ensuring nutrition education for doctors and healthcare providers. 

Healthy nutrition 
According to the institute, combined healthcare spending and lost productivity from suboptimal diets cost the economy US$1.1 trillion annually. Moreover, it underscores that around 85% of all healthcare spending is related to the management of diet-related chronic diseases, with a lack of good nutrition being the leading driver of poor health outcomes. 

FIM interventions can bend these cost curves, says the institute. For example, suppose all eligible US citizens would receive medically tailored meals through the healthcare system. In that case, the FIM institute estimates that US$13.6 billion could be saved annually, even after accounting for the program’s cost. 

Produce prescriptions — previously researched at Tufts University — offer cost savings and health benefits by improving body mass index, blood sugar and blood pressure levels while decreasing food insecurity. 

Ridberg adds: “We can rest easily on the science that supports that eating a variety of fruits and vegetables every day supports health, as does aiming for a diet rich in minimally processed foods, including whole grains, beans, nuts, yogurts and fish.” 

“This would be a meaningful start for most US consumers, > 90% of whom currently eat fewer than the recommended 5–6 cups of fruits and vegetables daily.” 

To advance research, the FIM Institute studies FIM’s impact, effectiveness and best practices on program design.Filling research gaps 
One of the main activities of the FIM Institute is to advance research and innovation. For example, conducting research on FIM’s impact, establishing an evaluation framework to assess its impact and effectiveness on health endpoints, exploring strategies to integrate FIM into healthcare settings and performing policy, legal and economic research on its advancement. 

“Some of the key research gaps in FIM have to do with best practices for program design, dose and duration,” details Ridberg. “In other words, how much food or money for groceries should participants receive, and for how long?” 

She adds that research also aims to understand better which patient populations or groups are most appropriate for these programs — for example, programs are underway across the country for individuals with diabetes, hypertension or high-risk pregnancies, as well as veterans. 

“We still have a lot to learn about how FIM programs impact patient-centered outcomes like quality of life, mental health or caregiver well-being, and many of us are working to understand better so-called spillover effects within a household that come from things like sharing food, or cooking and eating together as a family.” 

Ridberg explains that the FIM Institute is asking many of these questions in its research, testing different types of programs for various populations and engaging in qualitative research to learn more about participants’ lived experiences in these programs. “We also focus on convening diverse stakeholders on these topics, especially in our annual Food is Medicine National Summit.”

By Jolanda van Hal