IFT bolsters Food is Medicine program using easily understood pyramid model

06 Mar 2024 --- US-based Institute of Food Technologists (IFT) has established a steering committee consisting of several food scientists to support the national Food is Medicine (FIM) initiative, which currently has numerous pilot programs and investments underway, including teaching kitchens and farming strategy initiatives. The FIM initiative is invigorated off the back of the inaugural Food is Medicine summit, hosted by US Department of Health and Human Services (HHS) and a key building block of the national strategy to end hunger and reduce chronic disease by 2030.

Nutrition Insight catches up with IFT’s Senior Director of Government Affairs and Nutrition and registered dietitian and chef Anna Rosales, who shares the latest insights on how the institute is driving FIM forward.    

“What we are working to elevate is the critical role of food science within food and nutrition security. A lot of times people don’t make that connection between food science and food and nutrition security, but it is incredibly important and there are so many challenges within that have food science solutions,” says Rosales.

“What we’ve done is gather a group of our member experts to form what we call our Food and Nutrition Security Steering Committee. The next big steps are related to reimbursement, education and better integration of nutrition into healthcare,” she adds.

“It’s largely physician training, but really into healthcare and professional training, to help make sure that healthcare professionals are screening for nutrition, nutrition security and understand what that looks like. Other big ones are around the social services wrap around, making sure that those are being integrated into the healthcare environment too.”

FIM pyramid
Experts, including key players from Tufts and Harvard universities, devised a Food is Medicine “pyramid” with the goal of establishing a system that is commonly understood by the various stakeholders in the chain. This is widely being referenced by various stakeholders.

“You have emergency food programs and then you have the population level health programs and then nutrition referral, food referrals, medically tailored food packages and the medically tailored meals at the very top (of the pyramid),” Rosales explains.

“The framework is really important to bring some common language around these different concepts because we have different collaborations and pilots happening and we really want to make sure we can share results and then apply that information to understand what’s working, what’s not working and how we can bring this forward in a better way.”FIM explores the economic value of the initiative for food scientists, medical insurance companies and the food industry.

The pyramid captures the idea that there are certain diseases that can be prevented or treated through diet and behavior changes. Conditions like celiac disease, for example, can be treated by following a gluten-free diet. 

It aims to address inequalities and includes food as culture, food as community, food as an expression of care, among others. HHS has developed a five-point language and principles framework for FIM to help healthcare providers support their patients to make the necessary dietary, health, and nutritional shifts to support the prevention and treatment of illness.

A major challenge is that dietary intervention may not have clear research showing its benefits in reducing healthcare costs, which is a critical concern for healthcare insurers. The FIM pyramid will help bridge the disconnect between healthcare and social services and the need for additional research supporting dietary and well-being interventions. 

“Food scientists are the individuals to help develop and produce medically tailored meals if they’re to be done at scale. If we look at the very bottom of the pyramid, where we have the basic necessities of food for all food scientists are the ones that help make sure that we have an affordable, available, accessible and acceptable food supply.

“They’re this critical piece of this puzzle and within the food system and within food as medicine. IFT, we’re just working to elevate that role of food science and to make sure that people, when they’re talking about food is medicine, that they are including food science in those conversations and thinking about how food science can help bring this forward.”

Nutrition education
The first “Food is Medicine” summit was held in Washington, DC in late January and hosted by the HHS. The event elaborated on the role of nutritious food in preventing and treating illness. The summit aimed to advance discussions on how the US healthcare system can better serve patients, combat obesity and food insecurity, and promote racial equity. It aims to transform healthcare to a wellness-care focus away from illness-care. 

“One of the key things that is important for these interventions is that while we have these larger frameworks that we’re looking to bring forward, we all recognize that they have to be localized for the individuals. They have to fit the individual communities and represent their cultures and what is acceptable for them,” Rosales outlines.

Research shows that if physicians have minimal nutrition education, they are twice as likely to refer patients to a registered dietitian for counseling. When they are educated to screen for malnutrition and food insecurity, they are better able to connect people to food and nutrition resources.

Medically tailored meals — meals prescribed for patients when they are discharged from the hospital — are an important aspect of the FIM initiative. Medically tailored meal trials have shown a reduction in readmission rates when people have access to nutritious meals. 

Enabling healthcare providers to hand out “produce prescriptions” is a key part of the ongoing discussion, where healthy foods are prescribed to food insecure patients and integrated into medical strategies.

“There’s a lot of public and private partnerships that have been happening and are even getting more geared up coming out of this summit. There’s pilots both in healthcare settings, in school settings, in medical schools on integrating nutrition, training and nutrition education for physicians,” she explains.Getting healthcare insurers to support the initiative is one of IFT’s top priorities.

For example, the Rockefeller Foundation invested an additional US$80 million over the next five years to advance Food is Medicine programs in the US and the Medically Tailored Home-Delivered Meals Demonstration Pilot Act was passed.

Courting health insurers
Currently, many roundtable discussions are centered on integrating FIM into the medical sector and figuring out the timing of interventions and healthcare insurance models. These spheres impact manufacturing, production and innovation of food. 

“If food is medicine and we’re looking at how we can actually put insurance dollars toward it, we may soon have reimbursable food products, meals and more. This is a whole new space and economic opportunity for food scientists. Food science has the chance to innovate, create change, and bring forward a better food system at scale,” says Rosales.

IFT prioritizes finding solutions for how healthcare insurers might invest in FIM and creating a uniform model to report and evaluate the financial cost of outcomes. 

“They’ve started off by identifying challenges in food and nutrition security, with food science solutions, and then one-by-one we’ve taken these cross-cutting challenges and we’ve brought together individuals — agriculture scientists, public health nutritionists or public health scientists — to have roundtable discussions across the food system and look at where the gaps are and where we need more research or investment,” Rosales concludes.

Meanwhile, amid rising healthcare spending, food insecurity and diet-related diseases, the US Food Is Medicine Institute called for the implementation of 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.

In 2023, a comprehensive new report endorsed by several esteemed US research institutions quantified the potential health and economic benefits of FIM — food-based nutrition interventions used in healthcare to treat or prevent chronic diet-related disease.

By Inga de Jong