Transforming healthcare: Food as medicine could avert millions of hospitalizations, experts flag

27 Sep 2023 --- A comprehensive new report endorsed by several esteemed US research institutions has quantified the potential health and economic benefits of Food is Medicine (FIM) – food-based nutrition interventions used in healthcare to treat or prevent chronic diet-related disease.

Incorporating targeted food and nutrition strategies into healthcare on a national level will improve health and quality of life, reduce work for hospitals, and cut healthcare costs, according to experts studying FIM efforts. 

“For too long, our medical system has undervalued the importance of food as both treatment and prevention for many serious and chronic illnesses. But this is now starting to change as evidence accumulates about the benefits of effective Food is Medicine interventions, such as those described in our new report,” the report’s senior author, Dariush Mozaffarian, a cardiologist and director of the Food is Medicine Institute tells Nutrition Insight.

FIM interventions show tremendous promise for improving nutrition, reducing food insecurity, improving health outcomes and increasing health equity.

“Despite the proven and estimated benefits to patients, healthcare systems, and the economy, FIM interventions are not universally available to healthcare providers as a prescribable intervention, nor to patients as a covered intervention. As a result, FIM is largely unavailable to individuals who might benefit,” Mozaffarian explains.

Preventive nutrition makes economic senseWhile Food is Medicine interventions have been known for years, they are not implemented in ways that reach many US citizens.
“The True Cost of Food: Food is Medicine” case study report is the brainchild of researchers at the Food is Medicine Institute at the Friedman School of Nutrition Science and Policy at Tufts University, through support from The Rockefeller Foundation.

“A broad, overarching recommendation is that we must place a stronger emphasis on providing healthy food as a tool for treating chronic disease and developing the infrastructure needed to support national scaling of FIM interventions,” says Mozaffarian.   

“It’s important to share the results of reports like ours through education and outreach to policymakers, advocates, and stakeholders in the health and nutrition research and policy worlds.” 

National implementation of Medically Tailored Meals (MTMs) in Medicare, Medicaid and private insurance for patients with both a diet-related condition and limited ability to perform activities of daily living could avert approximately 1.6 million hospitalizations, the data shows.

The net savings of such an endeavor would be around US$13.6 billion in one year of healthcare costs alone. Implementing produce prescription programs for patients with diabetes and food insecurity has the potential to avert 292,000 cardiovascular events.

The strategy could add 260,000 quality-adjusted life years, measuring how well a treatment lengthens or improves patients’ lives. This approach has shown promise in recent years for boosting nutrition and improving health outcomes, reducing food insecurity, and increasing health equity.

“Today’s report further demonstrates how FIM interventions, combined with nutrition education for doctors and insurance coverage of nutrition counseling provided by a registered dietitian, could make a real difference in the 10,000 weekly US deaths and 1.1 trillion dollars in annual healthcare spending and lost productivity due to poor diets,” says Mozaffarian.

Matter of national concernThe report demonstrates the enormous health potential and economic benefits of producing prescription programs and medically tailored meals using FIM.
The report comes in the wake of 2022’s historic White House Conference on Hunger, Nutrition and Health and the National Strategy on Hunger, Nutrition, and Health that highlighted the need to harness the potential of FIM. 

The report discusses several potential national policy solutions, organized broadly around developing infrastructure, generating opportunities and funding, and strengthening USDA nutrition programs.

“The true costs of our food system – the environmental impact of how food is produced, the working conditions of the people who grow our food, and the impacts on our health, health care spending and health equity are too often left off the price tag,” laments Devon Klatell, VP, Food Initiative at The Rockefeller Foundation. 

“This report can assist governments, companies and consumers in better evaluating the value of FIM interventions by considering not just the price paid for food, but the return on investment in improved health outcomes they can deliver.”

Scientifically sound guidelines
The report findings are built around two studies published in JAMA Network and the Journal of the American Heart Association.

“The association of national expansion of insurance coverage of medically tailored meals with estimated hospitalizations and health care expenditures in the US” is a health and economic evaluation of the true cost of expanding the implementation of MTMs nationally. 

“The health and economic impacts of implementing produce prescription programs for diabetes in the United States: A microsimulation study” is a health and economic evaluation of the true cost of expanding the implementation of produce prescriptions nationally for adults with diabetes and food insecurity.

In 2021, it was addressed that a shift toward food as medicine could help address a host of chronic diseases that are on an upward trend, according to Susan Benigas, the executive director of The American College of Lifestyle Medicine (ACLM).

By Inga de Jong