National US survey shows strong public support for Food is Medicine programs

A majority of US adults surveyed said they would be interested in food-based nutrition interventions, especially those affected by food and nutrition insecurity. Nearly 90% of respondents agree that eating healthy foods is key to preventing obesity, high blood pressure, and type 2 diabetes. 

Food is Medicine interventions incorporate nutrition-related services into medical care as part of a plan to prevent or treat diseases. According to the study’s authors, this is the first national survey on knowledge, perceptions, and experiences with these interventions. 

The Food is Medicine Institute team at Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, US, surveyed 3,009 adults. This group represents US demographics across sex, race, insurance coverage, household income, education, and health status. 

Although under 30% of participants know the Food is Medicine movement, over half would try one of its initiatives if offered through their health care providers, such as a produce prescription, medically tailored grocery, or meal programs. Almost 70% of respondents facing food and nutrition insecurity were interested in program participation. 

“This study affirms that the public understands the importance of food in their health, but they don’t always have means to access the food they want,” says first author Ronit Ridberg, a research assistant professor at the Friedman School. 

“We were struck by the disconnect we found in clinical settings. Only a quarter of respondents reported that their primary care provider had asked if they had enough food to eat, and fewer than half had conversations about diet during their clinical encounters.” 

Food is Medicine coverage

Over two-thirds of respondents said that government programs such as Medicare and Medicaid should help pay for Food is Medicine initiatives, and half of participants felt private insurance should also pay for these interventions. 

The study, published in Health Affairs, suggests a need for new regulatory incentives and contract requirements for care plans managed by these government programs to encourage Food is Medicine interventions. Currently, 15 states have approved or pending Medicaid waivers for nutrition interventions. 

The research calls for increased nutrition-related training of healthcare professionals.The study also indicates that ongoing efforts in primary care settings are not benefiting the majority of US adults. Thse involve screening patients for nutrition security, discussing the role of diet, and linking them to registered dietitians and nutritionist counseling. 

Ridberg suggests that participants’ experiences are likely due to healthcare providers’ limited nutrition education and the burden of focusing on many topics in one appointment. She adds that doctors and nurses say they can feel uncomfortable asking about food and nutrition insecurity and often don’t know the right resources to give patients. 

Therefore, the research also calls for increased nutrition-related training of healthcare professionals and the development of Food is Medicine accreditation standards for healthcare organizations. 

“Such changes could help advance national efforts to address poor nutrition, diet-related illness, health disparities, and rising health care costs in the US,” reveals the report. 

Challenges to healthy eating

Around half of respondents would be more likely to make positive dietary changes if they had regular conversations about their habits with care providers. The authors note that over 80% of participants would take steps to get healthier if they knew it would help them feel better, treat a health condition, or reduce future disease risk. 

At the same time, 83% of respondents pointed to healthy food costs as the most frequent barrier to its consumption. Over 50% of participants believe that health care should help reimburse those costs or provide some healthy food. 

Other barriers to healthy eating include family traditions around unhealthy foods (79% of respondents), a lack of nutritious food options in retail (57%), stores or food pantries with healthy foods are too far away (56%), and not knowing which foods are healthy (48%). 

“There’s a misconception that many people don’t want to eat nourishing foods, or that they prefer unhealthy products — but our new results highlight that most US citizens want to eat better but face specific barriers and challenges,” says Dariush Mozaffarian, senior author on the paper and director of the Food is Medicine Institute. 

“Our research shows there is demand for food-based therapies as part of health care, providing valuable information for state and federal policymakers to build momentum toward more holistic, cost-effective care.”