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MANNA: CEO talks health benefits of medically tailored meals in disease management
16 Apr 2025 | MANNA
Sue Daugherty, the CEO of medically tailored meal provider MANNA, highlights the evolving landscape of Food is Medicine in the US. She details how prescribed medically tailored meals can support people battling serious illnesses, save healthcare costs, and help patients using GLP-1 medications. She also highlights the importance of Food is Medicine Coalition Accreditation, which holds companies accountable to standards to ensure nutritionally balanced meals.
This is Yolanda von Ha from Nutrition Insights, and today I'm gonna be talking about the food as management movement and the role of medically tailored meals within that, with Sue Doherty, who is the CEO of Manna, which is a US company that has been providing these types of meals since 1990.
So I'm really curious if you can talk a bit about how the landscape of Buddhist medicine has evolved over the decades, and specifically the role that manna has played in that shift.
Sure.
So, NANA, we started as an organization in 1990.
So we're celebrating our thirty-fifth year and we've certainly been in the space of food as medicine throughout those decades, but it certainly has shifted over the years.
So we were founded as an HIV AIDS organization and so we were providing meals, you know, mainly in the 1990s, more as comfort, right?
And helping people to die at a time when, you know, people were alone and And often, you know, family members, you know, were afraid to support other family members.
So I joined MANA in 1999 as a registered dietitian and nutritionist, and it was a really interesting time during that landscape because once medications became available, right?
You start, you know, we, we saw a big shift.
I tell the story all the time and I remember it like it was yesterday.
And then I was providing nutrition counseling to an individual, and they had a triglyceride level of over like 800, which is crazy high, right?
Like normal is under 150.
And I tru truly thought like it was a mistake.
I thought the lab had messed up and I called the infectious disease doctor and said, you know, what's going on?
And he's explained to me that this was a side effect from the HIV AIDS medications.
And so it was really the first time for me.
That I saw this like metabolic disorder that was happening.
And at the same time, I remember seeing the gooey mac and cheese being cooked in the manta kitchen going out, and really had this thought like, you know, we need to change.
And so that's when we kind of say the science was born here at Mana, and we really should.
That are focused on helping people die to helping people live.
And so, you know, we knew that cholesterol was an issue.
We knew that we needed to have healthy fats and really, that's when we revamped the entire menu cycle to make sure that we were providing the right nutrition to help people when their, when their fight.
And then we expanded beyond HIV and AIDS.
Today, we're an organization that I think last year we touched over 80 different illnesses, and so our clients that we're serving are really the sickest of the sick, right?
They're the 5% that's costing the healthcare system, 50% of the cost, and often, our clients are alone, right?
We don't have a financial criteria, but the reality is those that we serve are a significant, a significant amount of people are food insecure and don't have access to healthy food.
And so here at Madam, we really, you know, we do believe in food as medicine and as a dietitian, I would be so frustrated when I worked in the healthcare system and people would get discharged, and they would be told, OK, here's your medications, we called all your medications into the pharmacy.
You're gonna You go here for your physical therapy, your occupational therapy, or your radiation or your chemo.
And then very often, there's this complex diet that is prescribed.
And not like, oh, eat better.
No, it's more like have a 4-gram phosphorus, 4-gram potassium, 2 g sodium, 2000 cc fluid restricted diet.
And it's like, what are people supposed to do with that, right?
I'm a dietitian.
I'm fortunate that I have a support system.
I have money in my pocket.
That would be really hard for me to follow today.
And so that's really what we see at MA is that we are the pharmacy for your prescription diet.
We have 12 different diet modifications, and often clients come to us and they're maybe coming to us because they're newly diagnosed with cancer, but they may also have diabetes and high blood pressure and so we make sure that we're providing the right nutrition to meet all their illnesses.
Really interesting, and I'm, I'm curious if you can dive a little bit more into how Mana ensures that all the meals that you're providing are medically tailored, but also that they support specific clinical outcomes as you were describing.
Sure, so, it's interesting, you were asking earlier about the landscape, right?
And so, You know, for 35 years, we've been kind of screaming at the top of the mountain like, hey, this is really, really important.
And I would say for probably about 32 of those years, us and we are part of the Food as Medicine Coalition, right?
So there's a national organization, so there's , you know, organizations across the country that make up this coalition, and we all came out of the HIV AIDS crisis, and we've all expanded to now serve all illnesses.
But we've been doing this work for a long time.
And I would say, the White House hosted a conference a few years ago that kind of uplifted Buddhist medicine.
And because insurance now, because of research, right, that man have published, we were the first organization in the country that published research in 2013.
That showed not only do clients have better health outcomes, they have significant reduction of health care costs, right?
And so that was really the tool that armed us to partner with mostly Medicaid providers here across the country where, for a small portion, right?
Very tough.
Completely controlled population, they will treat a prescribed diet, just like they would treat a prescribed medication and they're reimbursing for that.
But that's still very tightly controlled.
But I hate to say this, right?
But now that there's some money in the space, right?
There's much more competition.
And there's a lot of for-profit entities popping up, and there's a lot of folks claiming that they're, they're doing food as medicine or that they're doing medically tailored meals, but there's really no standard yet set nationally to define what that is.
And so, I'm proud to be part of the FIMIC.
Coalition where they, with the organization that launched the first accredited program model that if you receive this accreditation, it holds you to a set of standards that you're providing and practicing.
And so Mountain was the first organization in the coun in in Pennsylvania to receive that accreditation.
And so, we at least are, you know, if we say that we're providing X meal, we know that we've been, you know, we've had site visits, we are audited, you know, our nutrient analysis goes through an extensive, you know, review.
So, The quality of product that we have to use, you know, no preservatives, things like that.
And so it's confusing, I think, for people right now.
I think there's a lot of people in this space being like, oh yeah, we're food as medicine or we're medically tailored meals and You know, they're not, and so that also can be concerning if people think they're getting something that they're not getting.
Yeah, and , this accreditation program that you just mentioned, I'm really curious if you can dive a bit into what does that mean in practice for companies that want to be, to have this accreditation from the Food as Medicine Coalition.
And you also already touched a bit on how that sets you apart from other companies, but Please feel free to expand a bit more on that.
Yeah, so right now for the accreditation, it is, only at this, at this point, but that's being, evaluated.
It's only eligible for nonprofit organizations.
And so to receive the accreditation, you have to have registered dietitians on staff, working with, chefs that are ServeSafe certified, right?
So there's certain standards that your kitchen has to be upheld to.
Again, certain, you know, ingredients that you have to use and, you know, no preservatives, you know, , there has to be, again, if you're saying you're providing like a 4 g potassium, you know, that's all, that there has to be, a nutrient analysis that goes along with each recipe to show that you're meeting the standards and the guidelines that are associated with the different diets that you're providing.
We're a volunteer-driven organization, right?
And that's a key component, I think for our program.
We kind of think that, you know, this doesn't necessarily tie to the accreditation, but we do think there's something about folks coming in and volunteering and giving their time that means something, right?
We hear from our clients all the time.
The food is great, but the love is better, and I just think of myself, right?
There's been times in my life that, you know, I, I may be sick and not feel , and if I'm fortunate enough to have someone that takes time to prepare something for me, even though in my head I'm like I really don't want to eat this, but you almost feel like, oh, you know, you need to do that, and we think that, that there is some of that with our clients, but Our dietitians are all, you know, organizations have to have dietitians that are are upholding the American Dietetic Association criteria for providing counseling and education and follow-up, you know, we provide cooking classes.
So there's a whole and you can go on Fix website and see the, it's a very, very detailed criteria that you need to meet to receive the accreditation.
Awesome, really interesting.
Another topic, we talked about medically set up meals a bit already, but, one thing that's almost every nutrition interview we talk about is these GLP-1 drugs that are coming up and are being really, really popular in terms of weight management, metabolic health management.
I'm really curious, where do you see medically tailored meals fitting into that conversation specifically?
I think that that is such an important topic right now.
I think, you know, I'll be honest with you, we could talk forever, right, about how these drugs have kind of exploded, and the initial intent in regards to diabetes and so forth, but as a dietitian, it's kind of blown my mind a little bit that, you know, I kind of think about , weight loss surgery, right?
And so, when, if someone, yeah, and I haven't been practicing as a dietitian in a while, so it may have changed slightly at this point, but back when I was practicing, right?
If you were someone who you were gonna be considered for weight loss surgery, There was a whole set of stuff that had to happen before you got to that surgery, right?
Like you had to see a dietitian, you had to meet with a, a counselor, you had to demonstrate that diet, you know, failed, and there was a whole bunch of stuff that had to happen.
Before you got to that point.
And I think that's a little bit of the problem specifically in regards to weight loss, right?
It's like people just being put on this medication.
There's a lot of folks are not changing their diet, right?
So they're losing weight, but they're still not eating in a healthy fashion.
And then folks are, you know, there's some data coming out now with like malnutrition, right, associated with it because people aren't eating and so they're losing all this weight, but they're losing muscle with that.
And so, It just kind of fascinated me that it fascinates me that there's not this intervention, and I think now because of honestly costs and how it has exploded, I think that that's being reevaluated, and I think medically tailored meals can play a huge part in that, right?
And it, it, I feel like we always jump, right, to like, The most least efficient or cost, like why we, why we don't jump to, hey, let's provide you with a healthy diet that's carbo carbohydrate controlled or whatever, sodium-controlled, whatever, congestive heart failure, right?
And let's see what happens.
And the other thing is also what happens when people come off of the medication.
So I think that that is being reevaluated and I think medically tailored meals has a big role.
I think You know, what I feel like I, I battle constantly when I'm advocating for policy change is that people just can't wrap their brains around the fact that when we talk about medically tailored meals, we're not talking about food.
We are actually talking about a treatment, a prescribed intervention.
And so people get like, Which again we could talk about this all day, right?
People get like, oh, food as an entitlement, which one, I think food should be an entitlement, but I have to always back up and be like, I'm not talking to you about food.
I'm talking to you.
Like, these diets have been prescribed forever.
I've like tried to do the history of like, when was the first like prescribed diet written, right?
But like, In healthcare, people get prescribed diets all the time.
And here in the United States, when you get admitted to the hospital, you can't receive food until a diet order is put in for you, right?
Like it's that, that's like how, but people don't think about how they're gonna access it.
And so I think, I think medically tailored meals has a huge component in at least making sure that people learn how to eat.
A balanced diet, and, and then if that fails, OK, then like move to the medication, or when you come off, make sure that you're still giving people a balanced, balanced diet, but it, it concerns me.
I don't know how it is over there, but here, I feel like everybody and their mothers on these drugs, and it just really, really does concern me what happens when people come off these drugs and, and what's gonna happen, God forbid.
While on the drug, if you get sick and you're all right, you're malnourished because you've been losing weight but not doing it in in the healthiest way, and now you have to go back on chemotherapy and radiation, I think there's gonna be a lot of consequence.
Yeah, no, definitely, I think that's something that we're seeing here as.
It said there's there's this surge of interest also pushback on not just doing the drugs but doing a whole program around it, so that you're having that good quality nutrition.
I think that's something that we see here a lot for sure.
Yeah, I think that's a really useful direction.
And I'm also curious, in terms of scaling medically tailored meals, do you see any particular challenges or opportunity to achieve that?
So definitely through, I think through the Food as Medicine Coalition, we recognize that There's, you know, NA-like agencies, but not enough of us, right?
And so there is, they have an accelerator program that one of our sister organizations out of Boston, where we actually just accepted our first international program out of Australia.
So for folks that are interested in learning our model, right, and doing medically tailored meals and we want, right?
We want this to be available, you know, all across the country and I think it's really important.
You know, to recognize that here in Pennsylvania or Philadelphia even maybe what we're serving our community isn't what folks in Texas would be, you know, like, I think it's really important to recognize the local communities that we're in.
And so, you know, over the years, you know, Mana our board or, you know, they've at times been like, oh, like we should just put mannas all across the country and it's like, no, like that, like we are mana because we've been in our community for 35 years and we have the trust of our community and the volunteers, which I think resonates them with the clients that we're serving.
And so I think the accelerator program is a great opportunity for folks that want to learn the model, but on a scale also, we do have the ability.
To shit our mules.
So we have, as part of Mana, we have a division of MA called the Manna Institute, which is a research and evaluation arm.
Because again, you know, when I'm kind of pounding the streets and being like, hey, why is not everyone who gets prescribed a diet, why is not that being covered, right?
And, it always, we need more data.
I would argue there's plenty of data, right, that shows You're gonna save the federal government significant dollars and you're gonna have better health outcomes, but we launched the Manta Institute, and it's just fascinates fascinating to me that the data continues to show, right, that folks, one, like the, like, that's a big component also, right?
Like they have to like want to eat the meals, but they have very specific Requests or needs that would be different, right, across the country.
And so the accelerator really is this amazing program.
I believe it's like a nine-month program and folks come in.
We just had the organization from Australia come visit us a couple of weeks ago and can really then hopefully build more models like MA like local to the communities that we serve.
Awesome.
And just to round off this interview, if we look, I'm curious what your hopes are for the Buddhist medicine movement, and how organizations like MAA can help, continue that change.
So, certainly our current administration here in the United States is Potentially, you know, presenting some challenges, right?
And so, I really do hope that since there is so much momentum in this space, and I think that FIMIC has always been, the Fred Mi Coalition has been the leader in the space, and I'm hope, hopeful that the federal government will look at that and look at these standards and really hold them to the highest standards and and Hold others to that same level of accountability.
And really, I, I, my ultimate hope, right?
And my ultimate goal that I come here every day and fight for is that someday, right, medically tailored meals will be a mandated covered expense, right?
Like, just like you get prescribed your medication, if you get prescribed a diet, that should be accessible and that should be accessible for all, and it's a win-win, right?
Again, it's one of those things like sometimes you see like a headline.
Like eating fruits and vegetables, you know, is good for you.
It's like that we have to do research, right?
We actually have research, we have a lot of data that shows this is an outcome that is a win-win for everyone, and it, it should be accessible and covered for all.
