Nutrition Rx: Understanding the viability of ‘food is medicine’

Here’s something that might be hard to swallow: You, or someone you know, probably aren’t eating as well as they should be.

Everyone knows that a healthy diet is important. What you eat can profoundly affect your health, appearance, lifespan, and risk of chronic disease. A poor diet can lead to many chronic diseases and conditions, including obesity, cardiovascular disease, hypertension, stroke, diabetes, and more. All these conditions are among the leading causes of death globally, underscoring a worldwide problem that needs to be tackled.

Most Americans want to eat healthy, and make an honest effort doing it, but asking someone to have a healthy diet is easier said than done. Some people may lack the money or time to adopt better eating habits. Others simply may not know where to begin.

To address these problems—and potentially reduce the prevalence of preventable chronic diseases in America—health systems, nonprofits, and the federal government have launched or funded “food is medicine” programs. In this blog, we’ll dig into what “food is medicine” is, gauge its benefits and limitations, and chew on why this healthcare trend matters.

What is 'food is medicine?'

'Food is medicine' (FIM) is a healthcare approach built on the knowledge that a patient’s diet and the food they eat play important roles in disease management and prevention. The initiative aims to reduce chronic disease in the U.S. by funding diet-related research, investing in medically tailored meal programs, improving access to nutrition resources, and addressing food insecurity in communities.

While the concept has been around for several years, serious momentum behind FIM began to grow after Congress called upon the Department of Health and Human Services in 2023 to develop and implement a strategy to reduce chronic diseases by 2030.

Big steps from the federal government, nonprofit agencies, health systems, and payors have already been made to support the FIM movement. CMS has approved Medicaid coverage for nutrition interventions in five states, with more likely to follow. Health systems are combating diet-related diseases by integrating nutrition programs into their services. Insurers like Aetna, Humana, and Elevance are adding food benefits to their Medicare Advantage plans. Altogether, these organizations are working to leverage nutritious food and healthy eating habits to produce better outcomes, lower the cost of care, and reduce the rate of chronic disease in the country.

Benefits of 'food is medicine'

Let’s look at some of the key benefits of the ‘food is medicine’ initiative:

Disease management

The U.S. Department of Agriculture reports that about half of all American adults have one or more chronic diseases, and many more are overweight or obese—which increases their risk of health problems. This can result in cardiovascular disease, high blood pressure, type 2 diabetes, some cancers, poor bone health, and more. Implementing FIM programs can lower—or even prevent—the likelihood of these conditions developing, by helping patients lose weight and get the nutrients they need to meet clinical dietary guidelines.

Cost savings

Using food as a preventative medicine and teaching patients healthy eating and dieting habits could help curb healthcare costs while reducing chronic conditions. According to research from the Friedman School of Nutrition Science and Policy, implementing medically tailored meals could avert about 1.6 million hospitalizations and result in a net savings of $13.6 billion in healthcare costs in just the first year.

Help reduce food insecurity—particularly among minority and BIPOC patients

The USDA reports that about 17 million U.S. households were food insecure during 2022—an increase of 3.5 million households in 2021. However, adults and children living in low-income and BIPOC communities are statistically more likely to lack access to affordable, nutritious food than those living in wealthier or White neighborhoods.

While data suggests that episodes of food insecurity are generally short-lived, the effects of dietary changes can persist over extended periods of time. These changes in diet often translate to households consuming fewer servings of fruits, vegetables, and dairy in favor of foods high in added sugars, saturated and trans fats, and refined grains. These unhealthier foods are usually cheaper to buy and have a longer shelf life.

As a result, food insecurity increases the likelihood of a person developing chronic diseases. Children may be particularly impacted, with studies suggesting that food insecurity leads to iron-deficiency anemia, acute infection, and developmental and mental health problems.

To address this problem, prescription produce programs can be pioneered to help food-insecure households and communities access the nutritious food they need to live healthily.

Limitations and problems with the 'food is medicine' approach

Between federal investment and support from payors, health systems, and nonprofits, the ‘food is medicine’ movement is becoming more and more promising. As FIM impacts the complex healthcare landscape, however, healthcare organizations should take note of some limitations before integrating or accounting for FIM programs in their strategies for 2024 and beyond.

Here are some of the most notable challenges to the success of FIM adoption:

1. Chronic diseases are caused by more than just diet and lifestyle. It’s important for healthcare providers and payors to recognize that food should not be a stand-alone remedy for all health conditions. While health, diet, and lifestyle can contribute to chronic diseases, their development may also be caused by genetics, autoimmune conditions, exposure to environmental toxins, or other forces. Instead, “food is medicine” should be used to complement appropriate therapies or procedures.
2. Bogged down by misinformation. Unfortunately, conversations around food and dieting are rampant with misinformation, unverifiable anecdotes, and promotions of fad diets or eating habits with little (or no) scientific backing. Healthcare organizations should consider creating and sharing resources that promote health literacy. Easily understood health information can help patients manage their diet, prevent chronic conditions, and better manage health problems should they arise.
3. Clinicians will need to be trained. Should FIM approaches become more popular, clinicians will need to be taught and trained on the appropriateness and use of these interventions. In the future, healthcare professionals may need to be more knowledgeable about nutrition science and be able to coach patients. In-depth, science-based education on food nutrition, however, can be time-consuming and expensive to implement. Adding this type of education to medical and nursing schools and residency programs is a solid first step.

How will “food is medicine” impact the healthcare landscape?

Despite some obstacles, the ‘food is medicine’ movement is gaining traction and shaping up to impact the healthcare landscape.

With so many organizations getting involved, collaboration will be key to addressing the lingering problems and concerns surrounding FIM. For example, healthcare providers and payors can partner with food retailers and technology companies to implement studies and develop evidence supporting their strategies—or to make putting food on patients’ tables a more frictionless process.

FIM’s impact on the U.S. food system will be equally as important. Currently, the federal government subsidizes agricultural production to maximize crop output and keep costs low. This typically results in highly processed food, snacks, and beverages with high levels of sodium, sugars, fats, and refined grains. Of course, this practice is in direct contrast with our nation’s dietary guidelines and may be a contributing factor to food insecurity and the prevalence of chronic diseases.

With a FIM approach, patients living with a chronic condition or experiencing food insecurity may be enrolled into produce prescriptions or medically tailored meals. While this may help address the symptoms, advocating for change in U.S. economic policy could target the underlying problem. Healthcare organizations could lobby to redirect agricultural subsidies to fruits, vegetables, and other nutritious crops, which could help make healthy food cheaper and more accessible—and make unhealthy food items more expensive.

Learn more

So, is the ‘food is medicine’ approach a delicious idea that’s ready to go? Or does it need more time in the oven? While that is up to you to decide, any program that helps people access nutritious food and live healthier, longer lives is a step in the right direction.

This blog is the sixth in a series of posts exploring the healthcare trends that we believe will shape the landscape in 2024. If you missed our previous trend, I recommend reading our post on drug prices becoming more transparent, driven by regulatory pressures and competition. Or you can jump back to the beginning and read up on the trends you’re most interested in.

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