Top Things to Know: Food Is Medicine
Published: September 28, 2023
Prepared by Jen Muse, MS, RD, CDN, Science & Health Advisor, American Heart Association
- An estimated 90% of the $4.3 trillion annual cost of health care in the US is spent on medical care for chronic disease. Unhealthy diets are a major risk factor for many of these diseases.
- Diet quality in the US falls far short of recommendations due to systematic barriers to the adoption of healthier eating patterns, commercial determinants of health, and socioeconomic factors. These barriers result in a slow rate of adoption of food-based interventions to prevent or treat disease.
- Food Is Medicine (FIM) may be defined as the provision of healthy food resources to prevent, manage, and/or treat specific clinical conditions in coordination with the health care sector. This can be prescribed by a health care professional, health care organization or health insurance plan, and can include interventions such as medically tailored meals, medically tailored groceries, and produce prescriptions.
- These interventions are not new; however, the existing FIM evidence is limited by small sample sizes, non-randomized comparisons, and broad differences in the intervention intensity, duration, food distribution modalities and measurement tools tested, as well as differences in the incorporation of complementary intervention approaches such as nutrition and lifestyle coaching. Further rigorous research is needed on the comparative effectiveness of nutrition-based interventions relative to standard medical care in preventing and treating disease.
- Food Is Medicine represents a paradigm shift focused on the incorporation of food and nutrition programs into the health care system to prevent, manage, and/or treat specific clinical conditions.
- Both the limitations of existing research and the potential of FIM interventions present important opportunities for coordinated scientific effort to study FIM. The American Heart Association, with funding from the Rockefeller Foundation and other partners, will fund and conduct clinical trials and other research to determine the cost-effectiveness of FIM interventions in preventing and treating diet-related illness.
- Because of the complexity inherent to the field, the Advisory outlines several principles that should guide research into the use of Food Is Medicine; some are relevant to all biomedical and clinical research, and others are more specific to the study of FIM.
- In addition to research, the Advisory also proposes concurrent efforts in public policy and advocacy, the creation of payment and quality assurance systems, a greater standardization of professional education to deliver nutrition counseling, educating the public on healthy eating, and prioritizing health and FIM with policymakers at the local, state, and federal levels.
- FIM is particularly important within the broader context of the AHA’s efforts to improve health equity by enhancing food systems and related policies to support improvements in health.
- This Presidential Advisory concludes with a call to action on the necessary steps to facilitate the multi-sectoral partnerships needed to develop the evidence on effectiveness and cost-effectiveness that will inform both the public and private payor coverage decisions regarding FIM interventions in appropriate clinical contexts.
Citation
Volpp KG, Berkowitz SA, Sharma SV, Anderson CAM, Brewer LV, Elkind MSV, Gardner CD, Gervis JE, Harrington RA, Herrero M, Lichtenstein AH, McClellan M, Muse J, Roberto CA, Zachariah JPV; on behalf of the American Heart Association. Food Is Medicine: a presidential advisory from the American Heart Association [published online ahead of print Thursday, September 28, 2023]. Circulation. doi: 10.1161/CIR.0000000000001182