Negative health outcomes, including cardiovascular disease, hypertension, various cancers, and type 2 diabetes have long been linked to nutritional deficiencies and poor diet. According to the Rockefeller Foundation, diet-related diseases cost the US around $1.1 trillion every year – and more than a million annual American deaths are linked to improper nutrition.
In recent years, the focus has shifted to looking at the interlinkages between health and nutrition from the other direction – how the right diet can help treat, prevent, and manage diseases and chronic conditions.
Increasing acceptance and growing funding
One of the earliest targeted food as medicine (or food is medicine) applications emerged during the HIV/AIDS epidemic in major cities in the US, where philanthropic organisations including Project Open Hand and God’s Love We Deliver recognised the value of tailored diets to address nutritional deficiencies among patients suffering from the virus. The interventions proved to be an effective way to improve life expectancies and quality of life, and in the years following these initial ad hoc approaches, many of the non-profits applied the principles in managing other diseases – from type 2 diabetes to cognitive diseases and heart disease.
Several decades on, the movement has become more organised and united – with groups like the Food is Medicine Coalition having over 350 members – and the concept has become decisively mainstream; at least in the US. In January 2024, the Department of Health and Human Services (HHS) hosted an all-day Food is Medicine summit. At the event, HHS announced its commitment to Food is Medicine principles that included facilitating easy access to healthy food, improving understanding between nutrition and health, and investing in the capacity of under-resourced communities.
Besides government support, the movement has also gained significant funding in recent years. The Rockefeller Foundation announced an additional investment of $80 million in Food is Medicine solutions in the US in January 2024 – bringing the total amount committed by the philanthropic institution to $100 million.
Food as medicine in practice: Produce prescriptions and farmacies
There are a growing number of applications of Food as Medicine that are being put into practice. Medically tailored meals (MTMs) are one of the foundational pillars of the Food as Medicine movement, also emerging during the HIV/AIDS pandemic as a custom diet to supplement the scarce medicinal treatments available at the time. Today, MTMs are often provided to patients suffering from heart and kidney diseases and diabetics. A 2022 economic evaluation found that a national MTM roll-out across the US could avoid 1.6 million hospitalisations and save $13.6 billion.
Food prescriptions – particularly produce prescriptions – are another example of Food as Medicine in practice that is gaining ground. According to the Tufts School of Medicine report True Cost of Food: Food is Medicine Case Study, nationally scaled-up produce prescription programmes targeting diabetes patients and food insecure Americans could result in 292,000 fewer cardiovascular events at a significantly lower cost than other medical interventions and preventative efforts. In 2022, grocery delivery company Instacart launched its Instacart Health initiative, which is built on the Food as Medicine philosophy. The company is working with the US government and other private partners to deliver food prescriptions to Medicaid members.
Farmacies – or ‘food pharmacies’ are another way to get healthy food to people who need it for medical reasons, or simply because they live in food insecure areas. Often organised by healthcare providers or hospitals, these initiatives ensure that families can get fruit, vegetables, whole grains, and other nutritionally approved foods – along with information and sometimes coaching – for discounted rates or at no cost at all.
Food as medicine and the food industry
In response to a call for action at the White House Conference on Hunger, Nutrition, and Health, several private sector players from the food industry made commitments to advance the Food as Medicine agenda. Consumer packaged food and beverage company Danone North America announced that all its children’s products would have less than 10 grams of sugar per 100 grams of product by 2040. The company also committed to investing in healthy-eating initiatives and nutrition and health research.
Tyson foods, a large food producer traditionally focused on meat products, also made commitments at the event. The company pledged $255 million in charitable donations towards expanding access to nutritious protein products and committed to reformulating its prepared foods to improve their nutritional value; and specifically to lowering sodium content.
But is there space for processed foods within a Food as Medicine approach? The American Heart Association (AHA), which organises the Health Care X Food initiative as a way to accelerate Food as Medicine in health care, told Fi Global Insights: “The use of healthy processed foods in our Health Care x Food initiative would need to complement the medically tailored grocery or medically tailored meal interventions that are led by our research grantees.”
The AHA also points to its 2021 Scientific Statement on Dietary Guidance to Improve Cardiovascular Health, which contains the guiding principle “choose minimally processed foods instead of ultra-processed foods”. However, the AHA also notes that “there is no commonly accepted definition for ultra-processed foods. [S]ome healthy foods may exist within the ultra-processed food category.”
