Food Is Medicine: A Movement Helping to Manage Chronic Illness

May 10, 2023

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Nutrition is inextricably linked to health. So are social and economic factors like education, housing, and job status. Many Americans don’t have access to good, daily nutrition because of structural racism, cost, inaccessibility, and lack of time for food preparation. The Food is Medicine movement recognizes these gaps by bringing whole foods within reach of those with chronic conditions.

Food is Medicine is a movement to increase access to whole foods for those with chronic medical conditions.
Food access is determined by structural racism, social, and economic factors — not simply by personal choices.
The movement focuses on providing food prescriptions, medically-tailored groceries, and medically-tailored meals. Registered dietitians make diet-related recommendations specific to chronic illnesses.
Medically-tailored meals are the most widely-researched intervention, showing a decrease in hospital admissions and emergency department visits.
Ongoing research is guiding health policy to make the Food is Medicine movement more widely available across the United States.

Studies have shown that Food is Medicine’s interventions can decrease hospital admissions and trips to the emergency department.

Food is Medicine movement

Food is Medicine is a movement focusing on the role of nutrition in chronic illness management through different programs and interventions. At this intersection of food and health, the Food is Medicine movement focuses on three kinds of interventions:

Food prescriptions
Medically-tailored meals
Medically-tailored groceries

Some chronic conditions this movement targets are:

Diabetes
HIV
A spectrum of heart and kidney diseases
High-risk pregnancy conditions
Chronic mental health conditions
Some types of cancer

Qualifications may vary by state. However, more research is underway to guide health policy that could make these interventions more broadly available.

Nutrition interventions

While the Food is Medicine movement is relatively young, it has taken shape through a range of services that make quality nutrition accessible. Some of these are:

Food pharmacies. Also called “food farmacies”, these are co-located within a healthcare setting. Some healthcare systems and nonprofits are providing access to, and education about, whole foods such as fresh fruits and vegetables.
Produce prescriptions. Healthcare providers can write prescriptions for healthy foods such as fruits, vegetables, legumes, and grains. These prescriptions act as vouchers or coupons to be used in grocery stores or food pharmacies. While this requires access to a store with these products, it can cut costs for otherwise costly groceries.
Medically-tailored groceries. This can range from a format similar to a meal kit, with pre-selected and proportioned groceries to be prepared at home, to a shopping list for an individual to pick up groceries and prepare them at home. Regardless of method, groceries meet nutritional requirements for each individual. Some programs offer delivery or distribution of groceries through a community site such as a food bank or healthcare setting.
Medically-tailored meals. The most widely researched intervention so far focuses on the role of medically-tailored meals in decreasing trips to the hospital for those with chronic illnesses, though the benefits extend far beyond decreased hospitalizations. Dietitians create medically-tailored meals to match nutritional needs specific to a condition. Meals are prepared ahead of time and delivered ready to serve, generally for a certain quota per month.

Medically-tailored meals decrease hospital admission

Food access has a direct link to health, which the World Health Organization defines as complete physical, mental, and social well-being. Unfortunately, the American healthcare system too often emphasizes health as personal responsibility with shame-filled messaging about eating healthier to avoid illness. Food is one aspect of health, but food access is impacted by many factors such as:

Where the nearest grocery store is
Monthly income
Time to prepare food

Not to mention that keeping up with the latest nutritional recommendations can be confusing.

Typically, a healthcare provider refers someone with a qualifying condition to a community-based nonprofit organization that provides medically-tailored meals. A registered dietitian then does an in-depth assessment to understand that person’s individual needs before creating meal plans that are prepped and delivered.

The impact of medically-tailored meals

Studies measuring the impact of medically-tailored meals show promising results for people with cancer, type 2 diabetes, kidney disease, heart disease, and HIV. The following improvements have been noted:

Better blood sugar control
Improved blood pressure
Improved sodium intake
Decreased depressive symptoms
Increased medication compliance
Improved quality of life

How to find medically-tailored meals

Ask your doctor about medically-tailored meals that may be available to you. Your doctor will need to refer you to a program that offers medically-tailored meals in your community. At this point, medically-tailored meals are not federally covered through Medicaid or Medicare, but several states are testing pilot programs funded on the state level.

If your state doesn’t yet fund and provide medically-tailored meals, ask your doctor for a referral to a dietitian who may be able to suggest a nutrition plan that is both specific to your condition and culturally appropriate. Following a tailored diet can prevent health complications by making gradual changes over time. For example:

Condition	Diet suggestions:
Type 2 diabetes	Healthy carbohydrates, fruits and vegetables, whole grains, and lean protein. Whole foods that are high in protein and fat slow down the digestion of glucose, helping to keep blood sugar steady.
Cardiovascular conditions	The DASH diet, which stands for Dietary Approaches to Stop Hypertension and focuses on fruits, vegetables, whole grains, low-fat dairy, and lean protein. This diet decreases daily sodium intake, which can decrease blood pressure. Sodium causes the body to hold on to water, which increases blood pressure. Whole foods that are low in cholesterol can help prevent plaque buildup in blood vessels.
Kidney disease	Low-sodium foods, but adding other spices to avoid sacrificing taste, and increasing whole foods like fruits, vegetables, beans, and meats. Lowering sodium intake can take pressure off of the kidneys.
Irritable bowel disease	The specific carbohydrate diet is a grain-free diet low in sugar, lactose, and processed foods. Eliminating certain carbohydrates that are hard to digest can reduce inflammation and prevent harmful bacteria from growing in the digestive tract.

Better food access can improve health outcomes. For those living with chronic conditions, medically-tailored meals have proven to decrease the frequency of healthcare use by improving access to good nutrition at home, improving mental health, and freeing up resources to cover medications. Food is sacred, cultural, and personal. It’s also political — in that food, access is shaped by much more than the ability to just “eat right.” Ask your doctor if medically-tailored meals are available to you. Ongoing research will hopefully make this a more accessible resource in the future.