Food as Medicine: Nutrition, not Just Food Security.

Author: Tolulope Adebile

Published on: 9/20/2024

 

One in five people dies from a suboptimal diet-related illness. Alarmingly, over one-third of the top ten leading causes of death worldwide are diet-related. This underscores the urgent need for "food as medicine" (FAM) interventions to prevent, manage, and treat illnesses. The concept of FAM emphasizes the critical role that access to nutritious food plays in maintaining health and preventing disease. This mini review explores the intersections between food and nutrition security and improved health through the lens of FAM.

While the terms food security and nutrition security are often used interchangeably, they represent different concepts. According to USAID, food security encompasses both economic and physical access to adequate food, ensuring individuals consistently have the means to obtain sufficient food to meet their dietary needs for a productive and healthy life. Conversely, nutrition security refers to the consistent availability, affordability, and accessibility of nutritious foods that prevent disease and promote well-being.¹ In other words, even if food is readily available, affordable, and accessible, it does not guarantee that such foods are nutritious.

The components of a healthy diet are well understood, yet embracing them remains a challenge for many, particularly in the United States. For instance, more than 80% of Americans consume less than the recommended intake of fruits and vegetables, whole grains, low-fat or nonfat dairy, legumes, and beans.² At the same time, they exceed the recommended intake of added sugars, partially hydrogenated fats, refined grains, saturated fats, meat, and sodium.² These dietary habits highlight not only food insecurity but also nutrition insecurity.

Addressing this issue requires a multifaceted approach that goes beyond simply providing access to food. One approach is FAM, which involves prescribing specific diets or food items as part of medical treatment plans, recognizing the therapeutic potential of food in managing and preventing chronic diseases. FAM takes many forms, including medically tailored meals (MTMs), produce prescription programs, and medically tailored groceries. While MTMs are typically for patients with high healthcare utilization and nutrition-sensitive chronic diseases, the later strategies can benefit a larger population of individuals with diet-sensitive illnesses.³

The benefits of the FAM initiative include improved health outcomes, reduced healthcare costs, and enhanced quality of life. For instance, MTMs can lead to better management of chronic conditions such as diabetes, kidney disease, and cardiovascular health,^2,4-5 ultimately reducing hospital admissions and medical expenses. Produce prescription programs encourage the consumption of fruits and vegetables,⁶ although the impacts on diet-related diseases remains inconclusive. Additionally, the FAM initiative sheds more light on health disparities by promoting population-level healthy food policies and programs.³

Conclusively, the “food as medicine” approach highlights the importance of nutrition, not just food security in improved health outcomes and well-being. By ensuring access to nutritious foods and integrating dietary interventions into healthcare, we can address the root causes of diet-related illnesses and improve public health outcomes.

 

Bibliography.

1. Mozaffarian, D., Fleischhacker, S., & Andrés, J. R. (2021). Prioritizing nutrition security in the US. Jama, 325(16), 1605-1606.

2. Volpp, K. G., Berkowitz, S. A., Sharma, S. V., Anderson, C. A., Brewer, L. C., Elkind, M. S., ... & American Heart Association. (2023). Food is medicine: a presidential advisory from the American Heart Association. Circulation, 148(18), 1417-1439.

3. Mozaffarian, D., Blanck, H. M., Garfield, K. M., Wassung, A., & Petersen, R. (2022). A Food is Medicine approach to achieve nutrition security and improve health. Nature medicine, 28(11), 2238-2240.

4. Berkowitz, S. A., Delahanty, L. M., Terranova, J., Steiner, B., Ruazol, M. P., Singh, R., ... & Wexler, D. J. (2019). Medically tailored meal delivery for diabetes patients with food insecurity: a randomized cross-over trial. Journal of general internal medicine, 34, 396-40

5. Chen, A. M., Draime, J. A., Berman, S., Gardner, J., Krauss, Z., & Martinez, J. (2022). Food as medicine? Exploring the impact of providing healthy foods on adherence and clinical and economic outcomes. Exploratory research in clinical and social pharmacy, 5, 100129.

6. Hager, K., & Mozaffarian, D. (2020). The promise and uncertainty of fruit and vegetable prescriptions in health care. The Journal of Nutrition, 150(11), 2846-2848.