‘FOOD IS MEDICINE’

Cari Shane Special to USA TODAY NETWORK

“The food they brought me was my medicine,” says Roseline Ifidon, 63. “I got off of six medications, because of the food. Because of the food,” says Ifidon, who, as part of a complex health care protocol, received a medical nutrition intervention known as Food Is Medicine (FIM).

Ifidon had not only suffered two strokes, but also had high blood pressure, sleep apnea, AFIB and was morbidly obese, she says. Through a local nonprofit in Baltimore, Moveable Feast, Ifidon received Medically Tailored Meals (MTMs) and personal nutritional counseling. In addition to losing 128 pounds, Ifidon says she decreased the number of daily medications she had to take from 14 to eight and she watched her out-of-pocket medical expenses decrease by more than $4,000 a year.

In the past, “there’s been a lot of unfortunate blame for people who have chronic illnesses,” says Carrie Stoltzfus, CEO of Food & Friends, a DC-based nonprofit that, like Moveable Feast, provides MTMs to those who are ill and in need. Both organizations are nationally accredited members of the Food Is Medicine Coalition (FIMC), which also provides Medically Tailored Groceries (MTGs) to individuals suffering from chronic, diet-related diseases such as diabetes, cardiovascular disease, obesity, osteoporosis and certain cancers, including colon and cancers of the digestive tract. A million Americans die each year from these preventable diseases.

One of the biggest problems, say those who are working to move the needle on integrating FIM into a national clinical care model, is that nutrition is largely missing from the health care system. FIM, which is not a fad diet, links food and medical care.

SO, WHAT IS ‘FOOD IS MEDICINE’?

FIM is a health care approach that uses nutritious food to prevent, manage and treat diseases. In addition to MTMs and MTGs, the third pillar of FIM is Produce Prescriptions Programs (PPPs).

An ever-growing body of research suggests that addressing nutrition insecurity, the way FIM does, not only improves health but also reduces the number of medical visits and medications a person needs; that, in turn, delivers cost savings to both the individual, as it did for Ifidon, and the public health system.

“For the cost of about one day in a hospital, our agencies could feed someone for six months with high quality, delicious, cooked from scratch, medically tailored meals,” says Alyssa Wassung, the executive director of the Food Is Medicine Coalition. “I want to double down on that. This isn’t just any food and it isn’t just food,” says Wassung.

Way too often, FIM is misunderstood, says David Waters, CEO of Community Sharings in Boston, also an accredited member of FIMC.

“It’s really important to understand it’s not a meal, it’s a nutrition intervention” for recipients who are often living with multiple illnesses, says Waters.

It begins with a nutrition assessment, and it includes nutrition counseling and education with a Registered Dietitian Nutritionist (RDN).

While many of the chronically ill who are discharged from the hospital are told to change their diets, most often they’re left to figure it out for themselves, says Sue Daugherty, CEO of MANNA in Philadelphia, an accredited member of FIMC. Discharge orders will include, for example, prescriptions that have been called into a patient’s local pharmacy and physical or occupational therapy appointments that have been scheduled for them. “All this is taken care of. And yet, often there’s this complex, restricted diet — four grams potassium, four grams phosphorus, two grams sodium, 2,000 cc fluids — and that’s the language. What are people supposed to do with that?” says Daugherty, who says the system frustrates her. “Why are prescribed diets treated differently than any other prescription?”

A lack of good nutrition is the number one driver of poor health in the United States. Those with lower incomes, historically marginalized racial and ethnic groups and rural Americans are most impacted.

Poor nutrition is also expensive. The country has some of the highest health care costs in the entire world, says Wassung. And, they’re driven by chronic diet-related diseases that can benefit from FIM, she says.

Chronic diet-related diseases afflict 60% of the U.S. population and cost the country $4 trillion a year.

For every dollar we spend on food, the U.S. economy loses a dollar to medical bills, lost work and illness linked to unhealthy eating.

Studies link FIM to better health outcomes as well as cost savings: $24 billion saved each year if all eligible Americans received MTM interventions. With 31% fewer hospitalizations and 20% fewer emergency department visits, there would be savings of approximately $1.6 million in hospitalizations alone.

Simultaneously, the health benefits of 6-month food interventions have been shown to last a full year, helping to decrease per-person health care costs by $3,433 a year. For those with cardiac disease and diabetes, the savings climb to $10,000 and $12,000 per individual, respectively.

“No other health care intervention that I can think of has this kind of power when it comes to durable cost savings” even for acute patients whose medical needs are complex, she says. “It’s really stunning.”

In 2022, the Biden Administration named FIM as a national health strategy that would integrate clinical nutrition into the U.S. healthcare system.

“The research continues to show that FIM programs are a smart investment: We can either pay less now for healthy and nutritious food or pay more later with expensive hospital and emergency room visits,” says Devin Klatell of the Rockefeller Foundation, which is helping to fund FIM initiatives.

Yet, because food and health care have not traditionally lived in the same space, Waters says FIM continues to be held to a different standard than other health intervention. “When we talk about most health care interventions, we don’t think about the cost. If you think about GLP-1s [which regulate appetite] or you think about a new cancer treatment, you think about whether there’s efficacy, whether there’s going to be impact, you don’t quibble about whether it’s expensive,” says Waters.

There’s also the impact on a person’s quality of life, says Wassung.

“I became more energetic, I became happier, I started getting more involved in more activities and in the community,” says Ifidon. There was also a “significant reduction in the cognitive load associated with managing multiple prescriptions,” which she says was “stressful.”

After hearing the anecdotal evidence, like Ifidon’s, for years, FIMC is now moving forward with studies that focus on the “happiness factor.”

“At a very basic human level, hearing that individual people’s lives have been improved or dramatically changed by just changing what they had access to from the food perspective is incredible and very translatable,” says Wassung.”

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