Access to food that promotes health and well-being is a struggle for many people. Food as medicine (FAM) is a way for healthcare professionals (HCPs) to incorporate nutrition interventions in patient care to improve health and nutrition security.¹ 

Choosing healthy foods is a critical component of healthcare. However, with only 38% of physicians discussing dietary intake during patient visits, nutrition is often overlooked as a strategy for improving health.² Improving the diet can prevent one in every five deaths worldwide from non-communicable diseases such as cardiovascular disease, cancer, chronic respiratory disease, and diabetes.^3,4 FAM interventions help supply food and sometimes nutrition guidance to support overall healthier dietary habits.¹

Although choosing foods that promote health can help reduce the risk of certain diseases and death, it’s important to note that FAM is not a replacement for much-needed medical care from a qualified HCP and a food prescription is not intended to be a substitute for a medicine prescription. 

Types of FAM Interventions 
Here are four common types of FAM interventions directed by HCPs at little to no cost to the patient. These interventions may be funded by government programs, philanthropy, or the healthcare system.¹ The availability of the FAM interventions described here varies by location, with Medicaid piloting programs in certain states. Non-profit organizations, such as Wholesome Wave, offer some guidance on identifying programs.

FAM Intervention	Details	Target Population
Medically tailored meals	Prepared meals designed for a specific health condition. This usually includes nutrition counseling.	People with complex medical conditions, such as cancer or HIV, who are not able to shop or prepare meals.
Medically tailored groceries	Grocery items tailored for a specific health condition.	People experiencing food insecurity who can cook at home.
Produce prescriptions	Vouchers or debit cards for free or discounted produce.	People at risk for diet-related chronic disease, such as diabetes or obesity, who are experiencing food insecurity.1
Culinary medicine	Personalized nutrition education with instruction on food preparation and cooking to support patients with the skills and education necessary to implement dietary recommendations.1	People who are interested in assessing their diet and participating in a program.2

The Role of FAM in the Healthcare System
Health-promoting foods can have big benefits for reducing healthcare expenses, especially when used for patients dealing with cancer, diabetes, and other diseases.^1,5 In an examination of over 1,000 patients, providing medically tailored meals was associated with a 16% reduction in overall healthcare costs, 49% fewer inpatient hospital admissions, and 72% fewer skilled nursing admissions.⁵ 

Lack of consistent access to nutritious foods can lead to greater intakes of lower quality foods often rich in refined carbohydrates, excess sodium, and excess saturated fat.⁶ Food insecurity often coexists with chronic health conditions such as obesity, and diabetes, and FAM interventions, such as produce prescriptions, have broad appeal and benefit for this population. FAM interventions can help extend food dollars and allow people to buy nutritious foods they otherwise might not be able to afford.¹ 

Food Environment and Food Choice 
Low quality food is often widely available in underserved areas.⁷ Patrons of food pantries in underserved areas have been found to have inadequate intake of fruits, vegetables, and whole grains and higher intakes of fatty meats, refined grains, and sugary beverages.⁸ A poor quality diet increases the risk of health conditions including cardiovascular disease, cancer, type 2 diabetes, and overall mortality.^4,7 

Dietary choices are shaped by the food environment. Prominent display of healthier food items in stores and pantries is shown to help nudge people toward these foods while allowing them to maintain freedom of choice.⁷ FAM interventions, such as produce prescriptions, are shown to lead to better intake of fruits and vegetables and better adherence to dietary recommendations by allowing people access to foods they might otherwise not be able to afford.^1,7

The Future of FAM

Here are some ways for HCPs to address the impact of nutrition on health:

1. Primary care providers can plan to discuss food and health during a patient’s annual physical.²  
2. When appropriate and available, HCPs can consider referring patients for medically tailored meals, medically tailored groceries, produce prescriptions, or culinary medicine. 
3. Identify the process for patients to utilize meals and vouchers for groceries and produce and include this information during referral. Verify and update this process as often as necessary.¹ 
4. HCPs can refer patients to a registered dietitian to provide nutrition guidance and support with cooking skills, shopping, meal planning, and food safety. The Academy of Nutrition and Dietetics Foundation, a charitable organization that supports nutrition professionals to help their clients live healthier lifestyles, developed resources and support for registered dietitians to provide nutrition-focused programs in food retail settings.⁹ Meeting with people while they shop for food can be an ideal way to provide nutritional support. 

Eating nutritious foods has undeniable health benefits.⁴ Support from HCPs with FAM interventions to allow access to foods that promote health and wellbeing can be a crucial part of healthcare. Continued research on the cost-saving and health promoting benefits of FAM interventions can help ensure crucial ongoing funding.

Learn More with Orgain

To further support your knowledge on the food as medicine (FAM) movement and lifestyle medicine, check out these other Orgain-sponsored educational resources:

The Good Clean Nutrition Podcast

Episode 9: The Crusade to Make Diet a Vital Sign with David L. Katz, MD, MPH, FACPM, FACP, FACLM

Episode 29: Understanding Food as Medicine with Doctor and Chef, Robert E. Graham, MD, MPH, ABOIM, FACP

References:

1. Downer S, Berkowitz SA, Harlan TS, Olstad DL, Mozaffarian D. Food is medicine: actions to integrate food and nutrition into healthcare. BMJ. 2020 Jun 29;369:m2482. doi: 10.1136/bmj.m2482. PMID: 32601089; PMCID: PMC7322667.
2. Parks K, Polak R. Culinary Medicine: Paving the Way to Health Through Our Forks. Am J Lifestyle Med. 2019 Sep 11;14(1):51-53. doi: 10.1177/1559827619871922. PMID: 31903082; PMCID: PMC6933573.
3. Piovani D, Nikolopoulos GK, Bonovas S. Non-Communicable Diseases: The Invisible Epidemic. J Clin Med. 2022 Oct 8;11(19):5939. doi: 10.3390/jcm11195939. PMID: 36233805; PMCID: PMC9572583.
4. GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019 May 11;393(10184):1958-1972. doi: 10.1016/S0140-6736(19)30041-8. Epub 2019 Apr 4. Erratum in: Lancet. 2021 Jun 26;397(10293):2466. PMID: 30954305; PMCID: PMC6899507.
5. Berkowitz SA, Terranova J, Randall L, Cranston K, Waters DB, Hsu J. Association Between Receipt of a Medically Tailored Meal Program and Health Care Use. JAMA Intern Med. 2019 Jun 1;179(6):786-793. doi: 10.1001/jamainternmed.2019.0198. PMID: 31009050; PMCID: PMC6547148.
6. Berkowitz SA, Fabreau GE. Food insecurity: What is the clinician’s role? CMAJ. 2015 Oct 6;187(14):1031-1032. doi: 10.1503/cmaj.150644. Epub 2015 Aug 17. PMID: 26283725; PMCID: PMC4592289.
7. Anderson E, Wei R, Liu B, Plummer R, Kelahan H, Tamez M, Marrero A, Bhupathiraju S, Mattei J. Improving Healthy Food Choices in Low-Income Settings in the United States Using Behavioral Economic-Based Adaptations to Choice Architecture. Front Nutr. 2021 Oct 6;8:734991. doi: 10.3389/fnut.2021.734991. PMID: 34692747; PMCID: PMC8526839.
8. Simmet A, Depa J, Tinnemann P, Stroebele-Benschop N. The Dietary Quality of Food Pantry Users: A Systematic Review of Existing Literature. J Acad Nutr Diet. 2017 Apr;117(4):563-576. doi: 10.1016/j.jand.2016.08.014. Epub 2016 Oct 7. PMID: 27727100.
9. Academy of Nutrition and Dietetics Foundation. https://www.eatrightfoundation.org/resources/food-as-medicine