This article is part of Food Tank’s primer series, “Food Tank Explains.” Each installment unpacks the ideas, innovations, and challenges shaping today’s food and agriculture systems, offering clear insights into complex topics. To explore more articles in the series, click here.
Food is Medicine (FIM) encompasses a variety of food-based interventions that aim to prevent and treat diet-related chronic conditions and advance health equity. Sitting at the crossroads of food and agriculture systems, nutrition, and healthcare, FIM programs focus on increasing access, availability, and affordability of healthful foods.
Poor diets are a major driver of cardiovascular disease, the leading cause of death worldwide, causing 45 percent of cardiometabolic deaths in the United States and 70 percent of new diabetes cases worldwide, according to a JACC State-of-the-Art Review by Dariush Mozaffarian, Director of the Food is Medicine Institute at Tufts University (FIMI). Globally, one in five deaths is attributable to poor diet—more than any other risk factor, including tobacco.
The burden of poor diets falls disproportionately on low-income communities and communities of color, where food insecurity and limited access to nutritious food contribute to higher rates of diet-related chronic disease. Among American Indians and Alaska Natives, food insecurity rates are roughly double those of white Americans in recent decades. Obesity rates are about 7 percent higher among Hispanic Americans and 15 percent higher among Black Americans than among white Americans.
Poor nutrition also carries a significant economic burden, contributing to chronic diseases that account for 90 percent of U.S. health care spending and more than US$1.1 trillion annually in combined medical costs and lost productivity.
FIM interventions span different levels of clinical intensity and support, with programs designed to match patients’ medical conditions and social needs. Produce prescription (PRx) programs, appropriate for the broadest group, provide patients with funds or vouchers to purchase fruits and vegetables from local food retailers, supporting both disease prevention and management.
Medically tailored groceries offer curated food packages selected by a registered dietitian nutritionist or other medical professional to address diet-sensitive conditions. These groceries are designed for patients who can shop and prepare meals.
Medically tailored meals (MTM) represent the highest-intensity intervention and are customized for patients with severe or complex conditions, who are unable to shop or cook and require comprehensive nutritional support. FIM initiatives frequently integrate nutrition and culinary education to reinforce preventive care and maintenance.
Farmers are central to all FIM initiatives and programs. Farmers supply the fruits, vegetables, and other foods used in FIM interventions, and their soil and crop management practices directly shape the quality and nutrient density of the food patients receive. Programs that source locally support farm income, reduce supply chain risks, and create economic benefits in rural communities.
Throughout history, food has been understood as a source of healing across cultures and medical traditions. Indigenous communities have “long known that food is medicine,” says Kate Nelson, an award-winning writer and editor and Alaska Native Tlingit tribal member. Indigenous foodways recognize food as inseparable from health, Nelson explains, with seasonal, regionally specific, and culturally grounded foodways understood as essential to healing both people and land.
In seventh-century China, physician Sun Simiao included food prescriptions in Recipes Worth a Thousand Gold, in the hope that sick people would alter their diet before trying drugs. In the U.S. FIM efforts trace part of their origins to the HIV/AIDS epidemic, when organizations such as God’s Love We Deliver and Project Open Hand emerged to provide nutritional and social support to individuals living with HIV/AIDS. Over time, these programs evolved from providing basic sustenance to offering medically tailored groceries and meals designed to support long-term health outcomes.
Despite its long cultural history, FIM has played a limited role in Western healthcare. Clinicians have had few practical tools to address patients’ diets, compounded by insufficient medical nutrition education and inadequate incentive and policy infrastructure.
In recent years, however, FIM is gaining rapid momentum across the U.S. health care sector, with interventions such as MTM and PRx moving into the mainstream. Public and private organizations have committed nearly US$10 billion to address diet-related disease and hunger, and companies such as Instacart have launched initiatives aligned with FIM strategies.
Early research indicates that FIM interventions are associated with improvements in dietary quality, food security, and health outcomes, along with reductions in health care utilization. A systematic review found that 21 of 22 PRx studies reported increased fruit and vegetable intake, and modeling suggests that national implementation could avert 274,000 cardiovascular events.
According to research conducted by FIMI, MTM have been linked to improved health and fewer hospitalizations, and are estimated to save US$23.7 billion in healthcare costs.
Existing evidence supports the promise of Food Is Medicine and justifies broader implementation, but indicates the need for more rigorous research, stronger clinician training, and sustained funding to scale these interventions equitably.
“Food is the big missing thing in how we approach our health in this country,” says Mozaffarian, expressing hope that eventually food will be prescribed as readily as a drug or surgery.
Articles like the one you just read are made possible through the generosity of Food Tank members. Can we please count on you to be part of our growing movement? Become a member today by clicking here.
Photo courtesy of Meagan Stone, Unsplash
