An American Heart Association (AHA) Presidential Advisory, co-authored by a committee including the dean of Weill Cornell Medicine, outlines an ambitious plan to increase rigorous research on initiatives aimed at providing food as medicine for chronic conditions.
Food is Medicine (FIM) is an increasingly popular approach to help treat or prevent chronic conditions by assisting patients to access healthier food through a variety of strategies, including produce prescriptions, food subsidies and prepared meals. Despite its growing popularity with health care institutions, governments and health insurers, the data available to guide implementation is limited. The call-to-action, published Sept. 28 in Circulation, provides a detailed plan for bolstering the evidence base and ensuring equitable, wide-scale implementation.
“Healthier diets are urgently needed to help turn the rising tide of chronic diseases in the United States,” said Dr. Robert A. Harrington, the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine and provost for medical affairs of Cornell University and a past president of the AHA. “Food is medicine interventions have enormous potential, but we need strong data to identify and implement successful approaches.
Poor diets are a significant contributor to chronic diseases like heart disease and diabetes, according to the advisory. They are also a major driver of health inequity. People living in communities of color or with lower incomes often have reduced access to the components of a healthy diet, the authors write. Healthy diets emphasize fresh fruits and vegetables, whole grains, protein sources like legumes, lean meats or low-fat dairy, and plant-based fats. Minimizing highly processed, sugary or salty foods made with refined grains and unhealthy fats is also important for a healthy diet, they further note.
But a growing number of FIM programs are trying to help patients eat healthier. Some involve clinicians writing “prescriptions” and health systems, insurers or other third parties helping subsidize the costs. Others provide medically tailored prepared meals that are designed with a patient’s individual health needs in mind.
Preliminary data show that FIM programs are feasible for health systems to implement, improve patient health outcomes, reduce health care utilization and are cost-effective, the authors state. However, the advisory identifies research gaps and proposes a coordinated plan for closing them. For example, it emphasizes the need for equity-minded research that respects individuals’ cultures and lived experiences.
It outlines a timeline that calls for developing the infrastructure necessary for large, high-quality FIM trials in 2023, starting definitive clinical trials by 2027, and implementing and disseminating successful approaches by 2032. It also highlights policy hurdles and the need for education about FIM for clinicians and the public.
The advisory lays the groundwork for the implementation of a FIM initiative launched in September 2022 at the White House Conference on Hunger, Nutrition and Health with support from organizations including AHA and the Rockefeller Foundation. The initiative began accepting its first round of research proposals in September 2023.
“High-quality Food is Medicine programs have the potential to transform millions of Americans lives, cut health care costs and advance health equity,” Dr. Harrington said. “The advisory helps us chart course for investigators, health care systems, insurers and policymakers to make these programs widely available.”