Food Is Medicine: A Presidential Advisory From the American Heart Association

Abstract

Unhealthy diets are a major impediment to achieving a healthier population in the United States. Although there is a relatively clear sense of what constitutes a healthy diet, most of the US population does not eat healthy food at rates consistent with the recommended clinical guidelines. An abundance of barriers, including food and nutrition insecurity, how food is marketed and advertised, access to and affordability of healthy foods, and behavioral challenges such as a focus on immediate versus delayed gratification, stand in the way of healthier dietary patterns for many Americans. Food Is Medicine may be defined as the provision of healthy food resources to prevent, manage, or treat specific clinical conditions in coordination with the health care sector. Although the field has promise, relatively few studies have been conducted with designs that provide strong evidence of associations between Food Is Medicine interventions and health outcomes or health costs. Much work needs to be done to create a stronger body of evidence that convincingly demonstrates the effectiveness and cost-effectiveness of different types of Food Is Medicine interventions. An estimated 90% of the $4.3 trillion annual cost of health care in the United States is spent on medical care for chronic disease. For many of these diseases, diet is a major risk factor, so even modest improvements in diet could have a significant impact. This presidential advisory offers an overview of the state of the field of Food Is Medicine and a road map for a new research initiative that strategically approaches the outstanding questions in the field while prioritizing a human-centered design approach to achieve high rates of patient engagement and sustained behavior change. This will ideally happen in the context of broader efforts to use a health equity–centered approach to enhance the ways in which our food system and related policies support improvements in health.

The American Heart Association at 100: A Century of Scientific Progress and the Future of Cardiovascular Science: A Presidential Advisory From the American Heart Association

“…The concept of Food Is Medicine, whereby food is prescribed by physicians for patients with diet-related medical conditions such as obesity and diabetes, is a particularly active area supported by growing evidence and in which the AHA, in collaboration with the Rockefeller Foundation and other partners, is developing a robust research infrastructure. 74 Organizations like the AHA can advocate for further strategies to address the social needs of patients by moving evidence-based approaches rapidly into communities to address food insecurity, transportation problems, and other social needs, thereby meeting patients and the public where they are.…”

You Are Where You Eat: The Local Environment and Risk of Heart Failure

“…healthy groceries are provided to patients in conjunction with health coaching, patient education, and dietitian consultations, have been used in patients with diabetes and hypertension and have the opportunity to reach patients with heart failure. 14,15 Additionally, the American Heart Association's Food is Medicine Initiative seeks to develop definitive trials of different interventions in populations with a focus on efficacy and scalability, with the ultimate goal of increasing the adoption and coverage of these interventions by insurance payers. 15 Another practical approach involves referring patients to specific resources to promote healthy eating, such as dieticians or fitness programs, or if unavailable, distribution of American Heart Association-and Heart Failure Society of America-recommended guidelines for a heart-healthy diet, incorporating culturally specific recommendations.…”

“…14,15 Additionally, the American Heart Association's Food is Medicine Initiative seeks to develop definitive trials of different interventions in populations with a focus on efficacy and scalability, with the ultimate goal of increasing the adoption and coverage of these interventions by insurance payers. 15 Another practical approach involves referring patients to specific resources to promote healthy eating, such as dieticians or fitness programs, or if unavailable, distribution of American Heart Association-and Heart Failure Society of America-recommended guidelines for a heart-healthy diet, incorporating culturally specific recommendations. 10,11 While all cardiology providers should introduce the importance of the topic, given the busy clinic environment, it is crucial to use the expertise of dieticians and other care team members to accomplish this goal.…”

How does eligibility for GusNIP produce prescriptions relate to fruit and vegetable purchases and what factors shape the relationship? A protocol for a secondary analysis of nationally representative data in the USA

“…There are also persisting disparities in FV accessibility, purchasing and intake among racial and ethnic minority groups and populations with low income that require unique policy, systems and environmental strategies to achieve nutrition security 5–10. One example gaining momentum is the Food is Medicine movement 11–13…”