If Food Is Medicine, Why Are We Withholding Treatment?

Last week, news broke that the USDA was canceling deliveries of fresh dairy, fruit, and other food to food banks. This was part of a $500 million program that now appears to be in jeopardy. This followed closely on the heels of $660 million cut by USDA that was expected to be used to bring fresh, locally grown foods into schools and food banks. While this doesn’t exactly sound like a science and medicine story — and while I’m reluctant to let government cuts become a major focus of this newsletter — there’s an obvious link to health, and a less obvious one to healthcare. So here we go.

If the idea of healthcare fills your head with images of hospitals and medications, you’re not alone. But recent initiatives have branched out beyond the traditional model with the launch of programs that consider food to be a key component of medical treatment, particularly for low-income and vulnerable communities. These “food as medicine” programs are often prescription-based, with recipients getting access to fresh fruits and vegetables through deliveries, farmers’ markets, food pantries, and more.

In North Carolina, for example, the state health department developed an initiative based on Medicaid funding to support access to food as part of an overall campaign designed to reduce healthcare costs. After several years and 20,000 residents served, the state reported reductions in emergency department usage, as well as fewer hospitalizations for adult women, among other benefits. In Pennsylvania, health insurance company Highmark provided food and nutrition counseling through a prescription program. With nearly 50,000 people served, Highmark reported that patients with high blood pressure or high cholesterol saw noticeable improvements in their numbers after six months.

Food-as-medicine programs tend to be highly targeted local efforts, so there’s not a lot of extensive data about how they perform or about long-term results. But even small, early-stage studies are helpful. Peer-reviewed research tells us that prescription food programs increase fruit and vegetable consumption among kids, improve outcomes among patients with otherwise uncontrolled diabetes, and decrease fast-food consumption among people with hypertension.

It may seem like all of this should go without saying: it’s no secret that fresh fruits and vegetables are core elements of any healthy diet. (And that’s coming from someone who still defines “breakfast of champions” as a bag of peanut M&Ms and a bottle of Mountain Dew.) But the idea of considering diet as a key pillar of healthcare, one that can be prescribed just like a beta blocker, is not yet the norm in medicine. Results from the programs mentioned above suggest that we should rethink how we approach this — and that delivering fresh, nutritious food could be an important step both for improving health and for reducing the overall costs of healthcare.

Stopping programs that are bringing dairy, produce, and other good food to kids and families can save money in the short term. But in the long run, the evidence says we’ll all bear the brunt of higher healthcare costs and a sicker population.