Providing nutritious meals to vulnerable populations can save lives and curb healthcare costs, experts said during a hearing of the Senate Health, Education, Labor, and Pensions (HELP) Subcommittee on Primary Health and Retirement Security on Tuesday.
“Poor nutrition is the top cause of death and disability in the United States … causing more harm than tobacco use, alcohol, physical inactivity, and air pollution,” said Dariush Mozaffarian, MD, DrPH, director of the Food is Medicine Institute at Tufts University in Boston.
What that means, in reality, is that the inability to access healthy food is “literally lethal,” Mozaffarian said. And while thousands of Americans know their diets are making them sick, many feel powerless to fix the problem.
Witnesses argued that food is medicine, which is why produce prescriptions, medically tailored meals, and counseling programs have been shown to substantially benefit patients with diabetes, depression, pain, and other chronic issues.
Erin Martin, MASM, a gerontologist and founder and director of FreshRx Oklahoma, a nonprofit food prescription program, said many healthy food initiatives were borne out of need.
During the COVID-19 pandemic, a physician from North Tulsa discovered that even his patients with diabetes who complied with their medications and medical visits were seeing their health decline. The lifespan of residents in North Tulsa is at least 8.5 years shorter, on average, than residents of South Tulsa, and the community had not had a grocery store for 14 years, Martin said.
In 2021, FreshRx Oklahoma launched a pilot program to provide residents who have type 2 diabetes with locally grown produce twice a week for 12 months, as well as four to six cooking and nutrition classes each month. Program participants also received quarterly health check-ins, Martin explained.
Produce is bought using prepaid debit cards and farmers’ market vouchers, and through online shopping models, depending on the community
Of the first 300 participants in the program, 80% have seen their A1C levels drop an average 2.2 points — with one participant’s falling 8.2 points in less than 6 months. Another participant lost 116 lb and reversed her type 2 diabetes.
Jean Terranova, JD, senior director of policy and research for Community Servings in Boston, said her organization provides medically tailored meals to thousands of people in Massachusetts and neighboring states.
As part of these services, a nutritionist evaluates all participants on their health and dietary needs, access to food, and ability to support themselves. Participants receive meals each week for themselves and their families from one of 16 meal plans, plus snacks such as fresh fruit and yogurt, as well as milk, and nutrition education and counseling.
One 66-year-old participant, a man named Chuck, lost 50 lb and avoided having his foot amputated after receiving a cardiac diabetic diet through the program.
A 2019 JAMA study on the program showed that it led to a 16% net savings on total healthcare spending, resulting from fewer emergency department visits, hospital admissions, and emergency transports.
When asked about the use of GLP-1 receptor agonists and where they fit in with nutrition, Mozaffarian cited a report from Sen. Bernie Sanders (I-Vt.), chair of the HELP Committee, which showed that if half of Americans eligible for GLP-1 agonists actually took them, the U.S. would double its national spending on all prescription drugs combined.
“We just can’t afford those drugs, as effective as they are. So, we need to integrate nutrition and ‘food is medicine’ and lifestyle together with GLP-1’s to be able to mitigate that loss,” he added.
Terranova thanked Subcommittee Chair Sen. Ed Markey (D-Mass.) and Ranking Member Sen. Roger Marshall, MD, (R-Kan.) for bills they and other senators introduced that would require federal agencies to publish nutrition best practices, expand access to medically tailored meals through community health centers, and provide seniors with healthy meals.
In terms of legislative actions, Terranova urged Congress to increase funding for NIH to explore the benefits of medically tailored meals, and Martin asked the HELP Committee to integrate prescription produce programs into federal health programs.
Mozaffarian encouraged Congress to support “meaningful funding” for the NIH to launch Food is Medicine Centers of Excellence and called for “meaningful nutrition education for doctors” in coordination with the national accreditation and licensing organizations responsible for medical education.
Finally, Mozaffarian noted that while the U.S. is never going to eliminate processed and packaged foods, there are ways to make them healthier. His hope is that as Food is Medicine takes root, it will shift incentives for how food is produced.
“Right now we’re pouring money down into healthcare and taking money away from every other priority,” he said. “If we put some money in food, we can start to reverse that cycle and make food healthier.”
