Things have changed recently in California and a few other states, and Medicaid now covers some foods intended for patients with diet-related conditions. As a result, I now prescribe “medical support foods” or MSF to some of my patients. This is paid for by insurance, just like medicine.
The move to embrace “food as medicine” is bolstered by research showing that food prescribing by medical professionals can reduce health care costs and improve health, especially for those who don’t have the resources to access healthy foods. I’m here.
In a recent study, researchers estimated $185.1 billion in healthcare over 10 years by providing the benefits of a nationwide “medically adjusted diet” to individuals with conditions such as heart disease, cancer and diabetes. We estimate that it could save costs and avoid more than 18 million hospitalizations.
For those who view food as an integral part of healing, this is a monumental step. But prescribing food is not as easy as it sounds.
Diet is more complicated than any pill. This makes it difficult for doctors and patients to know which medically conditioned foods are the best medicines and which suppliers can best provide these dietary regimens.
First, it’s really hard to pinpoint which supplier provides the most nutritious food. Medicines, whether generic or brand-name, have roughly the same composition, regardless of who makes them. However, the nutritional content of food varies greatly depending on the seed, season, growing method, processing method, and storage time before eating. Combining foods to create a diet further increases nutritional variability.
For example, Denise Shea, a physician and chief medical officer of California-based Contra Costa Health Plan, said the lack of standardization has caused food vendors bidding to provide prescriptions to his plan’s subscribers. It became difficult to choose between.
Hsieh has extensive experience in contracting medical supply companies for pharmaceuticals and other healthcare products, but this is his first foray into the food sector. He said he received little guidance from the California Department of Health Services about what to buy. I’m just suggesting that you provide it.
“After all, my basic criteria are [for vendors] “They don’t charge us for giving food to patients and giving them McDonald’s,” he said.
In the end, Hsieh signed contracts with six vendors. He said he hopes these vendors will offer meals and groceries that replicate the cost savings and health benefits of “food is medicine” research, but which vendors will achieve this? “I have no experience” to judge.
Michelle Kuppich, a registered dietitian and director of the California Food Is Medicine Coalition, is also concerned about the quality of some foods entering this growing medical market.
“There are a lot of new companies entering the space because money is at stake and people want healthcare,” Kuppich said. She said she suspects some of them “started by selling meals prepared for weight loss and then rebranded.”
Kuppich has found it difficult to obtain information about the nutritional value of some foods on the market. “There is a lack of transparency regarding ingredients,” she said.
Some vendors offer foods that are as ultra-processed as the fast-food meals Hsieh wants to avoid. Ultra-processed foods are associated with a higher risk of chronic disease and premature death.
For example, GA Foods, a Florida-based vendor of medical support foods, sells more than 50 types of corn syrup, including additives such as corn syrup and other sweeteners, food colors, flavoring additives, hydrolyzed proteins, and preservatives. We provide a “nutritionally balanced” diet. Mary O’Hara, senior marketing manager at GA Foods, said: “Our medically tailored diet portfolio is continually evolving to meet patient needs and new innovations in health and wellness.”
And Tracy Smith, vice president of marketing for Mom’s Meals, an Iowa-based company that serves more than one million meals a week nationwide, says their meals contain magnesium, zinc, iron, calcium, and a micronutrient blend of vitamins C and B1. B6 “Ensure that meals fully meet one-third of the dietary reference intake for humans. Instead of including food, we do it.”
Fortifying foods with vitamins and minerals can prevent anemia and other ailments associated with deficiencies of specific nutrients, but cannot replicate the more complete nutrition provided by whole foods. contains all the nutrients found in Mom’s Diet Blend, plus dozens of additional disease-fighting compounds that together affect health.
Kathryn Couch, Founder and CEO of Ceres Community Project, a non-profit MSF supplier based in Sonoma County, California, said: client requirements. Couch says sourcing food locally and limiting storage and transportation times helps ensure higher nutritional quality. (It also helps support local economies and reduce environmental footprints.)
Healthcare providers also face the challenge of identifying vendors that offer foods that appeal to the palate and soul.
“None of these dietary interventions work if people don’t want to eat the food,” says Some Foods, a researcher who led a pilot study in medicine and is now in the university’s Department of General Medicine and Clinical Epidemiology. Associate Professor Seth Berkowitz said. North Carolina Medical College. He explained that food provides gastronomic delights, cultural connections and family memories.
Berkowitz said domestic vendors offer “economies of scale” that keep costs down, but a pilot study he was involved in in Boston showed positive results “from scratch. They received their food from a non-profit organization that said they “made” meals and provided shopping…from local farmers.
“Mission-oriented organizations can be profitable,” says Berkowitz. “It remains to be seen if these small efforts will scale the secret sauce that paid off.”
nutrition and lifestyle coaching
In addition to providing food, MSF vendors in California are expected to provide nutrition and lifestyle coaching to their clients. Studies show that combining food assistance with education is more likely to promote healthy eating patterns.
As with food, these services vary. Some vendors offer subscribers access to quick nutrition consultations and healthy eating apps, while others offer real-time cooking and shopping classes.
Sarah Nelson, executive director of 18 Reasons, an MSF provider in the San Francisco Bay Area, said: She found that when clients were given recipes and practiced preparation in a group setting, they were more likely to try new vegetables.
“Nutrition education and counseling are just as important as diet, so that you can prepare healthy meals once the prescription is over,” says Kupich.
How to work in a hospital
I recently wrote a prescription for a 50 year old woman with poorly controlled type 2 diabetes. She was enrolled in her MediCal, California’s health insurance program for children and adults with limited income and financial resources.
I did my best to direct her to vendors that offered the most delicious, most nutritious, and culturally relevant foods. I found it difficult to understand which one it was.
She ultimately chose a nonprofit that sources most of its food locally and delivers meals to her doorstep. Two months after her prescription, her blood sugar improved, so I called her to tell her the good news. I asked her what she thought of her diet. “They are very nice. It’s really nice to see them,” she said.
It took me a while to realize she was referring to the delivery person, not the food.
Her comment made me wonder what caused the positive change in blood sugar. Was it food? social connection? both?
Anyway, it was a reminder that food isn’t a pill, it’s a much more complicated drug.
Daphne Miller is a Family Physician and Clinical Professor at the University of California, San Francisco, and a Research Scientist at the University of California, Berkeley School of Public Health. She is also the founder of the Health From the Soil Up She Initiative.
