'Food Is Medicine': When Fruits and Vegetables Become Part of a Prescription
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"Food is medicine" is now at the forefront of the federal strategy to end hunger and reduce diet-related diseases. This concept of medical care, also known as "food as medicine," involves tailoring meals to a patient's medical needs.
Food therapy has long been an important component of Traditional Chinese Medicine. However, using food as medicine is still an emerging concept in Western medicine, and many U.S. health experts are supportive of the government's efforts in advancing this initiative.
Produce prescription programs, for example, have allowed providers to prescribe fruits and vegetables to patients with diet-related diseases or those facing food insecurity.
Evidence shows that these programs can effectively increase fruit and vegetable intake. A 2021 study also found that a 15-week produce prescription significantly reduced hemoglobin A1C levels in patients with diabetes.
Nicole D . White, PharmD, CDE, an associate professor in pharmacy practice at Creighton University, told Verywell that produce prescriptions are written by healthcare providers "like they would write a prescription for a medicine."
Under these programs, fruits, vegetables, or other diet-related recommendations are prescribed instead of medications. These prescriptions may be filled using vouchers that are subsidized by farmers markets, grocery stores, or other community partners, according to White.
"It's a really exciting movement for medicine that we’re treating root causes, rather than putting band-aids on things that we could have addressed earlier and prevented potentially," White told Verywell.
Produce prescription programs are currently funded by the USDA's Gus Schumacher Nutrition Incentive Program. While the programs might differ from region to region, they generally aim to treat diet-related diseases or relieve food insecurity by providing patients with nutritious fruits and vegetables.
For instance, a program in North Carolina called RP Rx gives patients $40 a month to spend on fruits and vegetables at local Food Lion grocery stores. Another program run by NYC Health + Hospitals/Queens fills produce prescriptions with the help of a local produce box delivery service. In Pennsylvania, the Fresh Food Farmacy offers nutrition education along with prescription-filling meal kits.
Brent Ling, MSPH, the director of external affairs at Wholesome Wave, a nonprofit that established the National Produce Prescription Collaborative, told Verywell that providers are still experimenting with the best ways to deliver produce prescriptions.
"We want to make sure that it's done in a way that's equitable, that is accessible to the ones who need it the most, and ultimately, to everybody in an equitable fashion," Ling said.
While more research is needed to optimize best practices, Ling said that the evidence is clear that produce prescriptions help patients manage their diabetes while also improving their "engagement with the healthcare system overall."
Produce prescription programs are a promising tool in the management of diet-related diseases, but experts say there are still barriers to making these programs more mainstream.
"We never really give food and nutrition the chance it deserves. Why? Our training has been woefully insufficient for far too long," Kofi Essel, MD, MPH, FAAP, a pediatrician and director of the George Washington University Culinary Medicine Program, said at the White House conference.
According to Essel, most medical schools don't reach the minimum number of recommended training hours on food and nutrition. Without this training, healthcare providers may not be equipped to prescribe meaningful diet-related interventions.
In coordination with the White House Conference, the American College of Lifestyle Medicine announced a plan to address this gap in nutrition education by donating food is medicine continuing education courses to 100,000 healthcare providers.
As more healthcare providers are trained in nutrition and produce prescription programs expand, experts say that providers should keep food access and cultural sensitivity in mind.
"It's important to incorporate that health equity and make sure we have the lived experience of families at the table. It's critical," Essel said.
Produce prescription programs have been helping patients in underserved communities, but they're not yet widely available. Check with your healthcare provider to see if there are any existing produce prescription programs in your area.
Zou P. Traditional Chinese medicine, food therapy, and hypertension control: a narrative review of Chinese literature. Am J Chin Med. 2016;44(08):1579-1594. doi:10.1142/S0192415X16500889
Lyonnais MJ, Rafferty AP, Spratt S, Jilcott Pitts S. A produce prescription program in eastern North Carolina results in increased voucher redemption rates and increased fruit and vegetable intake among participants. Nutrients. 2022;14(12):2431. doi:10.3390/nu14122431
Bryce R, Wolfson JA, Cohen AJ, et al. A pilot randomized controlled trial of a fruit and vegetable prescription program at a federally qualified health center in low income uncontrolled diabetics. Prev Med Rep. 2021;23:101410. doi:10.1016/j.pmedr.2021.101410
United States Department of Agriculture. Gus Schumacher nutrition incentive program.