References: Food is Medicine and Health

This page contains numerous articles showcasing the beneficial impact of food is medicine programs on health, particularly those that partner with local organic and regenerative farms and focus on equity, In some studies, HGA1C  dropped by 1 or 2 percentage points. (Rosas et al 2025; Wang et al 2014)   A drop in 1 percentage point (from 8.5% to 7.5% for instance)  can reduce risk of diabetes-related complications by 40%, supporting better long-term health. (Fralick et al, 2020) and can reduce ER visits (Lage et al 2020)

Studies have consistently shown that  Food is/as Medicine and Food is Health interventions can have a positive impact on reducing chronic disease, reducing hospital return rates and improving human health outcomes.

And a higher consumption of fruit and vegetables is associated with a lower risk of all cause mortality, particularly cardiovascular mortality. In some cases, this may be equivalent to a fistful serving size having positive health implications. (Lee et al 2022)These programs are a powerful lever for helping to address not only health and inequity issues, but when sourcing and supporting local farms with more nature-friendly approaches, but also aid in supporting environmental, climate and biodiversity issues while supporting smallholder farmers and local economies.  A win win win in my book!

I have put *** next to the resources I have found to be particularly helpful and/or compelling.

Please note: These articles have been updated through July 2026

Adams, EL, Figueroa, R, White, KE, Bell, BM, Alegria, K, and Yaroch, AL. Prioritize “food is medicine” initiatives in the 2024 farm bill for human and planetary health. Transl Behav Med. (2024) 14:330–2. doi: 10.1093/tbm/ibad083

  •  The initiatives within FIM prioritize the inclusion of nutrient-rich foods to support healthier dietary intake and habits
  • Evidence supports the benefits of Food is Medicine interventions in improving food security, diet quality, health outcomes, financial strain, and mental health 

ANTHEM BLUE CROSS FOUNDATION GRANT HELPS 83% OF PARTICIPATING PROJECT ANGEL FOOD DIABETES CLIENTS IMPROVE BLOOD SUGAR LEVELS. Angelfood.org. 2026.

  • The results underscore the power of medically tailored meals as a food-as-medicine intervention for people living with serious illness and diabetes in Los Angeles County. In addition to improved blood sugar control, 60% of clients experienced a reduction in emergency room visits while receiving services — demonstrating the program’s potential to improve health while helping clients avoid costly, preventable acute care. 

Bernstein A, Hunnes DE. Food is Medicine Interventions and Climate Change. American Journal of Lifestyle Medicine. Published August 26, 2024.

  • FiM may be able to advance lifestyle medicine and population health objectives, as well as mitigate some of the health care and food-related drivers of climate change, by focusing on 4 key areas: (1) Increasing the absolute number and proportion of patients who follow plant-based diets; (2) reducing food waste; (3) reducing unnecessary health care utilization; and (4) lowering transportation-related greenhouse gas emissions related to food procurement.
  • Ultimately, thoughtful, data-driven, and urgent interventions that span the food and health care sectors are needed to sustainably support not only FiM, but human, environmental, and planetary health as well.

Bhat S, Coyle DH, Trieu K, Neal B, Mozaffarian D, Marklund M, Wu JHY. Healthy food prescription programs and their impact on dietary behavior and cardiometabolic risk factors: a systematic review and meta‐analysis. Adv Nutr. 2021;12:1944–1956. ***

  • A poor-quality diet is a leading risk factor for noncommunicable diseases worldwide (1, 2), with 1 of every 5 deaths across the globe attributable to a suboptimal diet (3). Furthermore, diet-related diseases including obesity, diabetes, and cardiovascular disease place a tremendous financial burden on healthcare systems (4–6), with costs projected to rise over the coming decades (7, 8). Food insecurity, defined as lack of access to nutritionally adequate food, is associated with the greater consumption of inexpensive nutrient-poor foods (9–14), lower intake of fruit and vegetables and other healthy foods (15, 16), and higher risk of cardiometabolic diseases.
  • Pooled estimates revealed a 22% increase in fruit and vegetable consumption, corresponding to 0.8 higher daily servings  BMI decreased by 0.6 kg/m2 and HbA1c by 0.8%   

Caputo, J. Produce Prescription Programs for Patients with Diabetes Could Save Billions in Health Care Costs,  Website Food & Nutrition , Health , Friedman School of Nutrition Science and Policy.  2023

  •  Their modeled implementation of a nationwide produce prescription program—which would provide free or discounted fruits and vegetables to eligible Americans living with diabetes —projected extensive reductions in national rates of cardiovascular disease and associated health care costs. 
  • “Of the strategies that can improve nutrition and diet-related health outcomes for Americans, evidence continues to build that produce prescriptions are a terrific option,” says senior author Dariush Mozaffarian, a cardiologist and Jean Mayer Professor at the Friedman School, who is also launching a new cross-university initiative that will be the first of its kind to focus on advancing Food is Medicine. “These innovative treatments are exciting because they can not only improve health and reduce health care spending, but also reduce disparities by reaching those patients who are most in need.”
  • Their analysis estimated that a national produce prescription program for 40- to 79-year-olds with diabetes and food insecurity could prevent 296,000 cases of cardiovascular disease (for example, heart attacks and strokes) and gain 260,000 quality-adjusted life years (years lived with good health) over the lifetime of current patients.
  • Through these health gains, these benefits were also estimated to save $39.6 billion in health care spending and $4.8 billion in costs of lost productivity. At the same time, implementing the program nationally would cost $44.3 billion, including all expenses for screening patients, providing food and nutrition education, and necessary administration.
  • Taken into account all costs, a national produce prescription program for patients with diabetes and food security would be highly cost-effective, costing $18,000 per quality-adjusted life year gained
  • Original Study: https://www.ahajournals.org/doi/10.1161/JAHA.122.029215

Chen S.Sourcing and the Health Multiplier Effect: Recipe4Health Food Is Medicine Model. Presentation presented at: Rodale Institute Roots to Results Convening; November 2025; Kutztown, PA.  (Mary Purdy in attendance).

  •  Food insecurity significantly increases the risk of developing diabetes. T – ait et al. (PLOS ONE, 2018)
  • Food Is Medicine addresses one of the most modifiable drivers of chronic disease – food insecurity – by integrating nutritious food into healthcare to improve health outcomes, reduce healthcare utilization, and support long-term disease prevention.
  • The impact of Food Is Medicine can be amplified through sourcing. Recipe4Health’s “Health Multiplier Effect” demonstrates that when medically tailored food is sourced from regenerative, local farms, the benefits extend beyond individual health to improve ecological health, strengthen local economies, and advance equity.
  • Recipe4Health combines produce prescriptions, behavioral health coaching, clinician training, and braided funding (Medicaid, county, USDA, and philanthropy) into a scalable model that has shown measurable improvements in health behaviors, mental health, diabetes management, and reduced emergency room utilization.
  • Participants demonstrated improvements in:
    • Health behaviors
    • Depression symptoms (44% reduction)
    • Anxiety symptoms (32% reduction)
    • Hemoglobin A1c
    • 15% lower likelihood of emergency room visits compared with controls
  • Economic Impact
    • Approximately $670,000 directed to local regenerative farms.
    • Estimated $1.90 generated for every $1 invested for the state.
  • The model illustrates how Food Is Medicine can serve as a catalyst for systems change by connecting healthcare, agriculture, policy, and community partnerships to create lasting health, economic, and environmental benefits.

Congresswoman Barbara Lee Introduces Bill to Address Food Insecurity’s Impact on Chronic Health Conditions , Oakland Post Website. 2024

  • This legislation would reduce nutrition-related chronic diseases and food insecurity and improve health and racial equity in the United States, and would increase Americans’ access to healthy, nutritious, organic, and affordable foods, as well as behavioral services such as health coaching and nutrition counseling, especially in low-income communities.
  • A growing body of research demonstrates that using healthy food, termed “medically supportive food,” in a clinical setting helps the healthcare system address food and nutrition insecurity, chronic disease, racial and health equity, and the intersections between them. The National Food as Medicine Act would:
    • Establish a Food as Medicine Waiver Grant program to establish, implement, and expand Food as Medicine interventions to reduce nutrition-related chronic conditions and improve health
    • Establish a USDA Food as Medicine Technical Assistant Program to support producers to connect with local health care systems to provide for FAM interventions
    • Direct the HHS Secretary to develop and issue Food as Medicine guidance to states and counties to aid in the implementation, planning, and expansion of Food as Medicine programs

Defraeye et al. (2025). “Advances in Food-as-Medicine interventions and their impact on future food production, processing, and supply chains,” Adv, Nutrition.

  • In the United States alone, diet-related diseases (cardiovascular diseases, hypertension, cancer, and diabetes), obesity, and food insecurity cost an estimated 1.1 trillion [1], namely 604, 359, and 146 billion USD, respectively. Other studies reported 50 billion USD in diet-related costs for cardiometabolic diseases in the United States per year, or 300 USD per capita [2]. Worldwide, unhealthy diets account for an estimated 3–150 EUR of healthcare costs per capita [3]. Furthermore, 1 of every 5 deaths globally (11 million people) in 2017 was attributed to an unhealthy diet, leading to 255 million disability-adjusted life years
  • Food-as-medicine (FAM) is an emerging trend among medical doctors, health insurers, startups, and governmental public-health and nongovernmental organizations. FAM implies using food as a part of an individual’s health plan to prevent or help treat acute and chronic health conditions and diseases.

Deng S, et al. Estimated impact of medically tailored meals on health care use and expenditures in 50 US states. Health Aff (Millwood). 2025;44(4):433-442. doi:10.1377/hlthaff.2024.01307

  • Researchers estimated the impact of providing 10 medically tailored meals (MTM) per week to all eligible patients for an average of 8 months. MTM are home-delivered meals customized for patients with severe, complex, or chronic conditions based on therapeutic, evidence-based dietary specifications.
  • In 49 states, the estimated net cost savings per patient ranged from $732 (Oregon) to $6,299 (Connecticut). In one state (Alabama), MTMs were cost-neutral but would still yield health benets.
  • In all states, the estimated number of hospitalizations prevented ranged from 2,400 (Wyoming) to 211,000 (Florida).
  • $23.7B in healthcare cost savings.
  • Bottom line: These results support the implementation and evaluation of medically tailored meals in public and private health systems at the state level and nationwide.
  • IMPORTANT: The estimated impacts on healthcare costs and hospitalizations do not incorporate potential additional benefits of MTM for quality of life, disease progression, caregiver well-being, or health equity.
  • Note from Mary Purdy:  Not all investments yield economic results and that is not what necessarily matters most.  Equity, wellbeing are sometimes something that we cannot put a price on, and which matters more than anything with a dollar sign next to it. 

Ewing-Chow D. Food Is Medicine: The “Big Bet” Changing How America Eats. Forbes. Published March 19, 2025.

  • Food is Medicine (FIM) as a public health strategy: The Rockefeller Foundation is investing over $100 million in FIM programs to show that nutritious food can prevent and manage chronic diseases, reduce healthcare costs, and address food insecurity.
  • 90% of the $4.3 trillion America spends on healthcare goes to chronic diseases— many fueled by poor diets— that disproportionately impact vulnerable groups such as people of color, low-income households, rural communities, seniors, and veterans. Every year, 500,000 people die from diet-related conditions, driving $1.1 trillion in healthcare costs— the same amount the country spends on food.
  • Veterans as a starting point: Veterans, who face high rates of obesity, diabetes, and heart disease, are among the first beneficiaries of FIM pilots, with stories like Herman Johnson’s highlighting the potential for life-changing outcomes.
  • FIM programs have the power to improve health, lower costs, and change lives.

Figueroa R, Houghtaling B. Food is Medicine and implementation science: A recipe for health equity. Transl Behav Med. 2024 Mar 21;14(4):234-240. doi: 10.1093/tbm/ibae005. PMID: 38366890.

  • This paper proposes that, in order to reduce the rates of Type II diabetes, cardiometabolic diseases, and cancer, among others; we prioritize Food is Medicine (FIM) as a way to prevent and address the impact of diet-related diseases. FIM is a pyramid of programs interested in promoting access to nutritious foods consistently to promote health.

Food is Medicine Advancing Health Equity Through Nutrition, August 2025  American Public Health Association***

  • “Food is Medicine” is an emerging approach to healthcare that integrates nutrition interventions, such as produce prescription programs, medically tailored meals and medically
    tailored groceries, into clinical care to prevent, manage and treat diet-related chronic diseases. Grounded in growing evidence that nutrition is a key determinant of health, Food is Medicine programs aim to improve patient health and well-being, reduce healthcare costs, and advance health equity.
  • Recommendations
    • Improving nutrition training for health care professionals to ensure providers know when nutrition interventions are appropriate.
    • Investing more in data collection, evaluation and equity-centered research for Food is Medicine programs.
    • Strengthening nutrition standards for Food is Medicine interventions and other nutrition assistance programs

Food is Medicine: Peer-Reviewed Research in the U.S.: Medically Tailored Meals, Medically Tailored Food Packages, and Nutritious Food Referrals Food. (2020) Center for Health Law and Policy Innovation of Harvard Law School (

  • The purpose of this table is to provide an overview of peer-reviewed research associated with Food is Medicine interventions. Food is Medicine refers to a spectrum
    of programs, services, and other interventions that recognize and respond to the critical link between nutrition and health. These services include both the provision of
    food itself or tailored food assistance (vouchers for produce, etc.) and a nexus to the health care system. Policymakers, health care providers, and social service
    organizations have begun to recognize that connecting people with complex health conditions to Food is Medicine interventions is an effective and low-cost strategy
    to improve health outcomes, decrease utilization of expensive health services, and enhance patient quality of life
  • While interest in Food is Medicine interventions has also been growing in the scientific community, notable opportunities exist to fill current gaps in Food is Medicine research. This summary of evidence is a working document and is a preliminary step to assess the state of research surrounding Food is Medicine services. The table below includes peer-reviewed research that focuses on three different categories of Food is Medicine services: medically tailored meals, medically tailored food packages, and produce prescription programs.

Fralick M, Colacci M, Odutayo A, Siemieniuk RA, Glynn RJ. Lowering of hemoglobin A1C and risk of cardiovascular outcomes and all-cause mortality: a meta-regression analysis. J Diabetes Complications. 2021;35(4):107842. doi:10.1016/j.jdiacomp.2020.107842

  • Among over 130,000 adults with diabetes, reduction in hemoglobin A1c was associated with a decrease in cardiovascular risk

From Farm to FIM: The Economic Impact of Local Food is Medicine *** (Rockefeller Report) 

  • The public supports these FIM programs, and nearly 4 in 5 people believe they should be covered by health insurance.
  • More than half of U.S. states have pursued some form of policy change to expand or explore FIM, signaling growing bipartisan momentum.
  •  When FIM programs intentionally prioritize locally-sourced food from small/midsized farms, and regional food businesses, it helps those dollars circulate locally, supports rural communities, and can encourage more resilient and regenerative production practices.
  •  Serving the 43 million Americans who could benefit from FIM would significantly improve health outcomes and support farmers and food businesses by contributing $50.2 billion in demand for healthy food.
  •  Policies need to shift to embed local/regenerative sourcing into FIM programs, incentivize and reimburse FIM programs build infrastructure to enable and champion local and regional food supply chains.
  • Diet-related chronic diseases affect nearly half of Americans and cost the U.S. more than $1.1 trillion dollars annually. At the same time, many of the 1.7 million small and mid-sized family farms in the US face persistent financial pressure. With the disappearance of 28,000 farms annually, inequitable distribution of food, and an environmental/climate crisis, food is medicine programs offer a way to improve health equitably, support local economies, and make our agriculture system more resilient.
  • With targeted guidelines that localize FIM according to each state’s capacity, states can achieve measurable economic gains: • $45 billion+ in annual GDP growth nationwide through localized FIM programs • 316,000 new jobs supported by local FIM supply chains • $5.6 billion in annual revenue for small and mid-sized family farms, along with greater market stability and opportunities for investment

Gonzalez N, Samad I, Thomas O, Rice J, Valdez R, Burt K. Food as medicine through the lenses of Food Access, Justice, and Sovereignty. Curr Opin Pediatr. 2025 Feb 1;37(1):13-18.  FULL TEXT ALSO FOUND HERE: 21.pdf  ***

  • Be sure to see the amazing graphic which is the featured image on this page
  • We introduce the Food Access, Justice, and Sovereignty (FAJS) framework, which expands FAM efforts to address acute food disparity through community-based strategies grounded in justice and sovereignty.
  • Community-driven solutions are essential for shifting power toward greater integration of the lived experiences of community, which can enhance positive behavioral changes needed for greater prevention and management of chronic illness.
  • The original spirit of FIM which was supporting small producers, prioritizing prevention, and uplifting community voices, is being diluted as resources flow toward well-funded national players, while the lived experiences of communities most impacted by food insecurity are overlooked.
  • It’s time to reimagine FIM through the lens of Food Access, Justice, and Sovereignty (FAJS) where power and capital shift to communities, where culturally relevant foods are the norm, and where food interventions build environmental and human resilience. This is what real investment in health or people and planet looks like.

Gordon B, Ridinger S, Krick R, Grosvenor L, Charron R. Fruit and Vegetable Prescription Program for Diabetes Control Among Community Health Centers in Rural Idaho and Oregon. Am J Public Health. 2022;112(7):975-979.

  • A Fruit and Vegetable Prescription program (12–16 weeks, 2018–2020) was implemented at community health centers serving rural communities in the northwestern United States. The impact of the program on type 2 diabetes control was evaluated. Reductions in mean hemoglobin A1C were statistically significant (P < .01). The percentage of participants with critically high blood glucose levels (A1C > 9%) decreased from 76% to 41%
  •  Of note, residents of rural communities experience high rates of obesity and physical inactivity coupled with poor dietary choices; thus, the need for FVRx programs for this population emerges.4

Hager K, Kummer C, Lewin-Zwerdling A, Zhongyu L. Food is Medicine Research Action Plan. Published April 2024 ***.

  • This report from the Aspen Institute outlines a roadmap for equity-centered research that can revolutionize how diet-related conditions are prevented, treated, and managed in the United States. It is the first report to pull together the latest peer-reviewed Food is Medicine research in a digestible, comprehensible and action-oriented format 

Jamila McLean, State Health and Value Strategies. How States Are Using the RHTP to Advance Food Is Medicine Interventions. Shvs.org. Published 2026 ***.

  •  State Medicaid agencies are increasingly formalizing FIM interventions by leveraging policy options such as section 1115 demonstration pilots, value-added benefits & in-lieu-of services (ILOS), and home and community-based services (HCBS). FIM interventions can vary in scope, combining direct food provision with nutrition counseling and education or solely focusing on one or the other.
  • EG: Maryland’s RHTP application proposes the Empower Rural Marylanders to Eat for Health initiative, which focuses on strengthening rural food access and nutrition supports. The initiative includes investments in cold storage infrastructure such as freezers, refrigerators, and lockers to reduce post-harvest spoilage and help small farms reliably supply local markets.

Juraschek SP, Col H, Ferro K, et al. DASH-Patterned Groceries and Effects on Blood Pressure: The GoFresh Randomized Clinical Trial. JAMA. Published online November 09, 2025. doi:10.1001/jama.2025.21112

  • In this randomized clinical trial of 180 Black adults with elevated blood pressure or hypertension, low sodium-DASH groceries ordered online with dietitian counseling decreased blood pressure at 3 months vs a monetary stipend. Blood pressure increased back to baseline levels after the grocery intervention ended.
  •  Participants were randomly assigned to 12 weeks of home-delivered, DASH-patterned groceries ordered weekly with dietitian counseling without emphasizing cost or three $500 stipends every 4 weeks intended for self-directed grocery shopping.
  •   In this study, a program of home-delivered, DASH-style groceries plus dietitian counseling decreased BP and LDL cholesterol levels beyond comparable monetary compensation. However, effects were not maintained after the intervention ended.

Kayser A. How Food Is Replacing Pills as Medicine at the Top US Hospitals. Newsweek.com. Published 2026. ***

  • Extensive research has linked nutrition intake to health status—both the kinds of foods and how much of it an individual consumes. A 2019 study supported by the National Heart, Lung and Blood Institute found that suboptimal diet across 10 food groups accounted for more than 18 percent of all ischemic heart disease, stroke and type 2 diabetes in the U.S. An unhealthy diet was responsible for 45 percent of all cardiometabolic deaths—including heart disease, stroke, diabetes and chronic liver disease, which are among the nation’s biggest killers. 
  • Ultraprocessed foods contribute to the problem. The CDC reports that American adults consumed 53 percent of their daily calories from ultraprocessed foods—and kids nearly 62 percent. Meanwhile, in Mediterranean countries like Italy, where people receive roughly 10 percent of their daily energy from ultraprocessed foods, rates of chronic disease are significantly lower than in the U.S.  
  • Mixed messages about nutrition haven’t dampened the demand for reliable guidance. In July 2024, Deloitte’s Center for Health Solutions asked more than 2,000 U.S. adults how they felt about food to manage health. Although 76 percent of survey respondents said they’d prefer to use food over prescription medications as health management, two-fifths said they did not have a clear understanding of which foods could make an impact. 
  • Internationally renowned hospitals are starting to prioritize FAM and other nutritional interventions, including Cleveland Clinic, ranked third on Newsweek and Statista’s World’s Best Hospitals 2026 list. In December 2023, the health system committed $10.5 million to combat childhood hunger and food insecurity.
  • At Cleveland Clinic, the multimillion-dollar infusion has helped establish “food pharmacies”—health system-operated food banks, staffed by a dietitian who can guide patients toward healthy options, recommend recipes and provide additional nutritional support tailored to the individual’s condition. Another program at Cleveland Clinic gives vouchers to eligible patients, allowing them to choose healthy foods from a website, then have the groceries delivered to their door. This one has been a blessing for patients who live in food deserts, lack reliable transportation or have “many other competing demands,”
  • The individualization that FAM programs require can make them difficult to scale. Similar to nurses and physicians, dietitians are in short supply and high demand. The global food services company Sodexo reports a 44 percent gap between staffing needs and available nutrition experts in medical settings. Other health care professionals—often overworked, facing workforce gaps of their own—rarely have the time to provide nutrition counseling.
  • Community organizers also tend to have better connections to local people and cultures, and can address their needs with greater sensitivity, according to the Aspen Institute’s recently released Food Is Medicine Community Action Plan.  
  • The most significant challenge in FAM is funding. Food costs rose 19.1 percent between January 2022 and January 2026, according to data from the U.S. Bureau of Labor Statistics, compiled by CBS News. Hospital leaders told Newsweek that they feel a responsibility to tackle food insecurity, as nutrition is a critical component of their patients’ health. But it’s tough to foot that bill—especially as health care costs go up, reimbursement rates go down and more patients are uninsured, requiring hospitals to spend more on charity care.  
  • As with any treatment or prescription, health insurers are the obvious payer of choice for FAM.

Lage MJ, Boye KS. The relationship between HbA1c reduction and healthcare costs among patients with type 2 diabetes: evidence from a U.S. claims database. Curr Med Res Opin. 2020;36(9):1441-1447. doi:10.1080/03007995.2020.1787971  (COST REDUCTION)

  • For patients with T2D (N = 77,622), multivariable analyses revealed that a 1% reduction in HbA1c was associated with a 2% reduction in all-cause total health care costs and a 13% reduction in diabetes-related total healthcare costs
  • These reductions resulted in annual cost savings of $429 and $736, respectively.
  • For patients with an index HbA1c ≥7% (N = 33,648), a 1% reduction in HbA1c was associated with a 1.7% reduction in all-cause total healthcare costs and a 6.9% reduction in diabetes-related healthcare costs with associated annual cost savings of $545 and $555, respectively.
  • The analyses also found that having an index HbA1c <7% compared to HbA1c ≥7% or having an index HbA1c ≥7% and subsequently reducing HbA1c to below 7%, was associated with significant cost reductions.

Lee SH, Moore LV, Park S, Harris DM, Blanck HM. Adults Meeting Fruit and Vegetable Intake Recommendations – United States, 2019. MMWR Morb Mortal Wkly Rep. 2022 Jan 7;71(1):1-9 ***.

  • Adults should consume 1.5-2 cup-equivalents of fruits and 2-3 cup-equivalents of vegetables daily.† A healthy diet supports healthy immune function (1) and helps to prevent obesity, type 2 diabetes, cardiovascular diseases, and some cancers (2); having some of these conditions can predispose persons to more severe illness and death from COVID-19 (3).
  • consuming approximately five servings of fruits and vegetables daily is associated with a 13% to 15% reduction in all-cause mortality, averaging a 3% to 5% reduction per additional cup

Long JM, Yoder A, Woodcock L, Constantina Papoutsakis. Impact of a Dietitian-led Food as Medicine Program in the Food Retail Setting: A Feasibility Study. Journal of the Academy of Nutrition and Dietetics. 2024;124(11). doi:https://doi.org/10.1016/j.jand.2024.07.007

  • Key Findings: In this 6-month descriptive feasibility food as medicine study, ≥80% of the most prevalent nutrition problems improved (ie, excessive energy intake, n = 21 of 26; excessive carbohydrate intake, n = 7 of 8; and obesity, n = 5 of 5). Improvements were observed in dietary quality of food consumption patterns, reported health-related quality of life, body weight, waist circumference, and systolic blood pressure. Randomized controlled trials using registered dietitian nutritionist–led food as medicine strategies in the grocery retail setting should be considered for future testing.
  • Registered dietitian nutritionists (RDNs) are at the forefront of incorporating food as medicine (FAM) programs in nutrition care.1 Tools and strategies RDNs use to deliver FAM programs include medical nutrition therapy (MNT), optimization of food selection, frequency and quantity of consumption, preparation methods, and improving food access.2 FAM interventions, such as personalized nutrition education, prescriptions for produce, and medically tailored meals or food programs, may be associated with improved health outcomes and reduced health care use and costs.3-5

MassHealth. New UMass Chan Evaluation: Innovation at MassHealth Led to Improved Health Outcomes and Lower Costs. Mass.gov. Published 2026 ***

  • Thes programs saved Massachusetts over $512 million and delivered measurably better health outcomes for its members.
  • Nutrition supports reduced total cost of care, with hospitalization rates 23% lower and Emergency Department visits 13% lower among members who received at least 90 days of nutrition support.
  • Hospitalization rates were 23% lower and Emergency Department visit rates were 13% lower among those receiving nutrition support services, as compared to eligible non-participants.

Mozaffarian D. Medically Tailored Groceries for Blood Pressure Control: Promise, Progress, and Need for Optimal Design. JAMA. Published online November 09, 2025. doi:10.1001/jama.2025.20943

  • A study published in JAMA, the GoFresh trial by Juraschek et al, represents an important contribution to the evidence base, testing whether home-delivered groceries patterned after the Dietary Approaches to Stop Hypertension (DASH) diet can improve blood pressure among Black adults living in “food desert” neighborhoods.
  • In this randomized, parallel-group trial, 180 Black adults with elevated systolic blood pressure (SBP, 120-150 mm Hg) and not receiving antihypertensive medications were assigned to either 3 months of home-delivered DASH-patterned groceries with dietitian counseling or a $500 monthly stipend for self-directed grocery shopping. The DASH groceries were designed to provide the full dietary needs of each household and achieve calorie and nutrient targets including a potassium/sodium ratio above 2.0 and saturated fat intake less than 7% of energy. The primary outcome was change in office SBP at 3 months, with secondary outcomes including diastolic blood pressure (DBP), low-density lipoprotein (LDL) cholesterol, body mass index (BMI), and dietary adherence.

Mozaffarian, D, Aspry, KE, Garfield, K, Kris-Etherton, P, Seligman, H, Velarde, GP, et al. “Food is medicine” strategies for nutrition security and Cardiometabolic health equity: JACC state-of-the-art review. J Am Coll Cardiol. (2024) 83:843–64. doi: 10.1016/j.jacc.2023.12.023

  • Food is Medicine (FIM) is a healthcare strategy aimed at improving health outcomes and promoting health equity by incorporating nutritious food into disease prevention, management, and treatment
  • FIM encompasses a range of interventions with varying levels of intensity, tailored to the complexity and needs of patients, from more intensive therapies like MTMs designed for patients with complex medical conditions and high healthcare usage to population-level policies and programs aimed at reaching general populations
  • Evidence supports the benefits of Food is Medicine interventions in improving food security, diet quality, health outcomes, financial strain, and mental health

Oude Griep LM, Bentham J, Mahadevan P. Worldwide associations of fruit and vegetable supply with blood pressure from 1975 to 2015: an ecological study.BMJ Nutr Prev Health. 2023;0:e000455.

  • Low fruit and vegetable consumption is a major modifiable risk factor for raised blood pressure (BP)
  •  Significant associations between combined fruit and vegetable supply and raised BP were observed. Over the past four decades, combined fruit and vegetable supply has been consistently and strongly associated with lower prevalence of raised BP globally. However, the heterogeneous regional trends in fruit and vegetable supply underpin the need for international organisations and individual governments to introduce or strengthen policies for increased fruit and vegetable supply to reduce the burden of non-communicable diseases at national and global levels.

Platkin, C., Cather, A., Butz, L., Garcia, I., Gallanter, M., Leung, MM., Food As Medicine: Overview and Report: How Food and Diet Impact the Treatment of Disease and Disease Management. Center for Food As Medicine and Hunter College NYC Food Policy Center; March 30, 2022, available at foodmedcenter.org and nycfoodpolicy.org.

Project FoodBox. Fruit & vegetable prescriptions improve A1C in diabetic adults:implications for clinical practice. Published 2025. Accessed January 3, 2026.

  • Project FoodBox partnered with UCI Health to launch a culturally tailored Food as Medicine initiative serving Latino adults with uncontrolled diabetes. The program addressed barriers to glycemic control, including limited produce access and nutrition knowledge, through weekly fresh produce delivery and diabetes education over eight weeks.Project FoodBox partnered with UCI Health to launch a culturally tailored Food as Medicine initiative serving Latino adults with uncontrolled diabetes. The program addressed barriers to glycemic control, including limited produce access and nutrition knowledge, through weekly fresh produce delivery and diabetes education over eight weeks.
  • Participants achieved a clinically significant average A1C reduction from 8.5% to 7.5%, meeting diabetes care guidelines. The intervention also resulted in improved fruit and vegetable intake and reduced risk of diabetes-related complications by 40%, supporting better long-term health. Annual savings are estimated at $1,500 per patient, plus further savings from avoided complications.
  • Produce prescription programs have been shown to increase intake by nearly one serving per day and drive mean A1C reductions of approximately 0.7–0.8 percentage points—with associated decreases in BMI and improvements in cardiovascular health markers.

Rahman M et al. Front. Nutr., 11 December 2024. Sec. Nutrition and Sustainable Diets. Volume 11 – 2024 Integrating Food is Medicine and Regenerative Agriculture for Planetary Health ***

  • This paper highlights key opportunities, recent policy developments, and evidence gaps, calling for concerted efforts to clearly define RA practices and foster collaboration between community, healthcare, agriculture, and policy stakeholders. Strengthening these interconnections could lead to more resilient food systems and improved health outcomes at both individual and population levels.
  • The extensive impact of food systems on planetary health highlights the urgent need to transform how food is produced, distributed, and consumed. Achieving sustainable food systems will require multisectoral collaboration across food supply chains.
  • RA focuses on building and improving soil health, utilizing grazing livestock, eliminating synthetic inputs, and enhancing biodiversity, all with goals of creating economically and biologically stable agricultural systems
  • While recognizing adherence to these practices can be important, ensuring that standardized regenerative certification is accessible, particularly for marginalized, diversified, and/or limited-resource producers, is also critical.
  • Food procurement within FIM programs represents an opportunity to advance planetary health by sourcing whole foods (produce prescriptions and medically tailored groceries) or ingredients (MTM) produced using sustainable agricultural practices, such as those used in certified organic or regenerative systems.

Rosas LG, Chen S, Xiao L, et al. The effectiveness of Recipe4Health: a quasi-experimental evaluation. Am J Prev Med. 2025;68(2):377-390.

  • a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a “Food Farmacy” (16 weekly produce home deliveries) alone or in combination with a “Behavioral Pharmacy” (16 weekly group visits).
  • Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months 
  • Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone 
  • R4H resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.

***Seligman HK, Angell SY, Berkowitz SA, et al. A Systematic Review of “Food Is Medicine” Randomized Controlled Trials for Noncommunicable Disease in the United States: A Scientific Statement From the American Heart Association. Circulation. Published online June 18, 2025. ***

  • About half of American adults have cardiometabolic disease,1 generally defined as including cardiovascular diseases, diabetes, and diseases associated with metabolism and inflammation and widely understood to affect other organ systems, especially the kidneys.1,2 Cardiometabolic disease contributes to significant cardiovascular morbidity and mortality in the United States. Treatment for diet-related cardiometabolic disease costs approximately $50.4 billion3,4 annually in the United States alone, 
  • Poor diet quality is a leading risk factor for cardiometabolic disease and is responsible for an estimated 45% of all cardiometabolic disease deaths.4 Randomized controlled studies have demonstrated that healthier dietary intake improves cardiometabolic risk.6,7 Thus, improving dietary intake is a critical component of the prevention of cardiometabolic disease, and diet can play an important role in managing cardiometabolic disease.8 In addition, poor diet quality has been linked to numerous cancers; therefore, improving dietary intake may support the prevention and management of cancer as well. The evolving term nutrition security acknowledges the importance of diet quality for achieving optimal population health outcomes across numerous disease states
  • In this review, we systematically examined published randomized controlled trials examining Food Is Medicine programs in the United States, categorizing them into different stages of development using the National Institutes of Health Model for Behavioral Intervention Development.
  • Randomized controlled trial data were generally consistent with findings in the observational literature, indicating that common Food Is Medicine approaches often positively influence diet quality and food security, which are theorized to be key mediators for clinical outcomes. However, the impact on clinical outcomes was inconsistent and often failed to reach statistical significance. These observations highlight the need for larger, higher-quality Food Is Medicine studies focusing on the measurement of clinical outcomes within well-designed programs and the need for additional randomized controlled trials that more systematically map out the relationship between participation in different types of Food Is Medicine programs and health outcomes.

Tong N. Elevance Health expands food as medicine support to community health centers. Fierce Healthcare. Published August 18, 2025.

  • Earlier this year, Kaiser Permanente and Tufts University’s Food is Medicine Institute established a new network to propel the food as medicine movement. Elevance Health was among the network’s founding members, as were other Blues plans.

Wang X, Ouyang Y, Liu J, et al. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 2014;349:g4490.Published 2014 Jul 29. ***

  • This analysis pooled data from 16 long-term studies following over 800,000 people for up to 26 years. The researchers looked at how fruit and vegetable intake related to risk of death from any cause, heart disease, and cancer.
  • Higher consumption of fruit and vegetables was significantly associated with a lower risk of all cause mortality for an increment of one serving a day of fruit and vegetables
  • SPECIFICS
    • Fruits + vegetables: ~5% lower risk of death
    • Fruit alone: ~6% lower risk
    • Vegetables alone: ~5% lower risk
    • The benefit plateaus at about 5 servings per day. Eating more than that didn’t continue to reduce overall mortality risk.

Wang L, Lauren BN, Hager K, et al. Health and Economic Impacts of Implementing Produce Prescription Programs for Diabetes in the United States: A Microsimulation Study. J Am Heart Assoc. 2023;12(15):e029215. ***

  •  The model estimated that over a lifetime (mean=25 years), implementing produce prescriptions in 6.5 million US adults with both diabetes and food insecurity (lifetime treatment) would prevent 292 000 (95% uncertainty interval, 143 000–440 000) cardiovascular disease events, generate 260 000 (110000–411 000) quality‐adjusted life‐years, cost $44.3 billion in implementation costs, and save $39.6 billion ($20.5–58.6 billion) in health care costs and $4.8 billion ($1.84–$7.70 billion) in productivity costs. The program was highly cost effective from a health care perspective (incremental cost‐effectiveness ratio: $18 100/quality‐adjusted life‐years)
  • In practice, a national produce prescription program could be enacted through the inclusion of produce prescriptions as a covered benefit, as is already occurring in limited capacities in select Medicare Advantage plans and in several state Medicaid programs, or perhaps through a new program administered by the US Department of Agriculture similar to the Supplemental Nutrition Assistance Program for Women, Infants and Children.
  • A recent systematic review and meta‐analysis of 13 predominantly US‐based produce prescription interventions found these programs increased fruit and vegetable consumption by 0.8 servings per day, decreased body mass index (BMI) by 0.6 kg/m2, and among patients with diabetes, decreased hemoglobin A1c (HbA1c) by 0.8 points. 9 Our recent pooled, patient‐level analysis of 9 other produce prescription programs across 22 sites in 12 states demonstrated similar health gains 

Whitelaw G. The Active Leadership Ingredients That Turn Food Into Medicine. Forbes.

  • Strong leadership in food-as-medicine initiatives depends heavily on trust, compassion, and love, especially in how leaders build relationships with the people and communities they serve.
  • It’s not enough to provide healthy food, leaders must also model healthy behaviors, create a caring environment, and commit personally to the values they promote in order for food to truly act like medicine.

Examples of Food is Medicine Programs and Resources

  • https://odphp.health.gov/foodismedicine/promising-practices-and-tools/bright-spots/empowering-indigenous-food-sovereignty-through-collaborative-education-and-action
  • https://odphp.health.gov/foodismedicine