Emerging research illustrates the impact Food is Medicine interventions have on improving health outcomes, lowering overall health care utilization, and lowering health care costs.
Medically Tailored Meals
Receipt of MTM services (10 meals delivered weekly) was associated with significantly fewer inpatient admissions, (incidence rate ratio [IRR], 0.51; 95% CI, 0.22-0.80; risk difference, -519; 95% CI, -360 to -1457 per 1000 person-years).
Intervention receipt was associated with fewer skilled nursing facility admissions (IRR, 0.28; 95% CI, 0.01-0.60).
The model estimated that, had everyone in the matched cohort been encouraged into treatment (and including the cost of program participation), mean monthly costs would have been $3838 vs $4591 if no one had been encouraged into treatment (relative risk of mean per person per month expenditures difference, 0.84; 95% CI, 0.67-0.998; risk difference, -$753; 95% CI, -$1225 to -$280), representing approximately 16% lower health care costs.
In a randomized cross-over study, when participants with type 2 diabetes received medically tailored meals, they experienced substantially improved diet quality as measured by the 2010 USDA Healthy Eating Index (HEI).
The average HEI score (out of 100 possible points, with 100 representing the healthiest diet) for participants on medically tailored meals was 73.1, in comparison the average HEI score without medically tailored meals was 39.9 (p<.0001).
While receiving medically tailored meals, participants also reported lower food insecurity (42% "on-meal" vs. 62% "off-meal”), less hypoglycemia (47% "on-meal" vs. 64% "off-meal") and fewer days where mental health interfered with quality of life (5.65 vs. 9.59 days out of 30) (all p<.05).
Individuals dually eligible for Medicare and Medicaid who received medically tailored meals from Massachusetts-based Community Servings for 6 months had 50% fewer inpatient admissions and 70% fewer emergency department visits than similar patients not enrolled in the meal program (p<.05).
Researchers found an average net savings of $220 per patient per month (16% savings on total medical expenditures) after factoring in the costs of the medically tailored meals.
Adherence to antiretroviral therapy for HIV patients increased from 47% at baseline to 70% (p = 0.046) at the end of the 6-month intervention.
Diabetes distress (p < 0.001) and perceived diabetes self-management (p = 0.007) improved for patients with type 2 diabetes after 6 months of medically tailored meals.
The study observed decreased depressive symptoms (p = 0.028) and decreased binge drinking (p = 0.008) at the end of the intervention for all diagnoses.
Fewer participants sacrificed food for health care (p = 0.007) or prescriptions (p = 0.046), or sacrificed health care for food (p = 0.029) once they were connected to medically tailored meals.
The total average monthly health care costs for recipients of medically tailored meals were 31% lower than the comparison group ($28,000 vs.$41,000) at the end of the three-month intervention (p=.0006).
93% of the treatment group with inpatient hospitalizations were discharged to their homes as compared to only 18% of the comparison group (p=.0001).
Medically Tailored Food
Participants in a 6-month medically tailored food intervention received diabetes-appropriate food, blood sugar monitoring, primary care referrals, and self-management support.
Among participants with elevated HbA1c (at least 7.5%) at baseline, HbA1c improved from 9.52% to 9.04% (p<.0001).
Fruit and vegetable intake increased from 2.8 to 3.1 servings per day (p<.001), self-efficacy increased (p<.0001), and medication adherence increased (p<.001).
Produce Prescription/Voucher Programs
If enacted on a national level over a lifetime, a 30% subsidy on fruit and vegetable purchases by enrollees in Medicare and Medicaid would prevent 1.93 million Cardiovascular Disease (CVD) events, gain 4.64 million quality-adjusted life years and save $39.7 billion in formal health care costs.
Compared to no intervention, a 30% fruit and vegetable subsidy would increase mean intakes of fruits by 0.4 servings/day and vegetables by 0.4 servings/day.
A similar 30% subsidy on broader healthful foods enacted over a lifetime including fruits and vegetables, whole grains, nuts/seeds, seafood, and plant oils would prevent 3.28 million CVD events and 0.12 million diabetes cases, gain 8.4 million quality-adjusted life years, and save $100.2 billion in formal health care costs.
Richard Bryce et al, Participation in a farmers' market fruit and vegetable prescription program at a federally qualified health center improves hemoglobin A1C in low income uncontrolled diabetic, PREVENTATIVE MEDICINE REPORTS, (2017).
A fruit and vegetable prescription program at a Federally Qualified Health Center led to decreased HbA1c levels in patients with uncontrolled type 2 diabetes living in a low-income neighborhood in Detroit.
Patients receiving produce prescriptions of $10 / week for 4 weeks at a clinic in Detroit had a decrease in HbA1c from 9.54% to 8.83% (p=0.001).
Primary care patients screened for unmet social and nutrition needs using the Health Leads program were referred to community-based nutrition assistance programs.
The evaluation found improvements in blood pressure (p<.05) and cholesterol levels (p<.05), but not blood glucose level when compared with the control group.
Population-Level Healthy Food Program and Anti-Hunger Programs
Lauren Oshlo et al, Financial incentives increase fruit and vegetable intake among Supplemental Nutrition Assistance Program participants: a randomized controlled trial of the USDA Healthy Incentives Pilot, AMERICAN JOURNAL of CLINICAL NUTRITION, (2016).
A randomized controlled trial in Hampden County, Massachusetts, enrolled 7,500 SNAP households to receive a 30% rebate on fresh produce purchased with SNAP benefits at retail grocers. Recipients of the rebate consumed 26% more fruits and vegetables than households receiving normal SNAP benefits (p<001).
Researchers also found a decrease in refined grain intake and higher overall Healthy Eating Index - 2010 scores for recipients of the 30% rebate.