While hardly a new concept, ‘food-as-medicine’, where doctors prescribe diet changes as part of formal treatment plans, has risen in public awareness since the COVID-19 pandemic’s economic effects exposed the risks many people face in terms of poor nutrition chronic disease, hunger, and food insecurity. A whole-food (non-processed), predominantly plant-based diet has been shown to prevent, treat, and even reverse some chronic diseases.
As more people grow receptive to the idea of so-called ‘farmacy’ prescriptions, clinicians must fully grasp the evidence that supports the efficacy of prescribing whole-food, plant-predominant diets and equip themselves with the resources and knowledge to prescribe food appropriately and effectively.
Everyone knows that public health advice says to eat more vegetables. But we can apply the concept of the dietary spectrum when making recommendations, to help patients avoid common pitfalls when using calorie density to lose weight, or identify which macronutrient sources may contribute to halting disease progression.
In the USA, the average four-year medical school curriculum spends less than 1% of all lecture time on nutrition, and one study found that only 14% of internal medicine resident physicians self-reported feeling qualified to offer nutritional advice to patients.
As acceptance of food as medicine grows, clinicians and healthcare systems should work to ensure that historically underserved communities – where lifestyle-related chronic diseases are often prevalent – are not excluded. People in these communities need the resources to help them shop for, and prepare, healthy food on low, or fixed, incomes. Clinicians can help patients to navigate the barriers to acceptance of healthier diets, such as dispelling the myth that a plant-based diet doesn’t supply sufficient protein levels.
There are examples of health systems working to achieve better food-health equity. Geisinger Health System in Pennsylvania has established a ‘Fresh Food Farmacy’ to prescribe food to people suffering from diabetes and food insecurity. Patients receive more than 20 hours of diabetes education, welcome kits containing measuring cups and spoons, recipes, and enough whole-food, as fruit and vegetables, to prepare 10 healthy meals for their family every week.
Also, Massachusetts General Hospital Revere Healthcare Center partnered with a local food bank to develop a plant-based food pantry to serve food-insecure patients with chronic diseases, providing food to an average of 384 recipients a month. The hospital will evaluate the project’s health outcomes and seek out sustainable funding. This could help establish a model for places to replicate.