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Kos Diabetes Group: Food as Medicine [1]
['This Content Is Not Subject To Review Daily Kos Staff Prior To Publication.']
Date: 2023-08-11
There is a growing movement called “Food is Medicine”. This has come from the realization that the top cause of poor health was not being addressed by healthcare and the best nutritional science wasn’t being translated into policy. Fruits and vegetables are the top recommendations for a fiber-rich ‘diabetes diet,’ along with legumes and whole grains, but studies have shown that only one in 10 Americans eat the recommended amount of fruits and vegetables daily, and this is tied more to affordability and access than personal choice. This has led to a growing push for produce prescriptions to become commonplace.
Everyone should have access to healthy fruits and vegetables
A national program could be enacted through inclusion of produce prescriptions as a covered healthcare benefit. Programs are already being piloted by several states under Medicaid section 1115 waivers as well as by private healthcare payers. The findings will help inform implementation to scale and evaluate these programs across the United States.
Even though it’s estimated that it would cost $44.3 billion to implement, accounting for screening patients, providing food and nutrition education, and associated administration, produce prescriptions would still be cost-effective, with the cost being on par with other preventative health-care measures such as blood pressure screening and control, cholesterols screening and control, and cancer screening.
These results suggest that a national produce prescription initiative could benefit all Americans, highlighting the potential of Food is Medicine strategies to alleviate health inequities caused by food and nutrition insecurity and diet-related diseases.
A previous study from the Friedman School looked at health records in 184 countries and estimated that poor diet was a factor in more than 14 million cases of Type 2 diabetes in 2018, which was around 70% of new diagnoses of the condition across the globe.
Meanwhile, a 2021 trial found that a 15-week Fresh Prescription program involving low-income diabetics in Detroit resulted in a significant lowering of hemoglobin A1C levels, which is key in getting the condition into remission.
One aspect of the Food is Medicine movement is the development and use of additional specific interventions that have immediate impact on treatment of disease. One example is to provide medically tailored meals that are nutritionally personalized to specific health conditions such as diabetes, and prescriptions for fruits and vegetables to treat diet-related diseases or help avoid complications in high-risk pregnancies.
Medically tailored meals (MTMs) are healthy, home-delivered meals customized and fully prepared for individuals living with advanced illnesses, including diabetes, heart failure, end-stage renal disease, HIV, and cancer. The meals often serve to support those with lower incomes and limited mobility, as well as individuals who regularly experience food insecurity. The programs typically deliver 10 meals per week—five lunches and five dinners—to eligible patients.
Implementing additional MTM programs across the country could help prevent 1.6 million hospitalizations and save insurers a net amount of $13.6 billion per year after paying for the cost of food, with most savings occurring within the public health insurance programs Medicare and Medicaid. Over a 10-year period, $185.1 billion less could be spent on healthcare and nearly 18.3 million hospitalizations averted.
Currently, MTMs are not a covered benefit under Medicare or Medicaid, so they remain unavailable to the vast majority of patients who might benefit from them. For people with chronic illness and physical limitations that make it difficult for them to shop and cook for themselves, these programs would be a highly promising strategy for improving health and well-being. The estimated reductions in hospitalizations and associated cost savings reflect that.
The majority of MTM programs currently available in the United States are run by nonprofit organizations like Community Servings in Boston. These programs are largely supported by grants, donations, and ad hoc funds such as Section 1115 waivers under Medicaid, which offer limited coverage for MTMs in a few states.
Food is not just for prevention—it can be used as treatment for people with debilitating conditions like heart failure, uncontrolled diabetes, HIV, and cancer. With medically tailored meals, patients are treated using the power of food and put on a steady path toward healing. Studies suggest that expanding medically tailored meal programs nationwide—one key recommendation of the new Biden-Harris National Strategy on Hunger, Nutrition, and Health—would help reverse our ‘sick care’ system, keep people out of the hospital, and save billions of dollars each year.
Additional reading
https://newatlas.com/medical/prescribing-fruit-veg-type2-diabetes/
now.tufts.edu/…
https://now.tufts.edu/2023/06/01/food-medicine-uniting-innovation-and-equity
www.rockefellerfoundation.org/.…
nutrition.org/…
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[1] Url:
https://www.dailykos.com/stories/2023/8/11/2186559/-Kos-Diabetes-Group-Food-as-Medicine
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