Research shows that up to 90% of adults don’t meet the government’s dietary recommendations for eating enough fruits and vegetables. And for people who live in low-income areas with fewer grocery stores that carry fresh produce, this number could be even higher.
Given the direct connection between diet and some chronic diseases such as hypertension, diabetes and high cholesterol, some clinicians are turning to food “prescriptions” to help patients manage their health.
This movement is called “food as medicine” or "lifestyle as medicine." And in addition to gaining traction in the exam room, some employers and health plans are investing in this concept by offering cooking demonstrations, nutrition assistance benefits, farmers markets on site for easier shopping and other creative ways to help people make dietary changes.
“The food and lifestyle as medicine movements are growing in popularity,” says Martha Shepherd, DO, MPH, FAAFP, Medical Director, Vanderbilt Health at Metro Nashville Public Schools (MNPS). “Employers are tired of paying for benefits that don’t necessarily improve outcomes. As a result, they are taking matters into their own hands and investing in food and lifestyle support when they can. There’s no payment model built around these other solutions yet, but the trend is moving that direction.”
One sign of an uptick in the food as medicine approach is a report showing that this year, 1,475 Medicare Advantage (MA) plans offered enrollees financial help to buy more nutritious foods—mostly fruits and vegetables. In comparison, in 2020, when the Centers for Medicare and Medicaid Services (CMS) introduced new rules on the supplemental benefits MA insurers could offer, only 101 plans offered this type of benefit. While the food as medicine movement is still in its early stages for employers and many health plans, some innovative organizations are already offering benefits that help employees improve their diet—and their overall health.
Nutrition Benefits at Metro Nashville Public Schools
Dr. Shepherd notes that MNPS has started to incorporate some aspects of food as medicine, including a partnership between Vanderbilt Health and FoodSmart from Cigna Healthcare. This partnership provided unlimited nutritionist visits to eligible employees, who also received a validated measure to represent their current dietary needs. The program also screened for social determinants of health to identify food insecurity and find solutions for employees who have difficulty accessing nutritious foods.
The program resulted in several success stories—especially for residents of North Nashville where there is a lack of access to nutritious foods.
“Nutritionists showed employees how to use Instacart to build recipes, purchase fresh ingredients and get groceries delivered,” Dr. Shepherd explains. “Some people were able to go to the grocery store and talk to the nutritionist on FaceTime while shopping to get real-time advice and help making choices.”
While it’s still early to see results of this program, Shepherd notes that MNPS has seen a reduction in cardio-metabolic spend in people who are engaged in the program.
In the future, Dr. Shepherd thinks more employers use a combination of health plan design and vendor support to offer more robust nutrition benefits to employees. These offerings could include anything from on-site teaching kitchens to one-on-one nutritionist support, to tailored meal plans and more.
“We’ve really lost our connection to food—where it comes from, how to prepare it and how to eat for our health,” she says. “In many cases, packaged convenience foods are driving chronic conditions and health issues. Employers are starting to recognize that by helping health plan members access healthier foods, they can help their employees improve overall well-being.”
