What if we recognized that food is medicine?

Food can be both a source of joy and apprehension. It nourishes us and delights our senses yet is also a source of stress in the form of food insecurity and/or disordered eating. The twin forces of capitalism and white supremacy cooperate to manufacture these pernicious distortions to which queer folks are particularly vulnerable.

LGBTQIA2S+ people are at higher risk of developing an eating disorder, experiencing poor diet quality or food insecurity, and becoming obese. This risk is further elevated for trans folks and for queer people of color. Ultimately, these food-related and social factors intersect with an individual’s long-term quality of health, often creating a vicious cycle.

For these reasons, I was ~intrigued~ when I came across an idea that is becoming popular in nutrition policy circles: food is medicine. The basic principle is rather self-explanatory - providing meals or groceries tailored to specific nutritional needs through community organizations. These services range from prevention to treatment and are paired with nutrition counseling in community-based settings. So, beneficiaries not only receive free/subsidized meals but also empowerment through knowledge of their specific dietary needs.

To be clear, this idea is not new. Food as a critical and tailored determinant of health is as old as human society. This is a case of Western medicine converging on traditional forms of knowledge that have been actively suppressed. For example, food therapy is a critical component of traditional Chinese medicine. In Indigenous American communities, diet is a grounding spiritual practice. The Black Panther Party worked with nutritionists to guide their innovative Free Breakfast for School Children Program.

The upside in the specific framing of food as medicine is its potential to integrate into capitalism through health insurance. If we collectively value nutrition as a necessary part of health and medicine, then food and groceries should be covered by health insurance. While not a panacea, this shift would decrease or even eliminate financial barriers to healthy eating and food security.

I know what you’re thinking: Health insurance doesn’t even want to pay for required care now. Why would they pay for groceries? But, even health insurers would benefit in this paradigm. A 2022 economic analysis of the impact of medically tailored meals for over 6.3 million American adults with diet-sensitive conditions predicts $13.6 billion in annual savings for health insurers. From the patient perspective, the same analysis forecasts an annual decrease of 1.6 million hospitalizations.

Truthfully, this reality is a long way off, but the movement is common sense and gaining momentum. In 2022, the United States Department of Health and Human Services (HHS) began studying food is medicine initiatives. In parallel, a bipartisan group of national legislators has introduced The Medically Tailored Home-Delivered Meals Demonstration Pilot Act. If enacted, Medicare beneficiaries with certain health conditions (like congestive heart failure, COPD, diabetes, and chronic kidney disease) will be eligible to receive 2 medically tailored meals per day for at least 12 weeks. However, the bill has yet to receive a hearing in either the House or Senate.

Despite the progress in some policy circles, food is medicine remains largely unknown to the broader public. So, I wanted to highlight some of the amazing work in this area being done by community organizations around the United States. Unfortunately, I am not able to highlight all of the groups doing this work, but if you want to know more, I recommend checking out The Food Is Medicine Coalition. The coalition is an American non-profit collective of community groups that are delivering medically tailored meals to at risk populations. You can find the complete list of coalition members here. Check out the list to see if there is an agency in your area!

The Metropolitan Area Neighborhood Nutrition Alliance (MANNA) serves clients in the Greater Philadelphia and southern New Jersey area. MANNA works with clients with chronic diseases (like kidney disease, HIV/AIDS, cancer, and COPD) by providing 21 tailored meals per week. A 2013 study of MANNA’s services found that within 6 months of receiving meals, clients’ average monthly cost of health care decreased by $10,000. The effect was even stronger for patients living with HIV/AIDS. Further, the MANNA cohort had fewer and shorter inpatient hospital stays compared with a cohort that was not involved with MANNA. Since then, MANNA has expanded their services to include nutrition counseling in both individual and group settings.

Food Outreach, located in St. Louis, provides food and groceries for people living with cancer or HIV/AIDS. Food Outreach employs both dietitians and chefs who collaborate to develop a new menu every 2 weeks. The dietitians directly interface with clients to ensure that the menu has options that fit individuals’ dietary needs and food sensitivities. Each week, clients select which scratch made meals they want to receive based on personal taste and dietician feedback. Below, you can listen to Sandra, a Food Outreach client and cancer patient, talk about what her Food Outreach has meant to her.

Open Hand delivers medically tailored meals to homebound people living with chronic illness in the Atlanta area. Clients are referred to Open Hand through their health care providers. All meals provided by Open Hand are approved by dietitians who cater meals to meet individuals’ specific health needs. Participants also have the opportunity to enroll in cooking classes and nutrition therapy. The Produce Prescription Program at Open Hand has led to increased food security and confidence in preparing healthy meals, and one in four clients saw decreases in blood pressure after 6 months in the program.

Mama’s Kitchen serves residents of San Diego who are at risk of malnutrition due to health conditions. Clients receive free medically tailored meals delivered to their homes twice a week. Mama’s Kitchen offers rotating menus of meals adapted to meet the specific dietary needs of clients with a range of conditions, including HIV/AIDS, cancer, congestive heart failure, type 2 diabetes, and chronic kidney disease. Folks who receive medically tailored meals or who are HIV positive can also schedule free one-on-one sessions with a registered dietician to craft individualized nutrition goals. Below, you can hear from Jeremy and his family about the impact of Mama’s Kitchen after Jeremy’s stroke and diagnosis with congestive heart failure.

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