As studies highlight the positive social impact of Food is Medicine programs on American lives and healthcare, here are seven produce prescription startups helping feed more nutritious and affordable meals to Americans.

This article is the fourth installment of our Food is Medicine (FIM) content mini-series.

Almost a quarter of Americans were food insecure as of December 2022 – a figure that increased from the year before. Meanwhile, according to the USDA, nearly 19 million residents – or 6.1% of the total US population – live in low-income, low-access areas and have trouble getting to a grocery store.

The same body also says food insecurity is associated with numerous health conditions, including hypertension, hepatitis, stroke, cancer, asthma, diabetes, arthritis, kidney issues and heart disease – the leading cause of death in the US.

Affordable and inclusive access to nutritious and fulfilling foods is paramount to Americans’ health and finances. Food is Medicine programs – which include produce prescriptions and medically tailored meals – are being suggested as a solution. One study has found that these initiatives can help reduce diseases, improve quality of life, and cut billions in healthcare costs in the US.

As this industry grows, it’s becoming host to a number of companies providing Food is Medicine services. Here are seven produce prescription startups helping improve food security in the US.

FarmboxRx

Founded in 2014 by Ashley Tyrner, who herself used to live on food stamps in a rural food desert, Boston-based FarmboxRx began as a direct-to-consumer (D2C) service called Farmbox Direct that shipped food boxes across the US. It grew to $1M in revenue, before pivoting to a healthcare focus in 2019 and rebranding to its current name.

The company partnered with Medicare Advantage, Medicaid and private health insurance plans to offer a nutrition program that makes it easier for members of wellness-focused medical plans to eat more healthily. Healthcare providers pay FarmboxRx for the food that’s shipped to customers, which includes fruits and vegetables, lean proteins, essential pantry goods, and even ready-to-eat meals.

The startup’s healthcare move saw it make nearly $35M in revenue last year and rank 100 on the 2023 Inc. 5000 list. To double down on this focus, it closed its D2C business last year – what started with a single health plan offering has now grown to 87 different plans.

“While looming potential shutdowns wouldn’t have [an] immediate impact [on] Medicare/Medicaid coverage, or FarmboxRx, as mandatory spend programs, the stagnant negotiations on discretionary appropriations could very well impact the 40+ million Americans that rely on federally funded food assistance programs such as SNAP and WIC,” Tyrner told Forbes earlier this month.

Everyone’s Harvest

Founded in 2002, Everyone’s Harvest is a Californian operator of farmers’ markets, which launched its produce prescription program Fresh Rx in 2014. Doctors prescribe patients vouchers of up to $35 per week to spend on fresh fruits and vegetables at any of Everyone’s Harvest’s five markets.

So far, the initiative has provided over 1,000 families with more than $630,000 worth of produce – in 2022 alone, it catered to 268 families with fruits and vegetables worth $135,000. It recently received two grants worth $700,000 in total. The first – a $200,000 grant over two years – is from the Central California Alliance for Health, which focuses on expanding the program’s reach to Medi-Cal recipients and educating people with nutritional knowledge and recipes.

The $500,000 federal grant was awarded by the USDA’s National Institute of Food and Agriculture, as part of its Gus Schumacher Nutrition Incentive Program (GusNIP). Spread over three years, Everyone’s Harvest hopes to use the grant to improve dietary health through increased fruit and vegetable consumption – research has found that prescriptions can lead to a 30% higher intake of produce in Americans. It also aims to reduce food insecurity, healthcare use, and associated costs.

The two grants are budgeted for a total of 244 patients, according to the company’s executive director, Hester Parker. She told Monterey County Weekly: “My dream is that, eventually, these types of preventative produce prescriptions will become an allowable insurance expense. As we’re able to show that it’s cost-effective as far as the utilisation of health care, maybe it becomes an allowable expense paid for through insurance.”

Hungry Harvest

If you’re thinking Hungry Harvest sounds familiar, that might be because you’re a Shark Tank fan. Its founder Evan Lutz bagged a $100,000 investment from Robert Herjavec in the 2016 edition of the show, before returning in 2020 to share a progress update. That year, it raised $14M in a Series A round.

The company began as a redistributor of ‘unwanted’ produce otherwise destined for waste. It started off as a D2C service, before expanding to wholesale for the foodservice industry, then launching a line of branded products, and eventually introducing a Food is Medicine program called HarvestRX.

According to its website, Hungry Harvest has collaborated with over 100 community organisations, including school systems and colleges, hospitals, insurance providers, and food banks. Since 2014, it has saved over 22 million lbs of food from going to waste and donated or subsidised over 1.5 million lbs of produce to partner organisations and via its own food access programs.

In August, it opened a new funding round with a $5M goal, raising $1.15M as part of the round earlier this month. Business-to-business sales have become the dominant revenue driver as the HarvestRX plan has expanded.

“Hungry Harvest has been with me, and I’ve been with Hungry Harvest, every step of the way over the past 10 years, both personally and professionally,” Lutz told Technical.ly. “[Moving] from packing boxes in a parking lot to working with some of the largest healthcare providers in the entire country, it’s just a surreal feeling.”

About Fresh

Launched in 2013, Boston-based About Fresh offers tech-enabled food prescription, using a debit card service called Fresh Connect. Food-insecure patients get prepaid Fresh Connect Mastercards – funded by healthcare organisations and monthly limits set via an enrolment form – which they can use to shop for fresh fruits and vegetables at local grocery stores, farmers’ markets and mobile markets.

The prepaid debit card automatically recognises the eligible healthy foods from the basket, the costs of which are deducted from the final bill. The initiative can track shopping activity and expenses, generating monthly summaries of how patients use these cards. Meanwhile, healthcare teams tie cardholders’ shopping and engagement data back to electronic health records, which helps assess health outcomes, medical costs, patient experience and healthy food access.

About Fresh struck a deal with fintech provider FIS earlier this year, which expanded its access to 10,000 grocery stores, including retail giants Walmart, Kroger, Albertsons and Safeway. The company operates Fresh Truck, described as a farmers’ market in a bus.

“We are building a first-of-its-kind infrastructure, making it possible for health plans, providers, community-based organisations and others to leverage the scale and efficiency of grocery retail and e-commerce to maximise the value of their investment into ‘food as medicine,’” said About Fresh co-founder and CEO Josh Trautwein.

Season Health

Based in Austin, Texas, Season Health was founded by Josh Hix, former founder of meal kit service Plated. It’s marketed as a digital food pharmacy that combines meal prescriptions with delivery logistics.

It emerged from stealth mode in February 2022 and received a $34M Series A injection two months later. It works with dietitians to develop meal plans and recipes that aim to help patients manage and possibly reverse chronic conditions like diabetes and kidney disease, with plans to expand to other areas like maternity health, heart health and cancer.

It has established anchor partnerships with the likes of health organisations like Geisinger, CommonSpirit Health and Cricket Health, and is working with – among others – Walmart, Daily Harvest and Instacart (which itself announced a Food is Medicine impact study earlier this month).

“Designing food that tastes good, that is culturally relevant because people eat differently and that helps serve the needs of their entire household or whoever they’re eating with, is a lot of what made Plated successful in health outcomes,” Hix told Fast Company. “Can we get people to stick to those interventions? We think yes, but that’s on us to go prove.”

VitaBowl

Launched in 2020, VitaBowl is a Food is Medicine-focused meal delivery service co-founded by nutritionist Sarah Brandow, Michelin-starred chef Dominique Crenn, Charles Michael Yim and Miko Lorenzo.

The startup offers plant-forward meals that cater to various dietary needs, including low-carb, pescetarian and other options. It recently launched veggie burgers and juices too. VitaBowl has served a host of B2B customers across government, K-12 schools, hospitals and corporations, generating annual sales of $1M.

“Our goal is to essentially collaborate with the health insurance companies, so that these meals and programs are medically tailored and reimbursable, which is, quite frankly, very different than some other meal prep services,” Yim told Forbes.

To that end, VitaBowl raised $3M in a seed funding round in May, taking its total valuation to $10M. It’s on track to be profitable by the end of the year and will focus on B2B clients as that delivers high margins and requires little marketing spending.

“I believe you should feed yourself with high vibrational food that’s nutrient dense and personalised for your body,” said Crenn. “Food is medicine. Food connects you with what matters. VitaBowl embraces that ethos.”

Free From Market

Headquartered in Kansas City, Free From Market is a patient-driven platform that supports lower-income consumers with chronic health conditions in accessing diet-specific foods.

A recipient of the 2022 Google for Startups Black Founders Fund, the company raised $2.1M in seed funding round in January. It will use these funds to improve its proprietary technology platform and expand its delivery model to provide people with access to affordable and nutritious foods, telenutrition, and necessary data to improve health outcomes.

In addition, the investment will help Free From Foods broaden its reach with managed care plans, providers and community-based organisations, and measure the effects of Food is Medicine interventions in treating health conditions. The startup offers bulk ordering for businesses and direct-to-doorstep access for people who can buy produce, meals, shelf-stable and branded groceries, as well as complementary telenutrition support.

“One in three Americans has a condition where food is part of the standard of care, yet many Americans do not have access to food and resources needed to treat it,” said Free From Foods founder and CEO Emily Brown. “Our curated food is free from ingredients an individual does not want and full of all the nutrients they need to manage a healthy life. This funding round is merely one milestone towards our goal to make a lasting impact to improve healthcare in this country and centre health equity.”

Don’t miss parts one, two, and three of our Food is Medicine series: Can Produce Prescription Programmes Improve America’s Health & Food Security?, How to Save American Lives and Billions of Dollars with Food Prescriptions and US Healthcare Company & Grocery Retailer to Study the Impact of Nutritious Food Availability on Health.

The post Food is Medicine Series: 7 Produce Prescription Startups Helping Boost Americans’ Food Security appeared first on Green Queen.

A week after research found that Food is Medicine (FIM) programmes could save American lives and billions of dollars in medical costs, US healthcare company Kaiser Permanente and grocery delivery startup Instacart have announced a joint study examining the impact of convenient access to nutritious food on people’s health.

This article is the third instalment of our Food is Medicine content mini-series.

Kaiser Permanente, the largest integrated non-profit healthcare provider in the US, has announced it will team up with Instacart to measure the effects of food as medicine on members of its Medi-Cal members in northern and southern California who have diet-related diseases like diabetes and chronic heart failure, among others.

The study will provide participants with Instacart Health Fresh Funds, which are grocery stipends that can be used to buy “nutritious foods and pantry staples” including fresh and frozen produce, plant-based oils, and spices, via Kaiser Permanente’s curated Instacart Virtual Storefront.

“We know access can lead to better health outcomes, and we’re proud to partner with Kaiser Permanente to demonstrate the positive impact that nutrition security and food as medicine can have on a patient’s overall health and wellbeing,” said Sarah Mastrorocco, Instacart VP and general manager of Instacart Health.

The research will measure blood glucose levels compared to the usual standard of care, reported food and nutrition security, diet-related disease quality of life, patient readiness to change, and hospitalisation or emergency department visits.

Additionally, the programme will provide “dignity of choice” to participants, who will be able to use the Fresh Funds to select the foods that work best for them (within Kaiser Permanente’s recommendations). They will also have access to various national, regional and local retailers on Instacart, with the product being delivered to their doorsteps.

“At Kaiser Permanente, we know that without access to nutritious food, individuals are less likely to stay healthy, increasing the likelihood of new and widening health disparities and healthcare costs,” said Anand Shah, VP of Social Health at Kaiser Permanente. “This innovative study is one of the many avenues that we’re pursuing to improve the health of our members and communities with diet-related diseases.”

Kaiser Permanente: a renewed commitment to Food is Medicine

This isn’t Kaiser Permanente’s first foray into FIM initiatives. In September 2022, it joined food and nutrition leaders at the White House Conference on Hunger, Nutrition and Health to discuss strategies to address the US’s food- and diet-related challenges. Coinciding with the summit was an announcement of Kaiser Permanente’s $50M FIM commitment to strengthen food and nutrition security programmes and build evidence for how food can help prevent and cure some health conditions.

“When people are hungry, or lack proper nutrition or equitable access to the food they require to address their most pressing medical needs, they are less likely to get or stay healthy,” Bechara Choucair, senior VP and chief health officer at Kaiser Permanente, said at the time.

The commitment, which runs through 2030, will support initiatives that include screening nine million of its members for social health needs and expanding e-commerce solutions to increase nutritious food purchase options for recipients of the Supplemental Nutrition Assistance Program and Women, Infants, and Children benefits.

It will also focus on expanding FIM initiatives like produce prescriptions and MTMs for those recently hospitalised with diet-related diseases and building strategic partnerships with innovative businesses, spanning those owned by underrepresented groups, small startups, and large-scale employers.

Additionally, in 2020, the healthcare provider launched three MTM studies for recently discharged hospital patients with chronic conditions, as a result of which, 2,100 patients received over 116,000 MTMs by August 2022.

Around the same time as the White House event last year, Instacart launched a ‘Health initiative‘ to leverage its platform, partnerships and products to enhance nutrition security, enable nutritious choices, and scale up FIM programmes across the country.

Building upon further research and California’s FIM efforts

The results of this newly announced study will provide further evidence of the impact of FIM programmes on people’s health and the medical sector in the US. Last week, a report by Tufts University’s Food is Medicine Institute examined the impact of medically tailored meals and produce prescriptions, and found that these programmes could help reduce diseases, improve quality of life, avert hospitalisations, and save billions in healthcare costs in the US.

“We look forward to continuing to build on this and other important research through our new study with Kaiser Permanente,” Mastrorocco wrote on Instacart’s website. “Through these kinds of public and private partnerships, we can create the evidence needed to support scaling the power of food as medicine to benefit even more families and communities.”

In a statement accompanying the announcement of the study, she said: “We’re dedicated to addressing nutrition insecurity, and by leveraging our technology, significant reach and retail partnerships, we can help families across the country get nutritious foods delivered through Instacart.”

Pamela Schwartz, executive director of food security at Kaiser Permanente, added: “We know food and nutrition insecurity is felt by people in the communities we serve, as well as by millions of Americans nationwide. Identifying best practices to address these inequities is essential to building healthier communities.”

Matsrorocco said Instacart Health tools like Fresh Funds and Virtual Storefronts can help Kaiser Permanente’s Medi-Cal patients take immediate action on their providers’ medically tailored nutrition advice. Also in California, the state has already been testing out fruit and vegetable prescription programmes, and a vast majority of Medi-Cal members participating in food programmes used MTMs in 2022.

Additionally, a bill aiming to make it mandatory for Medi-Cal to cover medically supportive food and nutrition for at least 12 weeks was held by the Assembly, given its high estimated costs. But the members who introduced the bill plan on reintroducing it next year, forecasting that it will gain momentum alongside the grassroots efforts in the state of California.

Don’t miss parts one and two of our Food is Medicine series: Can Produce Prescription Programmes Improve America’s Health & Food Security? and How to Save American Lives and Billions of Dollars with Food Prescriptions.

The post Food is Medicine Series: US Healthcare Company & Grocery Retailer to Study the Impact of Nutritious Food Availability on Health appeared first on Green Queen.

Food is Medicine programmes – which include medically-tailored meal initiatives and produce prescription campaigns – could help reduce diseases, improve quality of life, and cut billions in healthcare costs in the US, according to a new study.

This article is the second installment of our Food is Medicine content mini-series.

Poor nutrition is the leading driver of conditions that lead to death and disability in the US, a country that sees 10,000 deaths each week and $1.1T in annual healthcare spending. It’s characterised by some grave numbers. One in two Americans have type 2 diabetes or prediabetes, three-quarters are overweight or obese – with the latter making up 42% of the population – and 14 in 15 have suboptimal cardiometabolic health.

On the whole, rates of diet-related chronic disease in the US are high. This is complemented by the fact that 13.2 million American households (10.2% of the total) were food insecure at some point during 2021. Americans with food insecurity are estimated to spend an extra $1,800 on healthcare per year.

What is Food is Medicine?

One solution to these growing health issues? Food is Medicine (FIM) (also known as Food As Medicine) programmes. A new report measuring their true cost by researchers at Massachusetts-based Tufts University’s Food is Medicine Institute describes them as “food-based nutritional interventions that aim to treat or prevent disease, show tremendous promise for improving nutrition, reducing food insecurity, improving health outcomes and increasing health equity”.

The Biden administration’s National Strategy on Hunger, Health and Nutrition includes several FIM interventions and has generated support from multiple organisations that have committed to support such efforts. The American Heart Association and the Rockefeller Foundation have earmarked $250M to build a national Food is Medicine research initiative, while insurer Kaiser Permanente has committed $50M to programmes that increase food and nutrition security and improve health outcomes, among other initiatives.

The Tufts University researchers analysed the impact of FIM programmes through two case studies, one evaluating medically tailored meals (MTMs), which help people with specific dietary needs based on their medical conditions, and produce prescriptions, which aim to improve people’s health and food security.

The impact of medically tailored meals

Based on the researchers’ estimates, 6.3 million US adults would be eligible for MTMs. And if these individuals received MTMs, it would help avert 1.6 million hospitalisations and – after factoring in Medicaid and Medicare payments – save $13.6B in healthcare costs. And that’s just in the first year.

If implemented nationally over 10 years, it would save $484.5B in healthcare costs – from an insurer perspective, that’s a net cost saving of $185.1B – and avoid 18 million hospitalisations. But if you include people who are food insecure – who are younger and more likely to be Hispanic or non-Hispanic Black and have lower household income – the number of eligible participants for MTMs reduces to 1.9 million, with net savings of $5.5B.

“Few – if any – other interventions in healthcare are both cost-saving and cost-effective,” the study says. Vaccines and contraception can be cost-saving, for example, but measures like blood pressure and cholesterol screening and control or cancer screening don’t save money, despite being highly cost-effective. “In contrast, MTMs are estimated to gain health and save money – a rare outcome in medical care.”

The impact of produce prescriptions

Based on national data, 6.5 million adults could be eligible for fruit and vegetable prescription programmes. Participants received a $42 credit per month, and used an average of $32 (after subtracting unused vouchers).

The study found that a national implementation of produce prescription initiatives could prevent 292,000 cardiovascular events and generate 260,000 quality-adjusted life years – a measure of how well a treatment lengthens or improves patients’ lives – over a lifetime.

In a five-year period, they would avert 66,900 cardiovascular events, and produce 126,000 life years. The programme in the case study had better results among people under 65, and among non-Hispanic Black and Hispanic patients (compared to non-Hispanic White patients and other races or ethnicities).

In terms of costs, the implementation would save $39.6B in healthcare costs and $4.77B in productivity costs over a lifetime. In addition, the intervention would be cost-effective at shorter time horizons of five and 10 years.

“Compared to modern weight loss medications, produce prescriptions are much more cost-effective,” the researchers wrote. “The estimated ICER [incremental cost-effectiveness ratio] for weight loss medications is about $200,000 [per quality-adjusted life year], which equates to more than 10 times higher cost per health gained than produce prescriptions.”

Last month, separate research found that people on produce prescriptions ate 30% more fruits and vegetables per day, and witnessed a drop in blood sugar, body mass index and blood pressure. Additionally, they saw the odds of food insecurity – which is linked with chronic health conditions – reduce by a third.

Food is Medicine: policy recommendations

The researchers said that policy solutions can help facilitate and leverage the potential of FIM interventions to improve health and save medical costs for Americans.

There are three key pillars. The first focuses on infrastructure development, with the authors suggesting a flexible anti-kickback statute safe harbour specifically for FIM initiatives, or at least a clarification of the circumstances in which FIM programmes won’t be sanctioned. They added that a comprehensive set of Food is Medicine Networks or Centers of Excellence could be developed, and the Centers for Medicare and Medicaid Services could support efforts to develop electronic data infrastructure for food and nutrition insecurity.

Finally, healthcare, advocacy and policy stakeholders could ensure nutrition education for doctors. This could be done via reform of accreditation requirements, medical licensing exams, speciality certifications, and nutrition-centric research programmes.

The second pillar concerns the generation of opportunities and funding. Pilot programmes for MTMs and produce prescriptions could be conducted to provide individuals with support from insurance and government services. States could apply for waivers of Section 1115, which would help deliver FIM programmes to those who need them (nine states have already been granted these waivers). Additionally, private insurance payers and providers could be convened to discuss incorporating FIM interventions into health insurance plans.

Finally, the third pillar focuses on the USDA’s nutrition programmes. Researchers said that while the Supplemental Nutrition Assistance Program (SNAP) – formerly the Food Stamp Program – has been “successful in reducing food insecurity”, it needs to be leveraged more effectively to reduce nutrition insecurity. This could mean regular analysis and reporting on SNAP purchasing nationally, as well as an encouragement of state pilots testing approaches to advance food and nutrition security.

Additionally, the Gus Schumacher Nutrition Incentive Program (GusNIP) – which provides grants for produce prescription programmes – could be expanded to reach more SNAP participants. including in online retail; and encouragement of innovative state pilots to test new approaches to jointly advance food and nutrition security. And GusNIP’s existing $500,000 limit award per grant could be beefed up to $1M to support larger-scale projects.

Further research is key

The researchers stressed that continued evaluation is key. Areas that research could focus on include potential health and financial benefits for patients, caregivers, family members or households, and economic advantages for local, regional and national farms, retailers and associated supply chain stakeholders.

Further analysis could also look into an integration of FIM programmes with procurement priorities like the support of small and mid-sized farms, local and regional production, regenerative and organic agriculture, fair labour practices and food sector ownership from traditionally marginalised communities. Payers’ experiences in the implementation of FIM initiatives, their identification of barriers to their expansion, and patient experiences can be examined too.

“Food is Medicine interventions have emerged as a highly promising strategy for changing the status quo of US healthcare by placing a stronger emphasis on providing nourishing food as a specific intervention for treating and preventing diet-related chronic disease,” concluded the study.

The report’s senior author Dariush Mozaffarian, a cardiologist and director of the Food is Medicine Institute, said it demonstrates how FIM interventions like MTMs and produce prescriptions can combine with nutrition education for medical professionals and insurance coverage of nutrition counselling to make a real difference in Americans’ health and medical spending.

Devon Klatell, VP of food initiatives at the Rockefeller Foundation, which supported the study, added: “The true costs of our food system – the environmental impact of how food is produced, the working conditions of the people who grow our food, and the impacts on our health, healthcare spending, and health equity are too often left off the price tag.

“This report can assist governments, companies and consumers in better evaluating the value of Food is Medicine interventions by considering not just the price paid for food, but the return on investment in improved health outcomes they can deliver.”

Don’t miss part one of our Food is Medicine series: Can Produce Prescription Programmes Improve America’s Health & Food Security?

The post Food is Medicine Series: How to Save American Lives and Billions of Dollars with Food Prescriptions appeared first on Green Queen.

Can prescribing fruits and vegetables help fix a person’s health issues and improve their access to nutritious food? Produce prescription programmes are in the spotlight again, following the results of a new study – possibly the largest of its kind – finding that patients experienced weight loss and drops in blood pressure levels after eating more fruits and vegetables.

This article is the first installment of our Food is Medicine content mini-series.

Last September, the American Heart Association (AHA) launched its Food is Medicine initiative in collaboration with the Rockefeller Foundation, which aims to measure the impact of produce prescriptions with randomised trials and further research. Now, a study in its peer-reviewed journal, Circulation, has conducted what is most likely the largest trial to analyse the effect of fruit and vegetable prescriptions.

Researchers studied 3,881 people from low-income neighbourhoods with, or at risk for, poor cardiometabolic health who received between $15 to $300 a month (with a median of $63) to buy fruits and vegetables from grocery stores or farmers’ markets. The trial evaluated nine produce prescription programmes from 2014 to 2020, lasting between four to 10 months.

The benefits of fruits and vegetables

Focusing on the amount of produce people ate before and after receiving the prescriptions to assess health and food security, the analysis found that adults ended up eating 30% more fruits and vegetables (about 0.85 cups more than usual) per day. Children ate 0.26 cups more (+7%) produce daily.

Adults witnessed a decrease in blood sugar, body mass index and blood pressure, and saw the odds of food insecurity – which is linked with chronic health conditions – reduce by a third after participation in the programme. “We know that food insecurity impacts health through several important pathways, including overall dietary quality, but also through stress and anxiety, mental health and tradeoffs between paying for food and other basic needs such as housing costs, utilities, and medications,” said lead author Kurt Hager.

He noted that the size of the effect of fruits and vegetables on blood pressure was “about half that of commonly prescribed medications, which is notable for a simple change in diet”. So simply having better food access could have contributed to people’s health improvements too.

Eating more plants and diet-related disease

“The Covid-19 pandemic really underscored the high rates of diet-related illness in the US,” Hager said. “Heart disease and diabetes became leading risk factors for Covid-19 hospitalisation and death.” Heart disease is the leading cause of death in the US, and type 2 diabetes is among the top killers too. These conditions, as well as certain cancers, have been linked to our diets and what we eat.

One chronic condition that raises the risk of these health issues is obesity, which is the second leading cause of preventable death in the US (along with being overweight). And many studies have proven the positive impact eating more fruits and vegetables can have on human health.

Eating more plants has been linked to a lower risk of heart disease among adults by the AHA, while a study in the Nature Journal found that plant-based diets help feed gut microbes, which are associated with reduced risks of heart disease, obesity and diabetes. Another study has found that plant-based diets generally have better nutritional profiles than animal products, and are linked to improved overall health, increased muscle mass, and healthy weight loss.

In addition, replacing conventional processed or red meat with fruits and grains can reduce the risk of type 2 diabetes. Research published in the British Medical Journal says diets high in plant protein are associated with a lower risk of death from all causes.

Food prescriptions on the rise

Fruit and vegetable prescription initiatives have expanded in the last decade, and particularly in the last few years following the pandemic. In July, the US Department of Health and Human Services funded $2.5M to pilot a national produce prescription programme in tribal communities, as part of the Biden administration’s National Strategy on Hunger, Nutrition and Health. And in April, the Rockefeller Foundation partnered with the US Department of Veteran Affairs to analyse the impact of food and vegetables on veterans’ well-being, which included produce prescription.

The state of California has already been testing out food prescription programmes, and had a bill rejected that would have standardised the effort. Furthermore, research has found that incentivising healthy eating could save $100B in the US’s national healthcare costs.

There was a similar study to Hager’s in Australia, conducted by the University of New South Wales. It found that prescribing produce significantly improved diets, health benefits (like lower cholesterol levels and weight loss) and food security. Meanwhile, the UK is also investing in such programmes.

The food insecurity question

But some say food prescriptions are a stopgap measure in tackling food insecurity. As Canadian publication Healthy Debate‘s writer Tim Li says, they are “unable to resolve the broader experiences of material deprivation, let alone the underlying income inadequacy”. Summarising multiple responses to such initiatives, he adds: “Providers of food prescriptions in Canada have acknowledged that they are ‘at best, stopgap measures‘, ‘not a sustainable response‘, ‘not a solution to food insecurity‘ and ‘a response to broken social systems‘”.

Mitchell Elkind, chief clinical science officer at the AHA, called the Circulation study “wonderful”. “This analysis of produce prescription programs illustrates the potential of subsidised produce prescriptions to increase consumption of nutritious fruits and vegetables, reduce food insecurity and, hopefully, improve subjective and objective health measures,” he said.

But he stressed the importance of randomised trials, akin to those for a drug. Hager said more research is needed to find out if fruits and vegetables actually contributed to better health for participants. It’s possible that, as the Washington Post points out, the cardiometabolic health improvements happened because the money for fruits and vegetables addressed the larger food security issue for households – 56% of those involved in the study experienced food insecurity.

Hager called for a solution and outlined the importance of finding one quickly: “If we don’t figure this out, our healthcare costs are going to continue to skyrocket and we’ll continue to have some of the worst heart attacks, mortality rates and obesity rates in the world. We have to be better on this.”

Don’t miss part two of our Food is Medicine series: How to Save American Lives and Billions of Dollars with Food Prescriptions

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