Food is medicine: A prescription for better health outcomes

A 2023 study by the Ohio Association of Foodbanks found that 65% of survey participants reported cutting the size of meals or skipping meals due to lack of money. In addition, 55% had to choose between food or paying for medicine and health care, which further threatens the ability to manage chronic disease.

What if there was another way for everyone to access good nutrition and innovative health care? The good news — there is, and it is called the “food is medicine” approach. This approach prioritizes access to food and a nutritious diet. It’s why physicians, faculty and staff at The Ohio State University College of Medicine and The Ohio State University Wexner Medical Center already screen patients for food insecurity in the inpatient setting. They will soon begin this process across all outpatient clinics, as well.

Team approach on changing diet and exercise habits

Carol R. Bradford, MD, MS, FACS, dean of the Ohio State College of Medicine, says that when clinicians and scientists collaborate across disciplines to educate patients on the importance of establishing healthy dietary patterns, the levels of prevention and treatment of disease increase.

“Access to nutritious food has shown evidence of improved health outcomes, prevention of disease progression and lower costs of care,” Dr. Bradford says. “Strategies, such as medically tailored meals, groceries and produce prescriptions, provide consistent access to diet and nutrition-related resources that so many individuals in our communities desperately need.”

Research shows that these approaches positively affect food insecurity, diet quality, glucose control, hypertension and disease self-management. The Ohio State Wexner Medical Center continues to research and provide clinical care aimed at growing healthy habits through innovative and interactive nutritional programs.

Mid-Ohio Farmacy Program 

This program, in partnership with the Mid-Ohio Food Collective, where Dr. Bradford serves on the Board of Trustees, provides patients who screen positive for food insecurity with a "prescription" to access free, fresh fruits and vegetables at their local food pantry. Aaron Clark, DO, associate professor and chair of the Department of Family and Community Medicine at the College of Medicine, has been leading this partnership since 2019.

“Addressing hunger, healthy food access and nutrition insecurity addresses unmet social needs that often prevent individuals and families from thriving,” Dr. Clark says. “And we know it works! Studies show the program improves the health of its participants by reducing significant risk factors like body mass index and blood sugar levels.”

Nutrition’s therapeutic and protective qualities

Research shows that diet has profound effects on overall health and well-being and that using food and behavior-based interventions to help prevent, manage and treat diet-related diseases is crucial to advancing health equity.

Joshua Joseph, MD, MPH, associate professor of Internal Medicine and the Endowed Professor for Research in Internal Medicine in the Division of Endocrinology, Diabetes and Metabolism at the College of Medicine, collaborates with other researchers to find solutions to social barriers to health care and to improve health outcomes through food and nutrition interventions.

He and Daniel Walker, PhD, MPH, associate professor and vice chair for research in the Department of Family and Community Medicine, co-lead a controlled trial that aims to test the effects of providing fresh produce, diabetes education and community referrals on hemoglobin A1c levels in individuals with type 2 diabetes.

Funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the LINK study (Linking Education, Produce Provision and Community Referrals to Improve Diabetes Care) provides participants with diabetes and cooking education and with referrals to address food insecurity and other social needs.

“The aim is to deliver insight into what is the right ‘dose’ of these interventions to improve blood sugar among individuals with type 2 diabetes and food insecurity,” Dr. Walker says.

Drs. Joseph and Walker collaborate closely with Colleen Spees, PhD, RD, professor in the Division of Medical Dietetics at The Ohio State University School of Health and Rehabilitation Sciences, on a study titled “SUSTAIN: Promoting sustained behavior change and nutrition security in Medicaid-enrolled individuals with Stage 2 Cardiovascular-Kidney-Metabolic Syndrome (CKMS).”

They serve as co-principal investigators and lead the study, which received funding from the American Heart Association’s new Health Care by Food Initiative.

“The SUSTAIN study will examine the impact of ‘food is medicine’ interventions,” Dr. Joseph says. “This includes access to culturally appropriate and home-delivered foods, tailored behavioral counseling and care coordination to address non-medical health-related social needs.” 

SUSTAIN connects high-risk individuals with Instacart grocery delivery service, as well as with the Mid-Ohio Farmacy to provide home-delivered groceries for the study’s duration. Participants can also attend cooking demonstrations at a local community health center. In addition, they are connected to Health Impact Ohio, a Columbus-based regional health care equity improvement collaborative that addresses unmet social needs and works to increase quality of health for all people in the state.

SUSTAIN hypothesizes that a comprehensive “food is medicine” intervention, which includes medically tailored groceries, intensive behavioral nutrition therapy and addressing social needs, will improve nutrition security and ultimately improve cardiovascular health. 

“Patients with CKMS are impacted by poor dietary intake and nutrition insecurity, which alters cardiovascular health,” Dr. Spees says. “Participants in this study work with dietitians to address social drivers of health and catalyze impactful lifestyle changes.”

“Food is medicine” approaches are familiar territory for Dr. Spees, who also conducted a study called NutriCare, which provided more than 30,000 medically tailored meals and weekly nutrition counseling for high-risk patients with lung cancer. It was the first national, multi-site, randomized controlled trial to evaluate the full integration of nutrition in cancer care.

“Preliminary findings for Nutricare are quite promising and showing improvements in both physical and mental health outcomes for participants,” Dr. Spees says.

Qualitative results document that this intervention helped participants adjust to their diagnosis, leading to active coping through intentional self-care, behavior change and improved quality of life.

Community health and wellness outreach

Since its opening in the spring of 2024, The Ohio State Wexner Medical Center’s Healthy Community Center on the Near East Side of Columbus has helped thousands of residents through their health and wellness offerings, like a healthy café, where 50% of profits support food access in central Ohio; a demonstration and teaching kitchen featuring cooking and nutrition classes; fitness classes; urban gardening workshops that teach residents how to grow their own food; and Wellness Wednesday classes with a registered dietitian.

Other community programs include:  

• The James’ Mobile Education Kitchen —  educates public about healthy, cancer-preventive foods and how to prepare those foods at home
• Produce Perks — makes fruits and vegetables affordable to Moms2B and clinic participants by doubling the value of SNAP benefits, offering $1 for every $1 spent

The “food is medicine” approach supports physicians prescribing healthy nutrition, which can play a role in building a more nourishing and equitable food system. And it integrates nutrition in health care that helps patients heal.

“It combines nutrition, healing and health equity,” Dr. Bradford says. “These programs can also build healthy food environments and solid partnerships with other organizations and stakeholders.”