Creating an inclusive food-as-medicine movement that respects consumers, communities, cultures

“Two thousand six hundred years ago, Hippocrates said, if you want to know the health of a community, you look at the food that they eat and their habits. A hundred twenty years ago, Thomas Edison said​ the doctors of the future will no longer prescribe medicine but counsel their patients on diet and activities. [Food as medicine] is not a new concept. However, for too many decades, our healthcare system has looked at food and activities that happen in communities and [said], ‘We are not responsible for this,’” said John Lumpkin, president of Blue Cross and Blue Shield of North Carolina Foundation and VP of Drivers of Health Strategy at Blue Cross and Blue Shield of North Carolina.

Promoting health, proper nutrition through food-as-medicine programs

Food-as-medicine initiatives often require cross-industry collaboration from food and beverage brands, healthcare providers, retailers, health insurers, local non-profits, government entities, technology companies and others.

Food-as-medicine programs can include food prescriptions, apps that promote healthier food choices and financial incentives to purchase fruits and vegetables.

These programs try to reduce several negative health trends. Almost half (41.9%) of US adults aged 20 and older are obese, according to data published in the National Health Statistics Reports​. Additionally, 11.6% of the US population has diabetes ─ or 38.4 million people ─ according to CDC estimates​.

“We need to have some of these key important messages so that people who see this vast river of information can make choices for themselves. And then, we need to look at systems like goalscoring programs, [the Supplemental Nutrition Assistance Program] or [the Supplemental Nutrition Program for Women, Infants and Children, and] double bucks at farmers’ markets. We need to support those messages, but we also need to take the messages even further,” Lumpkin said.

Should the movement be called ‘food as medicine’ or ‘food is medicine?’ 

Stakeholders debate whether the movement should be called "food as medicine" or "food is medicine," with both being used in the past, the panel shared. 

The U.S. Department of Health and Human Services used 'food is medicine' for its event earlier this year, where the government revealed three public-private partnerships with Instacart, Feeding America and the Rockefeller Foundation to promote access to healthier foods in the US. 

Though disagreeing on the specifics of the naming convention, most panelists in the opening session and others agreed that the naming was less important than its impact on improving the health and lives of consumers. 

“This is our moment. We ... [have a] growing food-as-medicine movement that begins to place the food in its rightful place. So, food is medicine ─ food as medicine ─ the critical part is that we need to think about this huge part of our economy ... [and] look at critical factors that actually have an impact on people's lives,” Lumpkin said. 

Echoing Lumpkin’s sentiment on the terminology, Stacey Krawczyk, director of nutrition and wellness at the American Diabetes Association, added that food is literally medicine for individuals with chronic diseases and often part of their treatment plan. 

“It does not matter what language we use as long as we are always tapping into what people are interested in and what they see is a solution and the impact. And with people with diabetes, food is really medicine. It is a part of their treatment. It is how they manage,” Krawczyk said. 

Whose food is medicine?

Food-as-medicine stakeholders should consider a consumer’s heritage, culture and local community when developing a food-as-medicine program, suggested Melanie Hall, chief research and innovation officer at the non-profit Feeding America.

Certain foods and diets ─ like the Mediterranean diet ─ have received a disproportion amount of attention from health and nutrition experts, often disregarding the healthy foods that exist within other cultures, Hall noted. 

“The Mediterranean diet has a whole lobby behind it ... and that same level of energy is not there when it comes to African foods – diaspora foods – and we need to be able to change the conversation. So, in order to change the conversation and frame it, you have to have the representation. And so that is why we are trying to make sure as part of a food democracy that everybody’s food should be at the table,” Hall said. 

Additionally, for-profit and non-profit entities should develop collaboratively food-as-medicine programs that benefit both sides of the partnership, Lumpkin explained.  

“How do we mix for-profit and the non-profit sectors, so that the healthcare system does not become extractive of the non-profit sector but actually a true partnership? I think that is a real challenge,” Lumpkin said. 

He added, "When you think about food as medicine, we are also talking about health systems and health plans paying their way. And the only way that happens is ... if we create the evidence that food is medicine not only is the right thing to do ─ not only creates value ─ but also reduces cost."