Q&A: Food Is Medicine initiative to set stage for future dietary intervention research
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Key takeaways:
- The AHA’s new initiative will address unanswered questions in the field of “food is medicine.”
- The first round of feasibility and implementation research will inform future clinical trials in this field.
A recent American Heart Association Presidential Advisory stated that roughly 90% of the $4.3 trillion spent annually in the U.S. on health care is consumed by treatment of chronic disease, for which poor diet is often a major risk factor.
With support from the Rockefeller Foundation, the AHA launched the Food Is Medicine initiative to support research in the field of food is medicine and build upon the current body of evidence with the goal of informing future large clinical trials.
The AHA defines Food is Medicine as provision by the health care system of healthy dietary resources for the prevention or treatment of clinical conditions such as heart disease. Small dietary improvements could significantly improve CV risk, according to the advisory document, which also details the state of the field of food is medicine and a road map for a new research initiative to address the knowledge gaps.
With the first request for proposals focused on feasibility and implementation science closed as of Nov. 6 and currently in peer review, Kevin G. Volpp, MD, PhD, who was chair of the AHA Presidential Advisory writing group on food is medicine and is research lead on the new initiative, said he is “excited” about the growing interest in the field.
Healio spoke with Volpp, who is also director of the Penn Center for Health Incentives and Behavioral Economics and the Mark V. Pauly Presidential Distinguished Professor of Medicine at Perelman School of Medicine and Health Care Management at the Wharton School at the University of Pennsylvania, about the burgeoning field of food is medicine and the creation of the new initiative.
Healio: What does the concept of food is medicine mean to you?
Volpp: It’s helpful to recognize that six in 10 Americans have a diet-related chronic disease, and we know that food plays a big role in terms of the prevention of chronic disease, the treatment of chronic disease and the rate of acute chronic disease exacerbations.
The whole notion of food is medicine is about making healthy food more accessible to people with chronic conditions, through the health care system in such a way that we can improve their health and their health cost trajectory.
Healio: Could you tell us a little bit about the genesis of the Food Is Medicine initiative and the Rockefeller Foundation’s involvement?
Volpp: The Food Is Medicine initiative has come about because there’s increasing recognition of the role of unmet social needs in affecting people’s health and health outcomes. As part of that, there’s a growing recognition that unless we address these unmet social needs, such as food insecurity, we’re not going to be able to efficiently improve the health of the U.S. population.
The Rockefeller Foundation came to AHA with the main goal of working together to build evidence on what’s effective and what’s cost-effective for whom in terms of food is medicine programs, and to build stronger evidence on what works and what doesn’t work as a path toward convincing public and private payers to cover these services in the future.
Healio: How is the partnership going to pursue this goal?
Volpp: There are a number of things that the Rockefeller Foundation and AHA are doing together in pursuit of the goal of building evidence on effectiveness and cost-effectiveness of Food is Medicine programs nationally. One is that we are going to be supporting a lot of research in this space, and we are doing a lot of studies upfront to better map out how do we get people to enroll in these programs at high rates? How do we get high rates of engagement? How do we help people change their behavior to eat healthy foods? We want to run a lot of studies in which we systematically look at some of these questions so that we can look at a number of different populations around the country, different types of disease conditions and then as we build stronger evidence we will pursue longer-term studies, which map out more definitively what’s effective and what’s cost-effective for specific populations.
Healio: Could you provide a teaser of what kind of research was submitted?
Volpp: We’re very excited about the large number of proposals that we got in response to our first request for proposals. I can’t go into the specifics of the projects yet because we’re waiting until the peer review is done before we evaluate them more carefully. But I will tell you that we’re extremely excited about the fact that we have gotten applications from groups all over the United States, and we’re also excited by the large number of applications because it really highlights that there’s a lot of interest in this area. There’s a lot of recognition of the importance of Food is Medicine, and there’s a lot of appetite to dig in and build knowledge on what’s effective.
Healio: Do you think that this Food is Medicine concept was represented at this year’s AHA Scientific Sessions?
Volpp: I would characterize the field of food is medicine as one which is relatively nascent, but which has a lot of growing momentum.
There haven't been that many trials that have been run in food is medicine programs, to date, but an exciting abstract from researchers at Kaiser Permanente and Tufts University presented at Scientific Sessions, a first-of-its-kind randomized clinical trial, found that a 6-month produce prescription program significantly improved blood sugar control among low-income adults enrolled in Medicaid with Type 2 diabetes.
We are hoping to have 20 or so trials launched by the end of this year as part of our Food Is Medicine Initiative. In future Scientific Sessions, you will be hearing a lot more about food is medicine programs.
Healio: Is there anything that you would like to mention about this initiative or food is medicine in general?
Volpp: This is a historic opportunity for AHA and scientists to build evidence on what’s effective and what’s cost-effective in terms of addressing diet-related chronic conditions. We have a health system that’s been wired around the treatment of disease. As a nation, we are first in health care spending and 41st or 42nd in life expectancy. We’ve tried to improve health largely by reacting when people are sick and providing expensive medical care. We believe that there likely are more cost-effective alternatives to keep people healthy, to prevent CVD and to improve health equity. That’s why we’re so excited about the AHA Food Is Medicine Initiative. It has the potential to improve health for a great many Americans.
References:
- American Heart Association. Food Is Medicine Initiative. https://www.heart.org/en/professional/food-is-medicine-initiative. Accessed Nov. 17, 2023.
- Nau C, et al. Abstract 578. Presented at: American Heart Association Scientific Sessions; Nov. 11-13, 2023; Philadelphia.
- Research, advocacy, education urged to address chronic disease through food is medicine programs. https://newsroom.heart.org/news/research-advocacy-education-urged-to-address-chronic-disease-through-food-is-medicine-programs. Published Sept. 28, 2023. Accessed Nov. 20, 2023.
- Volpp KG, et al. Circulation. 2023;doi:10.1161/CIR.0000000000001182.
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