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Analysis Food for Thought 2020

Food is medicine: actions to integrate food and nutrition into healthcare

BMJ 2020; 369 doi: (Published 29 June 2020) Cite this as: BMJ 2020;369:m2482

Read our Food for Thought 2020 collection

  1. Sarah Downer, clinical instructor and associate director1,
  2. Seth A Berkowitz, assistant professor2 3,
  3. Timothy S Harlan, associate professor and executive director4,
  4. Dana Lee Olstad, assistant professor5,
  5. Dariush Mozaffarian, dean6
  1. 1Center for Health Law and Policy Innovation, Harvard Law School, Harvard University, Cambridge, MA, USA
  2. 2Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
  3. 3Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  4. 4Section of General Internal Medicine George Washington University School of Medicine and Health Sciences, George Washington University Culinary Medicine Program, George Washington University, Washington, DC, USA
  5. 5Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  6. 6Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
  1. Correspondence to: S Downer sdowner{at}

Sarah Downer and colleagues review new efforts to incorporate food and nutrition into prevention, management, and treatment of diet related disease in healthcare systems

Key messages

  • In the face of the global epidemic of diet related chronic disease, there is increased experimentation with the use of “food is medicine” interventions to prevent, manage, and treat illness

  • Interventions used with increasing frequency in the US and piloted to some extent in other countries include medically tailored meals, medically tailored groceries, and produce prescription programmes

  • Scaled integration of these and other emerging nutrition interventions into healthcare would require significant investment in rigorous research to test different approaches and address knowledge gaps

  • Clinicians need more and better education and training on the appropriateness and use of these interventions

  • We also need to identify sustained funding streams to ensure equitable access and availability for patients

A global epidemic of diet related chronic disease has prompted experimentation using food as a formal part of patient care and treatment. One of every five deaths across the globe is attributable to suboptimal diet, more than any other risk factor including tobacco.1 Individual interactions with the healthcare system are an important opportunity to offer evidence based food and nutrition interventions. An emerging but compelling body of research indicates that such interventions delivered in the healthcare system might be associated with improved health outcomes and reduced healthcare usage and costs.2345678910 These data point to the potential for food and nutrition interventions to play a prominent role in the prevention, management, treatment, and even in some cases reversal of disease.11 When broadly deployed, interventions that are effective for individual patients have the potential to affect population health and shape broader food and health policy reform. Realisation of health benefits is, however, …

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