What are Food Prescription Programs?

Food as medicine has been advocated across the healthcare and wellness industries since ancient times. It was Greeks who first counseled to let food be the medicine. And, it seems, the United States are taking this age-old advice to heart with annual Food prescription Programs' Grants.

The premise of Food Prescription programs is simple: a health care provider or a health insurance plan provides a ''prescription" for food. Patients redeem it at a local farmer's market, grocery store, or a community-based sponsoring organization. Food Prescription programs make it easier for low-income patients and their families to access the fresh fruits and vegetables they need in order to ensure that they are eating balanced, healthy diets. (1) 

F&V Rx program

The Fruit and vegetables prescription programs (F&V Rx) generally begin with a partnership between a hospital and a local farmer’s market or community supported agriculture (CSA). For example, a patient presenting with cardiovascular disease might be prescribed $20 in fruits and vegetables, which could then be used to buy those items from the farmer’s market. Besides products, participants receive support and education throughout the program, and can attend additional nutrition, cooking, gardening, and chronic disease self-management classes.

This August, The U.S. Department of Agriculture (USDA) announced 15 awards totaling $7.5 million for Produce Prescription Grants. These grants are all part of the National Institute of Food and Agriculture’s (NIFA) Gus Schumacher Nutrition Incentive Program COVID Relief and Response (GusCRR) grants program. 

Examples of organizations funded for Produce Prescription Grants include:

• “Trauma-Informed VeggieRX” ($129,019) by Fresh Approach of Concord, California, for its program to increase access to and consumption of healthy foods among low-income populations;
• “MCHC FARMACY” ($619,681) program to provide SNAP participants extra incentives to purchase fresh produce by Mountain Comprehensive Health Corporation of Whitesburg, Kentucky;
• Community Outreach and Patient Empowerment Program, Inc., of Gallup, New Mexico, for its “Navajo Fruit and Vegetable Prescription Program”. (2)

Programs’ economical benefits

According to the CDC, roughly 70% of diseases in the U.S. are chronic and lifestyle-driven and nearly half of the population has one or more chronic health conditions, such as diabetes, asthma, heart disease, obesity, or cancer. Considerable part of annual healthcare costs (86%) in the U.S. are driven by chronic disease (3) and this proportion does not tend to get lower unless we ignore a healthy 5-a-day diet and lifestyle.

The study by Tufts University, followed adults between the ages of 35-80 who were enrolled in Medicare and/or Medicaid. Two scenarios were established: one in which Medicare/Medicaid covered the cost of 30% of fruits and vegetables, the other in which it covered fruits, vegetables, seafood, whole grains, plant oils, and other healthy foods. Appeared that the first scenario would prevent 1.93 million cardiovascular events and cut healthcare costs by $40 billion. But the second scenario is more than twofold effective. It would prevent 3.28 million cardiovascular events, 620,000 deaths, and 120,000 cases of diabetes–and save $100 billion medical expenses for the United States! (3)

A review carried out by the George Institute for Global Health, NSW, and Friedman School of Nutrition Science & Policy at Tufts University, US examined 13 programs that either subsidised or directly provided healthy foods as a form of medical treatment. Participants in the programs ate more healthy foods and improved in a few different health indicators such as blood glucose and blood pressure. (4)

During CDC trials of the F&V Rx Program researchers expect from participants a change in Body Mass Index (BMI), total cholesterol (Tchol) and more importantly — change in household meal practices and purchasing behavior. (5)

Passing the baton to UK

The UK government will trial the 'Community Eatwell' program, which would 'give GPs the option to prescribe fruit and vegetables - along with food-related education and social support’. With positive outcomes — improved participants' diet and health and cut spending on medication, Community Eatwell projects should be 'rolled out across all 1,250 primary care networks in England’ with the estimated cost of the program £2m a year over three years. (6)

Fruits and Vegetables prescription estimates goes with a wider set of proposals to reduce consumption of 'junk food', tax sugar and salt and use revenue to pay for healthy food for low-income families, reduce diet-related inequality and support reforms to farming and government policy (6).

The bottom line

Food insecurity is associated with poor nutritional health outcomes. Prescribing fresh fruits and vegetables in healthcare settings may be an opportunity to link patients with community support to promote healthy diets and improve food security. Studies show that F&V Rx programs in clinical settings may increase fruit and vegetable consumption among children in low-income households. It could also prevent millions of cases of chronic diseases and save billions in medical costs.