Understanding Food as medicine
Nutrition plays a critical role in overall health. The concept of Food as medicine (FaM) or Food is medicine was born from the commonly quoted phrase from Hippocrates "let food be thy medicine". At Qina we don't believe that food is medicine, we believe that food is food that can be used to nourish, comfort, feed and treat. However, we know that these phrases are popular. In this article, we cover the definition, research, trends and market developments in the FaM market.
By Hannah Norris
Food as Medicine
Despite clear evidence of the benefits that nutrition has on health, it has taken many years of clinical research, debate, discussion and even media exposure for a Food as Medicine initiative to come to the forefront. However, new opportunities are quickly emerging since the US government started heavily investing into the Food as Medicine movement in 2022.
What does “Food as Medicine” mean?
There is not a unified definition, but overall, the food as medicine concept looks to promote improved health through better food and diet, understanding the many benefits the food matrix of nutrients can provide and the concurrent impact on health.
It is generally accepted now that the diet can help to prevent, reduce symptoms or even reverse a disease or condition.
Across the board and in the context of this article, Food as Medicine and Food is Medicine are used interchangeably and mean the same thing.
Food as medicine can include
- Nutrition advice and programs with the aim to prevent, manage or reverse specific health conditions
- Medical and functional foods
- Medically tailored meals and groceries
- Produce prescriptions and subsidies – methods of access to healthy food
What are the key drivers of growth in the food as medicine market?
- Obesity epidemic
- Rising healthcare costs
- Increased awareness of the gut-brain connection
- A growing demand for personalized, preventive healthcare solutions.
- Increased Gen Z interest in health
- Increase in fitness consumers and wearable technology
- Increasing disposable income
- Increasing health awareness
- Increased government support e.g Biden’s White House Conference on Nutrition in September 2022 has led to many FiM pilot studies and initiatives being rolled out with $8 billion in new commitments to the FiM movement including research, initiatives and start up funding, which in itself is driving growth in the market. Although primarily in the US, it could pave the way for other countries to follow suit.
Other Drivers
“More than ¼ of Americans feel that certain medicines can be replaced with functional foods and beverages.” Prophecy market insights
What is the evidence for Food as Medicine?
Whilst there is an abundance of evidence in the benefit of food in supporting health, for example dozens of controlled trials showing the benefit of almonds on lowering cholesterol, there is a necessity for additional randomized, controlled and population level studies of food-as-medicine programs to be able to incorporate behavior change and understand the long term benefits to ensure governments continue to buy into FaM.
- The True Cost of Food, a national simulation study published in 2019 by Tufts University found that a 30% Medicare and Medicaid subsidy for fresh fruits and vegetables could prevent nearly 2 million cardiovascular events, more than 300,000 premature deaths from cardiovascular events and save $40 billion in total lifetime healthcare costs
- Another validated microsimulation model by American Heart Association estimates that produce prescription programs implemented nationally for US adults aged 40 to 79 years with diabetes and food insecurity could prevent 292 000 cardiovascular disease events, gain 260 000 quality‐adjusted life‐years, and save $39.6 billion in health care costs and $4.8 billion in productivity costs over a lifetime.
- A recently published narrative review (2024) on the evidence from recent pediatric-based FiM interventions supports the use of food-based interventions from prenatal to adolescents to improve child diet quality, food insecurity, and potentially impact long-term health, healthcare cost and greatest potential in life.
- A 2022 trial in Australia prescribing a fruit and veg box to food insecure with T2D, found both behaviour change improvements (in vegetables, fruits, whole grains, red/processed meat, trans fat, sodium, and alcohol consumption) and health changes to blood lipids and weight loss along with high satisfaction.
In addition to the studies above, there are many other research findings in favour of medically tailored meals, prescribed food and culinary medicine, not only in official research but also in real life settings conducted by companies such as Abbott Medical and Good Measures.
What conditions can Food as Medicine support?
According to the Global Burden of Disease Study 2017, circa 11 million deaths can be attributed to dietary risk factors between 1990 and 2017. A Lancet paper showed that a diet of plant-based proteins, unsaturated fats, whole grains, fruit and vegetables along with lower meat, refined carbohydrates, processed foods and sugar promotes well-being and lowers the risk of major chronic disease. With this, the importance of food as medicine is now being recognised and part of primary prevention of many of the conditions but most commonly in:
- Type II diabetes
- Cardiovascular conditions; heart disease, stroke and hypertensions
- Alzheimer's disease
- Kidney and liver disease
- And many more including gut health, hormonal health, fertility, skin issues, immunity, mood disorders, arthritis and even cancer
Market overview of the Food as Medicine segment
Funding for FiM startups has witnessed remarkable growth; $2.5B allocated to startups of the $8 billion in committed private funding from the Biden Administration’s Conference on Hunger, Health, and Nutrition to fuel food as medicine programs; World Economic Forum and its partners are investing in nutrition-forward business models and other opportunities for public-private collaboration outside of the clinical nutrition space.
The Food-as-Medicine ecosystem is the strongest market opportunity to elevate nutrition and begin a paradigm shift; startups in the nutritional food space are gaining increased traction as the market grows around 10% year on year; it’s expected that there will be a combination of public-private partnerships, nonprofit initiatives, and greater investment dollars flowing into food-as-medicine-focused and nutrition- focused startups along with strong incentives for functional food startups to fund clinical studies as they seek out commercial partnerships.
Innovators in Food as Medicine
There’s a variety of FaM products available; from meal services, to clinical sessions and food delivery provided by insurers, to medicinal and functional foods and medically tailored meals to digital recipes.
Examples of innovators
Season Health
Season Health calls itself “the leading food-as-medicine platform that enables people with chronic conditions to eat well and live well”. Patients receive a virtual dietitian provided by insurance, covering 100 conditions, that then links to recipes and delivered prepared meals based on the patient needs. Season Health boasts receiving $7million investment last year and also receiving FoodMed certification that qualifies the measurable results from the program.
Sifter
“Medically tailored grocery solutions”
A food as medicine technology enabling customers to shop based on their medical and dietary needs. Sifter uses over 1500 live data points to inform their technology working with both food retailers and health providers. Sifter is also FoodMed certified.
Sunbasket
A healthy meal delivery service, including recipe boxes and premade meals. There are choices of specific diets such as Paleo, Carb-Conscious, Gluten-Free Friendly, Diabetes-Friendly, Vegetarian, Pescatarian, Mediterranea and Keto-Friendly.
Following the White House Conference, Sunbasket partnered with EatLove, an AI powered personalised nutrition platform. The partnership links the meal plans and recommendations from EatLove based on client data and their medical needs, with the delivery of this in actual food and meals provided by Sunbasket, tackling one of the major issues when it comes to improving the diet; compliance.
Who are the big food innovators participating in the Food as Medicine movement?
Nestle, Abbott’s Food as Medicine Program, Fresenius Kabi AG announced a partnership with Vifor Pharma, Barry Callebaut, Danone just to name a few.
Programs, Initiatives and Public-Private Partnerships
The American Heart Association’s Health Care by Food™ initiative
- AHA along with The Rockefeller foundation are funding FiM research. Grants available up to $400,000 over an 18-month funding period; The AHA anticipates funding up to $3 million in awards.
- Rockefeller also working with the likes of Walmart, Instacart, Kroger and Good Measures to support the government initiatives.
- Food if Medicine Coalition (FIMC) are providing research, public policy and building a network of non-profit orgs to help expand access to MTM interventions though FIMC accelerator program
- Institute of Food Technologists (IFT) has established a steering committee consisting of several food scientists to support the national Food is Medicine (FIM) initiative
- Culinary medicine education programs are also fortunately popping up, for example FoodShare South Carolina is providing education and culinary for both community and physicians
Challenges and considerations
At present it has been challenging to consistently see clear health improvements through dietary intervention from clinical trials and therefore highlights a gap in evidence. The research so far has also been criticized for the lack of under-representation in trials, for example the DiRECT trial in Type 2 Diabetes was mostly white participants despite the largest risk being in South Asian ethnic groups.
In addition to this, it has to be recognised not all results are promising. A control study looked at health outcomes in diabetes in those with food insecurity with no improvements. Nevertheless, it’s still early days and as most health care professionals understand, it can take years of education and societal change to make an impact on food decisions, there’s not always a quick fix.
Another challenge in the advancement of food as medicine initiatives lies in the integration of artificial intelligence and the ethical considerations surrounding its use. As companies invest in sophisticated digital platforms, AI is increasingly being used to tailor dietary recommendations, predict health outcomes, and analyze large-scale data from diverse populations. However, this introduces questions around data privacy, potential bias in algorithms, and ensuring equitable access to technology-driven solutions. For food as medicine to fulfill its promise, these ethical issues need to be addressed with transparency and regulatory oversight, ensuring that AI-driven interventions prioritize patient well-being and inclusivity.
What are the other Gaps, Considerations and Threats in the Food as Medicine approach?
Opportunities in Food as Medicine
Despite the issues and challenges, this is an exciting time for food and health brands; health brands can capitalize on funding and initiatives and the desire for more healthy food brands; with backing from the government along with demand from consumers, it’s a good time to get on board the FiM movement. If food companies don’t want to be left behind they ought to work with health professionals and develop tasty but healthy alternatives that are also affordable.
It has been predicted functional foods will outgrow normal food in terms of investment and innovation and medical foods and medical meals are already rapidly growing, but we’re also seeing a lot of commercial FaM products leveraging digital health platforms, which is itself a quickly growing industry, so combining both digital health growth with consumer demand, governmental funding and the FaM trend, it’s an exciting time to innovate in this area.
The Qina take
Food is medicine is the provision of healthy food to prevent, manage, or treat specific clinical conditions and/or nutrition or food insecurity in a way that is integrated with the health care sector.
As the market for healthcare and wellness has grown and the US government is backing FiM initiatives, along with a surge in consumer demand, competition in medicinal foods are fierce, investors are pouring millions into startups developing innovative food-based solutions for chronic diseases, weight management, mental health and overall wellness.
A whole system approach is needed and behavior change science is critical in helping to understand what the barriers are to improved health.
The food-as-medicine movement is an area where positive social impact, investors’ returns and sound public policy can all align. It’s not just a promising investment opportunity, it’s a chance to participate in a paradigm shift that promises to redefine our approach to health and well-being for generations to come.
Critically this movement drives the research needed to measure health improvement, improve behaviour change, social change, create an eco-system of funding and innovation in food as medicine and shift the food industry toward healthier options as the norm and hopefully a much healthier nation.
For food-as-medicine initiatives to be successful, there must be effective collaboration among organizations, government bodies, retailers, health professionals, and, most importantly, the individuals themselves. To achieve meaningful, population-level change - and to support those most in need - these initiatives must be implemented on a national scale.
All companies mentioned in this article are listed in the Qina marketplace.
For a deep dive into the Food as Medicine movement, sign up to read our full Executive Data Brief here.
References
- https://www.seasonhealth.com/press
- https://www.eatlove.is/
- https://www.siftersolutions.com/food-retail
- https://www.forbes.com/sites/rebeccasuhrawardi/2023/02/03/nutrition-based-prescriptions-makes-its-way-into-the-american-mainstream/