American Heart Association awards $7.8 million to explore "food is medicine" options for health care

In an effort to identify effective food is medicine approaches for incorporating healthy food into health care delivery, the American Heart Association, the world's leading voluntary organization focused on heart and brain health research, now celebrating 100 years of lifesaving work, today announced grants totaling $7.8 million to 19 research projects nationwide as part of its Health Care by Food™ initiative.

The research projects focus on areas including food resource coaching for patients of a safety-net clinic, delivering food is medicine interventions in underserved communities, the impact of a produce delivery program on patients with heart failure and implementing food prescription programs in older adults. Overall, the projects will examine the efficacy of strategic approaches for providing healthy food as part of patient care to help treat, manage and prevent chronic health conditions in ways that alleviate health inequities.

With anchor support from The Rockefeller Foundation and contributions from inaugural collaborator Kroger, with additional support from Instacart, Kaiser Permanente and Walmart Foundation, the Association's Health Care by Food™ initiative is engaging in scientific research and public policy advocacy to promote the adoption of interventions that reduce chronic health conditions and curb health care costs. The initiative was first announced at the September 2022 White House Conference on Hunger, Nutrition and Health by the Association and The Rockefeller Foundation.

With the involvement of stakeholders across the public health ecosystem, we aim to mobilize $250 million toward building a future in which people and communities nationwide have equitable access to healthy food to treat and prevent chronic health conditions. Our coordinated research strategy will identify the most effective ways for food to address diet-related conditions, with the goal of making food is medicine interventions a regular and reimbursable component of health care."

Nancy Brown, chief executive officer of the American Heart Association

"When people cannot afford or access nutritious foods, they are at greater risk for cardiovascular disease, diabetes, and other chronic diseases that contribute to higher health care costs," said Dr. Rajiv J. Shah, President of The Rockefeller Foundation. "These research trials are an essential step in our efforts to ensure everyone's health insurance covers effective food is medicine approaches-;and can help them have the opportunity to live healthier, better lives."

An estimated 90% of the $4.3 trillion annual cost of health care in the United States is spent on medical care for chronic health conditions, many of them diet-related, including cardiovascular disease, Type 2 diabetes and obesity. The Health Care by Food™ initiative will address barriers to the widespread adoption of healthy food as a treatment for chronic disease and the health inequities that result.

Food is medicine may be defined as providing healthy food resources to treat, manage and prevent specific chronic conditions in coordination with the health care sector. Common food is medicine programs include medically tailored meals, which are often delivered to patients with diet-related health conditions or among those at high risk; produce prescription programs that integrate healthy food into a patient's health care plan, enabling patients to better follow their health care team's dietary advice; and medically tailored groceries, which may include a selection of grocery items prescribed by a registered dietitian or nutritionist for patients with diet-related acute and chronic health conditions who can pick up and prepare food at home.

The initiative's research roadmap is outlined in the 2023 American Heart Association Presidential Advisory on Food Is Medicine, which calls for addressing gaps in the study of current food is medicine interventions resulting from factors including small sample sizes, non-randomized comparisons and broad differences in data collection and measurement. The advisory writing group was chaired by Kevin Volpp, MD, PhD, the research lead for the Health Care by FoodTM initiative, the Mark V Pauly Professor at the Perelman School of Medicine and the Wharton School and Director of the Penn Center for Health Incentives and Behavioral Economics. The advisory proposes a coordinated research approach to examine the cost effectiveness of nutrition-based interventions in treating and preventing disease.

The research efforts announced today are the first to be funded under the Health Care by Food™ initiative. They are led by experts in the food and nutrition, behavioral science, epidemiology and cardiovascular research fields. The projects focus on rigorous pilot testing of ways to equitably increase enrollment and engagement in food is medicine interventions. The projects will test ways to accomplish significant short-term changes in healthy eating behavior to strengthen the foundation for subsequent studies that will assess longer-term behavior change.

The projects receiving awards were chosen because of the creativity of their ideas and their commitment to rigorous evaluations of food Is medicine interventions for people with, or at elevated risk for, chronic conditions. The projects are intended to ensure food is medicine programs serve populations in need, and to learn from their lived experience in assessing how to increase healthy eating behavior. The ultimate aim is to improve health in cost-effective ways through food is medicine interventions to support coverage of effective programs for the millions of people in America living with or at high risk for chronic health conditions.

"Research studies increasingly show that healthy food is critical to the effective treatment and prevention of chronic health conditions," said Victor J. Dzau, M.D., president of the National Academy of Medicine. "This initiative is vital to ensure we discover real-world evidence of the most impactful ways to incorporate healthy food into health care and benefit communities that face the biggest challenges accessing the food they need to get and stay healthy."

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