Food is many things. It nourishes our bodies, satisfies our senses, and gives us something to reap. Food is also a powerful cultural symbol that reflects the traditions, values and history of communities around the world.
But for a researcher at the Faculty of Agriculture and Life Sciences, food is also medicine.
Bailey Houghtaling PhD ’19, a registered dietitian, works to promote overall wellness among low-income individuals experiencing food insecurity and aims to prevent or treat diet-related diseases.
“Access to adequate nutritious food is essential to individual well-being,” said Houghtaling Ph.D. ’19, is also a registered dietitian and affiliated faculty member in the Department of Human Nutrition, Foods, and Exercise. “Food is Medicine can include a variety of interventions.”
The White House Conference on Hunger, Nutrition, and Health, held in September 2022, renewed national attention and issued a call to action to end hunger and reduce the prevalence of chronic diseases in the United States by 2030. Food is Medicine programs can help achieve this goal:
“These programs are promising, and there is currently a great deal of emphasis on understanding the effectiveness of promoting food and nutrition security, but it is important to recognize that Food is Medicine programs have been implemented in various communities and health care organizations with varying levels of support or capacity,” he said, who is also a national nonprofit Houghtaling, a research scientist at the Center for Nutrition and Health Impact, a research and evaluation center. “It is critical to understand factors related to these contexts that influence program adoption, implementation, sustainability, and scalability for public health impact.”
Houghtaling has written two articles focusing on the barriers and opportunities to the integration of food as medicine. His first article covers organizational factors in healthcare settings that influence the success of Food is Medicine programs.
The second article outlines how to leverage nationally representative data among U.S. households to identify individual, household, and community factors that likely influence participant participation and use of these programs. This is especially important for programs that limit redeemable products to fresh fruits and vegetables only. Not all Food is Medicine programs do this, but some do.
The first article was recently published in the Journal of General Internal Medicine. The second was recently published in BMJ Journals.
Both articles were funded by a grant from the National Institutes of Food and Agriculture to the Center for Nutrition and Health Impact. Established the Nutrition Incentive Program Training, Technical Assistance, Evaluation and Information Center through the Gus Schumacher Nutrition Incentive Program. The second article was also supported by the Robert Wood Johnson Foundation.
Food is Medicine in Health
Food is Medicine programs are relatively new and there are no standard guidelines for implementation in healthcare settings. Houghtaling and collaborators conducted a review to investigate barriers to integrating programs into U.S. healthcare settings.
“In our research, we focused on situations where health care partners, such as physicians or other allied health professionals, run programs to screen patients who have or are at risk for diet-related chronic diseases due to food insecurity,” Houghtaling said. . “We focused on programs where healthcare partners then provide low-cost or free healthy food incentives for those who screen positive [such as a produce prescription]for example, for fruits and vegetables.”
Electronic medical record functionality to identify and track patients and increase data sharing between partner organizations was identified as important to support implementation and evaluation. Strategies to help healthcare personnel implement these programs, such as providing reminders, problem solving, and technical assistance support, were also important.
The study found that involvement of physicians, allied health professionals, and students is also important for implementation success, and that capacity barriers are identified and addressed early and frequently. Support from leadership and alignment of the Food is Medicine program with the healthcare organization’s mission or values were also key to success.
“Many healthcare professionals who implemented these programs found them helpful and noted improvements in job satisfaction,” Houghtaling said.
Based on the findings of this study, the research team developed an implementation checklist that can be referenced for healthcare, partner organizations, and technical assistance personnel who will support Food is Medicine programs in these settings.
Houghtaling and co-authors noted several opportunities to improve the application of Food is Medicine in healthcare contexts moving forward.
Food is Medicine in Society
In the second study, the research team, also led by Houghtaling, outlined a plan to examine how “prescriptions” for products produced through the Food as Medicine incentive program could influence participation through the team’s protocol document.
Through the Gus Schumacher Nutrition Incentive Program, participants receive produce prescriptions that they can use only for fresh fruits and vegetables, rather than frozen, canned or dried options.
According to the researchers, this policy limitation could harm the participation and benefits of households living in communities where access to fresh produce is limited.
“Households face increasing barriers to accessing fresh fruits and vegetables in the U.S. due to a variety of factors,” Houghtaling said. “It is important to understand the implications of this policy limitation to inform future Food is Medicine policy that maximizes impact and equity.”
In the paper, the researchers plan to use the U.S. Department of Agriculture Economic Research Service National Household Food Purchases and Purchase Survey, a large nationally representative data set, to examine this policy limitation to support sensitive policy decisions.
Ensuring nutrition security, which means ensuring that all Americans have access to adequate amounts and variety of foods and beverages recommended by the Dietary Guidelines for Americans, including fruits and vegetables, is a national priority, and Virginia Tech researchers are helping achieve that goal.
By Max Esterhuizen