Farmacy – food as medicine

Prescribing food could be as cost-effective – if not more so – than common drug treatments while delivering significant health benefits, according to research published in PLOS Medicine.

The study rides on a wave of interest in food as medicine – “farmacy” rather than pharmacy – by doctors, hospitals and insurers as drug treatments for food-related illnesses like diabetes, heart disease and cancer fail to fulfill their promise.

Cost and health benefits

The researchers modelled the economic and health benefits of subsidising 30 percent of fruit and vegetable and 30 percent of wholegrains, nuts/seeds, seafood and plant-based oils.

Results showed that fruit and vegetable subsidies could avert nearly two million cases of heart disease while the wider incentive could prevent more than three million people from developing heart disease and 120,000 from getting diabetes.

The cost savings were also staggering – the resulting reduced use of health care services saved nearly US$40 billion and more than US$100 billion, respectively, confirming the cost-effectiveness of such an intervention.

“These new findings support the concept of Food is Medicine,” says lead author Dariush Mozaffarian; “that innovative programs to encourage and reimburse healthy eating can and should be integrated into the healthcare system.”

What about reality?

In reality, how likely are people to eat healthier food if it were subsidised?

One of the biggest barriers is access, and that’s where prescribing and subsidising food can make a difference.

Nutrition and cooking education might help as well – and is effective, as shown by research such as Australian studies Helfimed and SMILE.

These two interventions gave people suffering major depression food hampers and nutrition education, and in Helfimed they received cooking workshops. Both studies showed significantly improved diets in the treatment arm.

Depression symptoms decreased as well, suggesting that even psychiatrists could start prescribing diet.

Other research has found health benefits from food prescription programs, including lower blood sugar levels in people with diabetes, weight loss and increased intake of fruit and vegetables.

Having a GP validate and promote diet as a treatment could also be powerful.

“People may be more likely to make a behaviour change if the recommendation comes from their healthcare provider,” says Associate Professor Heidi Wengreen, “as part of a treatment plan for conditions such as diabetes, heart disease, high blood pressure, or obesity.”

Already, some doctors have started prescribing diet in the US, such as the Food Farmacy program at Nunnalee Pediatric Specialty Clinics in North Carolina.

Food and aging

Older adults, who often can’t afford healthy food, could derive even greater benefits from diet prescriptions. Poor diet has been linked to frailty with aging, associated with spiralling loss of strength, mobility and quality of life.

Even one extra meal a day could save lives.

Added to that, a healthy diet could displace the multiple medicines that are being prescribed to older adults, with many negative consequences.

Changing the culture of drug prescriptions could require an overhaul of the insidious and far-reaching influence that pharmaceutical companies have on clinical practice.

And although nutritional supplements might be a welcome alternative in some cases, nothing can replace a wholesome diet.


Cost of Malnutrition 

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