Food Security, Food as Medicine, Food for Hype

Sunday at FNCE brought us a fireside chat with Sara Bleich, the first ever Director of Nutrition Security and Health Equity. Make no mistake about it, this is big. Because without secure access to genuinely nourishing food, it will be terribly hard to close the gap in health that comes from chronic diseases – including obesity – related to nutrition. For Bleich, this work is close to her heart:

“This mission is absolutely vital, but to me, it’s also personal. I grew up in inner city Baltimore in a household that greatly appreciated the support of school meals, WIC, and program now known as SNAP. My parents were public school teachers, and my mom stepped out of the workforce when we were very young to take care of me, my sister, and my brother. These programs helped put food on the table for my family as they do for tens of millions of others.”

A Dose of Hype

The White House Conference on Hunger Nutrition and Health last month brought needed attention to this important subject. Coming along for the ride was a little dose of hype for the concept of prescribing tailored meals to prevent or better control chronic diseases. This is one of those concepts that can morph into whatever you want to think it is.

So naturally, venture capitalists sense an opportunity to make some money from a hot concept. In fact, investors have pledged $2.5 billion investors have pledged $2.5 billion for startups looking to exploit the interest in this concept. The only problem is that it’s hard to separate the hype from the objective opportunity to deliver better health outcomes.

Food Isn’t Really Medicine

The nomenclature here is unfortunate. Because food isn’t necessarily a substitute for medicine that a person might need. Further, it brings an implication that these diet-related diseases are a function of poor choices, as nutritionist Monica Reinagel explains:

“I am finding the food as medicine movement increasingly tone deaf.

“The implication is that if you’re unwell, it’s because you didn’t live right. Or eat well enough. Which is not always the case.

“Genes and privilege have an awful lot to do with one’s risk of ‘lifestyle’ driven disease processes.”

Nutrition Security Is Part of the Answer for Health Equity

Nutrition security is no doubt an important piece of the puzzle for solving the problem of inequities in health. So we were delighted to see Bleich speaking at FNCE and for the trail blazing work she is doing.

But let’s remember that food is not a substitute for medicine. Access to good nutrition is not a substitute for access to equitable medical care. People need both. This may explain why we don’t have strong evidence that food prescription programs, by themselves, are effective for delivering better outcomes in chronic disease management.

Good nutrition is indeed essential for good health. But food is not medicine. It’s nourishment.

Click here for more from Bleich and here for a systematic of food prescription programs for chronic disease management.

Life Extension at FNCE, photograph by Ted Kyle

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October 10, 2022