Pexels / Daria Shevtsova

Quick notes:

  • A study found that a prescription-based healthy diet initiative would be cost-effective after five years of implementation.
  • A subsidy for prescribed healthy foods could help encourage people to eat more fruits and vegetables.
  • Prescription healthy foods could be as or more cost-effective as preventative drug treatments for things like high cholesterol.

A report from Tufts University and Brigham and Women’s Hospital, focusing on the effects of healthful food prescriptions in Medicare and Medicaid, found that increasing the intake of healthful foods by 30% via health insurance prescriptions would improve health and reduce costs, and reduce the need for prescription drugs.

Researchers also say that, within five years, those comparative benefits would split even wider.

In a word, the study focuses on the “economic and health benefits that would accrue if 30% of the cost of healthy food purchases in supermarkets and grocery stores were covered through Medicare and Medicaid, through an electronic debit card,” the report stated.

Two dietary models were plugged into the study to arrive at the outcome:

— Study participants were issued 30% coverage of fruit and vegetable purchases, and

— 30% received coverage in the form of purchases of fruits, vegetables, whole grains, nuts/seeds, seafood, and plant-based oils.

Both models showed significant health care gains in participating health care consumers.

Private, public health care leaders ‘on board’

Are fruits, vegetables, and other healthy foods really the antidote to prescription drugs? A lot of smart scientists think so.

“We found that encouraging people to eat healthy foods in Medicare and Medicaid — healthy food prescriptions — could be as or more cost-effective as other common interventions, such as preventative drug treatments for hypertension or high cholesterol,” said co-first author Yujin Lee, Ph.D., postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts.

The health insurance industry and the federal government are on board with prescriptions including access to healthier foods, and subsidies to go along with the prescription.

“Healthy food prescriptions are increasingly being considered in private health insurance programs, and the new 2018 Farm Bill includes a $25 million Produce Prescription Program to further evaluate this approach,” Lee says.

According to the study, steering health care consumers not only leads to a healthier population, but some significant cost benefits that could ease the load on an overburdened U.S. health care system, as well.

This from the Tufts/Brigham and Women’s Hospital study:

— Over the course of the study population’s lifetimes, health food-based prescriptions would save $100 billion in health care costs.

— A prescription-based health care diet initiative would be cost-effective after five years of across-the-board implementation.

— 120,000 cases of diabetes in the U.S. and 1.3 million cardiovascular cases could be eliminated by implementing the healthy foods prescription model that the study advocates.

“Our findings support implementation and evaluation of healthy food prescriptions within healthcare systems to improve the diet and health of Americans,” said co-senior author Renata Micha, R.D., Ph.D., research associate professor at the Friedman School.

Other studies point to similar results

In a study entitled “Effects of 7 days on an ad libitum low-fat vegan diet: the McDougall Program cohort” — spearheaded by John McDougall, a Santa Rosa, California-based physician, and Laurie Endicott Thomas, a Madison, New Jersey-based diet and nutrition specialist — experts found that “a low-fat, starch-based, vegan diet eaten ad libitum for seven days results in significant favorable changes in commonly tested biomarkers that are used to predict future risks for cardiovascular disease and metabolic diseases.”

The patients covered in the study had a physical and laboratory tests on day one, at which point the doctor adjusted their prescription medicines, and many drugs for blood pressure and blood sugar were stopped on that day.

“The patients were then fed a low-fat, purely plant-based (vegan) diet in an all-you-can-eat setting,” Thomas says. “The patients were urged to eat until they felt full. Nevertheless, they lost an average of three pounds by day seven and their blood pressure and blood sugar levels also came down — even though most of them decreased or stopped their blood pressure or blood sugar medications on day one.”

Will Americans go along?

As the old saying goes, tying medical prescriptions into subsidized healthy foods is a great idea in theory. But is it a great idea in practice?

The more Uncle Sam pushes the idea, the better the outcome, health care experts say.

“Whether Americans will consume more fruits and vegetables for their health depends largely on whether the government will subsidize produce like it subsidizes industrial agriculture,” says Calloway Cook, founder of Illuminate Labs, a dietary supplements company.

It’s unfortunate that corn syrup, which is proven to be horrible for human health, is subsidized by the American government for the economic gain of big agriculture, Cook says.

“If produce was subsidized similarly you would see produce consumption rates go up and chronic disease rates go down,” he notes. “Healthy eating prescriptions are a good start, but they lack incentive when purchasing a wide variety of produce is still more expensive than buying flour, white bread, and cookies.”

“Government investment in subsidized produce for consumption by the American public would pay off enormously with increased production and decreased disease rates,” he adds.

On the merits alone, health and diet experts say the prescription food idea is a winner — with one big caveat.

“I hope we can all agree that food is medicine, and has the power to reverse and prevent disease,” says Tina Marinaccio, a registered dietitian nutritionist at Health Dynamics LLC, in Morristown, New Jersey. “However, the Tufts and Brigham and Women’s study was a simulation. Providing therapeutic diet foods to people does not mean they will prepare it.”

Marinaccio says that Americans spend more than half of their food budget on meals out, and ready-prepared food sales in supermarkets are at an all-time high.

“For this model to be effective, Medicare would have to offer other methods of delivery, such as providing shopping lists and simple recipes with the food, and/or contract with companies that can prepare and deliver therapeutic diet meals, and deliver to the recipients,” she says. “At that point, cost-effectiveness would need to be re-evaluated.”

Time will tell, but subsidies will tell more

If policymakers and advocates keep forging ahead with the concept, in time the idea of having physicians writing prescriptions for subsidized health foods will become normalized.

“As with any change I can see how there will certainly be push back, however, over time this will become a normal occurrence,” says Lisa Richards, nutritionist and author of the book, The Ultimate Candida Diet Program.

Because of the strong emotional ties many have with food, it may be harder for some individuals to grasp and implement the concept of food as medicine, Richards adds.

“There is a risk that it could come across as practitioners being passive and not wanting to adequately treat their patients,” she says. “But in the long-term, this is likely best for many patients dealing with acute and chronic illness and disease.”

Any subsidy the federal government could provide via Medicare, Medicaid, or the Affordable Care Act would help spur the movement along.

“I believe having a subsidy would make the concept of prescribing fruits and vegetables more acceptable and would certainly help to remove financial barriers for some patients,” Richards says. “Though eating healthy does not have to be expensive, this thought is common among Americans and having a subsidy might remove this issue.”

A deeper dive — Related reading on the 101:

Stay healthy year-round (on the cheap!) with these tips.

People often complain about the high cost of fruits and vegetables — get the most out of your pricey foods with help from this article.