Food is medicine, but money is the cure

• Clinical Success, Structural Failure: While food as medicine programs are proven to reduce hospitalizations and costs, they operate as a clinical patchwork that fails to address the underlying economic scarcity driving food insecurity.

• The Cost of Prescriptive Care: Medicalized nutrition models are burdened by high administrative overhead — requiring constant referrals and dietitian oversight — that limits their ability to scale compared to direct economic support.

• Agency vs. Paternalism: Moving beyond prescriptive boxes to unconditional cash transfers respects the autonomy of families, empowering mothers to act as their own health administrators by choosing the nutritious food that best fits their household needs.

For as long as I can remember, the conversation about nutrition has been framed as what you should do. Whole grains and ample fruits and vegetables should be the foundation of your diet. Lean protein sources and healthy fats should be prioritized whether your goal is to lose weight or build muscle.

Of course, the guidance from your doctor might get markedly firmer if, say, you have high cholesterol. Generally, though, it’s a fairly recent shift for medical professionals to be treating food and nutrition as non-negotiables for a healthy lifestyle.

Just this month, the American Medical Association at its 2026 annual meeting affirmed its stance that food is medicine. This represents a significant leap that squarely positions nutrition as a clinical intervention.

“What we eat and drink directly affects our risk for many chronic conditions, making nutrition a critical component of both prevention and long-term health,” AMA Immediate Past President Bobby Mukkamala, MD, said. “Embracing the principle that food is medicine can help individuals live healthier lives and strengthen the health of our communities.”

While the AMA can play a vital role in securing appropriations for food as medicine, their current policy framework is intentionally designed to define the clinical standards of care — validating the efficacy of these programs and fostering the research needed for broader adoption.

That will have a tangible impact. Evaluations of food as medicine programs consistently show they’re both medically effective and economically reasonable. But they’re also patchwork solutions in that they treat symptoms of a broken food system without addressing the root cause: the lack of cash and flexibility among poorer families.

Beyond the moral case, the most persuasive argument that can be made for any taxpayer-funded endeavor is the fiscal and economic impact. Many evaluations of anti-hunger initiatives show that they are more than economically viable.

Food as medicine is no different. Like so many other hunger interventions, research indicates that this policy effectively pays for itself.

There are some states where Medicaid recipients can get medically tailored meals (MTMs) as part of their healthcare plan. A study released this year looked at the impact on hospitalizations and emergency department visits among more than 1,800 low-income people receiving MTMs in Massachusetts.

The results were significant: a 31 percent decrease in hospitalizations and 20 percent decrease in emergency department visits compared to those who were not getting MTMs. The greatest cost savings were observed in those with chronic conditions like cardiovascular disease or diabetes.

Those savings represented 98 percent of the per-person program costs. It didn’t account for the economic benefits of a healthier, more productive population, which should more than make up the remaining $15 per person.

It has to be noted that food as medicine policies have significant limitations. For example, a study published this year in JAMA Internal Medicine tracked the health effects of an $80 monthly produce subsidy given to food-insecure individuals with type 2 diabetes. It found that this program on its own did not improve health outcomes.

Even without the varied results observed in that study and others, scaling these policies is limited by the infrastructure required. A prescriptive design requires screening, referrals, dietitian oversight, and other logistics — and that’s for every single person it serves.

In addition to the expansive overhead, there’s an argument that these prescriptive policies siphon away the agency of individuals. There’s a measurable psychological difference between being a patient in a nutrition program and a consumer with the power to make choices.

This is an idea I explored months ago in the context of a UNC Health study comparing interventions and their effects on blood pressure. In short, a group that received $100 per month in pre-selected boxes of healthy food actually had less significant blood pressure drops than a group that received a $40 subsidy to choose their own healthy foods.

Choice beat prescription.

It seems reasonable to scale the clinical approach of nutrition prescriptions for the chronically ill as a component of their treatment plans. But there are more practical approaches for the preventative care of families struggling to put food on the table. We need to evolve past requiring people to be sick enough to receive nutritional support that can stabilize or even improve their health.

If we’ve already proven that nutrition can improve health outcomes and save the healthcare system money, the next step to take is fixing the food system and empowering people to make their own healthy choices.

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