Food as Medicine is a movement that is picking up pace in the US. At the 2nd Annual Food is Medicine National Summit in April, hosted by Tufts University, Food Is Medicine Institute, in collaboration with Kaiser Permanente, Congressman Jim McGovern delivered a clear message to kick off the 2 day summit …..
“We need to accelerate our efforts this year. We don’t have to agree on everything but we have to find common ground and move forward”
A positive start and one that ignited what was an enthusiastic, open, collective sharing of experiences, ideas, challenges and opportunities to bring the power of food to the forefront of food and public health initiatives in the US.
I personally also loved his advice:
“Get creative and find a way to do this now…without political delay”
It got me fired up and ready for the session.
Congressman McGovern’s insight
“Food is family, it unites us, it links us to our culture and lifestyles”
was a theme which resonated time and time again throughout the sessions. In our passion as nutritionists to deliver healthier, more sustainable diets, we forget this at our peril. These sessions delivered online and in person were a great example of sharing knowledge and experience, in all directions. Many great speakers shared their lived experiences as beneficiaries of community food programmes, volunteers and leaders of several community initiatives. It felt like the right people were in the room. I loved this. This should be how every conference is. As nutritionists and stakeholders within the food system we should not be developing things for people, we should be developing ideas and solutions with people. Outcomes should also be shared and discussed collectively as was the case in this meeting, to ensure accessibility to information and its interpretation enables and encourages open dialogue across the many people that serve and are served by the food system.
“How can we help ensure everyone has nutrition security?”
As new guidelines for schools are published in the US and new rules are being issued for federal feeding programmes, this fabulous panel session addressed this question from multiple perspectives.
We got valuable insights from Jessica Lee, Centers for Medicare and Medicaid Services; Ruth Petersen, Centers for Disease Control and Prevention; Caree Cotwright, U.S. Department of Agriculture; Joshuah Marshall, Indian Health Service; Christine Going, Department of Veterans Affairs; Dan Glickman, Moderator, Friedman School of Nutrition Science and Policy; Bipartisan Policy Center.
We need to make the easy choice the healthy choice. We need to change the systems. Three key points were raised in the discussion which could be useful to all those interested in delivering work which answers this critical question;
- Procurement – key for nutritional standards implementation
- Pay attention to the context- individualisation matters
- Having metrics on impact is critical
“It’s not what’s the matter with you, it’s what matters to you”
This, one could argue, should be the central consideration we, as nutritionists, use as our north star. Words spoken by a US Veteran, the community food programme he described as working was based on the principal of whole health and the importance of meeting people where they are on their health journeys. Another thought-provoking statement pointed out the fundamental importance of community food provision. Hospital foods are prepared by chefs working with a dietitian. Outpatient services is where we make the difference. Where we teach people how to cook healthily in ways that matter to the veterans.
Partnership and integration are key, we cannot be successful alone
Multiple areas for potential partnership were highlighted. From Medicare (a US health insurance program for people age 65 years or older and younger people with disabilities) to screening measures, home delivered meals, pantry restocking, medically tailored meals, social services support, alongside SNAP (Supplemental Nutrition Assistance Programme) and WIC (supplemental nutrition assistance programme for women, infants and children) provisions. Alongside working partnerships, for example between the 60,000 US grocery stores working with the John Handcock Institute, Vitality’s birthplace, or the work being piloted by Instacart, a food delivery platform, and research institutes. The need for automation, integration of systems and data interoperability (the exchange of data between computer or software systems) were raised as challenges to overcome to enable the realisation of partnerships and fully integrated solutions for users.
Evaluation – what’s needed?
Another essential area of partnership that is needed is between government, industry, community and academia working collectively to answer questions of the many food is medicine pilots that are happening.
- What works, what doesn’t?
- Qualitative and quantitative data are both needed
- Is it working for who it is meant to work for?
- What is the most effective way to implement this?
- What tools can be given to people that work for them?
A call for adaptability was made in the evaluative approach used for continuously developing rapid research. Outcomes are needed, not only to support delivery of health metrics, and ensure scaled meaningful impact, but also, to deliver advocacy. Outcomes are needed to help advocate for the social safety net health initiatives deliver.
What do we risk in scaling food as medicine initiatives?
A number of key points were made that are worth sharing
- We must be hyper intentional about how these initiatives are scaled
- It should always be about the end user experience
- As things change, politics, supply chains, behaviours, trends, we should take learnings and apply them
- We need to be as effective as we are efficient
- The human component of these programmes is the secret sauce, human-centred delivery is key
- How do we scale for the individual with the need and their families too?
- Provider burnout and wellness in community and voluntary groups must be addressed
Finally, one last point we wholeheartedly agree with here at Nutrition Talent, we need quality standards. Registered Nutritionists and dietitians are the experts in food and nutrition and their expertise must inform the design and deployment of food and health initiatives.
We very much would like to commend the organisers and all the speakers involved for a powerful, open, inspiring session. If you would like to watch recording of this session you can do so here.
Should you be interested in a Food as Medicine initiative and need access to nutrition expertise, get in touch.