Hunger, Nutrition, and Health: Stepping Up to the Plate

Cate Collings, MD

The historic White House Conference on Hunger, Nutrition, and Health was an invigorating experience full of innovative ideas and ambitious goals to end hunger in America by 2030. The White House unveiled a strategy and an impressive $8 billion in public-private commitments to help millions of people with food insecurity and diet-related chronic diseases.

Much hard work remains to translate these ideas and proposals into actions that improve the health of individuals and families. But health professionals, primary care physicians in particular, may be wondering what this coordinated focus on nutrition will mean for their practices and how they can ensure that their patients experience the greatest benefits.

One recurring conference theme was the need to more effectively screen for food insecurity in medical encounters. Important food assistance programs like the Special Supplemental Nutrition Program for Women, Infants, Children (WIC), the Supplemental Nutrition Assistance Program (SNAP), and even school lunch programs were initially focused primarily on eliminating sheer calorie deficit. While some of these programs have implemented nutrition standards, there remains room for improvement to the nutritional content of the food that these programs provide to better supply the nourishment humans need to help prevent and treat chronic disease. In other words, as a practicing provider, begin to discern differences between food insecurity and nutritional insecurity. Your patient may be experiencing one, neither, or both of these conditions.

As a board-certified lifestyle medicine physician, I see this White House conference as an extremely promising sign that much-needed policy and regulatory changes are coming that will expand access to nutritional counseling and food as medicine. Some federal legislation has already been proposed that represents a first step. The Medical Nutrition Equity Act and the Medical Nutrition Therapy Act, for example, would significantly expand coverage of medical nutrition therapy services.

Expanded access to medically tailored meals or food packages and produce prescriptions, particularly in communities with high rates of diet-related disease, was also a topic of conference discussion.

Changes won't happen overnight, but there are several ways that physicians can prepare to thrive in a health system that encourages and rewards the restoration of health through nutrition and food as medicine.

Seek Nutrition Education

Writing a prescription for a medically tailored meal without understanding the science behind it is no better than a cardiologist prescribing a medication without understanding the drug's properties or benefits. Food as medicine is best prescribed by a clinician knowledgeable about nutrition and chronic disease. But few physicians receive sufficient nutrition education in medical school. We now face an opportunity for physicians to marry food-as-medicine prescriptions with fundamental knowledge of the "what and why" of those prescriptions.

In partnership with the White House Conference on Hunger, Nutrition, and Health, the American College of Lifestyle Medicine (ACLM) made a $22 million in-kind commitment to provide 5.5 hours of complimentary CME coursework to 100,000 physicians and other medical professionals treating patients in areas with a high prevalence of diet-related disease. It's easy to take advantage of this opportunity by registering here for the Lifestyle Medicine and Food as Medicine Essentials education bundle.

Inventory Your Community's Resources

Become familiar with nonprofit or private organizations that may already be helping to meet hunger and nutrition needs in your community. The Teaching Kitchen Collaborative has an interactive map of teaching kitchens and medically tailored meal and produce prescription programs. The American Academy of Family Physicians has a good Neighborhood Navigator tool to identify resources by zip code.

Startup companies that deliver medically tailored meals to patients' homes are growing in number and attracting investor attention. By identifying and connecting with these organizations, physicians can form partnerships that synergize healthcare and nutritious food sources in the community. Saint Luke's Health System's REACHN (Resilience, Education, Activity, Community, Health, Nutrition) Program is an example of a dynamic community partnership. As you prescribe lifestyle modification and connect your patients to relevant resources, emphasize to them that a lifestyle medicine prescription delivers only positive side effects, focused on eradicating the root cause of disease with the goal of health restoration.

Locate Registered Dietitians in Your Area

As more diagnoses become eligible for nutritional counseling, physicians will have increasing opportunities to collaborate with registered dietitians to whom you refer patients. It is vital that perspectives on nutrition interventions are aligned between the referring physician and the receiving dietitian. Know the style and methods of dietitians in your region so that recommendations are united and can be reinforced by members of the care team.

To promote effective collaboration, physicians and dietitians may want to participate in nutrition-related CE/CME activities together, share relevant journal articles, and review patient resources and group class topics. A good first step is for physicians to encourage dietitians to register for the free ACLM Lifestyle Medicine and Food as Medicine Essentials education bundle.

Be an Instrument of Change

If you are passionate about nutrition, work within your health system to influence change. Highlight the national priorities around food as medicine as represented at the White House conference. Encourage the replication of successful, scalable nutrition and food-as-medicine delivery models, and educate fellow clinicians on the resources that already are available. Promote partnerships with organizations in the business of providing and delivering medically tailored meals, and organize activities that raise awareness in the community. Join the growing Health Systems Council, a collaborative learning community of almost 80 health systems that are integrating lifestyle medicine, and be on the lookout for opportunities to support advocacy efforts related to nutrition policy.

Clinicians who lead the integration of nutrition programming now will demonstrate their value as the US health system evolves into one that finally, at long last, recognizes the outsized role of poor nutrition in chronic disease.

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