FROMLINE: In the New England Journal of Medicine, Seth A. Berkowitz, MD, MPH, associate professor of medicine at the UNC School of Medicine, published a perspective article on how medically tailored meals address the health consequences of food insecurity.

Newswise – CHAPEL HILL, NC – A diet rich in a variety of healthy foods full of antioxidants and nutrients is the key to an active, healthy life. However, for some, it is difficult to consistently keep healthy foods on the table, leading to nutritional problems. Food insecurity can lead to poor health outcomes and increased risk of diabetes, hypertension and other chronic health conditions. Individuals with complex chronic conditions such as diabetes or cardiovascular disease may benefit from tailored meals to maintain a healthy lifestyle and diet. Seth A. Berkowitz, MD, MPH, associate professor of medicine in the Department of Family Medicine and Clinical Epidemiology at the UNC School of Medicine, writes a perspective article on how medically tailored meals address the health consequences of food insecurity.

“We hope that research into medically tailored meals will lead to wider availability for the cases in which they have been shown to be helpful,” Berkowitz said.

Published in New England Journal of MedicineBerkowitz’s perspective emphasizes how clinicians need tools to mitigate health harms caused by food insecurity. Community Servings, a nonprofit organization that provides medically tailored meals to chronically ill people and their families, helps meet the needs of those who suffer adverse outcomes due to poor food quality. It is a treatment plan that focuses on the patient’s individual needs while harnessing the power and healing of food. Results from a randomized crossover pilot study conducted in Massachusetts from 2015 to 2017 in collaboration with the UNC School of Medicine, Massachusetts General Hospital and Community Servings showed how individuals who received meals significantly improved diet quality, reducing food insecurity decreased and improved mental health-related quality of life.

“Similar to how your doctor and pharmacist provides you with the right medications, medically tailored meal providers like Community Servings work with healthcare providers to provide patients with critical and chronic illnesses with home-cooked meals designed to accommodate multiple dietary restrictions carry. related illnesses,” said David B. Waters, CEO of Community Servings. “Most of us have no idea how to tailor our meals to dietary-related health concerns, leading to further health complications and poor outcomes for the most critically ill and isolated patients in America.”

These medically tailored meals are available to individuals with one or more complex chronic illnesses who are socioeconomically disadvantaged and typically experience food insecurity. Many of these people have difficulty managing complex diets or difficulty shopping and preparing food due to a disability or other circumstances. Berkowitz’s perspective explains how food insecurity is a pathway through which oppression manifests itself in poor health. He says women and people racialized as Black, Hispanic or Native American suffer from high levels of food insecurity.

“Women and people of color suffer disproportionately from food insecurity, likely due to systems of social relations that keep women and people of color away from the resources necessary to prevent food insecurity,” Berkowitz said.

The program involves Community Servings working with health systems and health insurers to help identify people who could benefit from medically tailored meals. The meals are an evidence-based nutritional intervention that is tailored to an individual’s specific health conditions and delivered to the individual’s home. Once identified, an individual will be referred to Community Servings to receive counseling from a registered dietitian. Meals are prepared under the supervision of a registered dietitian to meet the nutritional needs of people with HIV, diabetes mellitus, end-stage renal disease, cancer or other chronic illnesses. The program consists of 10 meals, approximately two-thirds of each participant’s weekly dietary intake, and is delivered to the participant’s home once a week. The food is ready and just needs to be heated. A qualitative evaluation of the pilot showed high levels of satisfaction and participants noted that the food seemed culturally appropriate and helped them manage their diabetes.

Participants recommended improvements to the program, including integration with lifestyle interventions. That’s why researchers are conducting two studies of medically tailored meals to treat diabetes, funded by the National Institute of Diabetes and Digestive and Kidney Diseases, according to Berkowitz. These studies examine the effects of meals in combination with telephone-based lifestyle interventions focused on glycemic control and weight change.

Berkowitz also said there have been observational studies of medically tailored meals that show that receiving these meals is associated with fewer emergency room visits, inpatient hospitalizations and nursing home stays – ultimately leading to a reduction in costly health care.

Much more needs to be done to combat food insecurity, but Berkowitz said medically tailored meals could be a good place to see a change for those suffering from food deprivation and serious illness.

“The best thing to do would be to change policies that prevent people from becoming food insecure. “But when this is not the case, doctors need tools such as medically tailored meals to mitigate the consequences of food insecurity when it occurs,” he said.

Media contact: Brittany Phillips, Communications Specialist, UNC Health | UNC School of Medicine

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