From depression to diabetes: if food cures at home the sufferer is better off and spending drops

'Let food be thy medicine'. Those who remember the aphorism of Hippocrates will certainly not be surprised to hear about the value of proper nutrition for those facing chronic conditions such as diabetes, heart failure, depression and other illnesses. Now, however, in this vein, there is a piece of research that says how much and how 'customising' meals, on the basis of nutritionists' indications, contributes to modifying not only the individual's health trajectory but also the economic and managerial performance of healthcare. And it points out how 'tailoring' a diet to the chronic patient has advantages for the health of the individual and the hospital, both in terms of health emergencies and day-to-day care costs, despite chronic conditions.

This is according to an analysis that appeared in Nature Medicine (first author Kurt Hager) conducted by researchers from the Food is Medicine Institute, Tufts University, UMass Chan Medical School, Community Servings, and various state health systems. In the US, pilot projects aimed precisely at providing meals tailored to medical needs have been underway for some time through Medicaid, the federal-state health insurance programme that serves 71 million Americans who qualify based on income or disability. "We often forget that proper nutrition for hospitalised patients is not only useful for the normal sustenance of the individual, but can also become part of the therapy useful for recovery or the avoidance of co-morbidities for the patient," comments Donato Angelino, professor of Human Nutrition at the Department of Biosciences of the University of Teramo. Suffice it to say that in Italia the percentage of patients with overt malnutrition or at risk of malnutrition is estimated at between 49% in hospitalised patients and 69% in those admitted to long-term care facilities'.

An analysis of the data on Massachusetts Medicaid recipients reveals the significant benefits of this simple measure, which also promotes the well-being of the individual since it is based on his or her personal taste. Those who received meals tailored to their medical needs had 31% fewer hospital admissions and a 20% drop in emergency room admissions. Per capita health care costs decreased by $3,433 over the period that patients participated in the meal programme (about six months on average), with a substantial parity in the balance between services provided and cost of service: the savings in medical services achieved thanks to the customised meals amounted to 98% of the programme costs. As Dariush Mozaffarian, cardiologist and director of the Food is Medicine Institute, explains in a note, 'the results demonstrate that food is indeed medicine, with important clinical and policy implications for health insurance coverage of medically customised meals to combat diet-related diseases and reduce healthcare costs'.

The researchers analysed data from 2020 to 2023 from 11 Massachusetts health systems, comparing what was observed in just under 2,000 people who received the meals with other Medicaid beneficiaries with similar characteristics who did not have the nutritional 'care'. Those who enjoyed the service were offered 10 meals per week, a mix of breakfasts, lunches and dinners, as well as snacks. Each participant had an initial consultation with a qualified nutritionist to tailor the meals to their medical needs and dietary preferences. "The nutritional visit is fundamental, especially when starting long-term treatment courses," Angelino points out. "Just think of the oncological treatment course, in which the altered perception of smell and taste can lead to the exclusion of entire categories of food with consequent nutritional deficiencies. In these cases, as in those of nephrological patients or those with gastro-intestinal disorders, it is essential to start a targeted nutritional pathway and to have support for the duration of hospitalisation that calibrates the diet according to the patient's behavioural and nutritional changes'. For the record, in the study on average meals were offered for six months.