From depression to diabetes: if food helps, patients feel better at home and healthcare costs fall

“Let food be thy medicine.” Anyone familiar with Hippocrates’ aphorism will hardly be surprised to hear about the importance of a healthy diet for those living with chronic conditions such as diabetes, heart failure, depression and other illnesses. Now, however, a new study has emerged in this field, showing how and to what extent ‘personalising’ meals, based on nutritionists’ recommendations, helps to improve not only an individual’s health trajectory but also the economic and managerial performance of the healthcare system. It highlights how tailoring a diet to the needs of a patient with a chronic condition brings benefits for both the individual’s health and the hospital, in terms of both medical emergencies and the costs of day-to-day care, despite the chronic nature of the condition.

This is according to an analysis published in Nature Medicine (lead author Kurt Hager) conducted by researchers from the “Food is Medicine Institute”, Tufts University, UMass Chan Medical School, Community Servings and various state healthcare systems. In the US, pilot projects have been underway for some time now, specifically aimed at providing meals tailored to medical needs through Medicaid, the federal-state health insurance programme serving 71 million Americans who are eligible based on income or disability. “We often forget that proper nutrition for hospitalised patients is not only useful for the individual’s basic sustenance, but can also form part of the therapy necessary for the patient’s recovery or to prevent the onset of co-morbidities,” comments Donato Angelino, Professor of Human Nutrition at the Department of Biosciences of the University of Teramo. “Suffice it to say that in Italy, the percentage of patients with overt malnutrition or at risk of malnutrition is estimated at between 49% of hospitalised patients and 69% of those admitted to long-term care facilities.”

An analysis of data on Medicaid recipients in Massachusetts reveals the significant benefits of this simple measure, which also promotes the individual’s well-being as it is based on their personal preferences. Those who received meals tailored to their medical needs had 31% fewer hospital admissions and a 20% reduction in A&E visits. Per capita healthcare costs fell by $3,433 during the period in which patients participated in the meal programme (on average around six months), with a substantial balance between the benefits provided and the cost of the service: the savings in medical costs achieved through the tailored meals amounted to 98% of the programme’s costs. As Dariush Mozaffarian, a cardiologist and director of the Food is Medicine Institute, explains in a note , “the results demonstrate that food truly is medicine, with important clinical and policy implications for health insurance coverage of medically personalised meals, in order to combat diet-related diseases and reduce healthcare costs”.

The researchers analysed data from 2020 to 2023 relating to 11 healthcare systems in Massachusetts, comparing the outcomes observed in just under 2,000 people who received the meals with those of other Medicaid beneficiaries with similar characteristics who did not receive the nutritional ‘intervention’. Those who received the service were offered 10 meals a 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 consultation is essential, especially when starting long-term treatment programmes,” says Angelino. “Just consider cancer treatment, where changes in the sense of smell and taste can lead to the exclusion of entire food groups, resulting in nutritional deficiencies. In these cases, as with nephrology patients or those with gastrointestinal disorders, it is essential to start a targeted nutritional programme and have support throughout the hospital stay to adjust the diet according to the patient’s behavioural and nutritional changes.” For the record, in the study, meals were provided for an average of six months.