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A Prescription for Change

When Dr. Kevin Volpp, founding director of the Center for Health Incentives and Behavioral Economics at University of Pennsylvania, says that the United States spends more on health care than any other country but ranks 48th in life expectancy, the paradox is undeniable. Chronic diseases such as diabetes, hypertension and heart failure dominate the nation’s $4.3 trillion annual health care expenditure, much of it driven by poor dietary habits. Volpp is the the scientific lead for the American Heart Association’s food is medicine initiative, Health Care by Food, a program dedicated to an innovative solution: using nutritious food as a clinical intervention to treat, manage and prevent diet-related chronic diseases. The initiative aims to make healthy eating a fundamental part of patient care, creating a shift from reactive treatments to proactive prevention. “The evidence is clear that the food we eat influences not only whether we develop diabetes or heart disease but also how well we manage these conditions,” Volpp says.

Access and affordability to nutritious food remain significant barriers, with 60% of Americans citing cost as the top obstacle to eating healthier. Volpp’s research highlights how structural issues—like food deserts and ultra-processed foods dominating affordable options—undermine public health. Health Care by Food seeks to tackle these issues, along with making food a part of treatment for anyone with diet-driven health conditions, with three key interventions—medically tailored meals (MTMs), medically tailored groceries and produce prescriptions.

“We’re not just providing food; we’re teaching patients to view healthy food as an integral part of their treatment plan,” says Lisa Sanders, national executive director of the initiative. “Gradually transitioning from medically tailored meals to guided grocery choices empowers patients to sustain behavior changes beyond the intervention.” Currently, Health Care by Food is funding 21 randomized trials across diverse settings, from urban centers to rural Navajo Nation communities. These trials are structured to answer critical questions: Which interventions work best for specific populations? What is the optimal “dosage” of food-based therapy? And, crucially, how can these interventions be scaled for broader impact?

Volpp describes the goal as “to make healthy food as accessible and integral to treatment as pharmaceuticals.” Large-scale adoption hinges on robust, reproducible outcomes that justify public and private insurance coverage. Health Care by Food offers a prescription not just for better health, but for systemic change—one meal at a time.