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NEW YORK — There’s a new dimension to the health and wellness offering of grocers, mass merchants and drug chains: Food Is Medicine. The concept, also called Food as Medicine, is a natural fit with supermarkets’ abundant offering of nutritious groceries, while the public’s long-standing trust in pharmacists positions drug stores — as well as mass merchants and supermarkets with pharmacies — to be a destination for advice on healthful diets.
And the drive to make Food Is Medicine a mainstay of retailers’ role in health care is gaining momentum, according to the two trade associations most closely involved with the effort.
“We definitely think that this work can continue to be scaled and sustained across pharmacies,” says Sara Roszak, senior vice president of health and wellness strategy and policy at the National Association of Chain Drug Stores.
NACDS is looking at how it can sustain that progress, she says, and will continue to work with state and federal officials as well as different health care stakeholders to build interest from payers, employers and health plans, and to leverage creative solutions to get pharmacy more involved in the broader health care arena.
“There’s a lot of interest in this space,” Roszak says, noting that the terminology “Food Is Medicine” wouldn’t have been broadly known or understood even five years ago. “Today, it’s a part of what many stakeholders across health care are doing as they look to how to address the big challenge of diet-related disease issues in this country. The topic generally has become more mainstream.”
NACDS’ collaboration with the Milken Institute and other groups has also helped elevate the pharmacy industry as a thought leader and giving it a seat at the table, she says.
In the aftermath of the election, she adds, “Administrations change, but I think this is one of those topics that transcends politics because the impact on Americans is so significant.”
NACDS under president and chief executive officer Steve Anderson is also optimizing the content of its Nourish My Health (nourishmyhealth.org) collaborative educational campaign. NACDS launched Nourish My Health and brought in leading health organizations in September 2023 — the American Cancer Society, American Diabetes Association and Tufts Food is Medicine Institute at the Friedman School of Nutrition Science and Policy at Tufts University — to educate people on the critical role that nutrition plays in preventing and managing heart disease, diabetes and cancer. Recently, the Alzheimer’s Association and March of Dimes have joined as partners.
“We’ve made a lot of progress — and with the support of the NACDS board of directors, and the NACDS Health and Wellness Innovation Advisory Group — we have charted the course of where we’re going in the Food Is Medicine space,” Roszak says.
With January being the time for new year’s resolutions, people are thinking about lifestyle changes, notes Roszak. “So we are in the process of onboarding new members and thinking about some additional initiatives we could take.
Unrelated to that, the NACDS Foundation — which Roszak heads — is launching a public health-focused study of Food Is Medicine care in pharmacies early next year.
“The momentum is continuing to build,” says Krystal Register, vice president of health and well-being at FMI – The Food Industry Association. That’s in large part because of gains in the policy space with specific programs being “funded and supported in all kinds of new ways.”
For consumers, “focusing on ‘what’s good for me, what’s better for me’ by making nutritious and healthy choices is wildly important,” she adds.
And growing awareness of the role that food plays in disease management and treatment is leading to recognition of “the connection between health care and the grocery store.” For example, with prescription type programs, doctors and nurse practitioners are “pushing patients into the grocery store with a prescription card in hand for food.”
She says health care providers, retailers and local community organizations are collaborating in a “circle of care.”
When it comes to the public’s attitude, she says no one is putting out their roasting pan for sautéed vegetables with oil and thinking or saying “Food Is Medicine.” There has been a reluctance to use that terminology, which Register understands. “Some people say, ‘Medicine? That doesn’t sound great,’ but in general, the concept is strong out there.”
Retailers, by contrast, are embracing food as medicine, whether with classes on heart health or signs saying a product is low in sodium. “This is kind of the sweet spot for retailers. More and more, they’re picking these programs up, and it’s where they want to be in the future. That’s where we see the uptick.”
While on the surface food is medicine may seem less relevant to drug chains, in fact, Roszak says “food itself is not the only part of a successful food as medicine intervention. Pharmacies without direct access to food still play a really important role in identifying people who could benefit from interventions from food prescriptions and dietitian referrals to baseline health screenings and disease management support.”
A1c and blood pressure testing can be indicative of dietary needs, she adds. And the trust that communities have in their pharmacists comes into play “and is helpful when you’re talking about sensitive topics like nutrition insecurity.”
Also, as with any health care provider, pharmacists want to be able to screen people and offer a ready solution when an issue is identified, even if it means referring to an outside resource. That approach works in other models of care like HIV and substance use disorder screening where the pharmacy has an important role in both screenings and referrals,” she notes.
When it comes to Food Is Medicine prescriptions, Roszak says pilot projects are exploring their feasibility. Published research has affirmed the unmatched value of pharmacists from their proximity to patients, expertise in chronic disease management and how much people trust them. Those resources, combined with actionable pieces from a Milken Institute report, can create tailwinds for Food Is Medicine prescriptions. Key recommendations in the report include Medicare, Medicaid and commercial health insurance payment pathways to support pharmacist interventions.
“Some of those changes are vital for implementation,” she says, noting that the report also talks about integrating pharmacy workflow and data interoperability. With pilots popping up, she adds, “we will begin to start hearing more about this type of work in the future.”
Register points out that even if someone is at a store just to pick up a medication, they might get a coupon for say, omega-rich seafood because the drug is for a heart condition. She says there are many FMI members with dietitians and pharmacists who work very closely together. “That’s great, whether it’s for their own employee base or for customers in your traditional clinical setting.”
“The pharmacist may be the first and best point of contact to say, ‘Hey, Krystal, did you know that we have dietitians on staff too that you can meet with?’ or ‘Did you know that we have all these recipes that are diabetic friendly?’ That pharmacist can be the conduit to open the door to all the nutrition services.”
The need for discretion in dealing with consumers is reinforced by confusion over nutrition, she adds. “There’s a good chance we’re about to make it even more confusing with some of the front-of-pack labeling not quite matching definition of healthy, and not quite matching some of the other claims that are out there. It would take a lot of explaining, and it’s very difficult to suggest that every single consumer work one-on-one with a professional to help guide them.
