Top Things to Know: A Systematic Review of “Food is Medicine” Randomized Controlled Trials for Non-Communicable Disease in the United States
Published: June 18, 2025
Prepared by EJ Cheon, PhD, Associate Science and Medicine Advisor
- Poor diet quality is a leading cause of cardiometabolic diseases, contributing to nearly half of related deaths in the U.S., underscoring the need for dietary interventions.
- Food is Medicine (FIM) programs provide free or subsidized healthy foods through produce prescriptions, medically tailored groceries, or medically tailored meals, often targeting food-insecure populations with chronic diseases, in close coordination with health care.
- This systematic review examined randomized controlled trials (RCTs), categorized them using the National Institute of Health Model for Behavioral Intervention Development, and assessed the impact of FIM interventions on non-communicable diseases, particularly cardiometabolic conditions.
- Of 14 RCTs identified, about half were early-stage (Stage 1) trials, and few progressed to larger real-world studies (Stage 3). No Stage 4 (effectiveness) or Stage 5 (implementation and dissemination) studies were identified.
- The trials examined varied widely in design, duration, intensity, and populations, making direct comparisons challenging.
- The current evidence shows that FIM interventions consistently improve diet quality and food security—key mediators for better clinical outcomes such as HbA1c, blood pressure, and body mass index—though impacts on clinical outcomes remain inconsistent.
- Larger, longer-duration trials are needed to better evaluate FIM programs’ effects on clinical outcomes.
- Identified knowledge gaps include understanding which populations benefit most, optimal intervention dose, duration, frequency, expected outcomes, and responsiveness to cultural needs.
- Systematic approaches using implementation science and behavioral economics can help address knowledge gaps. Implementation science fosters practical application of evidence-based interventions, while behavioral economics enhances engagement and sustainability.
- The American Heart Association Health Care by FoodTM initiative employs systematic methods to build evidence for FIM programs, progressing from research settings to scalable, real-world studies.
Citation
Seligman HK, Angell SY, Berkowitz SA, Elkind MSV, Hager K, Moise N, Posner H, Muse J, Odoms-Young A, Ridberg R, Troxel AB, Yaroch AL, Volpp KG. A systematic review of “Food Is Medicine” randomized controlled trials for noncommunicable disease in the United States: a scientific statement from the American Heart Association. Circulation. Published online June 18, 2025. doi: 10.1161/CIR.0000000000001343