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Food as medicine is real
Roger Selvage 2824

Food as medicine is real

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Health Equity

Mickie Cathers

Photo illustration of fruits and vegetables presented in a blister-pack

According to a new study published June 22, 2023, in the Lancet, the prevalence of diabetes will increase 60% worldwide by 2050. One key to the puzzle is how individuals and the health care community approach diabetes and how that relates to food and nutrition.

“Poor nutrition has surpassed smoking as a main risk factor for preventable chronic disease,” said Taylor Newman, PhD, RD, LD, director of nutrition at Kroger Health, during a session at the 2023 APhA Annual Meeting & Exposition in Phoenix. Poor nutrition is one of four main risk factors for preventable chronic diseases and is the leading risk factor for deaths worldwide. Heart disease, stroke, and T2D have reached $50 billion a year in health care costs.

Nutrition security is tied to health equity and is an essential social determinant of health (SDOH) that exists everywhere, even in affluent neighborhoods. “If you are obese and overweight, you are in nutrition insecurity,” said Jim Kirby, PharmD, BCPS, FAPhA, chief commercial officer at Kroger Health during the APhA2023 session.

Grocery store as a unique health care destination

Improving a patient’s health starts at the grocery store, where decisions are first made about what to bring home, said Kirby. “How often do you go to the doctor? How often do you go to the grocery store?” asked Kirby.

Grocery stores are frequent touch points with a wide geographic footprint and may offer accessibility, convenience, and in-store registered dieticians. “This is an opportunity for collaboration and interprofessional care between pharmacists and dieticians,” said Kirby. He encourages pharmacists to advocate for dieticians. “They are your teammates. They help you take care of your patients,” said Kirby.

Kroger partnered with the University of Cincinnati on a randomized controlled trial evaluating an individualized supermarket- and web-based intervention targeting nutrition (SuperWIN). The goal was CV risk reduction and adherence to the dietary approaches to stop hypertension (DASH) diet. The results of SuperWIN were published in Nature on December 1, 2022, and revealed clinically relevant and meaningful improvement in participants’ DASH score from baseline after 2 weeks which persisted to the study close at 3 months.

In the study, in-aisle education significantly increased adherence to the DASH dietary pattern compared to traditional nutrition counseling alone.

Kroger Health offers a suite of tools and resources helping people navigate healthy eating including the OptUP nutrition rating system. The OptUP app is a consumer tool that gamifies healthier food shopping and allows shoppers to track their progress.

“Patients can share their OptUP score with their pharmacist or physician to open up the conversation,” said Kirby. “It’s easier to have a discussion around reducing BP than just saying ‘lose weight, eat more fruits and veggies.’”

Pharmacists are uniquely situated to play an important interdisciplinary role in nutrition care. As pharmacists are more accessible to patients than physicians and can meet patients where they are in their community, they can start this conversation with their patients and engage SDOH screening. ■

Instacart and Walmart roll out ‘food as medicine’ programs

Instacart recently unveiled a program that includes a suite of tools enabling health care providers to prescribe food in the same way they would medications. Instacart Health is a “virtual food pharmacy” increasing access to healthy food, providing tools for nutritious grocery shopping, and offering a new platform for health care providers to recommend and order groceries for patients, which would be useful for a patient who has just been discharged from the hospital or otherwise encounters barriers to getting to the store. “We’ve seen firsthand via independent and partner research studies that online grocery delivery helps people get access to fresh food, adopt healthier eating habits, save time, manage their budgets and eliminate transportation and mobility barriers to nutrition,” said Instacart CEO Fidji Simo in a company blog post.

Walmart has also added an online and in-app platform allowing customers to “shop-by-diet” and determine if products meet their health criteria needs such as diets, allergens, interactions with medication, and medical conditions.

APhA offers a resource for building partnerships to expand access to valuable patient care services available at



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