Navigating the Terms of Food Interventions: What You Need to Know

The Food is Medicine movement is gaining traction. Yet, as this concept grows, so does the complexity of its terminology. What exactly do terms like "medically tailored" mean? What is the difference between produce prescriptions and food pharmacies? Should we say culinary medicine or culinary nutrition? Without clarifying these terms, it leaves many practitioners asking the question, "What should we call the food-based interventions that provide food, educate, and/or train skills aimed at improving health outcomes?" In this blog, we aim to clarify these terms, shedding light on how each concept plays a crucial role in food-based interventions.

Food is Medicine (FIM) is a term engendered by the 2022 White House Conference on Hunger, Nutrition, and Health, which suggests that "food" is inherently medicinal and fundamental to health. According to the National Institutes of Health (NIH), FIM embodies four pillars, including 1) research, 2) education and training, 3) community outreach and engagement, and 4) patient services.  

Food as Medicine (FAM), in contrast to FIM, is less general and implies that "food" can be used in a therapeutic or preventive context to manage or prevent health conditions. The term FAM tends to be used more by professional groups like the American College of Lifestyle Medicine and Health Meets Food.    

FIM or FAM programs represent a spectrum of food-based interventions integrated into health care for patients with specific health conditions and often social needs. We defined each term below and adapted several definitions from Mozaffarian et al.  

• Medically tailored meals are fully prepared meals tailored to the recipient's medical needs by a dietitian. They are typically provided as ten weekly meals (e.g., lunch and dinner on weekdays), are free, and are delivered to the home for about 3-6 months (with interim reassessments and the possibility of renewal). Meals are combined with individual, group, or digital nutrition and culinary education.    
• Medically tailored groceries are food items, usually selected by a dietitian or other qualified professional, provided to eligible patients. These items include fruits, vegetables, beans, whole grains, and sometimes nuts/seeds, poultry, fish, or dairy in fresh, frozen, or canned form. Implementation typically involves home delivery or pick-up at a food pantry, food distribution site, or healthcare facility or options for vouchers to spend at grocers. This program often includes individual or group nutrition education and lasts 3-6 months with the option for renewal.  
• Produce prescriptions and/or vouchers are discounted or free produce, mainly fresh fruits and vegetables, and are accessible through electronic debit cards or paper vouchers. These benefits can be redeemed at grocery stores, farmers markets, picked up at healthcare facilities, or utilized for home delivery. This initiative is often complemented by individual, group, or digital nutrition and culinary education. Participation duration varies but commonly spans 3-6 months, with interim reassessments and the potential for renewal.  
• Teaching kitchens (defined by Badaracco et al.) are physical and virtual forums that foster practical life skills through participation in experiential education. They serve as learning labs to translate these skills into practice and sustainable lifestyle change. In addition to building cooking skills, they may also provide nutrition education, mindfulness instruction, exercise prescriptions, motivational interviewing, and other services

Culinary nutrition, according to a recent article, is defined as the integration of culinary arts and nutrition that applies practical knowledge and skills to improve food and nutrition-related health. Culinary nutrition interventions are then considered food-based and hands-on education, allowing people to taste new flavors, engage with real food, and learn skills through experiential learning.    

Culinary medicine, in comparison to culinary nutrition, is defined by the same article as a health practitioner-led culinary nutrition intervention or activity. In this definition, culinary nutrition is the general term, whereas culinary medicine refers to the context of a healthcare setting.    

While these definitions provide valuable insights, they often adopt a top-down approach, dictating to the public what food-based interventions entail and how they should be utilized. While the clarification of terms is undoubtedly beneficial for advancing the field, there remains a crucial need for additional research focusing on the desires, necessities, and preferences of the individuals receiving these interventions and participating in programs. What is "Food is Medicine" called when communities can name it?  Share your thoughts and experiences with us.

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