Monday, October 10, 2022

Making nutritious foods accessible to all patients

 - Jennifer Middleton, MD, MPH

In the recent AFP editorial "Incorporating Lifestyle Medicine Into Practice: A Prescription for Better Health," Dr. Alex McDonald reviews the benefits of lifestyle medicine and provides a wealth of resources to incorporate it into practice. Dr. McDonald acknowledges that "[h]ealth and community resources greatly affect our patients' ability to benefit from lifestyle medicine," inequities addressed by the United States (US) White House Conference on Hunger, Nutrition, and Health earlier this month. The experts at this conference specifically called out the disparities in access to healthy food and laid out a strategy that each of us can play a role in enacting:

The White House report outlined a strategy based on 5 “pillars” for reducing hunger in the US and improving nutrition: improving food access and affordability; prioritizing the role of nutrition and food security in health, including in the prevention and management of disease; helping consumers make healthy food choices (and have access to healthy foods); supporting physical activity; and enhancing nutrition and food security research.

Dozens of health organizations, nonprofit organizations, and food suppliers pledged to increase access to healthy foods, expand Supplemental Nutrition Assistance Program (SNAP) benefits, and increase funding for nutrition education. Family physicians can contribute to this effort in several ways: 

1. We can improve our own knowledge of nutrition. The AFP By Topic on Nutrition is a solid place to start, as is the AAFP "Incorporating Lifestyle Medicine into Everyday Family Practice" guide referenced in Dr. McDonald's editorial above, and you might also score yourself on the "Starting the Conversation" scale.

2. We can strengthen our skills in behavioral counseling. Dr. McDonald's editorial contains links to the AAFP Lifestyle Assessment Tool which includes counseling strategies. There's also this informative 2018 AFP article on "Counseling Patients in Primary Care: Evidence-Based Strategies." 

3. We can identify persons with food insecurity in our practice settings and connect them to resources. This 2018 AFP editorial on "Food Insecurity: How You Can Help Your Patients" includes language for screening as well as links to food assistance programs. The Aunt Bertha online tool connects patients to resources by zip code. 

4. We can hold our elected officials accountable in supporting equitable access to nutritious foods. Expanding SNAP and allowing Medicaid to cover medically tailored meal delivery will require federal legislation. As election day draws near in the US, find out where your local candidates stand on eliminating health inequities.