Integration of food and nutrition into oncology care: Proceedings of the Food is Medicine in Oncology Care Symposium

Short abstract

Nutrition plays a pivotal role in cancer prevention, management, and treatment. To address cancer disparities, reduce risk, and improve outcomes for patients, it is critical to implement Food is Medicine interventions across the care continuum, supported by robust, evidence‐based research, strong community clinical partnerships, and effective policy design that successfully integrates nutrition into oncology practice.

Nutrition is what connects food to health.

—Keynote Speaker

INTRODUCTION

A brief summary of the symposium

Poor nutrition is a leading driver of morbidity, mortality, and health care spending in the United States. ¹ Each year, suboptimal nutrition is estimated to cause more than 80,000 newly diagnosed cancer cases: a staggering health burden for individuals and communities alike. ² The economic toll is equally profound—poor nutrition incurs an estimated $1.1 trillion annually in health care costs and lost productivity, ³ with $254 billion in economic costs among U.S. adults aged 20 years or older over a lifetime. ⁴ Addressing these trends requires a united effort to improve dietary patterns, promote access to nutritious foods, and prioritize preventive measures to alleviate this costly and preventable epidemic.

The integration of nutrition and health through the provision of nutrition supports, also known as Food is Medicine (FIM), has gained remarkable momentum in recent years among health care systems, payers, patients, and policymakers. ⁵ , ⁶ , ⁷ Although these strategies are promising, few studies have evaluated FIM programs for patients with cancer despite a compelling need. Data show that depending on the disease state, 30% to 85% of patients with cancer are malnourished at some point during the care continuum, ⁸ , ⁹ , ¹⁰ resulting in significant implications for treatment efficacy, quality of life, and survival rates. ¹¹ Malnourished patients with cancer are significantly more likely to develop treatment‐related toxicities and have reduced rates of survival and impaired quality of life. ¹² , ¹³ Those who are economically disadvantaged, uninsured, racial and ethnic minorities, older adults, and rural residents face even higher rates of malnutrition. For some patients, such as those with lung cancer, the consequences of malnutrition are compounded because of health‐related disparities and inadequate access to nutritious foods. ¹⁴ , ¹⁵

To address these gaps and highlight opportunities for change, in December 2024, a group of academic and nonprofit institutions held the first oncology‐specific FIM symposium. The Food is Medicine in Oncology Care Symposium represented a wide range of constituents in oncology care, including patients and their caregivers, oncology care providers, researchers and educators, community‐based organizations, for‐profit industry leaders, public and private payers, and government officials. The symposium, which was supported by the American Cancer Society (ACS), the Center for Health Law and Policy Innovation of Harvard Law School, the Food is Medicine Institute at the Friedman School of Nutrition Science and Policy at Tufts University, and The Ohio State University College of Medicine, the symposium attracted 950 participants (76 in‐person and 874 virtually) from 41 countries.

The symposium included three keynotes by Drs. Christina Economos, Dariush Mozaffarian, and Andrew Bremer, and four focused panel discussions. ¹⁶ Panel 1 highlighted the perceptions and experiences of two patients with cancer and their caregivers, sharing their perspectives on how nutrition shaped their cancer journey. Panel 2, led by leading researchers in the nutrition and oncology field, examined the latest research and research gaps in integrating nutrition into oncology care. Panel 3 comprised clinicians and community‐based FIM providers, detailed how FIM programs can be tailored to address the unique nutritional needs of patients with cancer. Panel 4 included speakers from across the U.S. government to discuss public policies and government initiatives to advance FIM programs. This report summarizes the key themes emerging from the symposium.

Methodology

This proceedings report has been written by the organizers, some of whom were also moderators of their panels (see symposium agenda in Appendix A). The authors referred to recorded transcripts and notes from each session to write a commentary that captures the overall summary of the event and how it impacts the ongoing momentum of FIM in oncology care. Each section begins with anonymous quotes from the event that are exemplary of a core theme. The sections then provide detailed summaries of the discussion on that topic or theme.

THE ROLE OF NUTRITION IN CANCER CARE

We need to meet people where they are and make recommendations, whether it be a treatment recommendation, a medication recommendation, a meal recommendation, culturally appropriate and meaningful to them.

—Keynote Speaker

Nutrition plays a pivotal role in cancer prevention, management, and treatment, offering a critical avenue to reduce risk and improve outcomes. Up to 85% of patients are malnourished, often involving unintentional weight loss and inadequate nutrition intake, at some point in their cancer care. ¹⁷ , ¹⁸ Additionally, patient nutrition needs are often complicated by other chronic illnesses, comorbidities, and treatment toxicities.

Evidence shows that dietary patterns low in minimally processed, nutrient‐dense foods like fruits, vegetables, whole grains, and dairy, and high in processed meats, red meats, and sugary beverages, are linked to increased cancer risk. ¹⁹ , ²⁰ In addition, poor nutrition increases risk of cancer through its effects on obesity. Furthermore, disparities in both nutrition and cancer burdens are profound—disproportionately affecting younger adults, Black Americans, and underresourced populations—and underscore the importance of adequate access to nutrition education and resources to support cancer prevention. ⁴

Additionally, cancer and its treatment induce metabolic disruptions such as systemic inflammation, muscle wasting, and altered fat metabolism, as well as other changes including appetite loss and change in taste, all of which exacerbate the challenges of maintaining adequate nutrition. ²¹ These challenges are compounded by the toxic side effects of cancer treatments leading to nutrition impact symptoms such as nausea, swallowing difficulties, and digestive complications. This cascade often creates a catabolic state resulting in unintentional weight loss, reduced physical strength, and interruptions in treatment. ²¹ Addressing these nutritional complexities is essential to supporting patients throughout their cancer journey.

Evidence documents that nonadherence to the ACS Nutrition and Physical Activity Guidelines among patients with cancer poses significant challenges to treatment outcomes, recovery, and overall health. ²¹ These ACS guidelines emphasize a diet rich in fruits, vegetables, whole grains, and lean proteins, while limiting red and processed meats, added sugars, and highly processed foods. ²² Yet, less than 5% of cancer survivors are fully adherent to the guidelines. ²³

Despite the importance of nutrition, oncology teams often lack sufficient dietitian support because of inadequate reimbursement models. A national study found that, despite the critical role they play, only one RDN is available for every 2300 patients with cancer in outpatient treatment centers, ²⁴ leading to grossly inadequate nutrition services. Additionally, a lack of nutrition education and support may leave patients unaware of the importance of proper dietary patterns during treatment. ²⁵ Addressing these barriers through tailored dietary interventions, nutrition counseling, culinary education, and community‐based programs is essential to help patients with cancer align their eating patterns with ACS recommendations and improve health outcomes.

The promise of FIM

FIM programs are really an important part of addressing disparities, and they can help close the gap in prevalence, severity, and complications of diet‐related disease.

—Panel Speaker

FIM interventions are a spectrum of programs and services that respond to the critical link between nutrition and health, encompassing the provision of health‐promoting foods integrated as part of the health care system. ²⁶ These FIM approaches hold transformative potential for health care by addressing the root causes of diet‐related illnesses. For cancer care specifically, FIM helps mitigate the nutritional challenges patients face during treatment while also addressing systemic disparities by ensuring sufficient access to nutrient‐rich foods, particularly for underresourced populations, including those in low food access, rural or remote areas.

The FIM pyramid (Figure 1) underscores the importance of a structured, tiered approach to delivery of FIM services, matching the level of nutrition support to acuity of patient need. FIM interventions (Table 1) build on the foundation of broader population‐level healthy food policies (e.g., nutrition labeling) and nutrition security programs (e.g., SNAP) through the targeted provision of nutrition education and interventions such as medically tailored groceries and produce prescriptions (for those who can shop and cook for themselves) and medically tailored meal (MTM) programs (for the most intensive/acute health needs). ⁶

FIGURE 1.

FIM pyramid referenced from Food is Medicine, Issue At‐A‐Glance, The Nutrition Policy Initiative at Tufts University, Page 2 (2023). FIM indicates Food is Medicine.

TABLE 1.

Top three tiers in the Food is Medicine triangle geared toward treatment.

Medically tailored meals	Fully prepared, home‐delivered meals, tailored to the medical needs of individuals living with severe illness by a registered dietitian nutritionist through a referral from a medical professional or health care plan. Medically tailored meals are provided in combination with education in the form of nutrition counseling or medical nutrition therapy with a registered dietitian nutritionist.
Medically tailored groceries	Unprepared or lightly processed healthy food items preselected by a registered dietitian nutritionist or other qualified professional, sufficient to prepare nutritionally complete meals that are tailored to specific diagnoses and medical needs. Groceries are provided to eligible patients at distribution sites or via home delivery and are often provided in combination with nutrition education.
Produce prescriptions	Electronic benefit cards or paper vouchers redeemable at food retail, including grocery stores and farmers’ market or via home delivery, which provide access to discounted or free healthy produce. Often in combination with nutrition education.

Note: Table descriptions reproduced from: Hanson E, Albert‐Rozenberg D, Garfield KM, et al. The evolution and scope of Medicaid Section 1115 demonstrations to address nutrition: a US survey. Health Affairs Scholar. 2024;2(2):qxae013. https://doi.org/10.1093/haschl/qxae013.

Although FIM services are not yet a standard benefit covered within U.S. health insurance programs, advances in FIM research have resulted in efforts by individual states and health plans to use existing flexibilities to incorporate them into coverage and care. Although subject to ongoing shifts in policy, these efforts have gained momentum over the past decade. As of December 2024, 16 states had approved or pending Medicaid demonstration pilots that included coverage for nutrition services. ²⁷ Similarly, a growing number of Medicare Advantage plans have incorporated interventions such as meals, food, or grocery benefits into their offerings as supplemental benefits or Special Supplemental Benefits for the Chronically Ill. ²⁸

These policy advancements underline the importance of reinforcing the role of nutrition in cancer care. Without a concerted effort to expand the research and integration of FIM services into cancer care, the oncology community runs the risk of being overlooked in the design of these new policies.

INTEGRATION OF FIM INTO ONCOLOGY CARE

Personal journeys and lived experiences: Patient perspectives on nutrition during cancer treatment (panel 1)

Cancer diagnosis is in and of itself a big upheaval in your life. It completely changes anything that you thought was important is not important anymore.

—Patient Speaker

A cancer diagnosis is undoubtedly a life‐altering experience for the patient and their caregivers and loved ones. The financial hardship that comes with a diagnosis of cancer is well‐documented and affects a large proportion of cancer survivors, often leading to further challenges with food and nutrition security.

Financial toxicity

Financial hardship takes a toll on many aspects of cancer survivors’ experiences. Survivors experiencing financial hardship are more likely to report fair/poor health, social functioning limitations, and work limitations than those without financial hardship. ²⁹

Food and nutrition insecurity

Financial hardship often forces cancer survivors and their families to make tradeoffs between paying for their cancer care and other basic needs, including paying for food. Estimates of food insecurity among people with cancer range from 17% to 55% ³⁰ —higher than the current food insecurity prevalence in the United States. ³¹

Several recent commentaries have called for systematic food insecurity screening of patients with cancer in the clinical setting, and inclusion of food access programs as an essential part of cancer care. ³⁰ , ³² , ³³ Because the lived experiences of people with cancer are critical to understanding how food and nutrition issues—and the programs intended to mitigate those issues—impact their cancer journey, we invited past participants from two FIM programs to participate on the panel. This included a patient and caregiver who participated in an MTM program while staying at an ACS Hope Lodge community, as well as a patient and caregiver who were enrolled in the NutriCare MTM clinical trial.

Patient and caregiver perspectives

Both patient–caregiver dyads expressed not receiving adequate information about nutrition, specifically what to eat to stay healthy during treatment, from their care team and felt this was a significant gap in care. Aside from lack of nutrition education, they also described their many medical appointments as a barrier to eating well. It was not uncommon for patients and their caregivers to spend an entire day at a cancer center attending appointments with various members of their care teams. The participants described how any delay or unforeseen change in schedule could interfere with their meal timing and would leave them with few options for a healthy meal. Both couples had to travel far from home to receive their care and stay in temporary housing—either a rented apartment near the cancer center, or the ACS Hope Lodge in the city of their treatment. Both cited being away from home as a barrier because of a lack of familiarity with their surroundings, lack of comfort with driving to grocery stores in a large urban area, and issues with parking.

The panelists described how the MTM programs they participated in helped to overcome some of those barriers. ³⁴ The participants expressed overall satisfaction and benefit from receiving MTMs while they were in treatment. They described how the meals provided financial relief, helped mitigate the stress of shopping and cooking, and relieved some of the burden from their caregivers. In addition, knowing that the meals were designed by nutrition professionals specifically for them was reassuring that they were eating healthfully.

The clinical trial also included intensive nutrition counseling and education by an RDN, which panelists found immensely valuable for healthy eating, even after the sessions had ended. Participants in the trial engaged in weekly dietitian‐delivered nutrition counseling and received MTMs over three 8‐week periods.

The panelists described minimal downsides of the meal programs, which included receiving more food than they could eat or store, forcing them to waste some food; occasional preference for a food that was not included in the meals; and isolated incidents of the food not being kept cold due to delivery delays, resulting in food waste.

Hearing the patient and caregiver perspectives directly from those who have engaged with a FIM intervention is invaluable in understanding the benefits of the programs and how to best meet the nutrition needs of people in active cancer treatment and beyond.

Supplying nutritional support: The role of Food is Medicine providers in oncology care (panel 3)

We think more about the gas we put in our cars than the fuel we put in our bodies, and that’s the foundation.

—Panel Speaker

FIM providers play a critical role in tailoring the clinical experience of a patient with cancer—as well as nutrition intake—to the specific needs of an individual. (These providers include, for example, registered dietitian nutritionists, clinical dietitians/nutritionists, medically tailored meals, food banks, produce prescription programs, and medically tailored groceries providers.) The panel highlighted wide‐ranging perspectives from a range of FIM providers—including an MTM program, RDN, and pediatric oncologist.

Screening

Oncologists play a critical role in diagnosis, treatment planning, and ongoing care. But RDNs and FIM programs also serve as critical anchors of support, helping the patient navigate their cancer across the care continuum. Supports outlined by the panelists included screening for food insecurity, nutrition insecurity, and malnutrition. This will require changes to practice: a 2019 study showed that only half of U.S. cancer centers screened patients for malnutrition risk. ²⁴ Research and panelists’ first‐hand experiences show that screening can empower providers to begin addressing food and nutrition insecurity and malnutrition concerns in their practice by encouraging enrollment in federal benefits programs; making connections to local food banks; and offering referrals. ³² Panelists shared that screening is an effective way of improving patient outcomes through necessary surveillance and is needed throughout the treatment cycle at several intervals, rather than solely at admission. It was also noted that a validated screening tool is crucial to allow health care providers to be able to capture the extent of the issue, which would then indicate the level of appropriate response.

Nutrition education and counseling

FIM providers also play a critical role in the delivery of nutrition and culinary education and behavioral counseling. Panelists shared that FIM interventions (see Table 1), when supplemented with lifestyle behavior education, proved to be more effective than food or meals in isolation. Although a few research studies examine the efficacy of both such models, more are needed to support implementation. ³⁵

Panelists also underscored the importance of providing education not only to the patient but also to caregivers, who shop and cook for loved ones and seek to support their nutritional well‐being. In particular, it was noted that nutrition counseling provided by RDNs helps mitigate the nutrition impact symptoms and oncology treatment‐related toxicities as described previously. Most notably, panelists stressed that the need to inform caregivers is amplified in pediatrics, requiring providers to think about the unique needs of children. This includes ensuring that nutrition education and counseling takes into consideration that children can be picky eaters, their diet could be heavily impacted by symptoms of chemotherapy, and parents can feel helpless when navigating caregiver obligations and their child’s cancer diagnosis.

Provision of food‐based interventions

Panelists also discussed the role FIM providers play in addressing the unique nutritional needs of patients with cancer. For example, an MTM organization on the panel underscored the importance of offering tailored meals (e.g., high protein or low sodium diets) to accommodate for the multiple comorbidities and diet‐related complexities many patients with cancer face and mitigate symptoms from poor nutrition that patients experience as part of their treatment. Panelists also emphasized the significance of tailoring meals to rigorous criteria and standards, such as those developed by the Food is Medicine Coalition for nonprofit MTM programs. ³⁶ Such standards can help ensure that FIM providers offer a high‐quality MTM intervention and determine the appropriate type, frequency, extent, site, and duration of the intervention, making it suitable for the patient’s diagnosis and in compliance with the accepted standards of medical practice. ³⁷

Challenges faced by FIM providers

Panelists emphasized that lack of coverage and reimbursement – both for RDN time and for food‐based interventions such as MTMs – is one of the most significant ongoing challenges to integration of FIM into oncology care. Offering oncology nutrition services at cancer centers ideally requires RDNs to support patients through diagnosis, treatment, and survivorship. Panelists discussed how inadequate reimbursement for RDN services at cancer centers could likely result in fewer RDNs being responsible for numerous patients, increasing provider burnout, and compromising individualized attention and patient outcomes.

Panelists representing community‐based FIM service providers also highlighted difficulties presented by the lack of consistent definitions and standards for FIM services, creating potential for differences in quality and approach across the nation. They noted that some of these challenges could be addressed by adopting shared definitions for terms such as “medically tailored meals” and “produce prescriptions.” As noted previously, stakeholders are making progress on the development of definitions and standards. ³⁷ However, these frameworks are not yet universally adopted or integrated into state and institutional policies, creating inconsistencies across the nation. Additionally, these panelists noted the challenges associated with the expectation that smaller community‐based organizations comply with the same regulatory standards (e.g., Health Insurance Portability and Accountability Act compliance standards) that a large health care institution would be held to—a costly and large investment for an organization primarily funding its operations through philanthropy.

Last, the panelists also observed that although the oncology care team plays a critical role in diagnosis and treatment, it may not always have the time and resources to address a patient’s nutritional needs. Better integrating FIM providers across the care continuum through advancements in coverage and infrastructure can empower these nutrition specialists to deliver needed care and reduce the burden on the care team.

Public policies and government initiatives to advance Food is Medicine programs (panel 4)

We have to be very thoughtful about how we impact what people eat.

—Panel Speaker

On this panel, experts from the White House Domestic Policy Council, the Department of Health and Human Services, the U.S. Department of Agriculture (USDA), the Centers for Medicare and Medicaid Services (CMS), and the Indian Health Service shared examples of how public policies and government initiatives are being used to advance FIM programs to improve nutrition and oncology care. A recurring theme that was recapitulated throughout the discussion was the need for a whole‐of‐government approach to address diet‐related chronic disease, and particularly for the expansion and integration of FIM programs in oncology care.

Panelists highlighted the various efforts and programs their respective agencies have implemented to support patients with cancer and their families. These include initiatives like the USDA’s National Institute of Food and Agriculture extramural funding opportunities, the Indian Health Service’s focus on social drivers of health, and CMS’s Innovation Center’s Enhancing Oncology Model, which integrates patient navigation and social needs screening. ³⁸

Panelists also discussed the importance of addressing health disparities and ensuring that nutrition support reaches all Americans. They emphasized the need for collaboration with private sector partners and other constituents to create a comprehensive system of care that includes nutrition education, workforce expansion, and data sharing.

Throughout the discussion, the panelists underscored the challenges of implementing these policies, such as navigating the complexities of eligibility criteria and ensuring that policies are flexible enough to meet the specific needs of different communities. They also highlighted the importance of public engagement and the role of patient navigators in connecting patients with necessary services.

Panelists also emphasized the impact the food system has on health outcomes of oncology patients and that transforming it is a necessary step towards improving patient outcomes. Specific actions that have been taken to improve the food system and empower consumers include the U.S. Food and Drug Administration’s changes to healthy claims on food labeling, sugar and salt labeling, as well as voluntary salt reduction. ³⁹ , ⁴⁰ The USDA’s My Plate is also critical to helping consumers and patients alike make more informed decisions in collaboration with their medical provider. ⁴¹ These programs are crucial to implementing FIM oncology care strategies.

Panelists also impressed upon the audience the importance of continued research to implement FIM oncology more broadly. Ideally, policies and grant funding for implementing FIM programs in oncology care should be adaptable/tailored to the needs of different communities and populations, which will ultimately make them more effective than a one‐size‐fits‐all approach. Public–private partnerships have provided examples of successful FIM pilots that have demonstrated improvement in patient outcomes. These pilots should be studied for scaling and implementation in different communities across the United States.

In conclusion, the panelists emphasized that advancement of this area will require continued promotion of approaches to studying the impact of nutrition on cancer outcomes and the ability of medical providers (not just RDNs) to provide nutrition education or services. They expressed optimism about the future of nutrition and oncology care, emphasizing the need for continued collaboration and innovative thinking to improve health outcomes for all Americans.

A ROADMAP FOR THE FUTURE: LATEST EVIDENCE‐BASED NUTRITION INTERVENTIONS RESEARCH, CURRENT GAPS, AND POTENTIAL OPPORTUNITIES

We need an entire system that’s communicating, collaborating, adapting, and working together to make a system like this work.

—Keynote Speaker

This section summarizes the key takeaways from a keynote speech and our second panel on “Approaches to Studying the Impact of Nutrition on Cancer Outcomes.”

Gaps in existing research and funding

Panelists noted that although a growing body of evidence supports the effectiveness of FIM interventions in improving cardiometabolic outcomes such as HbA1c, blood pressure, and body mass index, few studies have examined their impact on cancer‐related outcomes. Only one published study so far has evaluated a food‐based intervention to address food insecurity in patients with cancer. Conducted in New York City cancer clinics, the study found that 61% of patients faced food insecurity, prompting the implementation of three intervention strategies: a medically tailored food pantry, a home grocery delivery service with nutritionist guidance, and a food voucher program. ⁴² Results showed that participants in the food voucher and pantry programs had the highest treatment completion rates (>90%), whereas all three interventions significantly improved quality of life and food security. Importantly, patients made healthier food choices when provided with access and guidance, demonstrating the potential of nutrition support programs to improve both dietary habits and health outcomes.

Furthermore, the NutriCare clinical trial examined how an MTM intervention impacts dietary quality and prevention of unintentional weight loss among patients with lung cancer. Even though the study faced logistical challenges in meal delivery during the COVID‐19 shutdown, its outcomes suggest that integrating FIM into cancer treatment is both feasible and beneficial. Panelists noted that the study affirmed the importance of integrating delivered meals and nutrition counseling to work in tandem, as both are indispensable to an effective FIM intervention. ⁴³

However, a range of key questions remain that highlight an important gap around the lack of evidence from rigorously designed studies to assess the efficacy of FIM programs in improving cancer outcomes. Therefore, further research is needed to: (1) determine the effective FIM interventions for specific cancer types and address the different needs of patients with cancer at various stages of cancer; (2) improve long‐term adherence to dietary changes; and (3) assess cost‐effectiveness of implementing FIM in oncology care—an area that has not yet been explored in existing studies.

Panelists also emphasized the need for conducting research into the biochemical and immunological effects of nutrition on cancer treatment, such as research on the gut microbiome’s influence on treatment responses that underscores the need for a more personalized approach to dietary recommendations. ⁴⁴ Panelists also highlighted specific challenges in advancing oncology nutrition research. For example, securing funding for large‐scale nutrition studies remains a significant challenge, as nutrition research is often held to the same rigorous standards as pharmaceutical trials, despite fundamental differences in study design and intervention feasibility. ⁴⁵ Additionally, panelists highlighted that the lack of consistent assessment of malnutrition among patients with cancer and survivors serves as a barrier to progress. ⁴⁶ Inconsistencies in how malnutrition and dietary interventions are measured make it difficult to draw definitive conclusions across studies.

Partnership and collaboration

Moreover, panelists emphasized that collaboration among health care providers, researchers, policymakers, and insurers is critical for advancing the role of nutrition in oncology. Engaging major oncology organizations like the American Society of Clinical Oncology and National Comprehensive Cancer Network can help integrate nutrition into clinical guidelines and survivorship care plans. Moreover, leveraging screening and referral data in electronic health records and artificial intelligence–driven data analysis could enable long‐term tracking of dietary patterns and their impact on cancer outcomes. The discussion concluded with a call to action for a paradigm shift in nutrition research and the need to sustainably support the integration of oncology nutrition services into care delivery. Instead of waiting for “perfect” evidence from large‐scale randomized controlled trials, panelists encouraged policymakers and health care providers to act on the existing evidence supporting dietary interventions, while also continuing to emphasize the importance of generating more rigorous evidence in this space.

Considerations for the future

A keynote speaker discussed the broad considerations that should inform future program, research, and policy design, beginning with the role of participants and community (as shown in Figure 2). The speaker noted the importance of community engagement, partnering, collaborating, and cocreating interventions with community‐based organizations, community members, and patients themselves (e.g., adapting to cultural preferences), with a strong emphasis on implementation science. Furthermore, the speaker noted the role of behavioral science in understanding the motivators and barriers to FIM participation to elucidate and evaluate behavioral mechanisms and change that result from the implementation of a FIM intervention.

FIGURE 2.

Circular graphic adapted from Dr. Chris Economos’ presentation at the Symposium and the FIM pyramid referenced from Mozaffarian D, Blanck HM, Garfield KM, Wassung A, Petersen R. A Food is Medicine approach to achieve nutrition security and improve health. Nat Med. 2022;28(11):2238‐2240. doi:10.1038/s41591‐022‐02027‐3. CBO indicates community‐based organization; EHR, electronic health record; FIM, Food is Medicine; TA, technical assistance.

The speaker also highlighted the food and health care infrastructure required for the scaling of FIM programming. In the food system, this includes investment in agroeconomics and farming capacity to institutionalize FIM and scale up local production and address the lack of insurance, training, infrastructure, and support for farmers and local growers. Within the health system, this includes the training of health care professionals, unlocking the value of registered dietitians, and broadening the field of dietetics by training more professionals to do this work, alongside a range of health care professionals involved in FIM.

Finally, the speaker emphasized how these considerations and growing evidence base can inform policy development, noting the importance of thoughtful advocacy regarding FIM policy that considers and reflects how patients and other constituents may react to FIM policies being developed on the ground.

CONCLUSION

FIM interventions continue to play a critical role in oncology care to improve health outcomes, reduce economic burden, and mitigate treatment‐related toxicities for patients with cancer. For the successful implementation of FIM programs, we need a holistic approach that blends policy with practice and recognizes that adequate cancer care is incomplete without nutrition. Therefore, it is pertinent to call for more evidence‐based research studies, increased collaboration between constituents, and continuing efforts to sustainably integrate FIM programs into care delivery for patients with cancer. Adopting strategies that empower both patients and providers is an essential component of cancer care and will help ease the transition from diagnosis to survivorship.

AUTHOR CONTRIBUTIONS

Sara Raza: Conceptualization; funding acquisition; investigation; methodology; project administration; supervision; writing—original draft; and writing—review and editing. Kathryn M. Garfield: Conceptualization; funding acquisition; investigation; methodology; project administration; supervision; visualization; writing—original draft; and writing—review and editing. Kristen Sullivan: Conceptualization; funding acquisition; investigation; methodology; project administration; supervision; writing—original draft; and writing—review and editing. Nicholas J. Jury: Conceptualization; investigation; writing—original draft; and writing—review and editing. Laura Makaroff: Conceptualization; funding acquisition; investigation; writing—original draft; and writing—review and editing. Elaine Trujillo: Conceptualization; investigation; writing—original draft; and writing—review and editing. Mary Kathryn Cohen: Conceptualization; funding acquisition; investigation; project administration; and writing—review and editing. Kristina Gately: Conceptualization; funding acquisition; investigation; and writing—review and editing. Dariush Mozaffarian: Conceptualization; Funding Acquisition; Investigation; Visualization; And Writing—Review and editing. Christina Economos: Conceptualization; funding acquisition; investigation; visualization; and writing—review and editing. Colleen Spees: Conceptualization; funding acquisition; investigation; methodology; project administration; supervision; writing—original draft; and writing—review and editing. Fang Fang Zhang: Conceptualization; funding acquisition; investigation; methodology; project administration; supervision; visualization; writing—original draft; and writing—review and editing.

CONFLICT OF INTEREST STATEMENT

Sara Raza reports receiving grant funding from the Benton Institute for Broadband & Society and Bristol Myers Squibb Foundation. Kathryn M. Garfield reports receiving grant funding from the National Institutes of Health, the Rockefeller Foundation, the Walmart Foundation, the Builders Initiative Foundation, Kaiser Permanente National Community Benefit Fund at the East Bay Community Foundation, Bristol Myers Squibb Foundation, and the University of California, San Francisco; and contracts for technical assistance from the Food is Medicine Coalition, National Produce Prescription Collaborative, and Community Servings. Elaine Trujillo contributed to this article in her personal capacity. The views expressed are her own and do not necessarily reflect those of the National Institutes of Health or the U.S. government; she declares no conflicts. Dariush Mozaffarian reports research funding from the National Institutes of Health, Kaiser Permanente Fund at the East Bay Community Foundation, National Association of Chain Drug Stores Foundation, Google Health, and The Rockefeller Foundation; scientific advisory board, Beren Therapeutics, Brightseed, Calibrate, Elysium Health, Filtricine, HumanCo, Instacart Health, January Inc., WndrHLTH (ended: Season Health, Validation Institute); scientific consulting, Amazon Health; equity in Calibrate and HumanCo; and chapter royalties from UpToDate. The remaining authors declare no conflicts of interest.

Colleen Spees reports receiving grant funding from the Bristol Myers Squibb Foundation, the National Institutes of Health, and the American Heart Association.

Fang Fang Zhang reports receiving grant funding from the Bristol Myers Squibb Foundation, the National Institutes of Health, and the American Diabetes Association.

Supporting information

Supporting Information S1

Raza S, Garfield KM, Sullivan KR, et al. Integration of food and nutrition into oncology care: Proceedings of the Food is Medicine in Oncology Care Symposium. Cancer. 2026;e70228. doi: 10.1002/cncr.70228