Voices From the Field: Individual Leaders Share Their Stories of Food is Medicine

Abstract

Interest in Food is Medicine (FIM) interventions has surged nationwide, reflecting a growing commitment to integrating nutrition into health care. FIM approaches typically combine medically tailored or supportive food with nutrition and culinary education, aiming to improve clinical outcomes and health equity. As the field expands, it draws together diverse public and private actors from across health care, food systems, and agriculture, including clinicians, farmers, policymakers, retailers, and community advocates, alongside the individuals and families these programs serve. While existing research largely emphasizes program design and quantitative outcomes, qualitative inquiry offers an important complementary lens by describing provider and patient experiences. However, personal narratives of those shaping FIM remain underrepresented. This work elevates nine distinct voices from across the movement, including program founders, participants, health care leaders, clinicians, and food producers. Their stories reveal shared priorities of health improvement, equity, and scalability, while underscoring the passion driving this work. Ultimately, these accounts illuminate the human dimension behind the promise of FIM: food is medicine, and so much more than medicine too.

“Our medical data show improved clinical outcomes, reduced ER visits, better mental health, healthier behaviors, and food security.”

Introduction

National interest in Food is Medicine (FIM) therapies is rapidly growing. FIM integrates food-based nutritional interventions into health care as part of an individual’s treatment plan, accompanied by nutrition and culinary education. ¹ Programs typically include medically tailored meals, medically tailored groceries, and produce prescriptions. ¹ The earliest programs grew from medically tailored meals provided to patients with HIV under the Ryan White Act, and produce prescription partnerships between community-based organizations (CBOs) and farmers markets, legacies that continue through national collaboratives like the Food is Medicine Coalition and the National Produce Prescription Collaborative. Barely present in the peer reviewed literature just a decade ago, more than 270 FIM studies have been published through March 2025. ² At the same time, major research efforts such as the $250 million Health Care by Food initiative and large NIH and PCORI grants are supporting new research in the field.^3-5 As the research base grows, FIM is being implemented in practice. Sixteen states have approved or pending Medicaid 1115 Demonstration Waivers to provide FIM nutrition services,^6,7 and state-wide evaluations of such efforts in Massachusetts and North Carolina demonstrate health gains and cost savings.^8,9 The Veterans Health Administration, the country’s largest integrated health system, has FIM pilots in five states,^10,11 and multiple private payers have formed a new FIM National Network of Excellence to establish best practices and frameworks for implementing and evaluating FIM. ¹² Large supermarket retailers, employee benefit providers, and meal, grocery, and nutrition counseling vendors are increasingly engaging in FIM.

As FIM grows, it is engaging diverse public and private actors across health care, food, and agriculture systems. Clinicians, farmers, policymakers, retailers, community leaders, and of course individuals and their families are participating in FIM. Yet these stories have not often been told. By design, much of the published literature focuses on traditional research reporting around programs and their outcomes.^1,13 Qualitative studies complement this evidence by synthesizing the perspectives of providers and patients.^14-17 However, the direct stories and experiences of individual people in the FIM movement are less heralded. Understanding these accounts anchors the movement in the realities people face and reveals the human impact behind the data.

In this article we present nine voices from the FIM movement. These individuals represent founders and leaders of successful programs, participants receiving such programs, health care leaders, clinicians, food producers, and vendors. The shared values around improving health, advancing equity, building scale and efficiency, and creating shared value are evident across their stories—as is the collective passion driving their daily efforts. Food is indeed medicine, but it is not only medicine. It touches everyone, whether through planting, harvesting, transporting, procuring, providing, preparing, consuming, and sharing meals.

Voices

Steven Chen, MD (Chief Medical Officer and Founder of Alameda County Recipe4Health, San Leandro, CA)

“Imagine the day when Food as Medicine is covered by health insurance just like diabetes medications.” In 2016, I concluded my presentation before the Alameda County Supervisors with this invitational challenge to envision a new possibility for health care. At the time, I was a Medical Director and family physician at a Federally Qualified Health Center in California called Hayward Wellness, where I was leading efforts to embed integrative healing modalities—acupuncture, osteopathic manipulation, group visits, and food as medicine—into primary care for our most vulnerable patients.

Three years later, I had a meeting with Supervisor Wilma Chan. She pitched a vision of scaling Food as Medicine from local roots to national impact. “Build a strong Food as Medicine program in Alameda County,” she said. “Take it to the rest of California. Take it as far as you can to the nation.” I didn’t know it then, but that conversation changed everything. I left a fulfilling clinical and leadership role to answer her call, founding and scaling Recipe4Health, our County’s Food as Medicine program. That moment was a rare, crystalline pivot point—one that continues to guide me, especially on the hardest days.

This work is more than a professional calling—it’s deeply personal. I’m a Taiwanese American, the son of immigrants from a country shaped by colonization, martial law, and ongoing diplomatic exclusion. Taiwan is recognized by only 12 sovereign states, yet it continues to thrive through resistance and resilience—just like its people and its food. That story of survival is part of my own.

My father came to the U.S. during the wave of arrivals following the 1965 Immigration and Nationality Act, part of the so-called “brain drain” of engineers to help the US compete in the space race. His journey began in a small town where my A-gong (“grandfather” in Taiwanese), a farmer with only a third-grade education, was known as the wisest man around. Though A-gong taught himself to read later in life, his true knowledge came from the land. He grew food not just to feed his family but to care for his community. That relationship to land, food, and care—including healthcare—is foundational to how I see the world.

When we talk about Food as Medicine today, I challenge our field to ask: Where does the food come from? Who grows it? How is it grown? In our eagerness to “prescribe food,” we risk flattening food into a pill: severed from land, culture, and community, framed in a colonized and siloed way. While food is a substance we consume for nutrition and energy to sustain life, it is so much more than just a nutrient delivery pathway. A decolonized perspective reveals food “as” medicine, and food “as” culture, nourishment, resistance, community, power, and justice. The subtle yet powerful prepositional difference between “food is medicine” and “food as medicine” expands our understanding beyond only healing bodies and invites humble collaboration across sectors.

This is why we created Recipe4Health—a systems-level, scalable Food as Medicine model embedded in Community Health Centers that sources food from local, organic, regenerative, and Black, Indigenous and People of Color (BIPOC) farmers. By sourcing intentionally, Recipe4Health acts as a health multiplier, generating co-benefits for human health, soil/ecological health, and economic health—ensuring marginalized communities are not left behind. We call this triple health framework H3E, or “H Cubed E,” which we are developing to share with the field.

Today, over 9500 patient enrollees across 5 Federally Qualified Health Centers and their 18 clinics have received 12 weeks of doorstep-delivered local, regenerative, organic produce and health coaching—more than 120,000 produce boxes and equivalent to 2.2 million servings of food prescribed as medicine. I recall my patient with uncontrolled diabetes who lowered her A1c, reduced insulin needs from 76 to 5 units daily, and stopped hypoglycemic episodes—all through nutrient-dense vegetables, nutritional guidance, and group health coaching. Watching her grow confident with food, deepen connections with others, and improve her health affirmed the power of food as medicine. Beyond individual people, our medical data show improved clinical outcomes, reduced ER visits, better mental health, healthier behaviors, and food security. And the deeper story is how this work knits together personal healing, economic opportunity for farmers, and soil regeneration.

Working closely with Supervisor Chan, I had the privilege of partnering with state legislators and coalitions to drive policy and system change across California. In 2022, Recipe4Health became one of the first Food as Medicine programs in California to use federal Medicaid waivers (1115, 1915b, and In Lieu of Services) to pay for and cover produce prescriptions. What started as a local effort is catching fire state-wide and beyond. Currently, 16 states are leveraging these waivers to launch Food as Medicine programs nationwide. Together, we are harnessing a tiny portion of the $4.9 trillion annual US health care spend to heal and restore not just people, but local economies, soil, and land.

Systems change is hard. Policy is fragmented. Incentives are misaligned. On the toughest days, I return to Supervisor Chan’s voice and vision. I remember my grandfather, hands in the dirt, teaching himself to read, cultivating the land. I remember where I come from. This journey is personal, ancestral, collective—and this movement is just beginning.

Larry Davis (Member of the Michigan Collaborative for the Prevention of Type 2 Diabetes, Ann Arbor, MI)

The numbers 270 and 10.7 were used by the clinical pharmacist who received a referral from my primary care physician, who I had visited a couple of days prior with symptoms of frequent, almost non-stop urination and unquenchable thirst. The numbers made little sense to me at the time. But I would soon learn that they were indications that I had crossed the Rubicon from pre-diabetes to diabetes—and to make matters worse, I was not sure how long I had been unknowingly suffering. Two days later, my primary care physician prescribed insulin, and I immediately began injecting myself twice a day for the next two months. It was an overwhelming and life-changing turn, events that set me on a new health care journey.

Over the last three years, the information and support I have received from my Registered Dietitian Nutritionist (RDN) helped me create healthy diet plans and access diabetes maintenance resources. This included enrolling me into a home-delivered fresh produce service through the Healthy Jumpstart Initiative program. With the $80 per month stipend for three months, and a one year food delivery subscription, I was able to take an active role in making real changes to my nutrition. The result: my daily fasting blood glucose levels are now between 90-110 on average over the past two years, and my A1c has continued to drop, now in the normal range of 6.1.

Yet something else remarkable has resulted. I am now a Patient Advocate Board member of the Michigan Coalition for Type 2 Diabetes, where I have input in developing strategies to carry the message of diabetes prevention and management through a state-wide platform. This has also introduced me to the Food is Medicine initiatives led by the Tufts University Food is Medicine Institute, which has broadened my understanding of Food as Medicine efforts on a national scale. Being invited to participate in the first annual Food is Medicine Advocacy Day on Capitol Hill introduced me to the impact that patients can have upon national nutrition programs and policies for chronic illness prevention and maintenance through health care delivery systems and medical practitioners such as doctors, clinical pharmacists, RDNs, and patients themselves.

As my health care maintenance journey has allowed me to make lifestyle and dietary changes, it has also provided me with opportunities to learn more about the scope and range of the Food is Medicine movement through the efforts of Tufts University, its network of partners, and events such as the now annual Advocacy Day in Washington D.C. and annual FIM National Summit in Boston. Additionally, I have been invited to be a member of the Institute’s Community Council to provide patient perspectives on research proposals that I hope will be approved and funded to further the important work of the Institute.

I am currently putting some of what I’ve learned into use by sharing FIM information with local fresh produce food pantries, farmer’s markets, food access, and urban farming education. I also share my knowledge with nutrition programs such as The Farm Share Assistance program in Ypsilanti, Michigan, and the Building the Market in Detroit, Michigan, whose mission is to enrich their community nutritionally, culturally, and economically.

My journey as a senior male who lives with type 2 diabetes has been both challenging and rewarding. It has helped me live healthier by being active in my daily diet planning and understanding the importance of simple measures, such as reading food labels, that help me make informed dietary choices that are sustainable. My health care team of physicians, RDNs, and the larger Food is Medicine initiative have all played a major role in my emotional and mental health as well by helping me understand the dynamics of type 2 diabetes through nutrition education and user-friendly methods of self-care. I hope to continue to be a “voice in the field” of Food is Medicine.

Dion Dawson (Founder and Executive Director, Dion’s Chicago Dream, and CEO, Cosmic Crate, Chicago, IL)

When I placed a community refrigerator outside a liquor store on Chicago’s South Side in the summer of 2020, I wasn’t thinking about academic frameworks or national initiatives. I was thinking about survival: mine, and the people around me. That refrigerator wasn’t a symbol. It was a lifeline. A place where someone could grab a head of lettuce, some oranges, and a little bit of hope.

At the time, I didn’t realize I was laying the foundation for what would become one of the country’s most scalable, logistics-based Food is Medicine (FIM) initiatives.

I know firsthand what it feels like to wonder where your next meal will come from. I’ve lived that uncertainty. And I also know what it feels like to be seen as a statistic instead of a solution. As a Black man leading a health-focused, tech-enabled non-profit, I’ve often found myself at the intersection of innovation and invisibility. But I’ve learned to treat that intersection as a launchpad.

Today, through Dion’s Chicago Dream, we deliver weekly boxes of fresh, high-quality produce to thousands of households across more than 170 zip codes in the Greater Chicagoland region—no cost, no means testing, no stigma.

We are not a food pantry. We are a supply chain. And that difference is everything. To me, Food is Medicine isn’t just about reducing hemoglobin A1C or preventing hospital readmissions—though those are important. It’s about restoring stability to communities that have been designed to fail. It’s about building infrastructure that prioritizes both access and dignity. It’s about transforming food from an emergency to an expectation.

The results speak clearly, even as they tell only part of the story. Through our partnership with Foodsmart and CountyCare, we’ve supported over 70,000 members with personalized nutrition plans, medically tailored meals, and consistent delivery. In 2024 alone, we delivered more than 3700 meals to members in need, achieving measurable improvements in key health metrics: 35% of obese members achieved at least 5% weight loss, 86% saw blood pressure improvement, and 43% reported reduced food insecurity. From lowered insulin dosages to life-changing weight loss—ranging from 22 pounds to 123 pounds—we’ve seen the kind of outcomes that don’t just change charts, they change lives.

But the real story lives between the numbers. It lives in the patient who says she finally feels confident for the first time in years. In the father who tackled his binge eating and is now present for his kids. In the mom whose blood pressure came down and whose stress did, too. These aren’t just clinical wins; they’re generational ones. While data proves our model works, dignity proves it matters. Food is Medicine has allowed us to build systems that heal both body and spirit—and with the right partners, we’re only getting stronger.

We’ve turned produce into a prescription, but not just a clinical one. Ours is a prescription for consistency, for visibility, for community wealth. Through our Dream Delivery program, in-market Dream Vaults, and our soon-to-launch SaaS platform, Cosmic Crate, we’ve built a replicable model that prioritizes not only health outcomes, but economic ones. Every delivery represents a living-wage job, a trained driver, a data-informed route, and a commitment to excellence. We don’t rely on volunteers. We invest in people. We’ve created more than 50 wage-paying jobs and delivered more than 4.5 million pounds of fresh food. And we’re just getting started.

FIM has given organizations like mine a fresh language and a new lane to scale. But too often, these conversations are dominated by health care systems and pilot studies, while the social enterprises and CBOs doing the day-to-day work are left out of the room. If we want Food is Medicine to be transformational and not transactional, it must be rooted in stable, connected, and community-powered food systems, not patched onto broken ones.

Here’s what I’ve learned: Most FIM pilots begin with the doctor and end with the patient. But our model begins with the resident and builds outward—from the block to the boardroom. That’s a fundamental difference. It’s why our trucks run 6 days a week, in all weather. It’s why our recipients know their driver’s name. It’s why we’ve seen over 90% satisfaction across our delivery network. Because we treat logistics, consistency, and dignity as non-negotiables.

Food is medicine. But it’s also memory. It’s identity. It’s economy. It’s justice. And in the communities I serve, it’s often the only thing that still feels like a fight worth showing up for.

As a Black founder who has scaled in a space where few of us are expected to lead, let alone succeed, I carry this work with urgency and purpose. I don’t just want to be a voice in the FIM movement, I want to be a proof point that we can lead it. Our model has caught the attention of institutions like Tufts, the Rockefeller Foundation, and Johnson & Johnson because we’ve proven that Food is Medicine can be more than a prescription. It can be a platform. For health equity. For job creation. For scalable, systemic change.

At the end of the day, Food is Medicine isn’t just about getting people healthy. It’s about proving to them that they matter. That their zip code doesn’t dictate their worth. That we can dream bigger—and deliver on it. And that, to me, is the ultimate healing.

Vanessa Georges (Senior Health care Consultant, Community Servings, Boston, MA)

Food has the ability to heal not just those living with a critical or chronic illness, but also the loved ones who care for them.

Cancer. Just one word, yet it changes everything. The moment I was diagnosed, my world became filled with medical jargon, treatment plans, and a deep, persistent fear of the unknown. I found myself thrown into a cycle of chemotherapy, scans, surgeries, and side effects. But amid all the chaos, one quiet, steady force began to change the way I experienced illness and healing: the idea that food is medicine. And that food has the ability to heal not just those living with a critical or chronic illness, but also the loved ones who care for them.

At first, nutrition felt like an afterthought in the treatment process. My care team focused on radiation and chemotherapy. But my body was in crisis, and while treatment aimed to destroy the cancer, it also drained me in every other way: fatigue, nausea, weight loss, inflammation, and an overall sense of disconnection from my own body.

That’s when I started to look beyond prescriptions and treatments, and began asking a critical question: What can I do to help my body heal—not just survive? I learned that cancer cells thrive in inflammation and imbalanced environments. Research increasingly shows that certain foods may help support the immune system, reduce inflammation, and improve outcomes during and after cancer treatment. That’s when “food is medicine” stopped being a slogan—and started being my strategy.

I worked with an oncology dietitian who introduced me to Community Servings, a non-profit organization in Boston that provides meals to critically & chronically ill individuals and their families. The meals are scratch-made and medically tailored, meeting the medical and nutritional needs of clients with HIV/AIDS, cancer, kidney disease, diabetes, and other life-threatening illnesses. I worked with an RDN who helped me design a diet that aligned with my treatment plan. It wasn’t about magic foods or rigid rules; it was about the compassion and empathy I was shown at a time when I felt all alone. At first, even small adjustments made a big difference: my digestion improved, my energy stabilized, and I began to feel a little more like me again.

More than just physical relief, food gave me emotional grounding. When everything else felt out of my control, what I chose to eat became an act of power, presence, and healing. Eating healthy nutritious meals gave me a way of participating in my recovery—not passively waiting for treatments to work, but actively supporting my body in the fight.

There were moments of setback and frustration, of course. I wasn’t always able to eat “perfectly,” and I had to learn to let go of the idea that food alone could “cure” me. But what food did give me was strength, resilience, and dignity in a time when those things often felt far away. Cancer tried to take ownership of my body. But with every meal rooted in nourishment, I took some of that power back.

The science behind “food as medicine” is growing stronger, especially in cancer care. A 2018 study in JAMA Oncology found that cancer survivors who followed a healthy diet—including higher intake of vegetables, fruits, whole grains, and low red meat—had a significantly lower risk of mortality. The American Institute for Cancer Research emphasizes that a plant-forward diet can reduce cancer risk and support survivorship. And anti-inflammatory diets are linked to lower cancer recurrence rates and improved immune function, key to helping the body recover during and after treatment.

These aren’t just statistics; they became the foundation of how I rebuilt my life during cancer. Science validated what my body already knew: that food is fuel, food is support, food is medicine.

Living with cancer has been the hardest challenge of my life. But it also awakened me to the power of food—not just to sustain me, but to heal me. While chemotherapy targeted the disease, food helped me rebuild. While doctors fought for my survival, nutrition helped me recover strength, hope, and clarity.

“Food is medicine” isn't a miracle cure. But in my cancer journey, it has been a lifeline, one that continues to guide me as I move from treatment into survivorship. Every meal I eat now is an act of healing, of defiance, and of love—for my body, my life, and my future.

I am living proof that food has the ability to heal not just those living with a critical or chronic illness, but also the loved ones who care for them.

Hollie Harris (President and Chief Executive Officer, Appalachian Regional Healthcare, Lexington, KY)

I’ve always done my best to live a healthy life. I exercised regularly, ate well, and tried to make choices to keep me feeling my best. But at one point, I began experiencing a mix of seemingly unrelated symptoms: fatigue, joint pain, brain fog, skin issues, and ongoing stomach problems. I couldn’t figure out what was wrong. Eventually, a simple blood test provided the answer: I’m allergic to gluten. I never imagined something so common could be the culprit. But once I removed gluten from my diet, everything changed. My energy returned, my mind cleared, and my overall health improved dramatically.

Then came another unexpected challenge: a cancer diagnosis. Thankfully, due to my diligence with preventive screenings, it was caught early, and I received excellent care which led to a full recovery. That experience only deepened my commitment to wellness and reminded me how important it is to listen to our bodies and care for them intentionally.

Both of these experiences led me to embrace a concept many of us in health care are rediscovering: food as medicine. What we eat matters, not just for treating illness, but for preventing it and supporting lifelong health. For those of us with food sensitivities or allergies, that understanding can be life-changing.

Four years ago, I became President and CEO of the Appalachian Regional Health care (ARH) system which operates 14 hospitals, more than 100 clinics, over 30 pharmacies, and home health agencies, skilled nursing facilities, wound care centers, and medical spas in eastern Kentucky and southern West Virginia. ARH serves a population of 350,000 to 400,000 people throughout some of the most rural parts of Central Appalachia. Our communities are among the most beautiful places you will ever visit. But they are also home to some of the most chronically ill patients in the United States, as we have the country’s highest rates of obesity and diabetes.

ARH is a large health system with more than 6000 employees. These are 6000 people who live in our service areas and rely on us for their health care. So, it only made sense that we start from within.

Under my leadership, we have launched focused employee wellness initiatives and have a dedicated wellness team who develop monthly challenges where employees can win prizes just by staying active. We share nutritious recipes and offer hands-on cooking demonstrations. Our partnership with local farmers through a subsidized Community Supported Agriculture program for employees has been a runaway success, selling out within hours. We’ve now added meet-the-farmer events on site at clinics and hospitals to better foster a sense of community in our food and health systems, creating relationships between the people who grow our food and the people who are nourished by it. We have also partnered with gyms and fitness centers throughout our communities and are proud to say that every ARH employee has access to a free membership.

Inside our hospitals, we have worked to encourage healthier choices too. We have revamped our cafeterias, adding clear labeling, salad bars and more nutritious options. These are all small things when you take them piece by piece, but when you put them together, they are resulting in big changes.

Our employees are more engaged and productive—many are making potentially life-saving lifestyle shifts. For example, Paintsville ARH Hospital Chief Nursing Officer Crystal McGaffe has lost more than 100 pounds through healthy eating and exercise. But Crystal’s transformation goes far beyond the numbers on the scale. She willingly, and proudly, speaks of how she no longer needs the blood pressure and diabetes medication she was on before her wellness journey began. Her story is one of many real, personal transformations that prove just how powerful small lifestyle changes can be.

At the end of the day, we want to prevent and reduce heart disease, diabetes, and obesity, not just treat them. We know this approach challenges the traditional health care model. If we try to prevent illnesses before they take root, aren’t we cutting into reimbursements? Who pays for this new Food is Medicine approach? These questions need answers, but don’t slow our commitment.

Beyond our hospital walls, we are building new partnerships every week. For example, our work with God’s Pantry Food Bank has expanded to include food rescue efforts that improve food insecurity while preventing excess safe, nutritious foods from ending up in landfills. One of our key collaborators is the Kentucky Department of Agriculture. I co-chair the state’s Food is Medicine campaign alongside Kentucky Agriculture Commissioner Jonathan Shell. Together, we are creating pathways to bring Kentucky Proud products, produce and proteins into health care food systems while also promoting healthy diets, nutrient-driven behavior changes and sustainable lifestyle shifts.

Our community development team also works tirelessly to reduce barriers to access. One of the most common reasons given for not eating healthy is the affordability, especially for fresh fruits and vegetables. That’s why we have partnered with farmers’ markets to make food vouchers available for community members to purchase healthy, locally grown produce. For example, the Produce Voucher Program in Harlan County, Ky. provided $25 produce vouchers to 100 low-income seniors. The program demonstrated a return on investment of $71 for every $1 invested.

Healthy choices—diet and exercise—can help prevent or manage so many chronic illnesses. We in health care know this. The proof is in the science. The proof is in me. The proof is in Crystal McGaffe. Food is Medicine, and we have responsibility to help it grow.

Michelle Howell (Farmer, Need More Acres Farm, Scottsville, KY)

My great-great-grandmother, Effie Annie Earls, grew up in Metcalfe County, Kentucky, in the early 1900s. Her family cultivated nearly everything they ate, their survival dependent on the rhythms of the land and the work of their hands. Just two generations later, my mother and I found ourselves in rural California—isolated from extended family, living among migrant farm families, and facing the very realities my ancestors worked to avoid: poverty and hunger.

My husband, Nathan, comes from a long line of Kentucky tobacco farmers. For his family, tobacco wasn’t merely a crop, it was a lifeline. It paid the bills, bought his first truck, and covered college tuition. Farming, for both of us, is deeply embedded in our family stories. But we also came of age at a time when the agricultural landscape was changing rapidly.

We both pursued degrees in agriculture. Nathan motivated to support farmers like his family, and me driven by a desire to make healthy food more accessible to people like mine. In 2000, right out of college, we were hired by the University of Kentucky through funding from the Tobacco Master Settlement Agreement to help farmers transition from tobacco to fruit and vegetable production. Motivated by motherhood, I would join the community health planning council in 2009 and start our first Food is Medicine program in 2014. That opportunity launched us into what has now been a journey at the intersection of agriculture, health, and community development—rooted in generational memory, informed by lived experience, and focused on transforming food systems in Kentucky from the ground up.

Today, we operate a year-round diversified farm that produces over 100 types of nutrient-dense fruits, vegetables, grains, legumes and herbs. Using season extension tools like high tunnels and cold storage, we grow leafy greens, cruciferous vegetables, and fiber-rich staples like root crops and winter squash throughout the year. To round out the diet, we collaborate with nearby farms for pasture-raised proteins, legumes, grains, eggs, and dairy, ensuring a complete and culturally relevant food offering. This collaborative sourcing model strengthens the local farm economy while improving health outcomes through consistent access to fresh, nourishing food.

Supporting small-scale farmers first is key to building an equitable and resilient food system. By committing to buy what beginning and smaller scale farmers can produce—even in small quantities—we create steady income and help them reinvest in on-farm infrastructure like wash stations, cold storage, and high tunnels. Once their capacity is maximized, we supplement with mid-sized farms to meet remaining demand. This tiered procurement model ensures our growth is inclusive, relational, and regional—centered on health, sustainability, and community ownership.

As a full-time farmer, I’ve come to understand that the value of agriculture lies not only in what we grow, but in how we grow it, and with whom. Food is Medicine programs offer a powerful platform for this relational work. On the surface, our success is measured by outcomes like our 100% redemption rate and robust data collection methods. But what truly sets our programs apart is the strength of our local partnerships, particularly with front line public health and nutrition professionals. From health educators, food service staff, and community health workers, these frontline professionals are the human infrastructure that bridges farms and health care with the people we serve. Their emotional labor and cultural fluency are often invisible, but they are absolutely essential.

We combine the daily work of farmers like myself with the insight and care of these frontline professionals, alongside doctors, nurses, and RDNs who make the referrals. This interconnected network makes it possible to reach people in rural communities in meaningful, personalized ways. In fact, these professionals are often the ones who see and value my role as a farmer more than anyone else. Their ability to identify who in their community needs access to healthy, local food—and who is ready to engage—allows us to operate with both precision and compassion.

At the heart of our Food is Medicine model are referrals of participants who are ready to invest their time and energy into improving their health through locally sourced food. When referrals are made with care—ensuring participants are not only clinically eligible but genuinely interested—engagement increases, outcomes improve, and retention stabilizes. We provide weekly home delivery to remove barriers related to transportation or mobility, especially common in rural areas.

We have worked closely with the Kentucky Cabinet for Health and Family Services, Kentucky Medicaid managed care organizations, and the Kentucky Department of Agriculture to secure funding for produce prescription and Food is Medicine programs. By aligning our locally sourced Food is Medicine offerings with established, federally supported initiatives—such as the Diabetes Prevention Program, Diabetes Self-Management Program, and Blood Pressure Control Program delivered through local health departments—we are strengthening health outcomes for participants. Each grocery delivery includes fresh, Kentucky-grown produce, pre-portioned cooking kits, easy-to-follow recipes, and supportive text messages with preparation tips and nutrition education. This comprehensive, wraparound model supports lasting, sustainable improvements in health and wellness.

While scaling is often treated as the gold standard of program success, many of our food system’s failures are rooted in scale itself. We must be cautious not to replicate those dynamics. Instead, we need to embed small-scale models into broader systems, particularly in rural areas where impact can be observed more directly, and adaptations can be made quickly, to ensure both farmer and participant success. When we overlook the power of the small, we miss the truth that purchasing 100 bags of lettuce from a local farmer can sustain their farm, and that nourishing just 10 patients through a pilot program changes lives.

In the end, the future of Food is Medicine is not just about quantity. It’s about quality—of relationships, of food, and of care. And that begins, always, with the local.

Erin W. Martin (Founder, FreshRx Oklahoma, Tulsa, OK)

My journey into the “food is medicine” movement didn’t start in a classroom, but in the quiet, sterile hallways of long-term care facilities. I grew up around nursing homes, where I witnessed people spend the final chapters of their lives on 15, sometimes 30, prescription medications. I watched the light leave their eyes—not just from aging, but from a system that over-medicated, undernourished, and stripped away their dignity.

As a teenager and into my twenties, I carried the weight of those observations. Overwhelmed by endless problems to address, I kept asking: What could I do that would have the biggest impact? Where should I put all this passion that I was born with? I was searching for one solution that could produce many ripple effects. The more I looked, the more I realized how broken it all was. Chronic conditions weren’t reversed, they were managed with band-aid solutions. Symptoms were treated, but the root cause was ignored. And food—arguably our most powerful tool—was never even part of the conversation.

And then I witnessed something radical. I saw someone break free. They came off every medication. They changed their food, their environment, and their mindset—and they got better. They didn’t just survive; they became alive again. That moment shifted everything. I saw the truth: the natural aging process doesn’t have to mean disease. So why have we normalized it?

I traveled to Italy to study death and dying in five cities. There, I saw what quality of life could look like in both ancient traditions and modern systems: elders dying of “old age,” not disease, and often on zero prescription drugs. It reframed everything I thought I knew.

To me, food is medicine is about liberation. Not just from illness, but from hopelessness, disconnection, and disempowerment. I often think about Moses standing before Pharaoh and demanding, “Let my people go.” That story isn’t just ancient history; it’s still our reality. We are still entrapped, just in a different form. Bound by a health care system that profits off illness. Bound by a food system that feeds us chemicals instead of nourishment. Bound by narratives that tell us we have no choice.

When I began studying the civil rights movement and reading the words of Dr Martin Luther King Jr., I understood even more clearly: this is a fight for civil liberties. Our “health care” and long-term care systems are a violation of human rights. If all people are offered is a pill or surgery—and never the opportunity to transform their lives through food, community, and connection to the land—that is not freedom.

And still, something was missing. I began learning about soil health, nutrient density, and the deeper connection between human health and the health of our land. What I discovered was staggering: our agriculture system mirrors our health care system—both extractive, both depleting. Experiences like Kiss the Ground and diving into the regenerative agriculture movement gave me the hope I was desperately searching for. Here it was: the solution with the ultimate ripple effect. Healing our soil could heal our bodies, our communities, and our future.

Food is medicine, when rooted in regenerative agriculture, isn’t only a program or a policy. It’s a revolution. A restoration. It regenerates the soil, the body, the soul, and our relationships with one another. It gave me hope when I was young and heartbroken by what I saw around me. It showed me that healing is possible. That systems can change. That justice can taste like a vine-ripened tomato from a local farm instead of a heat-sealed plastic tray from a hospital kitchen.

This is why I do the work. Because I’ve seen chains break. I’ve seen people set free. And once you’ve seen that kind of liberation, you can’t unsee it. I’ve witnessed transformation, not just in bodies, but in spirits. And I know, deep in my bones, deep in my spirit: we were never meant to be this sick, this disconnected, or this trapped.

Food is the way home. The path back to ourselves, to one another, to the land. And medicine—real medicine—doesn’t come in a bottle. It tastes like love, smells like soil after rain, and moves like belonging—restoring what was broken between us and our bodies, between us and each other, between us and the Earth.

Pamela Schwartz (Executive Director for Community Health, Kaiser Permanente, Oakland, CA)

My professional journey in public health and health care is deeply rooted in personal experiences that shaped my passion for and dedication to the field. Two pivotal events in my life stand out: the premature death of my grandfather due to diabetes, and the time I spent working in a remote village in Guatemala. These experiences not only influenced my career path but also my commitment to addressing diet-related diseases and improving health outcomes.

My grandfather, whom I loved dearly, had a profound impact on my life. He suffered from diabetes, which eventually led to heart disease and his early death when I was 11 years old. I recall his struggle to manage his condition. Despite the efforts of my father, who was a doctor, to connect my grandfather with the best medical care available, the ability to manage diabetes was not as advanced as it is today. This personal loss gave me an early desire to play a role in treating and preventing such illnesses.

My commitment to public health gained greater force after college, when I worked in Guatemala at a remote orphanage, accessible only by boat. The diet in the village primarily consisted of rice, beans, tortillas and soda, with almost no access to fresh produce or nutritional education. A young doctor and I, a fresh college grad, were the only health care providers for the villagers. We did our best to offer basic health services, nutrition education, and fresh fruit to diversify the local diets. Still, I witnessed firsthand the consequences of limited health care and poor nutrition.

These formative experiences led me to pursue a career in public health and health care, eventually bringing me to Kaiser Permanente where I now lead our Food is Medicine Center of Excellence focused on transforming the way we treat and prevent diet-related diseases and hunger. This work is driven by the belief that health care should not only treat diseases but also prevent them through comprehensive upstream approaches that include dietary interventions: medically tailored meals and groceries, prescriptions for produce, nutrition education, enrollment in government assistance programs, and connection to local food resources. These interventions aim to prevent and manage the serious, and often fatal, impacts of diet-related conditions like diabetes, hypertension, and cardiovascular disease. Launched in 2024, the Center of Excellence coordinates all of our robust resources to bring Food is Medicine into health care delivery workflows.

It is important to understand that this approach is not one-size-fits-all; it considers cultural preferences and individual capabilities, ensuring that interventions are tailored to meet the diverse needs of the population. It’s about understanding the right programs, for the right people, at the right time.

We have made significant strides to spread the adoption of these food-based interventions into health care systems and communities across the U.S., including with the founding of the Food is Medicine National Network of Excellence alongside Tufts’ Food is Medicine Institute. Our partnership was founded to create a network of organizations from every corner of health care committed to driving change, improving health, reducing health disparities, and creating a more equitable and resilient health care system that recognizes the power of food in health.

This national momentum has led health systems, clinicians, academic researchers, and others to build a substantial evidence base that demonstrates Food Is Medicine’s potential. Great work is underway, and we know so much more than we did just a few years ago. Still, there is much to be done before health care fully embraces the future we all want. We believe that by transforming the way health care addresses diet-related diseases and food insecurity, it is possible to improve health outcomes—and quality of life—and to lower the cost of care.

Through my work in Food Is Medicine at Kaiser Permanente, I continue to honor my grandfather’s memory and the lessons I learned in Guatemala by striving to create a health care system that prioritizes prevention, education, and comprehensive care. And, my work has recently taken a more personal turn with my own diagnosis of pre-diabetes, which I have been able to control by more closely following the principles we promote.

More and more we are seeing Food is Medicine woven into the fabric of health care across the nation. The tremendous enthusiasm we have seen across Kaiser Permanente for the unique role food can play in health tells me we are on the right path. It is a pivotal moment across the nation to accelerate, sustain and scale Food is Medicine as part of how we care for our patients and our communities. And truly, it is a pivotal moment for changing the trajectory of diet-related disease.

David Waters (Chief Executive Officer, Community Servings, Boston, MA)

In 1989, when I first volunteered with Community Servings, it was a fledgling grassroots effort, bringing hot meals to 30 people who were living with AIDS in Boston. We hadn’t even delivered our first meal, and we had no idea what the organization would become. I was 30 years old, working in restaurants, and unclear what my future held. In those days, there were no medicines for AIDS, and my friends were dying. I didn’t know how to make sense of it, the overwhelming fear and loss. Was I safe? What could I do?

Food was a way to offer hope and nourishment to clients struggling with AIDS Wasting Syndrome. But of course, food is much more. Decades of research have proven what many of us learned as children: food heals. The compelling evidence base for Food is Medicine interventions has motivated the healthcare system to begin working with community-based organizations. But frankly, what originally allowed Community Servings to partner with leaders in health policy, medical research, and healthcare was nothing short of kismet.

I left the restaurant world to join Community Servings full-time in 1996. Over the years, we grew into a regional service, serving people living in poverty with HIV/AIDS. In 2004, recognizing that we could help clients with any diet-sensitive illness, we opened the program to people who had cancer, diabetes, heart disease, and other diseases. In recent years, we developed, with increasing rigor, meal plans with nutrition tailored for specific illnesses and conditions. Our work was inching closer to healthcare. What would it take for our medically tailored meals program to become a healthcare service?

In 2007, when our organization relocated to the Jamaica Plain neighborhood, we became the next-door neighbor of Harvard Legal Services. Coincidentally, I knew Managing Director Robert Greenwald from the world of AIDS advocacy. Robert had established a clinic that soon became the Center for Health Law and Policy Innovation, today a national leader in health policy reform and one of the Food is Medicine movement’s most important partners. In those days, our teams were toying with a question: What if health insurance reimbursed for our service? Robert’s Center steered us toward potential partnerships in health care, a sector that was undergoing rapid transformations. In the era of the Affordable Care Act, medically tailored meals had the potential to address what was known at the time as the “triple aim” of health care: improve the patient experience, improve health, and reduce costs. We just had to prove it.

To do so, we needed data. Our first health care contract partner, Commonwealth Care Alliance, was an early proponent of addressing the social determinants of health and eager to provide meals to their members. Unfortunately, we didn’t have the expertise to show our impact on health outcomes. Just when we needed entrée to the clinical research world, our paths crossed with another figure who would become a leader in the field.

Then an internist at Massachusetts General Hospital, Dr. Seth A. Berkowitz was on our radar after The Atlantic ran a story featuring his research. Jean Terranova, who had recently joined our staff, reached out and explained our interest. Together, we quickly got to work, and the outcomes exceeded our expectations. Our pilot research study found that among individuals with advanced diabetes and food insecurity, medically tailored meals improved dietary quality, food security, and mental health. Our second study with Commonwealth Care Alliance members demonstrated an average monthly savings in healthcare costs, even accounting for the cost of meals. A third study, published in 2019 in JAMA Internal Medicine, validated the net cost-savings with significant reductions in inpatient and skilled nursing facility admissions.

The timeliness of the findings cannot be overstated. In several states, Medicaid was beginning to fund nutrition services through pilot demonstrations. Medicare Advantage supplemental benefits would soon reimburse for home-delivered meals. The time was ripe for major policy change. Community Servings got ready. In 2020, when Massachusetts’ Medicaid program (MassHealth) began to fund medically tailored meals, eleven healthcare providers contracted with Community Servings to provide this intervention to their patients.

Today, we’ve reached a point that, 35 years ago, I never could have anticipated. Community Servings is a contracted provider through MassHealth’s Health-Related Social Needs program—and we have the NPI number to prove it. We’re co-investigators on three NIH-funded randomized control trials; Dr Berkowitz is co-principal investigator on two of them. Our research partners include the Tufts University Food is Medicine Institute, UMass Chan Medical School, and others. In 2025, we launched the AMPL Institute to advance access to medically tailored nutrition through policy and leadership. At a time when federal research and policy opportunities are losing funding—a time, candidly, when the uncertainty can feel paralyzing—we’re pursuing research and policy more than ever before. We’re building the evidence base. We’re advocating for system change. We’re working so that, through MTM, health care can support better health outcomes for everyone, especially the most vulnerable.

Faced with advanced diabetes and kidney failure, my best friend received Community Servings meals tailored for potassium, phosphorus and glucose, yet another example of the impact of the intervention. I’m confident Food is Medicine will move forward as it always has, through partnerships and dedication to the communities we serve. That gives me hope and continues to inspire me to act.

Conclusion

As shared by these nine testimonials, the relationship each of us has to food is deeply personal, cultural, emotional, and familial, while also rooted in political, agricultural, and historical contexts. Across these voices is a shared recognition of, and passion for elevating, the role and value of food in human health and flourishing. For those embedded in the FIM space, a key goal is to transform the U.S. health care system so that it leverages the power of nourishing food. Actors across the sectors represented herein and beyond are joined the growing constituency of people working to make this goal a reality: researchers who show who benefits, and how; health care leaders and policy makers who sustain investment in FIM implementation and evaluation; clinicians engaged in patient care and education; boots on the ground delivering the FIM services, from the land to the table; and most of all the individuals who receive the programs, helping them heal and thrive. All these voices will continue to speak, on their own and in concert, advancing the field and its increasingly persuasive case to reshape health care with food.

ORCID iD

Ronit Ridberg https://orcid.org/0000-0001-7920-3342