Diet-related diseases produce crushing health and economic burdens. The estimated US costs of diabetes, cardiovascular diseases, obesity-related cancers, and other obesity-related conditions are approximately $1.72 trillion per year,1 or 9.3% of the gross domestic product. This burden creates tremendous stress on government budgets, private businesses, and families. Marginalized groups often suffer most, with significant disparities in both diet and health leading to illness, suboptimal school and work performance, increased health costs, and lower productivity and wages.
Although the important role of food in health is increasingly recognized, nutrition has not traditionally been well integrated into health care systems. One obstacle has been demonstrating the efficacy and cost implications of specific nutritional interventions. In this issue of JAMA Internal Medicine, Berkowitz and colleagues2 evaluate one nutrition-focused intervention—free provision of medically tailored meals (MTMs) at home—and subsequent health care use. Using the Massachusetts All-Payer Claims database, the investigators matched individuals receiving MTMs with nonrecipients and assessed hospitalizations, skilled nursing facility admissions, and total health care expenditures. Outpatients were eligible for MTMs if they had a complex medical condition (eg, HIV, cancer, diabetes, end-stage renal disease, congestive heart failure) and were certified by a social worker or clinical health care professional as having substantial social barriers to healthy eating (eg, poverty, food insecurity).