Tufts Food is Medicine Institute's FIM FACT SHEET

Because we believe to effectively raise the bar on nutrition and health standards, we agree to say what we mean. Integrity is to do what we say, and we believe we need to define what our words and agreements mean. Our coalition leaders decided to support the FiM movement by defining our words and agree upon vocabulary which we will use to describe and define our body of work.

These definitions are our operant terms we all agree to use in our dialogues together, creating a culture of health and inviting others to join us. These terms are subject to change and are organic (responsive to inputs over time). Our definitions are prime to be adjusted, re-scoped, or re-defined as we all agree while we move forward creating a space for success in Food is Medicine ecosystem and all things change for the better in our community. 

Food is Medicine programs are prescribed ‘treatments” by doctors for patients suffering from a chronic diet related disease. FiM programs identify and measure disease effects, biomarkers, or nutritional deficiencies at the beginning and at the end of the six-month program to evaluate the effectiveness/success of the treatment with biomarkers and surveys. Educators, medical professionals, and coaches teach why and how to use the power of the FiM protocol to instill lifestyle and habit changes to control and reverse their disease. Sustained top- quality nutrition over time alters the body from a state of disease to homeostasis with positive health outcomes driving cost-savings on health care utilization for years to come. Using local, farm, or restaurant quality food, groceries, supplements and vitamins during a long term intervention of education and supply events or shipments. FiM Education Class definition and FiM Program operant definitions below in Section VII Definitions. 

Models: Healthy Food Prescriptions MTG, Poverello Eat Well Be Well MTG, MTM, FiM Coalition MTM providers (Gods Love we Deliver, Community Servings) 

HIGH IMPACT

Nutrition Security pantries at clinics, pop up pantries at Physician's offices or even mobile pantries at hospitals do not run series-based education classes and do not measure disease effects, biomarkers, or nutritional deficiencies. These do level up client’s nutrition to a more optimal diet using local and farm  fresh produce with 5-days life span, and dry goods such as pantry essentials like whole grain pasta and brown ride (not cheerios and canned peas and corn)  What is missing is the FiM Education Classes entail research-based curriculum with behavior change outcomes . Nutritional supplements and vitamins are often included in a true Food is Medicime intervention. 

Model: Eat Better Live Better, Pearl's Pantry for Seniors, Feeding Tampa Bay FoodRx sets of food

LOW - MID  IMPACT

Nutrition security "Farmacy" Produce Market programs and pop-ups identify and resource food insecure patients which is good, but do not measure nutritional deficiencies. Thus how can they properly chnage a patient's lifestyle without an intervention over weeks. How can they level up client’s nutrition intake to a more optimal positivelevel without measuring client baseline.  They do provide fiber and fresh produce, lean proteins, nuts and seeds, and whole grains from local farms or restaurant-supply chain with at least a 5-day life span and dry goods such as pantry essentials . Food is distributed during a series of food supply events, shipments, Mobile Market, or Pop Up events at a physician or clinic partner site who sends patients to the parking lot or pantry closet for the food. 

Model: Geisinger Food Farmacy Model (2017)

LOW-MID IMPACT

Sustainable federal nutrition programs SNAP/WIC/TANF are for children, families, students and neighbors living in poverty. School meals provide a boost in nutrition levels with quality nutrient dense foods for students. SNAP provides a boost in quality of nutrition consumed by clients who are food insecure. Referrals to SNAP, WIC and TANF pantries are fundamental to case management care in any FiM  program (produce prescriptions, MTM, MTG). Also double up bucks for fruit and vegetable incentives can be layered into patients shopping experience. 

Model:  Catholic Charities.  FiM CMS guidance for Medicaid Waiver 1115 requires client referral for SNAP, WIC, TANF connection/registration to local Community Based Organizations 

LOW- MID  IMPACT

 Nutrition security boxes fill a gap in nutrition for a week from what a client needs above the client’s existing SAD. Nutrition Security adds a boost in nutrition one time when consumed to fill the gap in nutrition. Each box has two keys to getting clients to consume the food in the boxes which drives the levers of the health as a Socieal Determinants of Health (SDOH).  Access is improved. Adoption is supported by recipe cards.

Model: Farmer Boxes from USDA Farms to Families program.

LOW IMPACT

Food security food or boxes fill the gap in food insecurity when a client runs out of food before they have money to buy food again. Going hungry, foregoing meals so kids can eat or to buy medication are solved with a food security food or box. Groceries such as pantry essentials and standard American diet (SAD) basic items for 3 meals a day for 2 persons or more meets the gap-filling foal as a Social Determinant of Health (SDOH). Depending on what is included in the food pantry sets, some is beneficial to health (salmon) and some is detrimental to health (candy, bakery treats, soda). 

Model: Food Pantry Sets, Second Harvest, PBC Food Bank 

LOW IMPACT

Post-diagnosis treatment protocol and program proven effective to promote positive changes in health markers (KPI’s) in support of a client’s return to a state of health and homeostasis over time using foods, lifestyle behavioral health intervention and FiM program elements as the medicine for diet and lifestyle related diseases, symptoms, and conditions. 

HIGH IMPACT

Prevention Interventions means changing lifestyle to avert disease progression pathways and to avoid a disease diagnosis for specific high-risk group by using sing foods and FiM program elements. Effective positive changes in health markers and key performance indicators (KPI’s) are the outcomes demonstrateing a client’s return to a state of health and homeostasis.

HIGH IMPACT

Protocol - without the behavioral health intervention- of health-promoting foods, often in regimens, are selected and curated to include optimal nutrients, bio-active and bio-available vitamins, minerals. Health promoting beverages and water are included. All foods mut be established  in the scientific literature to counter disease effects. Foods  may be defined as proteins, healthy fats(including nuts and seeds), gut-biome supporting pre- and pro-biotics, and carbohydrates (vegetables and fruits) in dose quantities, in specific proportion, with food-combining and time-of-day menus. Most regimens include recipes for how to prepare and enjoy the taste aof healthy meals for best results. Adoption is short term, for long term behavior change a lifestyle intervention is often necessary. 

MID  IMPACT

Disease-promoting food and beverages identified in the scientific literature as causal or correlated to any of the following: early death, stroke, heart attack, coronary heart disease, high blood pressure, diabetes, cancer, liver disease and renal failure. The list of items may include:  processed meats, sodium, sugar-sweetened beverages, high fructose corn syrup, partially hydrogenated corn oil, Glyphosate, GMO’s, contaminated water, etc. needing education through nutrition labels, infographics, social media campaigns and creative art demonstrations.  

NEGATIVE IMPACT