Eating for Two: Food as Medicine for a Healthy Pregnancy

Allison Nolan, MPH

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​Ever wonder what would happen if your doctor could prescribe groceries instead of pills? What if a nourishing meal was seen as necessary to your recovery—not just a nice bonus? For those with chronic illness or pregnant individuals, nutritious meals are essential. This is the foundation of Food is Medicine (FIM), the concept that access to nutritious foods, when built directly into healthcare, can improve health outcomes and reduce healthcare costs.

​Food is Medicine links nutrition to chronic disease prevention, management and treatment. Unlike traditional nutrition assistance programs, FIM includes personalized solutions like nutritious food referrals, medically tailored food packages and medically tailored meal programs. For those experiencing high-risk pregnancies, these targeted interventions can be game-changing by delivering to moms, high quality and nutrient dense foods chosen for their specific dietary needs, foods that they may not have access to otherwise.

Nutrition during pregnancy is crucial for both mom and baby’s health. In 2023, Massachusetts saw a 9.1% preterm birth rate which was even higher among women of color.  Conditions like preterm birth, gestational diabetes and hypertension can be better managed – or even prevented – with proper nutrition. Yet 21.5% of households with children experience food insecurity, hindering families’ access to the healthy diets they require during this critical period. Medically tailored meals have been shown to reduce food insecurity and decrease overall healthcare spending. Over the course of a year, one study found a 49% drop in hospital admissions and a 16% cut in healthcare costs among participants. For pregnant individuals who already have frequent medical visits, aligning food interventions with appointments makes it easier to identify needs and offer support right away.

In 2023, Medicaid covered 31.7% of all births in Massachusetts, making it a logical step to integrate FIM into this system. Through a special 1115 waiver, the state is piloting new ways to use Medicaid funds for food-related services. One example is Project Bread, which screens patients for food insecurity and connects them to resources. Another example is the Flexible Services Program, evaluated by Dana-Farber Cancer Institute, which gives participants autonomy in purchasing nutritious foods, and received positive feedback. Participants reported feeling more confident preparing healthy meals, setting them up for long-term improvement in eating habits.

Several programs are already underway with FIM as their focus. Community Servings provides medically tailored meals for chronic illnesses, including pregnant and post-partum individuals, with meals designed and prescribed by in-house registered dieticians. Participants get 15 meals delivered weekly and receive one-on-one nutrition counseling. About Fresh, a Boston-based nonprofit, allows providers to offer “produce prescriptions” via prepaid debit cards, giving people the freedom to buy the fruits and veggies that work for them. At MGH Revere, families can access a food pantry and learn to prepare healthy meals in an on-site test kitchen.

Behind many of these efforts is Food Is Medicine Massachusetts (FIMMA), a coalition of stakeholders pushing toward statewide FIM integration into healthcare. They have created two task forces: one to develop standards and engage with payers, providers and policy makers, and another to train healthcare providers to talk about FIM programs in clinical settings.

While these programs show positive results, some participants experience a “cliff effect” when food benefits end, making it harder to maintain progress. That’s why broader adoption of FIM – through Medicaid, Medicare, and private insurers – is key. The more we treat food as a core part of healthcare, the fewer people will suffer from preventable health issues.
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Because sometimes, the best medicine really is on your plate.

Author 
Allison joined CoRAL in 2024 as a project manager for the ECHO study. She received her Bachelor of Science from Cornell University and her Master’s in Public Health in Health Policy and Law from Boston University. Prior to joining HPHCI Allison worked as a research coordinator, working in the NICU at Tufts Medical Center on several studies. Her interests include maternal and child health, reproductive health and healthcare policy. Outside of work she is an avid reader and enjoys exploring new places and spending time outdoors.
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