Five years ago, before “plant-based” became big, I spotted 12 drivers I thought would support “food as medicine” as a megatrend.

Plant-based agriculture grew partly because of the interest in sustainability and the need to move away from animal to plant-based agriculture. Food as medicine will be much larger than the plant-based market, primarily because the economic impact is felt more personally.

Research has shown than food can help prevent, arrest, and reverse disease. Food is the primary and largest social determinant of health. The public and private sectors have no choice but to explore the benefits of food as medicine to reduce healthcare costs. While food as medicine may sound “fringe” to some, no one doubts the important role nutrition plays in medicine e.g. we use nutrition as therapy ranging from baby formula to providing nutrients intravenously.

In the food-as-medicine world, food can be used in lifestyle or preventative medicine as well as curative medicine. There are therapeutic practices to use food, “as, is, or, and” medicine. Diet can complement therapeutic interventions, i.e. food and medicine. In some cases, food is a legitimate alternative to conventional standards of care, i.e. food or medicine. In other cases, food is medicine. Examples would include targeted nutrient deprivation (TND) technology companies such as Filtricine, a food product under clinical investigation for the treatment of cancer. They make food that provides nutrition and starves certain types of cancers.

I have been attending Food as Medicine conferences at Tufts’ Friedman School of Nutrition, probably the nation’s leader in this field, for several years. For the last 18 months. I have been attending food conferences to learn more about the emerging food as medicine trend, including the Specialty Food Show in New York, the Natural Products Show East and West, the IFT First Show in Chicago, The Nutrition Show in Boston, a Food as Medicine conference in Boston at Tufts, and two hosted by Grey Green in Chicago and Washington DC.  I attended the White’s House’s National Nutrition Security and Healthcare Summit in DC and one of their regional “Come to the Table” conferences in Worcester.  In addition, I attended a speaker series at MIT on the microbiome.

Sunday Celebrations commissioned research on the food as medicine market in the following areas, CPG/Medically Tailored Groceries, Medical/Nutritional Meal Kits/Delivery, Produce Prescriptions, Medically Tailored Meals, Microbiome/Biotherapeutics, Software solutions of various types from personalized/precision nutrition, to helping one find healthy products in the grocery store, to functional foods and Nutraceuticals.

My conclusion: Food as Medicine will be much larger and broader than anyone can imagine because it is the convergence of several major trends.

First, because everybody eats, and our current food system is a major driver of chronic disease. Patagonia, the clothing manufacturer entered the food market because they realized that everyone eats, and they could have a larger impact on the planet through food than clothing. Second, the relationship between the rising cost of healthcare and poor nutrition practices. This market opportunity is attracting investment dollars and innovation trying to provide solutions. Third, our current dietary practices are reducing the quality and length of our lives. Fourth, more medical practices such as lifestyle, holistic, and integrative, have become accepted and all recognize the importance of nutrition.

At Grey Green’s Washington DC Food as Medicine Policy Summit, it was obvious how vested the federal government is in food as medicine. “Food is Medicine” is just one part of Health and Human Services’ work to make progress on commitments made during the White House National Strategy on Hunger, Nutrition, and Health to reduce the prevalence of chronic disease in the United States. This “all of government” approach includes the Departments of Agriculture, Health and Human Services, the Center for Disease Control, NASA, Medicaid, and Medicare among many others.  The federal government is responsible for feeding and paying the healthcare costs of those in the military, so the armed forces as well as the Veterans Administration are involved in food as medicine. The Department of Agriculture is looking at how to reform WIC and SNAP to support a food-as-medicine philosophy to creating more therapeutic food pantries.

In the life sciences, personal nutrition and/or precision nutrition, which includes genetics, biomarkers, and the microbiome in combination with digital therapeutics will significantly advance food as medicine approaches. This is the next generation of health and wellness coaching, weight management, and nutrition counseling.

In terms of personal nutrition we will see more foods designed specifically for women’s nutritional needs as well as food designed for specific life stages.

No one wants to cut benefits, but the rising cost of healthcare as a percentage of the nation’s budget is unsustainable. The private sector is also feeling the pain of rising healthcare costs and is looking for ways to reduce costs without reducing the benefits. They are looking for evidence-based food as medicine interventions as a way to treat and in ideal situations prevent or reverse chronic disease.

Improved dietary compliance and nutrition is one of the key pillars of health coaching and digital therapeutics. The issue is, that we have divorced nutrition from food such that most food is junk, from a nutritional perspective.

Even if the grocery store only sells natural or organic products, several studies have shown that 65-70% of all food in a grocery store is unhealthy, based on nutritional criteria. Our groceries contain too much salt, fat, and sugar. We now eat more food outside of the home than at home, and that food is just as bad or worse.

In essence, the American food system has become a giant chronic disease delivery system, which can be seen in Americans’ health outcomes.

A 2018 study by the University of North Carolina at Chapel Hill found that only 12% of American adults are metabolically healthy. As a nation, we are overweight, diabetic or prediabetic, have heart disease, and have diet-related cancers. This does not include all of the other health problems that are directly or indirectly related to diet.

However, it does not have to be this way. With the discovery of new ingredients, the creation of novel, all-natural ingredients, and AI’s ability to combine ingredients to provide the flavor profiles that we desire, and machine learning to develop the most desired tastes, we can make healthy and tasty versions of most of the unhealthy items in a grocery store.

There are a range of approaches to reducing chronic disease and related healthcare costs. Weight management drugs are estimated to be between $100 billion to $200 billion and are one approach. Another solution is to just make healthier food.

Ed Gaskin is Executive Director of Greater Grove Hall Main Streets and founder of Sunday Celebrations.