The Academy of Nutrition & Dietetics held the 2023 Food & Nutrition Conference & Expo in Denver, Colorado, from October 7-10, 2023. This annual meeting is the world’s largest gathering of 8,000+ food and nutrition experts, researchers, healthcare providers, and industry leaders. The meeting is planned for experts to collaborate on solutions to improve the nation’s health, provide updates, and showcase the latest products and services. Here are a few trends that may change how you look at nutrition and healthcare.
Medically Tailored Meals
Poor nutrition is the leading cause of illness, death, and healthcare spending in the US. It is crucial during cancer to treat poor nutrition, as up to 20% of cancer patients die from malnutrition and not the underlying disease1. The recent White House Conference on Hunger, Nutrition, and Health2 advocated for the integration of nutrition and health. One strategy to address this is the “food as medicine” movement, including the provision of food prescriptions for fruits and vegetables and medically tailored meals to high-risk populations, such as those undergoing cancer treatment.
Medically tailored meals (MTM) are meals that are customized for common medical conditions, such as heart disease, diabetes, chronic kidney disease, and cancer. Many organizations are studying the impact on patients who are provided MTM following a hospital discharge and during cancer treatment. Programs providing MTMs have shown that they result in a reduction in healthcare costs and a decrease in hospital readmission rates. Hospitals and non-profit organizations (for example, MANNA in Philadelphia) and insurance companies are providing MTMs in select areas. NutriCare, a project at Tufts University, is studying outcomes in patients with lung cancer who receive MTMs and dietitian visits. Some states are posting virtual maps to display where MTMs and food packages are available (for example, Food Is Medicine Massachusetts).
To keep up the good work, healthcare professionals can continue to screen for food insecurity and provide community resources to patients; watch the Medicaid Pilot in the eleven states that have a waiver to provide food as medicine services; monitor the bill that is being introduced in Congress to allow for MTM in traditional Medicare; and follow the re-introduction of the Medical Nutrition Therapy Act to expand the coverage of dietitian visits to Medicare recipients to include a broader range of disease states like cancer and malnutrition.
The Dietary Guidelines for Americans for Healthy Vegan and Vegetarian Diets
Plant-based food options continue to be a growing trend in 2023. Companies are developing products in addition to meat replacements to include seasonings, snacks, sauces, and fish alternatives. To be well nourished, it takes more than just eliminating animal products from your diet if you are choosing plant-based, vegan, or vegetarian eating. Many people look for eating guidance from The Dietary Guidelines for Americans (DGA) which are displayed online on government websites and nutrition messaging to the public. The MyPlate website from the United States Department of Agriculture is the visual interpretation of the DGA. In fact, MyPlate is improving the plant-based choices for a more nutritionally balanced meal plan. The Healthy Vegetarian Pattern from MyPlate can be modified to include a wide range of plant-based diets (vegan, lacto-ovo vegetarian, pescatarian, and more). To ensure that your plant-based eating is nutritionally balanced, consider using fortified soy beverages, plant-based foods that fit into your budget and cooking skills, and slightly processed foods with key nutrients.
Nutrition as Prevention for Improved Cancer Health Outcomes
In July 2022, the National Institutes of Health hosted an interdisciplinary workshop to determine knowledge gaps and to create recommendations to advance the understanding of nutrition interventions, especially around adults with cancer, outcomes, and weight loss before and during treatment. During this workshop, participants explored nutritional interventions to reduce the adverse effects triggered by malnutrition in patients with cancer. A panel of experts presented the findings.
Although 4 out of 5 people living with cancer are diagnosed with malnutrition3 it often goes unrecognized by providers, patients, and caregivers. When malnutrition is not addressed, cancer outcomes can be compromised, and mortality risk can be increased. And, even if it is diagnosed, malnutrition may not be aggressively treated. Less than 60% of cancer patients at risk for malnutrition receive any nutrition interventions4. Only an approximate 40% of these patients may receive Medical Nutrition Therapy (MNT) from a registered dietitian (RD)4. There is a shortage of registered dietitians in oncology outpatient centers, with a ratio of one RD per 2,308 cancer patients. Thus, this is a gap in access for patients in need of cancer nutrition care. Most cancer centers do not bill for nutrition services because it is not reimbursed through Medicare and many private insurers4. This limits some cancer centers to provide RD services.
Recommendations from the workshop include:
- More research on the cost-effectiveness of nutrition interventions
- Studies that integrate dietitians into healthcare cancer teams
- Increased malnutrition screening strategies for all people living with cancer
- Research that includes a diversity of cancer types and body compositions to better understand muscle wasting and cancer outcomes
IMPOSSIBLE is a Fallacy
Entrepreneur Mick Ebeling shared his perspective and accomplishments around the phrase “Everything that is impossible today will be possible one day.” Impossible is a temporary state of being, not permanent. Many things that we enjoy and use today were impossible years ago: cell phones, microwaves, flight, automobiles, electricity, and robotic surgery. Ebeling has tackled many seemingly impossible problems with a team of experts who work together, such as the Sudan famine, a successful painter who was limited due to paralysis, the lack of artificial limbs for war victims, and the struggle with food insecurity.
Ebeling has recently focused on food insecurity More than 44 million Americans struggled to put food in the table in 20225.This results in not eating enough to thrive. Some people are working two to three jobs to make ends meet and cannot get to a food pantry during the pantry’s hours as they often conflict with work hours. Ebeling’s Impossible Lab® developed a service called GoBento.com in Venice, California. GoBento is a text messaging-based service that connects people who need a meal with restaurants and grocery stores who donate meals and food boxes. He has partnered with insurance providers, Uber, Grub Hub and healthcare organizations to make food available. Stigma-free meals are accessed from nearby food establishments to people who ordered the meals via text messaging. Meals are picked up at the establishment just like a to-go meal or may be delivered by a service if the person has no access to transportation.
Ebeling encourages everyone to change their thinking from impossible to possible by starting slowly. Choose one person to help. Help solve an issue for one person by relating to the person and listening to their story. If you can help or solve an issue for one person, you can use the same skills to grow to help many people. #HelpOneHelpMany
Final Thoughts
Many important nutrition trends are evolving in the United States of America as well as around the world. Collaborations among health organizations, non-profit groups, and people who are agents for change can result in improved health outcomes and food security. Working together to prevent malnutrition and hunger in people with cancer and their families is our united goal. When you help one person, it can start a chain reaction of helping many people.
Learn more about nutrition and food insecurity during cancer care in our resources:
Food Assistance Resources and Tips
Through LLS’s Nutrition Education Services Center patients and caregivers of all cancer types can receive a free nutrition consultation with a registered dietitian who has expertise in oncology nutrition.
References
- Arends J, Baracos V, Bertz H, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clin Nutr. 2017 Oct.36(5):1187-1196.
- White House Conference on Hunger, Nutrition and Health. Accessed November 3, 2023.
- Trujilo EB et al. Closing the gap in nutrition care at outpatient cancer centers: ongoing initiatives of the Oncology Nutrition Dietetic Practice Group. J Acad Nutr Diet. 2018;118(4):749-760.
- Trujillo EB, Claghorn K, Dixon SW et al (2019) Inadequate nutrition coverage in outpatient cancer centers: results of a national survey. J Oncol 2019:1–8. https://doi.org/10.1155/2019/7462940
- Economic Research Service. Key Statistics & Graphics. United States Department of Agriculture. Last updated October 25, 2023. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/key-statistics-graphics/. Accessed November 16, 2023.
