By Diana Malkin-Washeim, PhD, MPH, RDN, CDCES, CD-N

Dr. Henry Bieler was an American physician and a germ theory denialist best known for his book, Food is Your Best Medicine, published in 1987. Thirty-nine years ago, he argued “...despite the advances in technological knowledge and millions spent on medical research programs, mankind sickens and dies; hospitals and mental institutions are filled with overflowing disease and the helpless. Here in our own country - with the greatest abundance of food stuffs and the higher living standards in history are to be found – a truly radiantly healthy person is as rare as a pearl in a barrel of oysters.” 1

First attributed to Hippocrates (c. 400 BC), the now-popular phrase “food as medicine” is a centuries-old philosophy prioritizing nutrient-dense foods to prevent, manage, or reverse disease, and it is now recognized as a health strategy to address chronic illnesses and food insecurity.

According to the Academy of Nutrition and Dietetics, Food as Medicine (FAM) programs “deliver both medical nutrition therapy (MNT) and food delivery.”2. FAM focuses on four areas: (1) encourage health and well-being, (2) address nutrition security, (3) promote food safety, and (4) manage and treat disease. MNT is comprehensive, and it is the way nutrition care is provided. FAM can also include culinary medicine, where we secure and prepare food, and how food aids in managing medical conditions and/or disease prevention. FAM’s goals are (a) improve access to nutrition services and MNT by a RDN (b) develop sustainable payment models (important for sustainability and consistency); (c) demonstrate effectiveness via various research methodologies; and (d) increase multi-disciplinary awareness and education.2

It is imperative that the above messaging of FAM also account for the social determinants of health (economic stability, education, social context, and neighborhood), which impact lives every day. Millions of Americans lack access to affordable, nutritious food, which drives poor health outcomes, especially in resource-poor communities. Unemployment affects food access and consumption of nutrient-dense foods. In addition, people may be forced to choose between purchasing nutrient dense foods versus paying for rent, heat, gas for transportation, and/or needed medication. Under these circumstances, there is also an impact on mental health3 and non-communicable diseases, e.g., diabetes, elevated lipids, chronic hypertension, cardiovascular diseases (heart attacks, stroke), cancers, and chronic respiratory diseases.

Food has a profound impact on diabetes management, directly influencing blood glucose levels and medication needs, specifically insulin. For example, if someone is taking a Sulfonylurea or injecting insulin and at the same time have limited food intake, they may experience a hypoglycemic event if they are not titrating back on either of these medications. Hypoglycemia can be a life-threatening condition if it is severe and/or if someone is unaware of their symptoms. Food as Medicine can be delivered through vouchers, medically tailored meals, or produce prescriptions to help prevent or treat diet-related medical conditions. This approach is especially urgent today given the prevalence of diet-related chronic diseases and the increasing strain of healthcare costs. Nutrition-related conditions are now a leading cause of death and food

insecurity in the U.S.,4 and these burdens further contribute to health disparities disproportionately among racial and ethnic groups.4

As we address all communities where good nutrition limits all barriers across the lifespan, we will see a significant decrease in diet-related chronic conditions while fostering improved health equity and longevity.

References:

1. Bieler, H. (1987). Food is your best medicine. Ballantine Books.
2. Academy of Nutrition and Dietetics (2026). Food as Medicine: The Academy's Strategic Roadmap. Transcript. Retrieved May 10, 2026. https://www.eatrightpro.org/food-as-medicine 
3. World Health Organization (2026). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide 
4. Brandt, E.J., Mozaffarian, D., Leung, C.W., Berkowitz, S.A., & Murthy, V.L. (2023). Diet and food and nutrition insecurity, and cardiometabolic disease. Circulation Research, 132(12), https://doi.org/10.1161/CIRCRESAHA.123.322065