Prescription Diet: Changing the Business Model of Food

Food as a medicine is not a new concept to mankind.
Natural medicine is well established in many cultures and societies.

Let’s take the example of ginger. People used ginger as far back as the 1st century AD to “gently stimulate the gut and profit the stomach (Dioscorides First century A.D.)”. The anti-nausea properties of ginger are generally known to many today. Systems of traditional medicine use ginger, and ginger ale has helped sailors with sea-sickness for generations. But, an internet search of “nausea treatments” leads to a list of complicated chemical names and WebMD tells us they may cause cancer!

Science is continuing to show the health benefits of food beyond nutrition. Consumers, from boomers to millennials, are changing consumption habits and exhibiting the desire for more complete food experiences rather than holding onto a separation of health and nutrition. Thus we see a holistic approach to condition specific health and nutrition.

This is a new phenomenon in people, but has been an active business effort for pet foods for years. Every pet food manufacturer has a line of prescription diets with a therapeutic purpose. Examples include gastro intestinal health, blood pressure, or kidney function. These diets are usually available only through veterinary channels. Pet owners find them effective enough to buy repeatedly. Why? Because they make their pets feel better.

Let’s imagine for a second the benefit of having our doctor prescribe food to cure an ear infection. How much more convenient would it be to eat a “prescription chicken nugget” than to wrestle with our kids over drinking the nasty pink medicine? There would be no more pills and no messing with liquids. And you would also be following a top recommendation of doctors—take with food.

Consider also people that need daily medication. Everyone that has had any kind of medication to take regularly has likely faced the “I forgot to take my pill” moment. This can be devastating, both for mental well-being of the patient and the caregiver, as well as the management of the disease. This creates significant tension in disease management.

A condition-specific prescribed food would ease this tension.
It would be simpler for us to take it upon ourselves to eat more vegetables. It would be just as good to find the regimen that works for each individual and stick to it. But this thinking is inherently flawed because i) consumers need to have knowledge and understanding of what works AND ii) they need to overcome their habits and cognitive biases that lead to their irrational behavior.

With medicine, the doctor knows best and tells us what to take. We do it without really questioning why, as long as it works. Doctors have the knowledge and are willing to provide it to us. The relationship is simple: me and my doctor, an ailment and a medicine. Therefore, both criteria are met. 1) we get the knowledge we need and 2.) we can adopt new habits and routines for the short-term to satisfy the acute problem.

With food, it’s more complicated. The consumer is the decision maker and has to fend off his own biases, the direct marketing assaults at the grocery store, the 17 restaurants within 2 blocks of the office, family, friends, and on and on… The relationship with food involves lifestyle and must be adapted and adjusted constantly to maintain a disease free state. Here, only the 1st criteria is met (and somewhat sparingly at that).

While most of us know that we should eat healthier and have a general sense of what that is, it is also true that as individuals we respond to foods and situations differently. Hypothetically we understand what we need to do, but there is doubt over whether or not it is the right thing to do.

Presuming we have the necessary knowledge to make the right decisions. The 2nd step is even more difficult. It relies on the assumption that consumers are rational and will do what is in their long-term best interest. Scores of research in behavioral economics shows with little room for doubt that consumers are irrational. That they prefer to think in terms of satisfying short-term and immediate desires and discount the long-term utility of their decisions.

Therefore, to successfully adapt food as medicine we would have to: 1.) know which foods are most functionally useful – to understand the benefit; 2.) get the right food to the right people at the right time – to realize the benefit; and 3.) do it in an affordable and convenient way – to overcome heuristics.

Which foods are most functionally useful?
Many clinically based programs have been developed to address the nutrition requirements of specific ailments, such as diabetes and obesity of course, but also cardiovascular diseases, high cholesterol etc. These special diets instruct patients on what they should or should not eat.

More recently, hospitals, such as the Cleveland Clinic are incorporating nutrition as a way to treat and prevent diseases in people. But the question is really what is the goal we want to achieve with using food as a way to manage care; prevention or cure ?

Prevention has been difficult to achieve in the past, mostly because we tend not to worry as much for a condition that is not already here. Nowadays, more people seek for better and healthier lifestyle to limit the risk of potential ailment. It often start with better food choices like organic, non processed, fresh food. The increased use of dietary supplements, and the popularity of these ingredient specific diet (low-fat, low carbs, paleo…) is also a good indication that consumers are ready to take charge of their health with the proper food. The problem is that the consumers make their choices based on the popularity of such or such functional foods or diet that was just on the latest TV show or blog without actually backing it by credible scientific or clinical data. We are far from a personalized nutrition.

The path personalized nutrition is not as simple as determining a specific condition because our relationship with food is a complex mix of physiological and psychological influences shaped by our environment. Of course, we can somewhat control some of the environmental influences, mostly with better information and prevention.

To help with fine tuning the diet / food and achieve a more personalized nutrition, several other options are growing. For example, the field of nutrigenomics is rapidly expanding our awareness of how we respond to foods at a molecular level. Companies such as Nutrigenomix are commercializing condition-specific diet recommendations based on our unique genetic makeup through healthcare professionals. This approach requires the extra step of getting tested, but these companies are taking the guess work out of the equation toward personalized nutrition.

How do we get the right functional food to the right people? Whether it is ordering pizzas or groceries, the food we want can be delivered to our door virtually anywhere. Take for example HelloFresh and Plated. These delivery services have packaged meals that come with minimal preparation needs. They are restating what our relationship with food should be: wholesome fresh, home prepared meals. These services are poised to disrupt our relationship with food. From procuring and preparing to the way we think about food limitations. These companies are slowly eroding the preconceived notions we have about what food delivery is and they are showing us what is possible.  In the context of food as a medicine, these delivery services will bring to our doors the right components for the preparation of these “healing” meals, eliminating the distractions from the environment.

How is this affordable? One of the major complaints in the media is that healthy food is too expensive. And for the most part, it is. Undoubtedly the condition-specific nature of disease prevention and management will add an extra cost burden. But a few models already exist to subsidize certain foods and medications: for example, the WIC program in the US or health insurance. WIC is the Special Supplemental Nutrition Program for Women, Infants, and Children which provides subsidies to low-income women, infants, and young children who are at nutritional risk. Health insurance is already established to reimburse doctor’s and patients for their health care costs.

Each component necessary to use food as a way to manage health care exists. Combining these three seemingly distinct models allows us to use food as medicine that is more personal, more accessible, and more affordable. The consumer is ready to embrace the Hippocratic way of life: “Let food be your medicine and medicine be your food”—you should be too.