Saturday, 12 May 2018

Cod and ‘Immune Broth’: California Tests Food as Medicine

Tests Food as Medicine

SEBASTOPOL, Calif. — On a foggy afternoon, Diana Van Ry, a retired judicial assistant, dropped by the boisterous kitchens of the nonprofit group where she volunteers to select up rock cod, cauliflower couscous and an “immune broth” enriched with vegetables and seaweed.

She planned to deliver the meals to Brandi Dornan, 46, who is recuperating from carcinoma.

“It’s the food I wouldn’t have thought to form myself,” said Ms. Dornan, who started getting the meals during radiotherapy and is grateful for the assistance.

“Wow, bless their hearts.”

The Ceres Community Project — its meals prepared for cancer patients by teenage sous-chefs — is at the forefront of the “food as medicine” approach increasingly embraced by physicians, health insurers, researchers, and public health officials.

The group is now participating in an ambitious, state-funded study to check whether providing daily nutritious meals to chronically ill, low-income people on Medi-Cal California’s version of the Medicaid program — will affect their prognosis and treatment, or the value of their medical aid.

Over subsequent three years, researchers from the University of California, San Francisco and Stanford will assess whether providing 1,000 patients who have a congestive coronary failure or Type 2 diabetes with a healthier diet and nutrition education affects hospital readmissions and referrals to long-term care, compared with 4,000 similar Medi-Cal patients who don’t get the food.

The interest in food as medicine is essentially an outgrowth of the nutritional the know-how acquired during the AIDS epidemic of the 1980s.

Organizations like Project Open Hand in San Francisco and God’s Love We Deliver in NY City sprang up to bolster the health of individuals whose lives were being decimated, often by the load loss called wasting syndrome.

As the disease became treatable with antiretroviral medicines, many groups expanded their missions to assist people with chronic conditions like heart conditions and diabetes.

“When you are feeling terrible, managing your diet falls to the rock bottom of your list,” said Karen Pearl, the president, and chief executive of God’s Love We Deliver.

The California's study will repose on smaller and fewer rigorous earlier research.

A study in Philadelphia by the Metropolitan Area Neighborhood Nutrition Alliance retroactively compared insurance claims for 65 chronically ill Medicaid patients who received six months of medically tailored meals with an impact group.

The patients who got the food racked up about $12,000 less a month in medical expenses.


Another a small study by researchers at U.C.S.F. tracked patients with H.I.V. and sort 2 diabetes who got special meals for 6 months to ascertain if it might positively affect their health.

The researchers found they were less depressed, less likely to form trade-offs between food and health care, and more likely to stay with their medications.

Their care also cost less: the worth of feeding each participant for 6 months was $1,184 per person, but half the $2,774 cost per day at a California hospital, consistent with the study.

“It lightens the load mentally,” said Conrad Anthony Nesossis, 69, a Mississippi native with diabetes who received hot meals delivered to his doorstep as a part of the study.

He still uses the seasoning mixture of garlic, onion, and flavorer he learned then.

I’m not a flowery cook, but it opened my eyes and my taste buds.”

Poor people can have an especially hard time controlling chronic diseases because they often eat cheap foods laden with sugar and salt and avoid costly fruits and vegetables.

“Sometimes there's a short-term sacrificing of food to pay the rent, or they are going without medications because they can’t afford the co-pay,” said Dr. Sanjay Basu, a professor of drugs at Stanford who is going to be involved within the new study.

“That’s once they unintentionally find yourself within the E.R.”

For cancer patients, a loss of appetite due to treatment side effects can cause malnutrition, which lessens the body’s ability to fight disease.

Dr. Fasih Hameed, an associate medical director at the Petaluma clinic, prescribes meals from Ceres to cancer patients also as those with hepatitis C.

“It’s how of holistically rebooting,” he said.

The study here in California, which can include patients in l. a. , San Diego, Oakland, and San Francisco dovetail with efforts just like the preventive food pantry at the Boston center and school of medicine culinary programs like one at the Goldring Center for Culinary Medicine at Tulane University, which features a teaching kitchen and medico chefs leading community cooking classes.

The House of Representatives Hunger Caucus recently launched a Food Is Medicine working party to seem at how research into medically tailored meals might inform national policy, said Rep.

Jim McGovern, Democrat of Massachusetts and co-chairman of the caucus.

Although medically tailored meals delivered daily are costlier than a visit to a food pantry, “it has the advantage of matching what we expect people got to what they're actually getting,” said Dr. Seth Berkowitz, a professor of drugs at the University of North Carolina School of drugs, who is functioning on several studies with Community Servings, a nonprofit nutrition program in Boston.

Daniel N. Mendelson, chief executive of Avalere Health, a Washington research and the consulting firm, said that to qualify for coverage under Medi-Cal and Medicaid, the tailored meals got to be medically necessary.

“If California’s large-scale demonstration with Medi-Cal populations reduces costs and provides proof of positive outcomes, every state will want to try to an equivalent thing,” he said.

Dr. Hilary K. Seligman, a professor of drugs at U.C.S.F. who will participate within the new California study noted that “the critical epidemics of our day — obesity and diabetes — are diet-related.

” The medical community, she said, “accepts the foremost expensive procedures and medications without batting an eyelash.

But with food, we've to prove it’s inexpensive to be accepted.”

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