Food as Medicine: Free Program Provides Medically Tailored Meals to People Living with HIV, Cancer in the St. Louis Region
Swamps. Deserts. Mirages. The terms refer to more than just our geographic environment. They also can be used to refer to our food environment or the food that is available to us day-to-day.
Food deserts are geographic areas in which residents have limited access to healthy food, such as fresh fruits, vegetables, and lean protein. Food swamps have adequate access to healthy food at retail, but also feature an overabundance of exposure to less healthy food and beverages typically found at fast food outlets and convenience stores. Food mirages are barriers low-income individuals face when trying to access healthy, affordable food in their neighborhood. For example, stores selling healthy food are available, but the food is out of reach financially.
In the St. Louis region, these food environments have led to nutrition insecurity among many residents. Those living with chronic illnesses like HIV and cancer are at particular risk from the negative health and quality-of-life effects of nutrition insecurity.
Food Outreach is working to change that paradigm. Founded in 1988 by a group of caring individuals cooking meals for seven of their friends living with HIV/AIDS, Food Outreach is the only community-based organization in Missouri and western Illinois that prepares and delivers medically tailored meals (MTMs) for individuals living with chronic illnesses, including HIV and cancer. The organization also has a pilot program to serve people with type 2 diabetes.
“Nutrition insecurity and related disparities have left under-invested communities at greatest risk for chronic illness and death,” said Julie Lock, executive director, Food Outreach. “For more than 35 years, we have been at the forefront of advancing the idea that nutrition can be a vital and holistic part of an individual’s wellness and medical treatment plan.”
Battling Hunger While Battling Cancer
Lock said that proper nutrition – including lean proteins, fresh fruits and vegetables – is important for everyone, but it is particularly important for people with life-altering illnesses such as cancer.
“Battling cancer increases the body’s need for protein,” Lock said. “When someone with cancer doesn’t get enough protein-dense calories through their diet, their body copes by breaking down tissue in order to survive, resulting in unintentional weight loss and loss of muscle mass.”
Without proper nutrition, Lock said cancer patients may experience waning energy and strength, poor sleep, and nausea. They also may have problems tolerating their cancer treatment, which can lead to treatment side effects or even the inability to complete treatment as prescribed.
The Medically Tailored Meal Program
Food Outreach is part of a national coalition of non-profit, medically tailored food and nutrition providers called the Food is Medicine Coalition (FIMC). FIMC defines medically tailored meals as “meals approved by a registered dietitian nutritionist (RDN) that reflect appropriate dietary therapy based on evidence-based practice guidelines. Diet/meals are recommended by an RDN based on a nutritional assessment and a referral by a health care provider to address a medical diagnosis, symptoms, allergies, medication management and side effects to ensure the best possible nutrition-related health outcomes.”
“Medically Tailored Meals are one of the least expensive and most effective ways to improve our health care system in an equitable way,” noted FIMC Executive Director, Alissa Wassung, in a statement on the organization’s website.
Food Outreach builds its MTM program around healthy entrees and side dishes that are protein-, vegetable-, and fruit-forward, with a focus on whole foods instead of heavily processed foods. Their Registered Dietitians (RDs) work together with their chefs and volunteers to plan, cook and flash-freeze over 6,000 meals every week, from menu selections that change every two weeks.
Clients receive two meals a day, matched to dietary restrictions and personal and cultural preferences. The scratch-prepared meals are supplemented with a variety of fresh, frozen and shelf-stable proteins, fruits, and vegetables, along with complex carbohydrate foods such as oatmeal, beans, and brown rice. Some clients, including those with swallowing or chewing disorders and severe nausea, receive protein shake supplements.
“Our RDs work with each client to assess their current nutritional status, their treatment plan and any side effects they are experiencing so we can match the meals we prepare with what the client can eat and digest,” Lock said. “They also delve into bigger issues around hunger by asking how recently the client had a scratch-prepared meal, whether they have food in their refrigerator and whether the client actually has a refrigerator and a way to prepare fresh food.”
For clients who lack some of these basic food preparation appliances, Food Outreach will supply a microwave and/or a blender at no charge. All of the agency’s services are provided at no charge to its clients.
Meeting Clients Where They Are
Many of Food Outreach’s clients pick up their meals at the organization’s midtown St. Louis Nutrition Center, where they can order off a “menu” of options, watch their meals be hand-packed by volunteers, and get help carrying their meals to the parking lot, if needed.
“They enjoy being with others and sharing the experiences they are going through,” Lock said. “The personal touches our friendly, respectful, and caring staff and volunteers provide help to nourish their souls as well as their bodies.”
Editor’s Note: Listen to three-time cancer survivor, Sandra, tell her story about her experiences with the caring individuals at Food Outreach.
Clients who are too weak or ill to pick up their food have meals delivered to their home, a service made possible due to the generous support of corporations and foundations, which allowed Food Outreach to significantly expand its pool of delivery vans and drivers.
“Our home delivery program gained traction during the COVID pandemic,” Lock said. “But it’s also an integral part of our strategy to meet our clients where they are and address adjacent issues like transportation insecurity.”
As in the old “give a man a fish/teach a man to fish” proverb, Food Outreach’s goal is to help its clients transition from its services by learning where and how to access healthy food, and how to prepare and cook that food in a way that fits their culture and lifestyle.
“We teach them how, even on a very limited budget, they can use the power of healthy foods to meet their physical and nutritional needs and advance their wellness journey,” Lock concluded.