Food is Medicine: developing a Medically-Tailored Meal (MTM) program to tackle type 2 diabetes and heart disease in Australia

Eating an unhealthy diet is a leading risk factor for chronic diseases worldwide. Innovative new programs to improve the diet of millions of Australians at high risk of heart disease, such as those with high blood pressure and type 2 diabetes (T2D), have tremendous potential to save lives and reduce healthcare costs. 

‘Food is medicine’ programs aim to integrate healthy food provision into the health care system for the prevention, management, and treatment of disease, especially for food-insecure patients and other vulnerable groups. A particularly promising approach is Medically tailored meals (MTM), whereby doctors ‘prescribe’ evidence-based pre-prepared healthy meals for patients. Prescribing healthy meals offers patients a new way of accessing the foods they need and for many disadvantaged patients with chronic diseases this will also make healthy foods more affordable.

Aim

We will test whether provision of MTM is a feasible and effective way of improving T2D management and reducing heart disease risk in the Australian setting. This will be an Australian-first study with most of the other significant research in the field being done by colleagues in the United States. 

Design

We will conduct a randomised control trial of an MTM intervention in individuals with undermanaged T2D, who have difficulty buying or eating nutritious food.

Method

Over 26 weeks, 106 participants in the intervention group will be prescribed MTM whereas 106 in the control group will continue their usual clinical care. The participants’ dietary intake, medication use, body weight, blood pressure, blood lipids and blood glucose level will be assessed pre- and post-intervention. A sub-sample of participants will be interviewed to understand how the program worked (or did not work) for them, and ways the program can be improved and scaled up.

Status

Recruitment is planned to commence in mid-2022. 

Expected outcome

We expect this Food is Medicine intervention to give Australian doctors a new and effective way of using diet to manage T2D and reduce heart disease risk in large numbers of patients. We expect the MTM to prove as effective as other therapies, to be preferred by patients, and to be as cost-effective as many existing drug treatments.

Funding

The study is supported by seed funding from an NHMRC Program Grant, NSW Cardiovascular Research Capacity EMCR Grant, and a generous philanthropic donation from the Estate of Faye Williams.