Better Food, Better Health: Redefining Chronic Disease Care Through Nutrition

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A UPMC pilot program initiated to solve persistent chronic disease challenges, “Better Food, Better Health,” has revealed profound lessons about hidden barriers to health, particularly those related to social determinants. Despite having insurance and theoretical access to care, there are UPMC Community HealthChoices members living in southeastern Philadelphia who continue to face a significant burden of chronic diseases, including diabetes, high blood pressure, and heart failure, and their inability to control these conditions frequently led to hospital admissions, highlighting a paradox where insurance alone was insufficient to ensure wellness.

Crystal Clark, MD, MPH, chief medical officer, UPMC Community HealthChoices, explains that the program's foundation was the belief that removing specific barriers could stabilize or improve members' health trajectories.

UPMC designed the pilot program around the concept of "food as medicine,” and it encompassed interventions that were multifaceted: increasing access to good fresh produce, providing medically tailored meals designed for participants’ particular health issues, offering education on nutritional decisions, and ensuring members spoke with a nutritionist at least monthly. To successfully implement this comprehensive vision, UPMC recognized the necessity of partnering with local Philadelphia community-based organizations that possessed deep community trust.

MANNA was brought in for its critical expertise in medical nutrition therapy, and it would go on to provide the medically tailored meals and nutrition counseling, delivered by registered dietitians. These meals are produced in-house using fresh ingredients and are conceived by registered dietitians and chefs. The goal was 2-fold: ensuring the meals were healthy for chronic conditions while also guaranteeing they tasted good, thereby combating the assumption that healthy food is bland. This support was all-encompassing, providing complete nutrition for each day, including breakfast, lunch, dinner, a healthy dessert, and a snack.

The other crucial partner, Philabundance, addressed the core issue of access, particularly for fresh produce. Philabundance supported the argument that dietary changes are likely to "move the needle" for chronic diseases.

By combining the structured guidance and education from MANNA with the autonomy offered by Philabundance's fresh produce, the pilot was able to cohesively address the full spectrum of needs required to help these individuals change the trajectory of their chronic disease.

Editor's note: Since this interview, Amba Kasongo has become program director of the Delaware Valley Chapter of the Alzheimer’s Association.