From the community | MAHA is worsening nutrition insecurity — ‘Food is Medicine’ can do better

Secretary of Health Robert F. Kennedy Jr. has named ultra-processed foods a leading cause of increased rates of chronic disease in children, according to the “Make America Healthy Again” (MAHA) strategy report. The report coincides with historical cuts to the Supplemental Nutrition Assistance Program (SNAP), reducing funding by roughly 20%. Of those who receive SNAP benefits, it’s estimated about 40% are children. In addition, major cuts were also made to the Women, Infants and Children (WIC) program, with a two-thirds reduction in fruit and vegetable benefits.

RFK has focused less on the overall consequences of these cuts and more on what beneficiaries are purchasing with funds. Budget cuts are accompanied by new food restriction waivers banning the purchase of non-nutritious items like soda and candy to “strengthen integrity and restore nutritional value within the Supplemental Nutrition Assistance Program” according to the Food and Nutrition Service website. Secretary of Agriculture Brooke Rollins stated in a recent news release, “With these new waivers, we are empowering states to lead, protecting our children from the dangers of highly-processed foods, and moving one step closer to the President’s promise to Make America Healthy Again.” The shift in focus from these massive benefit cuts by emphasizing the high rates of SNAP purchasing of ultra-processed foods as justification, grossly misses the mark.

A 2024 article estimates about 50% of SNAP recipients experience food insecurity at some point in a given year. Ultra-processed foods are both cheaper and higher in calories than most high quality, whole food alternatives. For those experiencing food insecurity, hunger and limited access to resources, purchasing ultra-processed foods is not only a matter of preference but a matter of practicality to stretch benefits and avoid hunger. Although these social programs were designed to supplement household groceries, benefit amounts even prior to the cuts aren’t enough to adequately supplement grocery costs for most household incomes. A 2024 analysis found the average cost per meal allocated by SNAP to be $2.84, 20% lower than the average cost of a “modest meal.”

MAHA’s policy action to reduce ultra-processed foods is a failed and oversimplified articulation of a more complex issue: nutrition insecurity. Americans who benefit from social programs like SNAP and WIC are not only food insecure, they’re often nutrition insecure. Nutrition insecurity is defined as “the lack of consistent or equitable access to nutritious, safe, and culturally appropriate foods” according to the U.S. Department of Agriculture. And despite recent policy shifts away from food initiatives like SNAP and WIC, research has established “Food is Medicine” interventions as a feasible solution to treating, reducing and preventing disease.

“Food is Medicine” includes a range of nutrition interventions for patients with health conditions such as diabetes or heart disease, or social needs like food and nutrition insecurity, the two of which often go together. These interventions include produce prescriptions, food boxes and medically tailored meals that have shown improvement in food security, blood glucose, body mass index, blood pressure and mental health. Increased investment in “Food is Medicine” programs could prove a viable solution to the issues targeted by both MAHA and social programs like SNAP and WIC, improving the nutritional value of the American diet.

Within the “Food is Medicine” movement, there is a growing demand to develop and evaluate culturally tailored foods in addition to medically tailored foods, particularly by American Indian and Alaskan Native communities and practitioners. American Indian and Alaskan Native households in the U.S. experience food insecurity at twice the rate as white Americans, and have the highest rates of type 2 diabetes compared to all other racial and ethnic demographics in the country. These disparities are a direct result of historical, systematic attacks on Indigenous foodways. Colonial contact introduced new processed foods like refined sugar and alcohol, and later forced relocation to Reservations introduced government issued food including lard, flour, coffee, sugar and canned meat.

“Food is Medicine” is not just an emerging field in behavioral health, it’s a tradition of many Tribal communities that dates back long before colonial contact. “Pre-contact foods” included a variety of legumes, complex carbohydrates, fish, game, nuts and seeds, and other important whole food staples to improve health. Evidence suggests whole foods maintain the structure of vital nutrients like fiber and complex carbohydrates, leading to greater satiation and glucose control. Ultra-processed foods typically strip fiber and have more calories from the added sugars and fats, leading to more frequent eating and spikes in blood glucose according to researchers. The added ingredients found in ultra-processed foods come from highly subsidized crops like soy, corn and sugar, meaning they are not only less nutritious but way cheaper per calorie.  Improving access to “pre-contact foods” challenges the structural and historical barriers that perpetuate the same health disparities MAHA’s strategy report aims to reduce. 

In a similar spirit to MAHA’s mission to eliminate ultra-processed foods, “Food is Medicine” programs offering culturally appropriate, “pre-contact” foods have potential to improve health and nutrition security. Cutting social programs like SNAP and WIC won’t reduce ultra-processed foods from the American diet. Instead these cuts worsen the nutrition security of Americans who need it most by taking away food, period.

While a focused effort is needed to reduce health disparities among populations experiencing the highest rates of nutrition insecurity and chronic disease, especially in light of funding cuts to programs like SNAP and WIC, we all could benefit from integrating pre-contact and cultural foods into our daily diets. So next time you sit down to eat a meal, consider what your family’s relationship with food is. What cultural or traditional foods did you eat growing up and what do they mean to you? Are there any pre-contact foods you enjoy? What’s their significance to the people who came before you?

You might find yourself looking at the potatoes, squash or salmon with a little more appreciation on your next grocery run.

Jasmyn Burdsall is a Knight-Hennessy scholar pursuing a master’s degree in community health and prevention research and a Ph.D. in epidemiology and clinical research at Stanford School of Medicine.

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