Evidence for FAM in diabetes ist he most extensive of any condition. Food insecurity is strongly associated with worse diabetes outcomes, including uncontrolled hyperglycemia, hypoglycemia, and poorer medication adherence.^10,11 A multi-state food pantry intervention providing diabetes-appropriate foods improved food security, fruit and vegetable intake, and diabetes self-management, and lowered hemoglobin A1c among participants with poor baseline control.<sup>12

‍</sup>Randomized trials of medically tailored meals and groceries show reliable improvements in diet quality, food security, and hypoglycemia.^13,14 Produce prescription programs have shown promising results for food security and glycemic control, including improved HbA1c at a Michigan federally qualified health center¹⁵ and in a pooled evaluation of 22 program sites across 12 states.¹⁶ Larger randomized trials now underway will help clarify how to design programs with the greatest clinical benefit.

Some of the strongest evidence for dietary intervention exists for hypertension and cardiovascular health through the landmark DASH trials.^17,18 Lowering dietary sodium combined with the DASH diet (rich in fruits, vegetables, whole grains, nuts and seeds, and low-fat dairy, and low in saturated fat) produced the greatest reductions in systolic and diastolic blood pressure.

FAM programs now translate these findings into practice. In an evaluation of produce prescription programs across 12 states, adults with hypertension experienced meaningful reductions in blood pressure,¹⁶ and a 2023–2024 evaluation of four produce prescription projects using electronic health record data found significant reductions in both systolic and diastolic blood pressure alongside a clinically and statistically significant decline in HbA1c.¹⁹

Medically tailored meals (low-sodium, DASH-pattern) are feasible and well accepted after hospitalization for heart failure. The GOURMET-HF pilot at Michigan Medicine found that four weeks of home-delivered, sodium-restricted meals after discharge were safe andacceptable and improved diet quality and heart-failure quality-of-lifescores.²⁰ A 2025 systematic review of medically tailored meal studies in heart failure (2013–2023) showed reduced risk of rehospitalization.²¹

Effects of FAM program on hospital utilization in patients with heart failure are still being defined. A Philadelphia trial found that patients receiving at least seven medically tailored meals per week after discharge had reduced malnutrition risk and 30-day readmission rates of 9–13%, well below national averages.²² Larger trials, including a 1,400-participant VA study, are being conducted.

Targeted nutrition support has strong outcome evidence, especially for hospitalized or recently hospitalized patients. In the EFFORT trial of more than 2,000 medical in-patients at nutritional risk, individualized nutrition support reduced adverse clinical outcomes and mortality,²³ and continued to reduce mortality at 6 months after discharge.²⁴ A specialized oral nutrition supplement reduced 90-day mortality in malnourished older adults after hospitalization,²⁵ and a meta-analysis of 27 randomized trials confirmed reductions in mortality and readmission with nutrition support.²⁶ In the US, a hospital-wide nutrition-focused quality improvement program was associated with fewer 30-day readmissions and shorter length of stay.²⁷

Cancer-associated malnutrition and cachexia are common, especially in gastrointestinal, head and neck, lung, pancreatic, and advanced-stage cancers, and food insecurity is increasingly recognized as a barrier to completing treatment.²⁸ Current ESPEN and ASCO guidelines recommend early nutrition screening and individualized dietary counseling with oral nutrition supplements as needed.^29,30

Randomized trials and meta-analyses show that nutrition intervention during treatment improves dietary intake, limits weight loss, and improves quality of life and treatment tolerance.^31–33 Evidence for medically tailored meals specifically is newer but growing. For example, a 2026 pilot randomized trial of medically tailored meals during radiotherapy for head and neck cancer demonstrated feasibility and high retention,³⁴ and trials in lung and colorectal cancer are in progress. Across studies, data shows that interventions should be tailored to cancer type, stage, treatment burden, and patient needs.

Nutrition support is established, evidence-based care for individuals with COPD who are malnourished or at risk, helping to counter increased energy expenditure, weight loss, sarcopenia, and cachexia.

Meta-analyses of randomized trials show that oral nutrition supplements and nutrition support, particularly high-protein options, increase body weight and improve functional capacity and quality of life, with the largest gains in those undergoing pulmonary rehabilitation.^35,36

Food insecurity is strongly linked to worse HIV outcomes, including lower antiretroviral therapy (ART) adherence, higher viral load, depression, and mortality risk.³⁷ In the first randomized trial of medically tailored food support for people with HIV (six months of tailored meals and groceries with nutrition education) reduced hospitalizations and improved food security, mental health, and physical health compared with standard food assistance.³⁸ Earlier work with the same program showed that comprehensive, medically appropriate food support improved ART adherence and diabetes self-management among people with HIV and comorbid diabetes.³⁹

Nutrition during pregnancy shapes both maternal and infant outcomes, and food insecurity is associated with a higher risk of gestational diabetes, hypertensive disorders, excessive weight gain, and preterm birth.

Evidence for FAM programs designed specifically for pregnancy is emerging. A systematic review of US Food is Medicine programs for pregnant women found consistent improvements in food security and fruit and vegetable intake, however, clinical and birth outcomes are rarely measured.⁴⁰ In Michigan, a prenatal fruit and vegetable prescription program in Flint improved diet and household food security across pregnancy and the postpartum period.⁴¹ Pilot randomized trials of medically tailored meals for gestational diabetes report high acceptability, and trials measuring birth outcomes are now underway.

Dietary management is central tos lowing chronic kidney disease (CKD) progression and controlling its complications. However, renal diets can be complex and difficult to follow, especially for people experiencing food insecurity. Current KDIGO and KDOQI guidelines recommend plant-rich dietary patterns and limiting ultra-processed foods, cto improve blood pressure, body weight, and metabolic acidosis.<sup>42,43

‍</sup>Evidence for FAM interventions in CKD is still early, and some large scale trials have had mixed results.⁴⁴ Small studies of renal-appropriate meals show improved dietary adherence and nutritional status. Given the difficulty of the renal diet, medically tailored meals specially tailored to this population offer greater benefit.