The Kroger Co. is piloting a program in which physicians can write “food prescriptions” that patients fill at a local store under the guidance of a Kroger Health professional.
Under the test, launched in the spring and now in its next phase, a Cincinnati doctor makes dietary recommendations to diabetes patients and directs them to a nutrition expert at a Kroger supermarket in Forest Park, Ohio, said Kroger Health registered dietitian Bridget Wojciak, RDN/LD. At the store, a dietitian provides personal nutrition counseling and food suggestions to help the patient better manage the disease, in line with the doctor’s orders.
“Right now, we're in pilot with a local Cincinnati physician offering holistic care for patients with diabetes. As part of that program, it includes a nutrition prescription, which is fulfilled at a Kroger store,” Wojciak said. “Upon successful completion of this pilot, we have plans for rapid expansion, with a vision of filling more nutrition prescriptions than we do prescription for medication.”
Bridget Wojciak, a Kroger Health registered dietitian. (Photo courtesy of Kroger)
The food prescription is written, not electronic as with medications, according to Wojciak. Essentially, the script serves as a referral to a Kroger Health dietitian, who then performs an evaluation, which she described as a “total review.”
“It includes learning how to use the OptUP app, a personalized nutrition assessment and understanding patient lifestyle concerns around nutrition,” Wojciak explained. “Then that dietitian provides personalized food recommendations that can be fulfilled by nutrition team member in-store.”
Kroger’s free OptUP mobile app, rolled out in 2018, provides customer’s with a score indicating a product’s nutritional and/or health attributes based on nationally recognized dietary guidelines enhanced by Kroger Health dietitians.
Wojciak noted that the food prescription concept arose from the need to ensure the primary care team has input into patients’ diets and the nutritional guidance they receive is clear and easy to follow.
“When we say ‘food is medicine,’ we want to make clear that it very much still involves the holistic health care team and it still involves primary care,” she said. “We find that a lot of physicians give difficult-to-follow nutrition advice — along the lines of ‘You should improve your diet’ or ‘You should eat better.’ And that becomes very difficult for a patient to understand and implement. So a nutrition prescription is the strategic way to fill the gap between the physician's guidance and the actual products that will yield health benefits.”
Recommendations are made for specific food items and customized to the patient’s medical condition and additional information collected during the visit with the dietitian. Those receiving the prescriptions are just handed a shopping list, Wojciak pointed out.
“It’s much more comprehensive than that. Most people, even when given a list of foods, don't necessarily know how to make them, what to do with them, how to store them and how to make it fit into their lifestyle to actually generate the behavior change needed to improve their health. So that's why we incorporated a dietitian into the workflow,” she explained. “When you work with a registered dietitian with a nutrition prescription, it gives you personalized advice, not only based on your health condition but also on your lifestyle, the number of people in your household, your budget, how comfortable you are with cooking — any factor that would contribute to the way that you eat.”
Going forward, Kroger Health expects to extend the food prescriptions to other health conditions and diseases states at more stores, based on the results of the pilot.
“The vision is that it's not limited to primary care. Any physician can make a referral to a nutrition prescription at the expansion of the program,” said Wojciak.
Other health conditions that could be addressed by the program include heart disease and cancer. Kroger Health also envisions including pharmacists, nurse practitioners and other health professionals.
“Food just as important in preventing disease as it is in treating it. In the pilot, we're focusing on those with diabetes, but ‘food is medicine’ can be applied to anyone no matter where they are in their health and wellness journey,” Wojciak said. “Any medical condition could benefit from changes in diet and nutrition. But we encourage people to think of it more broadly and, in the future, also on the preventative side as well as the treatment side.”