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Experts representing a broad spectrum of professions and communities share their insights on the rapidly emerging Food is Medicine movement.
Introduction
by Dariush Mozaffarian, Dan GlickmanCan food heal?
by Alice WatersWhat is the connection between food and health?
by Marion NestleWhat is the link between ultra-processed foods and poor health outcomes?
by Mark HymanWhy does healthcare in the US focus more on treatment instead of prevention?
by Scott StollWhat is Produce Rx?
by Michel NischanWhat are Fresh Food Farmacies?
by Allison HessWhat is a Teaching Kitchen?
by David EisenbergDoes FIM work?
by Dean OrnishIf FIM works, why don't Medicare and Medicaid fund these programs?
by Sarah DownerExperts representing a broad spectrum of professions and communities share their insights on the rapidly emerging Food is Medicine movement.
Introduction
Executive Director
APCO Worldwide’s International Advisory Council
The national debate on healthcare in the United States, which has been going on for decades, centers on who should be covered and who should pay the bill. It’s an argument with no clear answers or an easy resolution because of two fundamental realities: healthcare is expensive, and Americans are sick.
Americans benefit from highly trained personnel, remarkable facilities, and access to the newest drugs and technologies. Unless we eliminate some of these benefits, our healthcare will remain costly. We can trim around the edges — for example, with changes in drug pricing, lower administrative costs, reductions in payments to hospitals and providers, and fewer defensive and unnecessary procedures. These actions may slow the rise in healthcare spending, but costs will continue to rise as the population ages and technology advances.
And Americans are sick — much sicker than many realize. More than 100 million adults, almost half the entire adult population, have pre-diabetes or diabetes. Cardiovascular disease afflicts about 122 million people and causes roughly 840,000 deaths each year, or about 2,300 deaths each day. Three in four adults are overweight or obese. More Americans are sick, in other words, than are healthy.
Instead of debating who should pay for all this, no one is asking a simpler and more imperative question: What is making us so sick, and how can we reverse this so we need less healthcare? The answer is staring us in the face, on average three times a day: our food.
Poor diet is the leading cause of mortality in the United States, causing more than half a million deaths per year. Just 10 dietary factors are estimated to cause nearly 1,000 deaths every day from heart disease, stroke, and diabetes alone. These conditions are dizzyingly expensive. Cardiovascular disease costs $351 billion annually in healthcare spending and lost productivity, while diabetes costs $327 billion annually. The total economic cost of obesity is estimated at $1.72 trillion per year, or 9.3% of gross domestic product.
These human and economic costs are leading drivers of ever-rising healthcare spending, strangled government budgets, diminished competitiveness of American business, and reduced military readiness.
Fortunately, advances in nutrition science and policy now provide a road map for addressing this national nutrition crisis. The Food is Medicine solutions are win-win, promoting better well-being, lower healthcare costs, greater sustainability, reduced disparities among population groups, improved economic competitiveness, and greater national security.
Some simple, measurable improvements can be made in several health and related areas. For example, Medicare, Medicaid, private insurers, and hospitals should include nutrition in any electronic health record; update medical training, licensing, and continuing education guidelines to emphasize nutrition; offer patient prescription programs for healthy produce; and, for the sickest patients, cover home-delivered, medically tailored meals. Just the last action, for example, can save a net $9,000 in healthcare costs per patient per year.
Nutrition standards in schools, which have improved the quality of school meals by 41%, should be strengthened; the national Fresh Fruit and Vegetable Program should be extended beyond elementary schools to middle and high schools, school garden programs should be expanded, and the Supplemental Nutrition Assistance Program, which supports grocery purchases for nearly one in eight Americans, should be leveraged to help improve diet quality and health.
Coordinated federal leadership and funding for research is also essential. This could include, for example, a new National Institute of Nutrition at the National Institutes of Health. Without such an effort, it could take many decades to understand and utilize exciting new areas, including those related to food processing, the gut microbiome, allergies and autoimmune disorders, cancer, brain health, treatment of battlefield injuries, the effects of nonnutritive sweeteners, and personalized nutrition.
Finally, the government plays a crucial role. The significant impacts of the food system on well-being, healthcare spending, the economy, and the environment — together with mounting public and industry awareness of these issues — have created an opportunity for government leaders to champion real solutions.
The provision of healthy food to prevent, manage, or treat chronic disease within our healthcare system by closing the gap between a medical nutrition prescription and the ability of a patient to fill and consume it on a regular basis.
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A study published in the British Journal of Nutrition revealed that “a Mediterranean-style diet rich in fruits, vegetables, whole grains, and healthy fats was associated with a 25% reduction in the risk of developing depression.”
Founder
THE EDIBLE SCHOOLYARD PROJECT
Can food heal?
Can food heal?
In a word: yes.
Food is the only thing that can heal us. Wendell Berry says that eating is an agricultural act — which means, of course, that eating is also an environmental act. You cannot separate the act of eating from the act of farming. Every time we eat, we have the power to choose foods that are vibrant, real, and alive—foods that have been grown by local, organic farmers who support the health of the land, which in turn nourishes us and supports our own health. Real health begins in the ground, with soil that has been replenished through regenerative agriculture. When we begin to eat food that’s been grown in this way, we begin to heal not only our own bodies but also the planet.
But when we say this sort of food can heal us, we are not simply talking about the ways in which certain foods can make us feel better when we’re sick. Nor is it simply about eating foods that are good for us. We are talking about health in a deeper, more profound way that relates to the pleasure of cooking and sitting down together at the table. This is also part of what heals us: a sense of belonging; of community and tradition, of season, time, and place; and of living in harmony with nature. When we gather at the table and share this food with family and friends, we are connecting with the roots of human civilization and connecting with our shared humanity.
The concept that every individual has the right to access food with dignity, recognizing their cultural preferences, nutritional needs, and the importance of fair and equitable food systems; emphasizes respectful treatment of individuals in the process of food production, distribution, and consumption, and acknowledges the interconnectedness of food and human dignity.
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Two studies published in The BMJ offer fresh evidence of the health risks associated with ultra-processed foods. One study linked eating more than four daily servings of ultra-processed foods to a 62% higher risk of premature death in comparison to the risk of death for those who eat little or none of these foods. The other study tied every incremental 10% increase in the share of the diet made up of ultra-processed foods to more than a 10% increased risk of cardiovascular diseases.
Worldwide obesity has nearly tripled since 1975. In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese.
Paulette Goddard Professor of Nutrition, Food Studies, and Public Health
NEW YORK UNIVERSITY
It’s obvious. We must eat to live. We must get energy (calories) and the nutrients we cannot make ourselves from food in order to grow, reproduce, and live long and healthy lives. Beyond these individual needs, how we produce and consume food is related to the three most prevalent public health nutrition problems facing today’s world: hunger (which affects about a billion people), obesity and its consequences (about 2 billion), and climate change (which affects everybody). Fortunately, the same dietary pattern addresses all three issues. Diets that best promote the health of people and the planet are largely, but not necessarily exclusively, plant-based, not excessive in calories, and avoid ultra-processed (‘junk”) foods to the extent possible.
Food is one of life’s greatest pleasures and plenty of truly delicious foods, meals, and cuisines fit this pattern.
Edible items that provide a high level of essential nutrients to support overall health and well-being such as fruits, vegetables, whole grains, lean proteins, and dairy products; offer a balanced mix of vitamins, minerals, proteins, and other beneficial compounds; fundamental for maintaining a healthy and well-rounded diet.
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Studies done by the National Institutes of Health show that consuming ultra-processed foods makes up over 50% of the total daily calorie intake among young adults aged 20-39 in the United States, leading to a 30% increased risk of developing obesity-related conditions.
A study published in the British Medical Journal (BMJ) found that consuming a diet high in ultra-processed foods was associated with a higher risk of cardiovascular disease. The study, conducted by researchers from the University of Paris, analyzed data from over 100,000 participants and concluded that each 10% increase in the proportion of ultra-processed food in the diet was associated with a 12% increase in the risk of cardiovascular diseases.
Founder and Director
The UltraWellness Center
There is one place where nearly everything that matters in the world today converges: our food and our food system—the complex web of how we grow food, how we produce it, distribute and promote it; what we eat, what we waste and the policies that perpetuate unimaginable suffering and destruction across the globe that deplete our human, social, economic and natural capital.
Eleven million people die every year from eating ultra-processed food and not enough real food. More than 2 billion are overweight and sick because of our food system. Over the next 35 years, the costs of chronic disease in the US, mostly driven by our industrial diet, will be $95 trillion, more than the annual economy of the entire world. healthcare costs are threatening businesses and governments globally.
The single biggest driver of chronic disease, which affects 1 in 2 Americans, is our industrial ultra-processed diet. Food is the biggest cause of disease and also serves as the cure for most chronic diseases, yet doctors learn nothing about food in medical school. Instead, our healthcare system focuses on managing the symptoms of diseases rather than addressing the root causes. One in three Medicare dollars is spent on type 2 diabetes (and more if you include pre-diabetes). Data show that by simply annually providing $2400 of whole real foods and social support to food insecure poorly controlled type 2 diabetics and their families, healthcare costs could be cut by 80% from $240,000 a year per patient to $48,000.
Perverse financial incentives encourage intensive use of insulin, medications, amputations, and dialysis rather than Food is Medicine. Shifting healthcare’s focus to prevention, health promotion, and using Food is Medicine through producing prescriptions, medically tailored meals, and reimbursement for Food is Medicine would improve the health of our nation while dramatically reducing healthcare costs. Changes in payments for services and programs that create health must be combined with policy shifts that address our toxic food environment. This includes supporting agricultural production of whole foods and regenerative agriculture, ending support for commodity crops turned into disease-producing ultra-processed foods, regulating food marketing, and reforming our food programs (like SNAP) to address health and hunger. These policies, in addition to other food and agriculture policies, must be implemented to alter our toxic food environment and address the loss of human, economic, social, and natural capital.
Food products that undergo extensive industrial processing, often containing additives, preservatives, and artificial ingredients; are typically low in nutritional value, and may contribute to health issues when consumed excessively; recognizing and reducing intake of ultra-processed foods is crucial for promoting a balanced and healthful diet.
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Physicians and Nutrition.
As of 2022, The U.S. spends nearly 18% of its GDP on healthcare, yet Americans die younger and are less healthy than residents of other high-income countries.
In 2021, 8.6% of the U.S. population was uninsured. The U.S. is the only high-income country where a substantial portion of the population lacks any form of health insurance.
Co-Founder and Board Chairman
THE PLANTRICIAN PROJECT
Why does healthcare in the US focus more on treatment than prevention?
Today, US healthcare is estimated to be an $8.7 trillion dollar industry and healthcare costs rose rapidly from 4.6% of GDP in 1950 to 17.9% in 2019.
During the 20th century, the burgeoning healthcare industry myopically focused on disease treatment, which was reinforced through innovative pipelines that researched and developed expansive pharmaceutical and medical device interventions.
These advances prolonged and saved lives; however, their success reinforced a reductionist approach to the management of population health. In parallel, third-party payment systems were introduced in 1929, and by 1955 more than 70% of the population was enrolled in a health insurance plan.
Source: Health Catalyst
Reimbursement models focused on a modern view of healthcare that emphasized the treatment of the “chief complaint.” This cultivated a volume-based healthcare system and created a financially disadvantageous milieu for the delivery of time-intensive preventative care like dietary and lifestyle counseling.
Medical education was also influenced by the 20th century evolution in healthcare delivery that emphasized first-line interventions including pharmaceuticals, procedures, or other technological solutions.
Nutrition and lifestyle training was limited, and today, only 27% of medical schools offer the recommended 25 hours of nutrition education.
Thus, the majority of physicians and clinicians are inadequately trained to deliver effective preventative lifestyle and nutrition care to their patients.
The state in which everyone has a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities.
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Students in medical schools across the country spend less than 1% of lecture time learning about diet.
Nonprofit Gaples Institute 4-hr interactive CME course, “Nutrition Science for Health and Longevity: What Every Physician Needs to Know” Nonprofit Gaples Institute interactive nutrition learning experience for the public, “Nutrition for Optimal Health”.
Doctors receive only 19 hours of nutrition education in medical school, and often none whatsoever in the 3-5 years of hospital based training that follows. We need to do much more to make doctors aware of the critical role that food plays in patient outcomes.
Physicians currently receive minimal nutrition education and, once in practice, are generally ill-equipped to even begin to help their patients make dietary changes. The deficiency of nutrition education in medical training has sobering implications for both our health and economy. For example, the current epidemic of diabetes is responsible for skyrocketing costs, yet fully 90% of type 2 diabetes is preventable through low-cost dietary and lifestyle interventions. Moreover, the World Health Organization estimates that 80% of premature heart disease is preventable through nutrition and lifestyle changes. Dietary approaches have an added bonus: unlike pharmacologic and procedural therapies, the side effects from nutrition-based interventions are entirely favorable.
Improvement of nutrition education and practice among physicians holds the promise of the ultimate win/win in medicine: better health at a lower cost.
A comprehensive evaluation of an individual's nutritional status to identify dietary needs, potential deficiencies, or excesses; involves collecting information on dietary habits, medical history, physical activity, and anthropometric measurements; this assessment helps healthcare professionals develop personalized nutrition plans and interventions to promote optimal health and prevent nutritional issues.
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In an American Dietetic Association (now the Academy of Nutrition and Dietetics) survey, 61% of respondents stated that they believe physicians are a “very credible” source of nutrition information. At the same time, though, in a study of internal medicine interns, in a study of internal medicine interns, 86% of respondents admitted to being inadequately trained to provide nutritional counseling.
Clinical Professor of Law
HARVARD LAW SCHOOL
Why do physicians need nutrition education?
Doctors with training in diet and nutrition can have a monumental impact on individual patient health and the public health landscape. The general public trusts their doctors and considers them to be among the most credible sources for accurate, up-to-date guidance on diet and food.
Yet, on average, doctors receive less than 25 hours of nutrition training (less than 1% of total lecture hours) throughout medical school. Most physicians are not prepared to counsel patients on nutrition and diet, and only 14% of practicing physicians report feeling qualified to offer nutritional advice to their patients.
With rates of obesity, heart disease, type-2 diabetes, and diet-linked cancers all on the rise, we are missing a critical opportunity to leverage the medical profession in order to support better outcomes for these most common and costly diseases.
Opportunities to increase the amount and quality of nutrition education provided to doctors exist at every stage of medical education. To name a few: for medical schools, Federal or state governments could create grants to launch or expand curricula on diet and nutrition; for residency programs, the Federal government could tie all or a portion of Medicare residency funding to the inclusion of nutrition education; and for continuing medical education, states can require a certain number of CME credits be taken in diet and nutrition to retain licensure.
Non-governmental accrediting bodies such as the Liaison Committee on Medical Education (LCME) and the American Council of Graduate Medical Education (ACGME) can require competency in diet and nutrition as criteria for accreditation of medical schools (LCME) and residency programs (ACGME).
Even a modest investment in nutrition training for physicians can significantly improve patient outcomes and provide for better population health, reducing the larger and more costly long-term human and economic costs.
A set of learning experiences designed to facilitate the voluntary adoption of healthy eating choices and other nutrition-related behaviors that are conducive to health and well-being; can occur in clinical or community settings, and can be used as part of disease prevention or treatment.
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Social determinants of health.
According to the Food and Agriculture Organization of the United Nations (FAO) report published in 2021, approximately 11% of the world’s population lives in a state of moderate or severe food insecurity.
According to a study conducted by the World Health Organization (WHO) in 2021, approximately 820 million people worldwide suffer from chronic hunger, highlighting the profound impact of social determinants of health on food insecurity.
Chief Executive Officer
Socially Determined
What are social determinants of health and what can they tell us about food insecurity?
The standard definition used in the United States for food insecurity is that “food insecurity exists whenever the availability of nutritionally adequate and safe foods or the ability to acquire acceptable foods in socially acceptable ways is limited or uncertain” (Anderson, 1990).
At Socially Determined, we believe food insecurity is multi-factorial and varies by individual, family, and community. Our team of data scientists and SDOH subject matter experts have developed a Food Insecurity index that incorporates 98 distinct data inputs related to a community’s ability to access a sufficient quantity of affordable, nutritious food. Key drivers included in the model include affordability, accessibility, and food literacy.
Affordability takes into account factors such as SNAP utilization and median gross income. Accessibility includes inputs such as the ratio and density of healthy and unhealthy food sources, vehicle ownership rates, drive times, and public transportation options. Food literacy includes factors such as high school graduation and higher education attainment rates.
Each of these factors (and many more) are included in the Global Food Insecurity Risk Index, which has been calibrated based on weighted contribution.
This approach enables us to quantify food insecurity risk using a dynamic, multi-factor approach that provides more precision and insight around the specific drivers within a community that informs mitigation and intervention strategies.
The ability of individuals in a particular area or population to acquire adequate resources (entitlements) for acquiring the appropriate foods necessary for a nutritious diet.
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In 2017, an estimated 1 in 8 Americans were food insecure, equating to 40 million Americans including more than 12 million children.
There’s a single, major occupant on all this land: cows. Between pastures and cropland used to produce feed, 41% of U.S. land in the contiguous states revolves around livestock.
Executive Director
Global Alliance for the Future of Food
What is food access?
I stood in the middle of tens of thousands of acres of row-crop, monoculture agriculture in the heart of the U.S. Midwest shocked as I listened to my Missouri farmer host tell me how hard it was to find fresh food for miles around. While we were surrounded on all sides by his farm what was growing — genetically modified soy, mostly — wasn’t destined for his dinner plate, or any dinner plate. It was headed to the vast global commodity market, eventually finding its way, most likely, into the bellies of cattle. The result? This farmer and his community faced a crisis of food access.
As one of the United Nations’ central tenets of food security, food access is both the physical and economic accessibility to healthy food. Importantly, food access isn’t valued by proximity to calories, but to real food: food that is nourishing and culturally appropriate. All around the world, there are local, state, and national governments innovating policies and programs to improve food access and there are social movements inspiring farmers, like the one I met in Missouri, to rethink the wisdom of growing crops for industrial use and reviving indigenous foods and biodiversity on farms to grow real food. Before I left that Missouri farmer’s land, he was proud to tell me that the year before his young daughter returned from college and inspired him to start their first kitchen garden. He wouldn’t let me leave without sending me off with a freshly harvested watermelon — his first.
The availability and affordability of nutritious and culturally appropriate foods for individuals and communities; involves factors such as geographical proximity to food sources, economic accessibility, and the presence of diverse and healthy food options; ensuring food access is crucial for addressing food insecurity and promoting overall well-being in populations.
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Unhealthy diet contributes to approximately 678,000 deaths each year in the U.S., due to nutrition- and obesity-related diseases, such as heart disease, cancer, and type 2 diabetes. In the last 30 years, obesity rates have doubled in adults, tripled in children, and quadrupled in adolescents.
Founder
Chef Ann Foundation
What is food literacy?
I believe Food Literacy is the collective understanding of our food system; including the growing, harvesting, packaging, selling, wasting, and eating of our food. Understanding how our food system impacts our health, the health of farmers and farm workers, the health of the earth, the health of our climate, the health of the economy, and the long-term health of generations to come, are all part of the knowledge base of Food Literacy.
At its most basic, Food Literacy is an understanding of the cycle of life, from soil, to farm, plate, body, and back to soil. This understanding helps us recognize the impact of our food choices on our lives, the lives of children and their children, and on the planet in perpetuity.
The magnitude of the importance of food literacy should lead us to mandate Food Literacy curricula as a component of PK-12 education, for there is nothing more meaningful than the health and well-being of the generations to come and the planet that we all call home.
Understanding the impact of food choices on health, the environment, and our economy.
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A study conducted by the American Diabetes Association found that food-insecure individuals have a 32% higher chance of developing diabetes compared to those with consistent access to food.
Research from the National Institutes of Health (NIH) indicates a strong correlation between food insecurity and hypertension. Adults experiencing food insecurity are more likely to have high blood pressure compared to those with consistent access to adequate and nutritious food.
Executive Director
International Cotton Advisory Committee
The most common disease associated with food insecurity is deep and enduring poverty. Poverty is a disease because it negatively affects the structure or function of an organism despite the absence of an external injury. It undermines the development of the mind, cripples because of healthcare costs and missed work and educational opportunities, and creates enormous psychological and physical pain. Poverty is also chronic because it undermines the ability to escape it – creating a trap that can last for generations.
Access to affordable, nutritious, and culturally appropriate food for all people at all times.
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Food is Medicine programs.
Using the Colorado All Payers Claim Database, Project Angel Heart of Denver partnered with researchers to study the impact of medically tailored Meals (MTM) on healthcare utilization. The study found that all-cause 30-day hospital readmissions were reduced by 13% when individuals received MTM and costs for individuals living with a variety of chronic conditions were reduced by an average of 24% compared to a control group.
What is a Medically Tailored Meal?
Medically tailored meals are one example of a Food is Medicine intervention. These are meals that are tailored to meet the unique nutritional needs of an individual based on their diagnos(e)s, as well as the additional complications that might come with that illness (i.e. treatment side effects, comorbidities, etc.). Research consistently shows that medically tailored meals improve health outcomes, lower the cost of care, and increase patient satisfaction.
Most often medically tailored meals are provided through a referral from a medical professional or healthcare plan. A medically tailored meal intervention includes three elements: a medical referral, a nutritional assessment by a registered dietitian nutritionist (RDN) who also oversees the meal plan design, and the preparation and home-delivery of these meals. Patients also benefit from the human connection provided by the home delivery of these meals, with research indicating that medically tailored meals reduce isolation and loneliness, which can negatively impact health outcomes.
Most providers of medically tailored meals are community based organizations who are members of the Food is Medicine Coalition. This group’s Clinical Committee has issued a sophisticated set of Medically Tailored Meal Nutrition Standards, based on research and more than 30 years of experience developing the science of medically tailoring meals. The Clinical Committee is made up of Registered Dietitian Nutritionists, who are experts in treating serious illness with nutrition.
A medically tailored meal intervention, as defined by the Food is Medicine Coalition, does not simply mean putting someone on a diet. FIMC clients’ medical lives are often complex – many are living with more than four serious illnesses at once – and they require an equally complex nutrition intervention. Medically tailored meals help the “sickest of the sick” in communities, often the 5% of patients that cost 50% of healthcare costs.
As well as having to manage a complex medical diet, many of the patients FIMC serves are too sick to shop or cook, and the majority are living at or below the federal poverty guideline meaning that their access to healthy food is severely limited.
Medically tailored meals (MTM) are meals approved by an RDN that reflect appropriate dietary therapy based on evidence-based practice guidelines. Diet/meals are recommended by an RDN based on a nutritional assessment and a referral by a healthcare provider to address a medical diagnosis, symptoms, allergies, medication management, and side effects to ensure the best possible nutrition-related health outcomes.
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The Healthy Eating Plate, created by nutrition experts at the Harvard T.H. Chan School of Public Health and editors at Harvard Health Publications, was designed to address deficiencies in the U.S. Department of Agriculture’s (USDA) MyPlate. The Healthy Eating Plate provides detailed guidance, in a simple format, to help people make the best eating choices.
Co-Founder and Executive Chairman
WHOLESOME WAVE
What is Produce Rx?
People living in low income communities have food access issues that can lead to a number of chronic diseases that are devastating. Fresh produce has been proven to produce better health outcomes for those who effectively increase their produce consumption. Instead of waiting until they require treatment, doctors can prescribe healthy food instead of medicine with the resources that result in affordable access to fresh food, and the knowledge to use it.
Here’s how it works: A patient is diagnosed as at-risk, and then qualifies for a 20-week intervention that includes the diagnosis from a prescriber, counseling from a nutritionist, basic nutrition and cooking education, and the financial incentive to purchase the produce. The “patient” participates in the programming, purchases and consumes more produce, then visits the clinic to check-in, adjust their healthy weight goals, and get a refill.
The Produce Prescription Program (aka, Produce Rx or PRx) connects healthcare providers with local farmers or markets to prescribe fresh fruits and vegetables to individuals facing food insecurity or health conditions; aims to improve access to nutritious foods and address diet-related health issues to promote a holistic approach to healthcare.
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According to a study conducted by Geisinger and published in the American Journal of Preventive Medicine in 2020, participants in a Fresh Food Farmacy program experienced significant health improvements. After one year in the program, participants with type 2 diabetes saw a 40% reduction in hospitalizations and a 78% reduction in medical costs compared to the year prior to the program.
Vice President, Health and Wellness
Geisinger
What are Fresh Food Farmacies?
We know healthy food plays an important role in overall health and treatment of diet responsive conditions but when patients begin to see just how profoundly they are impacted through the simple incorporation of fresh, healthy food, they began to fully appreciate just how much food influences their health.
A prescription-based Food is Medicine program that provides fresh, healthy, nutritious food, paired with education and clinical services, to a health plan’s most vulnerable population, and most importantly empowers participants to manage their medical conditions through food-related behavior and lifestyle changes.
By offering fresh food as part of a prescription-based program to their most at-risk patients, Geisinger improved patient outcomes while lowering per-patient costs Its Fresh Food Farmacy program has shown that participating patients have 75% less hospital admissions, 30% less Emergency Room visits, and are more likely to close their preventive care gaps by having more regular visits with their primary care physician. In addition, their participating patients with Type II Diabetes average a 2 point reduction in HbA1c, leading to a cost savings of $16,000-$20,000 per patient.
Offers people fresh and minimally-processed food items at significantly reduced prices or at no cost as a means to manage and prevents diet-responsive conditions; usually located in areas with significant low-income or food-insecure populations targeted for coordinated healthcare intervention strategies.
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According to a survey conducted by the Teaching Kitchen Collaborative in 2021, over 70% of surveyed institutions, including hospitals, universities, and community organizations, reported having implemented or planned to implement teaching kitchen programs within the next few years.
Director of Culinary Nutrition
Teaching Kitchen Collaborative
What is a Teaching Kitchen?
The term “teaching kitchen” elicits images of stainless steel kitchens used by students learning techniques to make food delicious. Within the context of Food is Medicine, however, teaching kitchens are more than just a place used to teach culinary techniques.
They are a “learning laboratory” aimed at changing lifestyle behaviors to ultimately improve one’s health (and thereby help decrease costs related to disease management as well as disease prevention and health maintenance).
Today’s teaching kitchens, which already exist in hospitals, medical schools, corporate worksites, colleges, K-12 schools, retirement facilities, YMCA’s and across the US VA system, typically include most or all of the following educational components:
Some teaching kitchens are “built-in”, whereas others are “pop-ups” or “mobile” and therefore less costly. Dozens currently exist and hundreds more are being planned across the US and globally. Importantly, all include more than just a “kitchen” and many seek to teach people to “eat, move and think more healthfully.”
The 30+ teaching kitchens associated with the Teaching Kitchen Collaborative are working to collectively develop best practices and to demonstrate, through research, that teaching kitchen curricula have the potential to predictably- and sustainably- change self-care behaviors, health outcomes, and, ultimately, the cost of healthcare, and quality of life for patients, employees, students, families and society at large.
Physical or virtual learning environments that contain a kitchen and allow "students" to develop health and wellness skills; instruction areas often include culinary instruction, nutrition education, exercise instruction, and behavior change strategies.
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Evidence: making the case to payers.
A study published in The Lancet proved that proper nutrition can prevent nearly 1 in 5 deaths globally, meaning a significant impact of nutrition on global mortality rates, emphasizing the powerful preventive aspect of food as medicine.
Adopting a Mediterranean diet can reduce the risk of cardiovascular disease by up to 30%.
President and Founder
Preventative Medicine Research Institute
Does FIM work?
For more than four decades, I have directed a series of randomized, controlled trials and demonstration projects proving that radically-simple diet and lifestyle changes can often reverse the progression of many of the most common chronic diseases.
This led CMS, after 16 years of rigorous internal and external review, to create a new benefit category to provide Medicare coverage for our reversing heart disease program.
Central to this program is a whole foods plant-based diet naturally low in sugar and fat; moderate exercise; stress management; and social support—eat well, move more, stress less, love more.
Our ongoing research and the studies of other investigators prove that many common and debilitating chronic diseases and even much of the damage of aging at a cellular level can be slowed, stopped, or even reversed by a lifestyle medicine program.
These include:
I continue to be amazed and inspired that the more diseases we study, and the more underlying biological mechanisms we research, the more new reasons and scientific evidence we have to explain why these simple lifestyle changes are so powerful, how transformative and far-ranging their effects can be, and how quickly people can show significant and measurable improvements—often in just a few weeks or even less.
Long-term health condition that lasts 1 year or more and typically persists throughout a person's life (e.g., diabetes, cardiovascular diseases, chronic respiratory diseases, certain types of cancer); often require ongoing management, treatment, and lifestyle modifications to control symptoms, prevent complications, and improve overall quality of life.
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•32 percent of Medicaid beneficiaries often purchase less-healthy food options than they otherwise would because of lack of money, compared to 13 percent of non-recipients;
• 28 percent of Medicaid beneficiaries purchase less food overall due to a lack of financial means, compared to 10 percent of non-recipients;
• 27 percent of Medicaid beneficiaries worry that their food will run out before they get money to buy more, compared to 7 percent of non-recipients; and
• 43 percent of Medicaid beneficiaries skip at least one meal per day due to a lack of food, compared with 28 percent of non- recipients.
Associate Director, Health Law and Policy Clinic Center for Health Law
Centers for Medicare & Medicaid Services (CMS)
If FIM works, why don’t Medicare and Medicaid fund these programs?
Historically, our primary public insurance programs, Medicare and Medicaid, have not covered food. However, emerging evidence that medically-appropriate food improves health outcomes and decreases health care utilization and cost has increased interest among policy-makers in experimenting with including food in these programs. Active Medicaid demonstrations that (in limited circumstances) cover food in states such as California, Massachusetts, and North Carolina, represent a critical first step to more widespread integration of food into health care delivery and financing.
Pioneering insurance companies across the country that administer Medicare and/or Medicaid through managed care or value-based payment structures have also started using medically-tailored meals and other nutrition interventions to great effect, albeit on a very small scale. Establishing uniform coverage and widespread access to critical food and nutrition services in Medicare and Medicaid depends on a few factors:
A healthcare model where hospitals and healthcare providers are paid (reimbursed) for services provided to individuals by government insurance programs (e.g., Medicare, Medicaid) or to people using out-of-pocket funds; pay for performance is a type of reimbursement model that emerged recently as part of an effort to reduce national healthcare costs in the United States.
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As of 2021, a statistic from the Food is Medicine Coalition revealed that only about 7% of healthcare spending in the United States is allocated to addressing nutrition-related needs or programs, despite evidence showcasing the effectiveness of such interventions in improving health outcomes.
President
Blue Zones Wellbeing Institute
If FIM works, why don’t most healthcare providers fund Food is Medicine Programs?
To some extent, through legislative mandate or specific regulations, FIM is a required covered benefit for individuals meeting particular clinical criteria such as infants suffering from severe GI disorders or inborn errors of metabolism, e.g. phenylketonuria (PKU). Additionally, Medicaid recipients may be eligible for food delivery under the 1981 Social Security Act, and as of 2018 CMS expanded the supplemental benefits provisions for Medicare Advantage plans to better address issues related to SDoH, including food.
That said, in the broader sense FIM is something that payers (health insurance companies and self-funded employers) typically have been unwilling to pay for. Unfortunately, this continues even today despite increased awareness of the positive impact good nutrition has on health and wellbeing.
FIM has been shown to be least as effective, if not more so, for treating certain chronic non-communicable disease states, than prescription medications. An excellent example of the impact that FIM can have is the Fresh Food Farmacy program run by the Geisinger Health System that has demonstrated a 40% reduction in diabetes complications and a 70% reduction in hospitalizations for patients enrolled in the program. Another example is the CHIP pilot program for diabetes management at Vanderbilt University Medical Center that showed a positive ROI within 6-months primarily through the need for fewer medications.
To be sure, the reasons that FIM is often not funded by payers are diverse and complex. However, a foundational problem is that healthcare coverage (insurance) is not designed to address a patient’s health and social needs outside of the medical setting. In other words, health insurance benefits are structured to help cover the costs associated with services and procedures traditionally deemed as medical expenses e.g. doctor visits, hospitalizations, labs, X-rays, surgery, and prescription medications. Despite what Hippocrates said dating back to 400 BC —”Let food by thy medicine…”, the fact that FIM has not been “medicalized” into a prescribed standard of care is the reason it goes largely unpaid. Equally important is that few providers (only a quarter of medical schools offer even a single course in nutrition) appreciate the clinical power of FIM or how to effectively use it.
Therein lies the conundrum.
How does FIM become a standard of care and something that providers demand, in order for it to become a recognized benefit and receive broad reimbursement?
Offers people fresh and minimally-processed food items at significantly reduced prices or at no cost as a means to manage and prevents diet-responsive conditions; usually located in areas with significant low-income or food-insecure populations targeted for coordinated health care intervention strategies.
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According to the World Health Organization (WHO), an estimated 690 million people globally are undernourished, while simultaneously, obesity rates are escalating, with over 1.9 billion adults overweight, of whom 650 million are obese.
Director of Culinary Nutrition
Teaching Kitchen Collaborative
Food is Medicine: An Imagined Future.
It’s 2030 now.
Looking back at 2019-2020, we reached a “tipping point.” Third-party payers and an increasing number of healthcare professionals and patients finally said, “Enough!” in the face of trillions of dollars in US healthcare expenditures (which finally reached 20% of GDP), continuous increases in rates of obesity and diabetes across all sectors of our society (and the world), and confronted by a reimbursement model in which doctors, other healthcare providers, insurers, and hospitals made their money by ordering more lab tests, scheduling more surgeries, prescribing more expensive drugs, and profiting every time a patient was seen in any setting.
Over the next decade (2020-2030), our healthcare system shifted to a “Pay for Performance” model, first demonstrated through governmental innovation grants from the Centers for Medicare and Medicaid and a handful of experiments by forward-thinking organizations and researchers. Together, they proved that by preventing chronic disease (e.g. obesity and diabetes) through enhanced lifestyle and by managing chronic diseases more effectively through a range of innovative Food is Medicine interventions, money could be saved and profits could be generated by keeping people well, managing their diseases more effectively, keeping them out of hospitals, and reducing the frequency of hospital re-admissions.
Experiment by experiment, evidence accumulated to show that the following practices resulted in lower rates of lifestyle-related chronic diseases (e.g., obesity, diabetes, heart disease, etc.), lower overall medical and health-related costs, enhanced quality of life, improved employee satisfaction and efficiency, and a more sustainable food system (and global environment):
Teaching people to choose their foods more wisely
Providing instruction on how to shop for and/or prepare healthier menu choices
Encouraging them to move more
Assisting them with access to more local, whole vegetables, fruits, nuts, whole grains, healthier animal proteins, and fats
Delivering medically tailored meals to all patients upon discharge (and performing a nutrition assessment with documentation in the medical record at all stages of healthcare)
Hospitals, which had previously offered some of the least healthy and least tasty foods imaginable, were transformed into showrooms of healthy, delicious, sustainable, and affordable food options. Teaching kitchens were built as extensions of hospital cafeterias, trained chefs made hospital cafeterias destinations for local diners as opposed to grab-and-go convenience options for those visiting patients or working there full time, and on-demand room service went from inedible to superb and family members visiting loved ones looked forward to ordering off these same delicious and nourishing menus. These healthy destination hospital cafes created new profit centers for hospital CFOs. Hospitals negotiated long-term contracts with local farmers, reducing their food costs, strengthening local economies, and protecting the global environment. Hospital employees were incentivized to eat better, learn to prepare their own healthy, delicious meals, and were provided “meal prep” kits on their way out of work so they could eat and cook the same healthier foods with their families, enabling them to “walk the walk” while enhancing employee satisfaction.
Medical schools and schools educating all health professionals began to require education and competency testing in providing nutrition and lifestyle guidance to all patients young and old, healthy and sick. Licensing and board examinations shifted accordingly, as did the training of healthcare professionals worldwide.
In 2020, when a few self-selected third-party payers looked at the Food is Medicine Map, launched in 2019 by The Lexicon’s GREEN BROWN BLUE activator, they identified “hot spots” where numerous programs involving Medically-Tailored Meals, Fresh Food Farmacies, Veggie RX programs, and multi-disciplinary Teaching Kitchens co-existed in geographic areas. unds were invested in demonstration projects aimed at proving that Food is Medicine programs: (1) could improve personal health-enhancing behaviors in a sustainable fashion; (2) were replicable and scalable; (3) resulted in significant increases in patient satisfaction and quality of life; and (4) most importantly, saved money and could convincingly bend cost curves for multiple populations at risk of chronic disease (including healthcare professionals and hospital employees).
This evidence led to third-party coverage for these interventions within a reshaped healthcare delivery system which cost less, and it began the U.S.’s forward journey towards a “Culture of Health” for all. It also inspired legions of new health professionals to become skilled in Food is Medicine and Lifestyle Medicine approaches. It sparked countless synergies with local and regional farmers and those developing urban agriculture and ways to refine and improve a regenerative food supply worldwide. These newly covered benefits led the way to scientific discoveries and practical advice with respect to how different foods impact different people’s microbiomes (and genes) differently. Large databases launched by real and virtual Food is Medicine research networks provided the data to better understand how changes in behaviors, including diet, impacted human and planetary health. As such, these initiatives also established Food is Medicine Learning Laboratories and nutrition-related translational research hubs of the 21st century.
Yes, the healthcare delivery system in 2019 was broken. However, between 2020 and 2030, we made good on the notion that “if you can break it, you can fix it.” And that’s what happened once U.S. leading third-party payers invested in this co-created, renovated health delivery system called “Food is Medicine.” These interventions sparked a series of transformations that led to better health for both people and the planet.
A type of reimbursement model aimed at improving the quality, efficiency, and overall value of health care; these arrangements provide financial incentives to hospitals, physicians, and other health care providers to carry out such improvements and achieve optimal outcomes for patients.
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About
Lexicon of Food is produced by The Lexicon, an international NGO that brings together food companies, government agencies, financial institutions, scientists, entrepreneurs, and food producers from across the globe to tackle some of the most complex challenges facing our food systems.
Team
The Food is Medicine Channel was developed by an invitation-only food systems solutions activator created by The Lexicon with support from Food at Google. This activator model fosters unprecedented collaborations between leading food service companies, environmental NGOs, government agencies, and technical experts from across the globe.
This website was built by The Lexicon™, a 501(c)(3) tax-exempt nonprofit organization headquartered in Petaluma, CA.
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Tools to align investment and grant making strategies with advances in agriculture, food production, and emerging markets.
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Chefs and food industry professionals seeking inspiration on ingredients and sustainable trends to enhance their work.
Individuals interested in food products, recipes, nutrition, and health-related information for personal or family use.
Individuals producing food, fiber, feed, and other agricultural products that support both local and global food systems.
This online platform is years in the making, featuring the contributions of 1000+ companies and NGOs across a dzen domain areas. To introduce you to their work, we’ve assembled personalized experiences with insights from our community of international experts.
Businesses engaged in food production, processing, and distribution that seek insight from domain experts
Those offering specialized resources and support and guidance in agriculture, food production, and nutrition.
Individuals who engage and educate audience on themes related to agriculture, food production, and nutrition.
Nutritional information for professionals offering informed dietary choices that help others reach their health objectives
Those advocating for greater awareness and stronger action to address climate impacts on agriculture and food security.
Professionals seeking curriculum materials, lesson plans, and learning tools related to food and agriculture.
We have no idea who grows our food, what farming practices they use, the communities they support, or what processing it undergoes before reaching our plates.
As a result, we have no ability to make food purchases that align with our values as individuals, or our missions as companies.
To change that, we’ve asked experts to demystify the complexity of food purchasing so that you can better informed decisions about what you buy.
The Lexicon of Food’s community of experts share their insights and experiences on the complex journey food takes to reach our plates. Their work underscores the need for greater transparency and better informed decision-making in shaping a healthier and more sustainable food system for all.
Over half the world’s agricultural production comes from only three crops. Can we bring greater diversity to our plates?
In the US, four companies control nearly 85% of the beef we consume. Can we develop more regionally-based markets?
How can we develop alternatives to single-use plastics that are more sustainable and environmentally friendly?
Could changing the way we grow our food provide benefits for people and the planet, and even respond to climate change?
Can we meet the growing global demand for protein while reducing our reliance on traditional animal agriculture?
It’s not only important what we eat but what our food comes in. Can we develop tools that identify toxic materials used in food packaging?
Explore The Lexicon’s collection of immersive storytelling experiences featuring insights from our community of international experts.
The Great Protein Shift
Our experts use an engaging interactive approach to break down the technologies used to create these novel proteins.
Ten Principles for Regenerative Agriculture
What is regenerative agriculture? We’ve developed a framework to explain the principles, practices, ecological benefits and language of regenerative agriculture, then connected them to the UN’s Sustainable Development Goals.
Food-related chronic diseases are the biggest burden on healthcare systems. What would happen if we treated food as medicine?
How can we responsibly manage our ocean fisheries so there’s enough seafood for everyone now and for generations to come?
Mobilizing agronomists, farmers, NGOs, chefs, and food companies in defense of biodiversity in nature, agriculture, and on our plates.
Can governments develop guidelines that shift consumer diets, promote balanced nutrition and reduce the risk of chronic disease?
Will sustainably raising shellfish, finfish, shrimp and algae meet the growing demand for seafood while reducing pressure on wild fisheries?
How can a universal visual language to describe our food systems bridge cultural barriers and increase consumer literacy?
What if making the right food choices could be an effective tool for addressing a range of global challenges?
Let’s start with climate change. While it presents our planet with existential challenges, biodiversity loss, desertification, and water scarcity should be of equal concern—they’re all connected.
Instead of seeking singular solutions, we must develop a holistic approach, one that channel our collective energies and achieve positive impacts where they matter most.
To maximize our collective impact, EBF can help consumers focus on six equally important ecological benefits: air, water, soil, biodiversity, equity, and carbon.
We’ve gathered domain experts from over 1,000 companies and organizations working at the intersection of food, agriculture, conservation, and climate change.
The Lexicon™ is a California-based nonprofit founded in 2009 with a focus on positive solutions for a more sustainable planet.
For the past five years, it has developed an “activator for good ideas” with support from Food at Google. This model gathers domain experts from over 1,000 companies and organizations working at the intersection of food, agriculture, conservation, and climate change.
Together, the community has reached consensus on strategies that respond to challenges across multiple domain areas, including biodiversity, regenerative agriculture, food packaging, aquaculture, and the missing middle in supply chains for meat.
Lexicon of Food is the first public release of that work.
Over half the world’s agricultural production comes from only three crops. Can we bring greater diversity to our plates?
In the US, four companies control nearly 85% of the beef we consume. Can we develop more regionally-based markets?
How can we develop alternatives to single-use plastics that are more sustainable and environmentally friendly?
Could changing the way we grow our food provide benefits for people and the planet, and even respond to climate change?
Can we meet the growing global demand for protein while reducing our reliance on traditional animal agriculture?
It’s not only important what we eat but what our food comes in. Can we develop tools that identify toxic materials used in food packaging?
Explore The Lexicon’s collection of immersive storytelling experiences featuring insights from our community of international experts.
The Great Protein Shift
Our experts use an engaging interactive approach to break down the technologies used to create these novel proteins.
Ten Principles for Regenerative Agriculture
What is regenerative agriculture? We’ve developed a framework to explain the principles, practices, ecological benefits and language of regenerative agriculture, then connected them to the UN’s Sustainable Development Goals.
Food-related chronic diseases are the biggest burden on healthcare systems. What would happen if we treated food as medicine?
How can we responsibly manage our ocean fisheries so there’s enough seafood for everyone now and for generations to come?
Mobilizing agronomists, farmers, NGOs, chefs, and food companies in defense of biodiversity in nature, agriculture, and on our plates.
Can governments develop guidelines that shift consumer diets, promote balanced nutrition and reduce the risk of chronic disease?
Will sustainably raising shellfish, finfish, shrimp and algae meet the growing demand for seafood while reducing pressure on wild fisheries?
How can a universal visual language to describe our food systems bridge cultural barriers and increase consumer literacy?
This game was designed to raise awareness about the impacts our food choices have on our own health, but also the environment, climate change and the cultures in which we live.
First, you can choose one of the four global regions and pick a character that you want to play.
Each region has distinct cultural, economic, historical, and agricultural capacities to feed itself, and each character faces different challenges, such as varied access to food, higher or lower family income, and food literacy.
As you take your character through their day, select the choices you think they might make given their situation.
At the end of the day you will get a report on the impact of your food choices on five areas: health, healthcare, climate, environment and culture. Take some time to read through them. Now go back and try again. Can you make improvements in all five areas? Did one area score higher, but another score lower?
FOOD CHOICES FOR A HEALTHY PLANET will help you better understand how all these regions and characters’ particularities can influence our food choices, and how our food choices can impact our personal health, national healthcare, environment, climate, and culture. Let’s Play!
The FOOD CHOICES FOR A HEALTHY PLANET game allows users to experience the dramatic connections between food and climate in a unique and engaging way. The venue and the game set-up provides attendees with a fun experience, with a potential to add a new layer of storytelling about this topic.
Starting the game: the pilot version of the game features four country/regions: Each reflects a different way people (and the national dietary guidelines) look at diets: Nordic Countries (sustainability), Brazil (local and whole foods instead of ultra-processed foods); Canada (plant-forward), and Indonesia (developing countries).
Personalizing the game: players begin by choosing a country and then a character who they help in making food choices over the course of one day. Later versions may allow for creating custom avatars.
Making tough food choices: This interactive game for all ages shows how the food choices we make impact our health and the environment, and even contribute to climate change.
What we eat matters: at the end of each game, players learn that every decision they make impacts not only their health, but a national healthcare system, the environment, climate and even culture.
We’d love to know more about you and why you think you will be a great fit for this position! Shoot us an email introducing you and we’ll get back to you as soon as possible!
Providing best water quality conditions to ensure optimal living condition for growth, breeding and other physiological needs
Water quality is sourced from natural seawater with dependency on the tidal system. Water is treated to adjust pH and alkalinity before stocking.
Producers that own and manages the farm operating under small-scale farming model with limited input, investment which leads to low to medium production yield
All 1,149 of our farmers in both regencies are smallholder farmers who operate with low stocking density, traditional ponds, and no use of any other intensification technology.
Safe working conditions — cleanliness, lighting, equipment, paid overtime, hazard safety, etc. — happen when businesses conduct workplace safety audits and invest in the wellbeing of their employees
Company ensure implementation of safe working conditions by applying representative of workers to health and safety and conduct regular health and safety training. The practices are proven by ASIC standards’ implementation
Implementation of farming operations, management and trading that impact positively to community wellbeing and sustainable better way of living
The company works with local stakeholders and local governments to create support for farmers and the farming community in increasing resilience. Our farming community is empowered by local stakeholders continuously to maintain a long generation of farmers.
Freezing seafood rapidly when it is at peak freshness to ensure a higher quality and longer lasting product
Our harvests are immediately frozen with ice flakes in layers in cool boxes. Boxes are equipped with paper records and coding for traceability. We ensure that our harvests are processed with the utmost care at <-18 degrees Celsius.
Sourcing plant based ingredients, like soy, from producers that do not destroy forests to increase their growing area and produce fish feed ingredients
With adjacent locations to mangroves and coastal areas, our farmers and company are committed to no deforestation at any scale. Mangrove rehabilitation and replantation are conducted every year in collaboration with local authorities. Our farms are not established in protected habitats and have not resulted from deforestation activity since the beginning of our establishment.
Implement only natural feeds grown in water for aquatic animal’s feed without use of commercial feed
Our black tiger shrimps are not fed using commercial feed. The system is zero input and depends fully on natural feed grown in the pond. Our farmers use organic fertilizer and probiotics to enhance the water quality.
Enhance biodiversity through integration of nature conservation and food production without negative impact to surrounding ecosysytem
As our practices are natural, organic, and zero input, farms coexist with surrounding biodiversity which increases the volume of polyculture and mangrove coverage area. Farmers’ groups, along with the company, conduct regular benthic assessments, river cleaning, and mangrove planting.
THE TERM “MOONSHOT” IS OFTEN USED TO DESCRIBE an initiative that goes beyond the confines of the present by transforming our greatest aspirations into reality, but the story of a moonshot isn’t that of a single rocket. In fact, the Apollo program that put Neil Armstrong on the moon was actually preceded by the Gemini program, which in a two-year span rapidly put ten rockets into space. This “accelerated” process — with a new mission nearly every 2-3 months — allowed NASA to rapidly iterate, validate their findings and learn from their mistakes. Telemetry. Propulsion. Re-entry. Each mission helped NASA build and test a new piece of the puzzle.
The program also had its fair share of creative challenges, especially at the outset, as the urgency of the task at hand required that the roadmap for getting to the moon be written in parallel with the rapid pace of Gemini missions. Through it all, the NASA teams never lost sight of their ultimate goal, and the teams finally aligned on their shared responsibilities. Within three years of Gemini’s conclusion, a man did walk on the moon.
FACT is a food systems solutions activator that assesses the current food landscape, engages with key influencers, identifies trends, surveys innovative work and creates greater visibility for ideas and practices with the potential to shift key food and agricultural paradigms.
Each activator focuses on a single moonshot; instead of producing white papers, policy briefs or peer-reviewed articles, these teams design and implement blueprints for action. At the end of each activator, their work is released to the public and open-sourced.
As with any rapid iteration process, many of our activators re-assess their initial plans and pivot to address new challenges along the way. Still, one thing has remained constant: their conviction that by working together and pooling their knowledge and resources, they can create a multiplier effect to more rapidly activate change.
Co-Founder
THE LEXICON
Vice President
Global Workplace Programs
GOOGLE
Who can enter and how selections are made.
A Greener Blue is a global call to action that is open to individuals and teams from all over the world. Below is a non-exhaustive list of subjects the initiative targets.
To apply, prospective participants will need to fill out the form on the website, by filling out each part of it. Applications left incomplete or containing information that is not complete enough will receive a low score and have less chance of being admitted to the storytelling lab.
Nonprofit organizations, communities of fishers and fish farmers and companies that are seeking a closer partnership or special support can also apply by contacting hello@thelexicon.org and interacting with the members of our team.
Special attention will be given to the section of the form regarding the stories that the applicants want to tell and the reasons for participating. All proposals for stories regarding small-scale or artisanal fishers or aquaculturists, communities of artisanal fishers or aquaculturists, and workers in different steps of the seafood value chain will be considered.
Stories should show the important role that these figures play in building a more sustainable seafood system. To help with this narrative, the initiative has identified 10 principles that define a more sustainable seafood system. These can be viewed on the initiative’s website and they state:
Seafood is sustainable when:
Proposed stories should show one or more of these principles in practice.
Applications are open from the 28th of June to the 15th of August 2022. There will be 50 selected applicants who will be granted access to The Lexicon’s Total Storytelling Lab. These 50 applicants will be asked to accept and sign a learning agreement and acceptance of participation document with which they agree to respect The Lexicon’s code of conduct.
The first part of the lab will take place online between August the 22nd and August the 26th and focus on training participants on the foundation of storytelling, supporting them to create a production plan, and aligning all of them around a shared vision.
Based on their motivation, quality of the story, geography, and participation in the online Lab, a selected group of participants will be gifted a GoPro camera offered to the program by GoPro For A Change. Participants who are selected to receive the GoPro camera will need to sign an acceptance and usage agreement.
The second part of the Storytelling Lab will consist of a production period in which each participant will be supported in the production of their own story. This period goes from August 26th to October 13th. Each participant will have the opportunity to access special mentorship from an international network of storytellers and seafood experts who will help them build their story. The Lexicon also provides editors, animators, and graphic designers to support participants with more technical skills.
The final deadline to submit the stories is the 14th of October. Participants will be able to both submit complete edited stories, or footage accompanied by a storyboard to be assembled by The Lexicon’s team.
All applicants who will exhibit conduct and behavior that is contrary to The Lexicon’s code of conduct will be automatically disqualified. This includes applicants proposing stories that openly discriminate against a social or ethnic group, advocate for a political group, incite violence against any group, or incite to commit crimes of any kind.
All submissions must be the entrant’s original work. Submissions must not infringe upon the trademark, copyright, moral rights, intellectual rights, or rights of privacy of any entity or person.
Participants will retain the copyrights to their work while also granting access to The Lexicon and the other partners of the initiative to share their contributions as part of A Greener Blue Global Storytelling Initiative.
If a potential selected applicant cannot be reached by the team of the Initiative within three (3) working days, using the contact information provided at the time of entry, or if the communication is returned as undeliverable, that potential participant shall forfeit.
Selected applicants will be granted access to an advanced Storytelling Lab taught and facilitated by Douglas Gayeton, award-winning storyteller and information architect, co-founder of The Lexicon. In this course, participants will learn new techniques that will improve their storytelling skills and be able to better communicate their work with a global audience. This skill includes (but is not limited to) how to build a production plan for a documentary, how to find and interact with subjects, and how to shoot a short documentary.
Twenty of the participants will receive a GoPro Hero 11 Digital Video and Audio Cameras by September 15, 2022. Additional participants may receive GoPro Digital Video and Audio Cameras to be announced at a later date. The recipients will be selected by advisors to the program and will be based on selection criteria (see below) on proposals by Storytelling Lab participants. The selections will keep in accordance with Lab criteria concerning geography, active participation in the Storytelling Lab and commitment to the creation of a story for the Initiative, a GoPro Camera to use to complete the storytelling lab and document their story. These recipients will be asked to sign an acceptance letter with terms of use and condition to receive the camera.
The Lexicon provides video editors, graphic designers, and animators to support the participants to complete their stories.
The submitted stories will be showcased during international and local events, starting from the closing event of the International Year of Fisheries and Aquaculture 2022 in Rome, in January 2023. The authors of the stories will be credited and may be invited to join.
Storytelling lab participation:
Applicants that will be granted access to the storytelling Lab will be evaluated based on the entries they provided in the online form, and in particular:
Applications will be evaluated by a team of 4 judges from The Lexicon, GSSI and the team of IYAFA (Selection committee).
When selecting applications, the call promoters may request additional documentation or interviews both for the purpose of verifying compliance with eligibility requirements and to facilitate proposal evaluation.
Camera recipients:
Participants to the Storytelling Lab who will be given a GoPro camera will be selected based on:
The evaluation will be carried out by a team of 4 judges from The Lexicon, GSSI and the team of IYAFA (Selection committee).
Incidental expenses and all other costs and expenses which are not specifically listed in these Official Rules but which may be associated with the acceptance, receipt and use of the Storytelling Lab and the camera are solely the responsibility of the respective participants and are not covered by The Lexicon or any of the A Greener Blue partners.
All participants who receive a Camera are required to sign an agreement allowing GoPro for a Cause, The Lexicon and GSSI to utilize the films for A Greener Blue and their promotional purposes. All participants will be required to an agreement to upload their footage into the shared drive of The Lexicon and make the stories, films and images available for The Lexicon and the promoting partners of A Greener Blue.
