RFP: A 'Food as Medicine' MoonshotOctober 31, 2022
The U.S Sick-care system is on a seemingly un-escapable upwards cost spiral, with no end in sight. Underlying most of the diseases of modernity (metabolic syndrome, heart disease and stroke etc) are all linked to poor nutrition for which the exponentially increasing costs to our healthcare system are a downstream consequence.
Personalized / Precision / Individualized nutrition is on the rise. Consumers want nutritious food delivered that doesn't sacrifice on convenience or taste. Traditional programs like Jenny Craig cost $20-$30/day but don't provide delicious or nutritious food. By comparison, plated and blue apron are ~$10/serving.
By solving for the food trilemma of quality/cost/convenience - we’ll see a step function improvement in patient nutrition when healthy, fully prepared meals can be delivered cheaply with minimal work needed from the consumer (bonus points if the food fits into a familiar taste profile the patient is used to).
Because most Americans eat fast food 1-3 times a week, in order to have any sort of impact, at scale, a solution will need to compete head-to-head with the fast-food industry, and win:
- ⅓ of Americans are eating fast food on any given day.
- People ages 20-39 years old eat the most fast food on any given day.
- Men consume more fast food than women.
- 83% of American families eat at fast food restaurants at least once a week.
- The average American household spends 10% of their annual income on fast food.
- People who earn more money tend to eat more fast food than those who earn lower incomes.
- Lunchtime is the most popular time to eat fast food.
- 34% of children eat fast food on any given day.
- Regular consumption of fast food increases your risks for obesity, heart disease, type 2 diabetes & depression.
- Regular fast food consumption increases 2.2% every year.
- McDonald’s is still the most popular restaurant in the fast food industry with $130.4 Billion spent there worldwide in 2019.
A problem with dietitians is that many don’t try to work within cultural nuances. Suddenly throwing someone into a totally new flavor profile or type of food requires really drastic changes not only to the patient’s diet, but the entire family that’s eating as well. There’s a good New York Times article about this, but what was pretty stark when looking at the data is how dietitians skew predominantly white. Food is one of the cornerstones of most cultures, so making it easier to transition into healthy habits by swapping out ingredients within existing recipes a patient already makes or slowly introducing new meals with similar flavor profiles might increase adherence and make the transition easier. Yes, if you replace paneer with tofu you’ll get a lot of angry South Asian families yelling at you, but that’s still an easier transition than throwing wilted kale in the mix.
They are not sustainable, so trying to attempt to solve the problem with yet another diet program is not going to move the needle. Any solution to the problem of poor nutrition will need to likely be at least as cost-effective, at least as convenient, at least as tasty and ideally much more nutritious than the next meal you are going to consume.
Potential partners to leverage.
- Cloud Kitchen
In 2021, certain Medicare Advantage plans started paying for health meals. This could provide a catalyst alongside other Medicaid-based programs which are coming online in the next few years to get a tailwind behind your effort.
What could actually solve the problem of poor nutrition, at scale?
- A breakthrough innovation in food science, to drive healthier, cheaper and more convenient food choices that are shelf-stable or easily stackable at the grocery store and manufacturable at scale (these usually compromise on nutrition and taste).
- A major distribution or ag-tech breakthrough which allows for healthy food to be produced in a decentralized network of local farms and self-farming operations.
- A digital therapeutic / CBT, which is able to somehow train the average fast-food loving consumer to eat well.
- Massive subsidies for healthy foods by health-plans (payers). I worry that they won't have the proper incentives to do this, given they benefit indirectly from rising healthcare costs, since their profit margins are effectively capped at 20%*
- Some combination of 1-4.
- In the simplest terms, the 80/20 rule requires that insurance companies spend at least 80 percent of the premiums they collect on medical claims