---
type: source
title: "AHA Scientific Statement: Food Is Medicine RCTs for Noncommunicable Disease — Inconsistent Clinical Outcomes"
author: "American Heart Association (multiple authors)"
url: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001343
date: 2025-01-01
domain: health
secondary_domains: []
format: systematic-review
status: unprocessed
priority: high
tags: [food-is-medicine, systematic-review, rct, hba1c, blood-pressure, bmi, aha, clinical-outcomes, evidence-review]
---

## Content

AHA Scientific Statement published in Circulation reviewing 14 US randomized controlled trials of Food Is Medicine interventions for noncommunicable disease.

**Scope:** FIM interventions including MTMs, produce prescriptions, medically tailored groceries, food pharmacies. Focused on US RCTs only.

**Primary finding:**
- FIM interventions "often positively influence diet quality and food security" — consistent positive finding across intervention types
- "Impact on clinical outcomes was inconsistent and often failed to reach statistical significance"
- Specific outcomes reviewed: HbA1c, blood pressure, BMI
- 14 RCTs showed improvements in diet quality and food security; clinical outcomes inconsistent

**Evidence quality assessment:**
- Most evidence exists for MTMs (most evidence, highest intervention specificity)
- Evidence for produce prescriptions and medically tailored groceries: "remains limited"
- Randomized trials on health outcomes, healthcare utilization, and cost of health care use: ongoing

**Context from related searches:**
- Recipe4Health (2,643 participants, before-after design): HbA1c -0.37%, non-HDL -17 mg/dL — observational, not RCT
- Multisite evaluation of 9 produce prescription programs: significant improvements in food security and F&V intake; "clinically relevant improvements" in HbA1c for adults with poor baseline cardiometabolic health — ALSO not RCT design

**Policy implications stated:**
- AHA supports expansion and standardization of FIM programs
- Calls for more rigorous RCTs with standardized outcomes
- Notes evidence is sufficient to support small-scale expansion but not system-wide policy without more controlled evidence

## Agent Notes

**Why this matters:** This is the most authoritative US evidence review of food-as-medicine RCTs. The AHA imprimatur gives it weight, and the finding — "inconsistent and often failed to reach statistical significance" — is directly relevant to whether Belief 2's intervenability claim holds. Coming from AHA (not a skeptical source), this is a meaningful acknowledgment of the clinical evidence gap.

**What surprised me:** The AHA is simultaneously an advocate for FIM programs (calls for expansion) and acknowledges the RCT evidence is inconsistent. This is not a debunking piece — it's a nuanced "promising but not proven" finding from a credibly pro-intervention source. That makes the inconsistency finding MORE credible, not less.

**What I expected but didn't find:** A breakdown of which specific intervention types showed clinical effects in RCTs vs. which didn't. The review covers FIM as a category while acknowledging heterogeneity without fully parsing it.

**KB connections:**
- Directly relates to the food-as-medicine section in the SDOH claim
- Supports the claim candidate from Session 1: "food-as-medicine interventions show inconsistent RCT evidence for clinical outcomes"
- Connects to the AHA June 2024 systematic review on SDOH and cardiovascular outcomes (if that's in the KB)

**Extraction hints:**
- The key extractable claim: "14 US FIM RCTs show consistent improvements in diet quality and food security but inconsistent and often non-significant effects on HbA1c, blood pressure, and BMI"
- This is a claim about EVIDENCE QUALITY by intervention type, not about whether food matters for health
- Distinguish the diet/food security finding (consistent) from the clinical outcome finding (inconsistent) — they're both important and the KB shouldn't collapse them

**Context:** The AHA Scientific Statement carries significant policy weight — it's the type of document that CMS and state Medicaid programs cite when making coverage decisions. Its ambiguous conclusion ("promising but inconsistent") reflects the genuine state of the literature.

## Curator Notes

PRIMARY CONNECTION: Existing food-as-medicine / SDOH evidence claims in health domain
WHY ARCHIVED: Most authoritative US RCT evidence review on FIM clinical outcomes — the canonical source for "what the evidence actually says"
EXTRACTION HINT: Extract two claims: (1) FIM consistently improves diet quality and food security (proven); (2) FIM clinical outcomes (HbA1c, BP, BMI) are inconsistent and often non-significant in RCTs (likely). These are different claims that the field conflates.
