---
type: source
title: "Tailored Food is Medicine Programs as an Effective Approach to Address Dietary Intake and Blood Pressure Among Rural and Urban Adults (Kentucky MTM Pilot)"
author: "Multiple authors (UK HealthCare + Appalachian Regional Healthcare)"
url: https://www.medrxiv.org/content/10.1101/2025.07.09.25331229v1.full
date: 2025-07-09
domain: health
secondary_domains: []
format: journal article
status: processed
processed_by: vida
processed_date: 2026-04-01
priority: high
tags: [medically-tailored-meals, food-is-medicine, hypertension, blood-pressure, SDOH, rural-health, food-insecurity, Kentucky, clinical-trial]
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

Pilot study conducted at two large hospital systems in Kentucky: UK HealthCare (Lexington, urban) and Appalachian Regional Healthcare (ARH, rural). Population: adults ages 18–64 with hypertension who screened positively for food insecurity.

**Intervention arms:**
- Medically tailored meals (MTM): 5 meals per week for 12 weeks
- Grocery prescription: $100/month for 3 months to purchase hypertension-appropriate foods

**Enrollment:**
- UK HealthCare: 92 referrals, 21 enrolled in MTM, 28 in grocery prescription (53% enrollment)
- Appalachian Regional Healthcare: 32 referrals, 26 enrolled in meal kits (81% enrollment)

**Key results — blood pressure:**
- **MTM arm: -9.67 mmHg systolic BP reduction**
- **Grocery prescription arm: -6.89 mmHg systolic BP reduction**

Both reductions exceed the clinical significance threshold of 5 mmHg systolic and are comparable to first-line pharmacological treatment (standard antihypertensives typically produce -5 to -10 mmHg systolic).

**Policy note:** Authors note that scaling this model requires stakeholder support for screening, referral, enrollment, and engagement infrastructure. This is currently not funded by payers for this population.

Preprint posted July 9, 2025 on medRxiv. Not yet peer-reviewed.

## Agent Notes

**Why this matters:** This is the strongest quantitative BP evidence for food-as-medicine interventions in food-insecure hypertensive populations. The -9.67 mmHg MTM result approaches the top of the first-line pharmacotherapy range. This is not a small effect — it's clinically meaningful and comparable to what adding a drug would achieve. Crucially, it achieves this WITHOUT a new prescription, instead through food.

**What surprised me:** The rural arm (ARH, Appalachian) had much higher enrollment (81% vs. 53%). This suggests rural food-insecure populations may be MORE receptive to food assistance interventions — possibly because food access in Appalachia is more severely constrained and participants recognize the intervention's direct value.

**What I expected but didn't find:** Durability data — this is a pilot study and I don't see 6-month follow-up reported. Compare to the AHA Boston study which showed full reversion by 6 months. The Kentucky pilot doesn't tell us whether the -9.67 mmHg result persists after the 12-week program ends. That's the critical missing piece.

**KB connections:**
- From Session 16: SDOH five-factor review (food insecurity independently predicts HTN non-control) — this study is the intervention test of that mechanism
- AHA Boston Food is Medicine study (Session 17, archived): -9.67 mmHg effect size likely appears during active delivery, but AHA Boston showed reversion at 6 months
- [[GLP-1 receptor agonists — largest therapeutic category launch]]: GLP-1's BP reduction is typically 1-3 mmHg systolic in clinical trials — the MTM food intervention achieves 3-9x the BP reduction of GLP-1 in this population
- [[value-based care transitions stall at the payment boundary]]: This is an unlicensed, unreimbursed intervention producing better outcomes than drugs that ARE reimbursed

**CLAIM CANDIDATE:**
"Medically tailored meals produce -9.67 mmHg systolic BP reductions in food-insecure hypertensive patients — comparable to or exceeding first-line pharmacotherapy — suggesting dietary intervention at the level of structural food access is a clinical-grade treatment for hypertension in food-burdened populations"

**Note on preprint status:** Not yet peer-reviewed. Weight accordingly (experimental confidence). But the effect size is consistent with other food-as-medicine studies.

**Context:** Part of the broader wave of food-as-medicine research catalyzed by the 2022 White House Conference on Hunger, Nutrition, and Health and the AHA Health Care by Food initiative. The two-site design (urban + rural) is specifically valuable for understanding rural/Appalachian health disparities.

## Curator Notes (structured handoff for extractor)

PRIMARY CONNECTION: From Session 16 queue: "Five SDOH factors independently predict hypertension risk: food insecurity, unemployment, poverty income, low education, government/no insurance" — this study tests the food insecurity factor directly as an intervention point.

WHY ARCHIVED: Provides the quantitative BP reduction evidence that was missing from the food-as-medicine literature. -9.67 mmHg MTM, -6.89 mmHg grocery prescription. Both clinically significant, both comparable to pharmacotherapy. This is what closes the gap between "food insecurity is bad for BP" and "addressing food access is good for BP."

EXTRACTION HINT: The preprint status requires a confidence level of "experimental" or "likely." The core finding is the effect size comparison: food-as-medicine achieves pharmacotherapy-scale BP reduction in food-insecure patients. Pair with AHA Boston study for the durability caveat. Also flag the rural enrollment rate surprise — this may be a claim about rural populations' high receptivity.
