Help Food-Insecure Patients Eat Well on a Budget

Food insecurity is a growing problem for Americans, according to the US Department of Agriculture. As a primary care doctor, you should be aware that soaring grocery prices and tight household budgets could be impacting certain patients’ access to high-quality food choices.

If your patients express frustration with the lack of nutritious foods available for meal planning, here is some practical advice you can offer to help them eat well on a budget.

Healthier Alternatives to Processed Foods 

Frozen microwavable meals, packaged lunch meats, sugary sodas, lunchbox meals, and starchy snacks are convenient, but they aren’t doing your patients any favors when it comes to nutrition. These overly processed foods should not be your patients’ go-to meals or snacks.

During your discussions with patients, suggest quick swaps, recommends Amy Bragagnini, a registered dietician and spokesperson for the Academy of Nutrition and Dietetics based in Grand Rapids, Michigan.

Here are some of her suggestions: 

• “Instead of serving deli meat or hot dogs for lunch, I would suggest getting a rotisserie chicken and shredding the meat for a homemade chicken salad sandwich,” she said. “The meat can also be used in other dishes, like adding it to soups and stews.”
• Skip sugar-laden sodas and instead naturally sweeten your drinks with presliced fruit or add a splash of fruit juice for flavor.
• Instead of buying granola bars for a snack, why not make your own? Take rolled oats and combine with cooking oil, a sweetener like maple syrup, and add nuts and dried fruit for a delicious snack for you and your family.
• Rethink snack options — instead of buying potato chips, why not air pop some popcorn at home, and then add a little seasoning or a sprinkle of parmesan cheese for a great movie-night snack? All you need is the popcorn, a microwave, and a brown paper bag.

Guiding Patients Facing Food Insecurity 

Your patients may express concern or frustration about the financial strain associated with eating a healthier diet or preparing more protein-based meals at home. Here are steps to help guide them to an affordable nutrition plan.

Inquire if you suspect a patient is food insecure. It’s very important that a medical facility has proper screening tools in place to identify those facing food insecurity, said Bragagnini.

“If a doctor suspects a patient may be food insecure, it is important to first use gentle and kind language about the subject of nutrition,” she said. “Instead of coming right out and asking if a patient is food insecure, maybe ask about the recent meals the family has had at home and how they prepared the meals.”

Doctors can also inquire about what grocery stores the patient frequents and whether they have equipment to prepare food at home, Bragagnini said.

Suggest ideas for healthier meal prep. If it’s determined that the patient does have the ability to store and prepare food at home, doctors can offer strategies to make this process healthier and more affordable.

“Offer ideas on ways that various foods can be used in multiple dishes,” said Bragagnini.

For example, a large bag of spinach can be used in a salad, wilted in a stir fry, or roughly chopped and added to spaghetti, so none of it goes to waste, she said. Bragagnini provides a second example: A hefty batch of lean, ground turkey can be used in several dishes like spaghetti, tacos, or added to stuffed peppers.

Another way to boost nutrition is to remind patients that eating more fruits and vegetables is an excellent way to lower the risk for disease. “Then, discuss affordable options for fruits and veggies — like buying them frozen or canned — and discounted produce is another great option,” Bragagnini said.

Discuss money-saving suggestions. Advise your patients to take extra time browsing options at the grocery store and suggest they buy “off-brand items” that are also high in fiber — like canned beans, brown rice, oats, or store-brand nuts and seeds, said Bragagnini.

Remind your patients to shop with intention. Suggest that your patients limit the time spent in the soda and snack aisles and instead shop with a grocery list and urge them to stick to it.

“This step begins with planning and preparation; encourage the patient to speak to their family and discuss dinner options for the week,” Bragagnini added.

Helping Patients Prioritize Nutrition

If you’re receiving pushback from patients saying they’re juggling work, family, and home and don’t have the time to devote to healthy shopping and food prep, have your responses ready.

“I validate their statements and let them know that almost all my clients struggle with the same busy schedule,” Bragagnini said. She then offers some ideas to help them have healthy “go-to” options when time is of the essence.

Some patients may disclose that meal preparation is one of the main obstacles to healthier eating.

“It is hard to beat fast food in terms of time and pleasing the family, even if we are well aware of the health concerns,” said Mark Loafman, MD, a board-certified family physician with Cook County Health in Chicago. “Driving past the drive-thru to go home and cook can be a tough thing to sell when counseling patients.”

Loafman suggests that patients involve their families in their plans to eat healthier. “Pleasing the family, and our own appetite, is well served by fun, flavorful recipes and starting with some transition recipes — like using cauliflower for ‘mac’ and cheese or for a pizza crust,” he said. “It can also help to get kids and partners involved in selecting recipes, prepping the food, adjusting seasonings, etc.”

Loafman explains how many recipes that can be made in large batches can be used in a variety of ways for different meals — adding an egg and serving over grains, using in a noodle bowl with broth, or wrapping in a burrito, etc.

Another option for busy patients is to try a slow cooker.

“The cheaper cuts of meat are a common and very effective way to save money,” said Loafman. Regarding that point, he recommends preparing a large batch on the weekend and serving it in a variety of ways for weeknight dinners and for lunch at work.

Experimenting with a wide array of spices, seasonings, vegetables (fresh or frozen), and yogurtscan add an exciting and tasty twist to these dishes — either by building on your favorite recipes and flavors or by trying something new, he said.