Opportunities for Individual- and Population-Specific Adaptations in Food Is Medicine: A Scoping Review

Food is Medicine (FIM) interventions are a promising approach for addressing food insecurity and nutrition-sensitive chronic conditions. Despite emerging literature on FIM, the nature and extent of adaptations within programs have not been systematically evaluated. Therefore, the objective of this scoping review was to synthesize evidence on individual- and population-specific adaptations in FIM interventions, including medically tailored meals (MTM), medically tailored groceries (MTG), and produce prescriptions (PRx). A comprehensive search of PubMed, Web of Science, and Cumulative Index of Nursing and Allied Health Literature was conducted in January 2025 using keywords related to FIM. Study participant and intervention characteristics were summarized, and adaptations were categorized according to: 1) age and household size; 2) disease state; or 3) culture and community. In total, 6266 abstracts were screened, and 89 peer-reviewed manuscripts were included in the review. The FIM interventions included MTM (n = 20), MTG (n = 18), and PRx (n = 51), and were mostly conducted in adult populations (71.9%). Most manuscripts (80.9%) included ≥1 population-specific adaptation, most commonly for disease state (46.1%) or culture and community (43.8%). Nearly all studies on MTM and MTG mentioned adaptations for disease state (95.0% and 66.7%, respectively) compared with a relatively smaller proportion of adaptations among PRx (19.6%). Disease state adaptations most commonly included aligning food provisions with evidence-based dietary guidelines. In contrast, a higher proportion of PRx and MTG mentioned adaptations specific to culture and community (51.0% and 50.0%, respectively) compared with MTM (20.0%). These adaptations varied widely, but included the translation of study materials, community engagement in intervention development, and client-choice models of food provision. FIM interventions are being implemented across the United States, with varying levels of adaptation to address unique needs of target populations. The findings highlight opportunities for further research on strategies to enhance adaptation, improve reach and effectiveness, and ensure the sustainability of FIM programs across diverse communities.