The following guest post was written by Culina Health CEO Vanessa Rissetto, MS, RDN. Rissetto was named by Essence magazine as one of the top 5 Black nutritionists that will change the way you think about food. Her true passion is that nutritional coaching and science-based health and wellness education is possible and should be available for all.
Despite what social media may have you believe, “food is medicine” is not some new TikTok trend. While the concept is fairly simple — give people nutritious food and they will feel better — it doesn’t mean that kale salads and turmeric lattes are the answers to better health. In fact, it’s much more nuanced than that.
For decades, highly trained registered dietitians have stood on the frontlines of healthcare, delivering this evidence-based approach to treating and reversing chronic conditions. However, these providers remain largely underutilized. In the United States alone, 1 in 3 adults live with metabolic conditions, yet only 0.2% of them have ever seen a registered dietitian. This is why clinical nutrition is healthcare’s largest untapped opportunity.
The Role of Registered Dietitians vs. Physicians in Healthcare
Dietitians assess patients’ needs, consider their health literacy and access to food, and provide non-judgmental support to help them achieve their goals. During weekly hour-long sessions — which are covered by most insurance plans — dietitians can gather the necessary information to not only create a personalized plan for the patient, but also monitor their progress and coordinate care with their physician if needed.
On the other hand, physicians can often only spend about seven to 13 minutes with each patient. This limited time makes it difficult for them to establish meaningful rapport with patients or gather enough information to address their concerns. Patients are also notoriously poor historians, and from a rushed physician’s viewpoint, most of them seem non-compliant. Given these factors, patients are often given a script for medication without any follow-up appointments for the foreseeable future.
The Impact of the “Food is Medicine” Approach
As a dietitian and co-founder of a nutrition-focused digital health startup, the concept of “food is medicine” is top of mind for me and many of the investors I meet. With the potential to reverse chronic conditions or, at the very least, alleviate symptoms, it’s easy to see why it’s so compelling.
From a business standpoint, investors appreciate that it’s an innovative, scalable idea. The product is clearly defined, and insurance companies have committed to covering the costs. In the context of healthcare, it has the power to save $13.6 billion in healthcare costs within a year and reduce acute care hospital costs by $45,000, saving patients more than $1,500 annually.
Unpacking the Barriers to Nutrition Care
A significant challenge in providing “food is medicine” care is that approximately 40% of the food in America goes to waste. This statistic doesn’t change just because we offer affordable nutrition care to people who need it. Patients grow tired of eating pre-made meals relatively quickly and often resist eating when sick. For instance, up to 67% of meal trays in hospitals go uneaten for various reasons. Telling patients that certain foods can improve their health doesn’t necessarily motivate them to eat.
Another barrier to care is the myth that registered dietitians are a luxury that only the elite can afford. You may recall newspaper articles about celebrity dietitians charging $1,000 per session to help people achieve their goal weight. These dietitians would go to lunches at Del Posto with hedge fund managers and order their meals for them. Talk about full service! However, if you were one of the 99% reading that article, you would think that dietitians only help with weight loss, only accept cash, and that you could never afford to see one. In reality, this couldn’t be further from the truth.
Making Clinical Nutrition Care Accessible to All
At Culina Health, we believe clinical nutrition services should be widely available and affordable to everyone. Before we started our company, my co-founder and I served on insurance panels and ran our own in-person practices. When the COVID-19 pandemic began, telehealth became more accessible and made it possible to start our company.
Since then, we’ve hit the ground running. In less than a year, Culina Health grew from two registered dietitians to nine with a $1 million revenue run rate and no marketing. Today, we’re a team of 60+ dietitians and growing. We were — and still are — on a mission to increase access to sustainable nutrition care, regardless of patients’ socioeconomic status. By leveraging science and patient data, we deliver evidence-based, culturally appropriate clinical nutrition support to the communities that need it most.
Integrating “Food is Medicine” as a Pillar of Healthcare
Since Culina Health began, we have completed 50,000 sessions and are on track to at least double our revenue this year. As we conduct more sessions and gather more data, our algorithms will become smarter, ultimately leading to even better patient outcomes and business growth. Case in point: we have one of the highest patient retention rates in the industry and an NPS score of 80, which is about 50% higher than the healthcare average.
This combination of positive health outcomes and powerful business growth attracted venture capital (VC) firms like Rethink Impact and the VC-arm of CareFirst, a healthcare payer with over 3 million members, to our company. They believe in us because they see that “food is medicine” works. With their support, we can continue improving our patients’ quality of life and expand our reach nationwide. If this approach has transformed our patients’ lives at Culina Health, imagine its potential impact on the entire healthcare system.