Tuesday, June 02, 2026

Medically tailored meals produce better health and lower costs

First statewide Medicaid analysis finds fewer hospitalizations and emergency visits—and lower healthcare costs—among meal recipients in Massachusetts

Tufts University

First statewide Medicaid analysis finds fewer hospitalizations and emergency visits—and lower healthcare costs—among medically tailored meal recipients in Massachusetts — image:
Medically tailored meals are home-delivered, dietitian-designed meals customized for individuals with diet-sensitive
conditions who often also have food insecurity and/or activity limitations
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Credit: Jake Belcher for Tufts University

At least a dozen U.S. states are rolling out medically tailored meals in pilot projects through Medicaid, the federal–state health insurance program serving 71 million Americans who qualify based on income or disability status. Now, the first large statewide analysis of Medicaid data finds that people with diabetes, heart disease, depression, and other conditions who received these home-delivered, dietitian-designed meals experienced significantly fewer health emergencies and lower costs of care than those who did not.

The new study, published today in Nature Medicine by researchers at the Food is Medicine Institute at Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, UMass Chan Medical School, Community Servings, and multiple state healthcare systems, found that Massachusetts Medicaid members who received medically tailored meals had 31% fewer hospitalizations and 20% fewer emergency department visits. Per-person healthcare costs declined by $3,433 while patients were on the meal program (an average of roughly six months), offsetting 98% of the program's cost.

"As the first state to broadly offer medically tailored meals in Medicaid to Americans with diet-related diseases, Massachusetts provided an important opportunity to evaluate the real-world impact of such a program," said senior author Dariush Mozaffarian, cardiologist and director of the Food is Medicine Institute. "Our results show that food really is medicine, with major clinical and policy implications for health-insurance coverage of medically tailored meals to impact diet-related diseases and healthcare costs."

The researchers analyzed data from 2020 to 2023 across 11 healthcare systems in Massachusetts. They compared outcomes for 1,866 people who received meals with similar eligible Medicaid members who did not, carefully accounting for differences such as demographics, health conditions, and prior healthcare use.

All meals were prepared and delivered by Community Servings, a Boston-based nonprofit. Participants received 10 meals per week—a mix of breakfasts, lunches, and dinners—plus snacks. Each participant had an initial consultation with a registered dietitian nutritionist to tailor meals to their medical needs and dietary preferences.

Study participants received meals for periods of time ranging from three to 33 months, with participants typically receiving meals for about six months.

Using Medicaid claims data, the researchers tracked hospitalizations, emergency visits, primary care visits, and overall costs. They also ran multiple statistical checks to confirm their findings, including analyzing data from before the meal program began to ensure that differences between groups were not already present. The results were consistent across all these approaches.

Medically tailored meals were not only associated with better outcomes but also net cost savings for Medicaid, even accounting for the cost of the meals, for people with certain conditions. These included heart disease, chronic kidney disease, diabetes, and depression—highlighting that the program could not only improve health, but also save the state and federal government money. Reductions in hospitalizations and emergency visits occurred within months while participants were receiving meals, indicating relatively rapid effects. The study also found that Medicaid patients receiving meals for longer had the largest improvements in healthcare costs.

Also, importantly, the program did not reduce necessary care, such as primary care visits.

"These findings show that medically tailored meals can be both clinically effective and economically sustainable within Medicaid," said first author Kurt Hager, an assistant professor of population and quantitative health sciences at UMass Chan.

The authors noted several limitations. Because participants were not randomly assigned to receive meals, any unmeasured differences between those who chose to receive meals and those who did not could have affected the results. In addition, the study reflects a program delivered by an established nonprofit serving people at higher risk due to health and economic factors; outcomes may differ among other meal providers or among healthier patients or patients with greater economic stability.

States across the country are increasingly testing Medicaid programs that address nutrition, and the Centers for Medicare and Medicaid Services have highlighted the important role of nutrition recently. Findings from Massachusetts could guide similar meal programs across the country.

"It's rare to find anything in medicine that both improves health and saves money," said Mozaffarian. "It should be a no-brainer to extend similar programs to patients in other states and covered by other health insurance programs, such as Medicare and employer-based insurance."

Research reported in this article was supported by the National Institutes of Health's National Institute of Diabetes and Digestive and Kidney Diseases under award number R01DK134452 and by the Massachusetts Executive Office of Health and Human Services. Complete information on authors, funders, methodology, limitations, and conflicts of interest is available in the published paper. The content is solely the responsibility of the authors and does not necessarily represent the official views of their funders.

Journal

Nature Medicine

DOI

10.1038/s41591-026-04407-5

Article Title

Medically tailored meals receipt and healthcare utilization and costs in Massachusetts’ Medicaid demonstration

Article Publication Date

2-Jun-2026

The brain, emotions, and the gut. How culture, stress, and social life shape gut health

Wroclaw Medical University

image:
Professor Agata Mulak, Department and Clinic of Gastroenterology, Hepatology and Internal Diseases, Wroclaw Medical University, Wroclaw, Poland. Professor Mulak is a co-author of a review published in Gastroenterology examining how sociocultural factors, stress, and culture influence disorders of gut–brain interaction.
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Credit: Wroclaw Medical University

Abdominal pain before an important exam, nausea during intense stress, or sudden intestinal problems following difficult life experiences — many people regard such symptoms as a temporary bodily reaction. However, a growing body of evidence confirms that the relationship between the brain and the gut is far deeper. The latest publication co-authored by Professor Agata Mulak of Wroclaw Medical University indicates that gastrointestinal health is influenced not only by genes, diet, and gut bacteria, but also by culture, social relationships, economic status, and the way individuals function within society.

The article, published in the journal Gastroenterology of the American Gastroenterological Association, forms part of the update of the Rome V Criteria, the most important international system for the classification and diagnosis of Disorders of Gut–Brain Interaction (DGBI). These conditions, until recently referred to as functional gastrointestinal disorders, include, among others, irritable bowel syndrome.

Disorders of gut–brain interaction

Disorders of Gut–Brain Interaction are currently among the most common gastroenterological conditions. It is estimated that they may affect up to approximately 42% of the general population. At the same time, they remain a major diagnostic and therapeutic challenge.

Patients often spend years being told that “their test results are normal,” even though symptoms such as abdominal pain, bloating, diarrhea, constipation, or nausea significantly impair daily functioning.

The shift in our understanding of the pathogenesis and course of Disorders of Gut–Brain Interaction is the result of a holistic approach to health and disease, consistent with the biopsychosocial model, which takes into account the interactions of biological, psychological, and sociocultural factors, - explains Professor Agata Mulak from the Department and Clinic of Gastroenterology, Hepatology and Internal Diseases, Wroclaw Medical University.

The new Rome Criteria emphasize that symptoms are neither “purely psychological” nor “solely intestinal.” Rather, they result from complex interactions among the nervous, immune, and endocrine systems, as well as the gut microbiota.

The gut–brain axis

In recent years, scientists have increasingly focused on the gut–brain axis, a system of bidirectional communication between the gastrointestinal tract and the brain. The gut is no longer viewed solely as an organ of digestion but as an active component regulating the functioning of the entire body.

This communication involves nerves, hormones, immune cells, and the gut microbiota — the billions of microorganisms inhabiting the gastrointestinal tract. This is why chronic stress can affect not only mental well-being but also intestinal function.

Chronic stress disrupts communication between the brain and the gastrointestinal tract, affecting intestinal motility, visceral hypersensitivity, intestinal barrier permeability, and the composition of the microbiota, - explains Professor Agata Mulak.

Research shows that prolonged psychological stress may increase intestinal hypersensitivity, alter the composition of gut bacteria, and intensify inflammatory processes. This, in turn, leads to greater symptom severity and a reduced quality of life for patients.

Loneliness, pressure, and sociocultural factors also affect the gut

One of the most important aspects of the new publication is its emphasis on sociocultural factors. This is an area that, until only a few years ago, received little attention in gastroenterology.

Scientists now have a much better understanding that gut health may also depend on living conditions, economic security, the quality of social relationships, and cultural norms concerning the expression of emotions and illness.

Sociocultural factors exert a significant influence on stress levels, lifestyle, and the way we perceive and respond to symptoms, - emphasizes the researcher.

Factors such as excessive workload, chronic financial insecurity, lack of social support, or experiences of exclusion may all play a role. In some cultures, openly discussing gastrointestinal problems remains socially taboo, which may delay seeking medical help.

Cultural norms shape the interpretation and expression of symptoms, as well as healthcare-seeking behavior, directly influencing the course of these disorders and the effectiveness of treatment, - adds Professor Mulak.

An increasing body of evidence suggests that disturbances of the gut–brain axis may have implications beyond gastroenterology. Researchers are investigating their associations with metabolic, autoimmune, neurological, and psychiatric disorders.

The gut microbiota may influence immune system function, metabolism, and brain activity. Consequently, imbalances in the microbiota are now being studied in the context of depression, neurodegenerative diseases, and obesity, among other conditions.

The medicine of the future will be more holistic

The new approach is also changing the way patients are treated. Increasing importance is being placed on building strong physician–patient relationships and tailoring therapy to each patient's individual needs.

Effective physician–patient communication, based on active listening, empathy, and trust, forms the foundation of successful treatment,- notes Professor Agata Mulak.

Experts emphasize that effective therapy should not rely solely on medication. It increasingly includes dietary modifications, improved sleep quality, physical activity, stress-reduction techniques, and psychological support.

A holistic approach not only reduces symptom severity but also improves patients’ quality of life. In the future, we can expect increasingly personalized therapies that take into account both the biological and psychosocial dimensions of health,- concludes the researcher.

Material based on the article: Sociocultural Aspects of the Pathophysiology, Clinical Presentation, and Management of Disorders of Gut–Brain Interaction

Authors: Reuben K. Wong, Xiucai Fang, Uday C. Ghoshal, Purna C. Kashyap, Agata Mulak, Yeong Yeh Lee, Ami D. Sperber, Gerald Holtmann

Did You Know? Key Facts About the Gut–Brain Axis

A graphic highlighting key facts about the gut–brain axis, including the role of the enteric nervous system, serotonin production in the gut, and the influence of stress and sociocultural factors on gastrointestinal health. The graphic accompanies a review published in Gastroenterology and co-authored by Professor Agata Mulak of Wroclaw Medical University.

Credit

Wroclaw Medical University

Journal

Gastroenterology

DOI

10.1053/j.gastro.2026.02.006

Method of Research

Literature review

Subject of Research

People

Article Title

Sociocultural Aspects of the Pathophysiology, Clinical Presentation, and Treatment of Disorders of Gut-Brain Interaction

Modelling life beneath our feet: A new step towards realistic soil ecology at the landscape scale

Pensoft Publishers

image:
A framework for assessing multiple ecosystem stressors.
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Credit: Liyan Xie

As soil health becomes a defining goal of the EU Soil Strategy for 2030, researchers at Aarhus University are rethinking how we model what lives beneath our feet. Their new spatially explicit population model for the soil invertebrate Folsomia candida (springtails), marks a significant step beyond standard laboratory testing.

For over 60 years, traditional ecotoxicological testing has provided valuable baseline data, but these highly controlled laboratory tests often overlook dynamic environmental drivers like fluctuating temperature and soil moisture. To address this critical gap, researchers developed a highly realistic stage-structured population model within the Animal, Landscape and Man Simulation System (ALMaSS) framework. The formal model is now available in the open-access Agricultural and Environmental Modelling journal.

“This model explicitly represents egg, juvenile, and adult life stages, linking development, reproduction, and survival to environmental conditions using empirically parameterized thermal performance curves,” note the researchers. This approached allowed for a non-linear look at how populations actually respond to their environment.

The newly published formal model integrates these dynamic landscape elements by combining static soil properties with hourly ERA5 weather data, vegetation growth, and daily crop management practices. A key highlight of the tool is its advanced soil moisture tracking, which uses a novel integration of evapotranspiration data and physical soil properties to accurately estimate surface soil water potential. Using daily time steps for simulations lasting up to five years, the model captures subpopulation dynamics at a high-resolution spatial scale of 100 square meters.

Even though the current version of the model focuses purely on environmental stressors without chemical exposure, its flexible structure serves as a foundational framework that can be easily extended. By eventually integrating toxicity modules, the model will enable the investigation of population-level impacts driven by agrochemical usage, such as pesticides and fertilizers, across different European farming practices.

"This mechanistic framework can improve the interpretation of standardised laboratory and higher-tier mesocosm tests, providing a crucial tool for assessing the impact of multiple stressors under environmentally realistic scenarios. Ultimately, models like this offer a pathway towards more scientifically grounded, realistic assessments of ecosystem health in a changing environment," concludes the team.

Original source:

Xie L, Duan X, Norouzi S, de Jonge LW, Topping CJ (2026) Integrating spatial and environmental stressors in a population model of Folsomia candida (Collembola, Isotomidae): a Formal Model within ALMaSS framework. Agricultural and Environmental Modelling 8: e184962. https://doi.org/10.3897/aem.8.184962

Spatial and temporal populations modelling.

Credit

Liyan Xie

DOI

10.3897/aem.8.184962

Article Title

Integrating spatial and environmental stressors in a population model of Folsomia candida (Collembola, Isotomidae): a Formal Model within ALMaSS framework

Sunlight-driven coproduction of hydrogen and valuable chemicals achieved with 100% selectivity using dual-functional sites

Ultrathin porous CdS nanosheets decorated with Ru single atoms and S vacancies enable record-high performance for ethanol photoreforming

Science China Press

Synergistic Ru single atoms and S vacancies on CdS nanosheets for efficient ethanol photoreforming — image:
Schematic illustration of the ethanol photoreforming process over Ru0.2-CdS. Under light irradiation, Ru single atoms (Ru SAs) trap photogenerated electrons while sulfur vacancies (S vacancies) capture holes, synergistically promoting charge separation. Ethanol is selectively converted into hydrogen (H2) and 1,1-diethoxyethane (DEE) with 100% selectivity. The dual-functional site design enables an 81.5-fold enhancement in H2 evolution compared to pristine CdS.
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Credit: Feng Liu, Chunyang Zhang, Shidong Zhao, Haowei Qie, Hairong Zhu, Maochang Liu

As the world seeks sustainable alternatives to fossil fuels, converting renewable biomass-derived ethanol into hydrogen and valuable chemicals using sunlight offers an attractive pathway. However, conventional photocatalysts suffer from rapid charge recombination and sluggish reaction kinetics, limiting efficiency and selectivity.

Now, a research team led by Professor Maochang Liu at Xi’an Jiaotong University, China, has developed a clever solution. They constructed ultrathin porous cadmium sulfide (CdS) nanosheets decorated with two types of “dual-functional” sites: individual ruthenium atoms (Ru single atoms) and sulfur vacancies. This design, reported in Science Bulletin, enables highly efficient and selective photoreforming of ethanol under simulated sunlight.

How it works
Under light irradiation, the Ru single atoms act as electron traps, while the sulfur vacancies capture holes. This spatial separation prevents the electrons and holes from recombining, allowing them to participate in desired chemical reactions. Moreover, the dual sites work together to weaken the key bonds in ethanol, lowering the energy barrier for its dehydrogenation. As a result, the catalyst converts ethanol into hydrogen and acetaldehyde with exceptional efficiency. In the presence of a trace amount of hydrochloric acid, the acetaldehyde further condenses to form 1,1-diethoxyethane (DEE), a valuable solvent and intermediate for pharmaceutical synthesis—with 100% selectivity.

Record-breaking performance
The optimized catalyst, Ru0.2-CdS, achieved a hydrogen evolution rate of 157.9 μmol/h, 81.5 times higher than that of pristine CdS. The apparent quantum efficiency at 400 nm reached 67.1%, meaning more than two-thirds of incident photons are effectively utilized. No byproducts such as carbon dioxide or light hydrocarbons were detected, and the liquid product DEE was obtained with full selectivity. The catalyst also showed excellent stability, maintaining its activity over seven consecutive cycles.

Beyond ethanol
The strategy proved general. When applied to lactic acid photoreforming, the same catalyst achieved a 27.3-fold enhancement in hydrogen production and 93.3% selectivity for pyruvic acid, another valuable chemical.

Why it matters
“This work goes beyond conventional charge-separation strategies by revealing a cooperative mechanism for bond-specific activation,” said Professor Liu. “Our dual-functional site design provides a fresh principle for developing photocatalysts that can simultaneously produce clean hydrogen and high-value chemicals from renewable feedstocks.”

The findings open the door to more sustainable and economically viable solar-to-chemical conversion processes, using abundant biomass-derived alcohols as starting materials.