Food is Medicine

Bruce Palmisano’s wounds wouldn’t heal. The wheelchair-bound Vietnam era vet took medication and nutritional supplements month after month, and still the burns on his feet – from scorching water in a foot massager – wouldn’t heal. Then Palmisano found MANNA, a Philadelphia nonprofit which provides medically appropriate meals to people like Palmisano struggling with chronic or acute illness.

Within a short time, Palmisano was fully recovered. “The program is wonderful,” he said. “Ever since I’ve been on MANNA, for the last four months, my feet healed up 100 percent.’’

MANNA provided Palmisano three high-protein meals a day, designed for wound recovery; it’s one of 11 menus developed by MANNA dieticians for clients with illnesses ranging from diabetes to cancer to kidney failure.

The organization feeds 1,000 people three meals a day, every day. Meals are free to clients. MANNA pays for those meals the way most nonprofits pay for services: they fundraise. MANNA has built an impressive network of individual donors, foundations and corporate sponsors and they organize big, creative fundraisers, like Pie in the Sky.

Palmisano’s case is cited by Ann Hoskins-Brown, MANNA’s director of Policy and Institutional Affairs, as evidence that food can be as necessary as medicine in restoring health. In MANNA’s vision for the future, doctors will write prescriptions for meals and insurance companies will pay for them. “We want medically-appropriate meals to be a standard part of healthcare, much like hospice care is available to everyone who needs it,” she said.

They knew it would be difficult to convince medical professionals and health insurance companies that food should be treated—and paid for—like medicine. In order to demonstrate their work’s true value, they invested in research. The report, published in the Journal of Primary Care and Community Health, showed that Medical Nutrition Therapy—which includes nutritional assessment and one-on-one counseling—coupled with medically tailored, home-delivered meals improves health, reduces costs and increases quality of life.

“The average savings was between $10,000 and $12,000 per person per month,” Hoskins-Brown said. “People weren’t going into the hospital as frequently and when they did, they stayed for a shorter period of time. And when they were released, they went directly home rather than to sub-acute care.”

The findings led directly to a remarkable reimbursement pilot in which a local health insurance company is providing coverage for MANNA’s comprehensive nutrition services for up to 200 of its members at any given time.

To market themselves to insurers beyond the pilot, MANNA’s next hurdle was to modernize MANNA’s data system. Nicole Laverty, nutrition and client services manager explained that this would not only allow MANNA to make systemic observations and improvements for their clients, but customers like health insurance companies expect quantifiable demonstration of impact. With support from The Barra Foundation, new software will replace 20-year-old technology that’s inflexible and cumbersome.

Technology will help MANNA transform their business model, but their ability to track data will also have a positive impact beyond the organization’s walls. If, for instance, MANNA can track the return of former clients—which it can’t do now because the program overwrites new intake information on old forms—it can potentially identify failures in other parts of the social safety net that can be improved.

Investments in research and technology paid off. MANNA’s new insurance company customers will enable the organization to reach thousands more clients through their health insurance providers. But above all else, simply: “It’s about serving our clients better,” Laverty said.

Feed a cold? Cure the flu with chicken soup? It turns out that these age-old techniques have the right idea: food can and should be treated as medicine for physical ailments. Philadelphia-based nonprofit, MANNA, believes in the power of nutrition to treat chronic and acute illnesses. Their delivery of medically-appropriate meals and nutritional counseling to a thousand local residents saves around $130 million in annual healthcare costs. Now their challenge is to demonstrate that value to their biggest customers yet: health insurance companies.

“We want medically-appropriate meals to be a standard part of healthcare.”

Ann Hoskins-Brown, MANNA’s director of Policy and Institutional Affairs

 

Story provided by The Barra Foundation

Illustration by Narrator Design

Healthy Holiday Eating

The holiday season has arrived!  According to the National Institutes of Health, the additional calories associated with holiday meals can result in an extra pound or two of weight gain every year. Maintaining healthy eating habits from the summer may seem like a challenge during the holiday season but it is possible! With these simple tricks you can enjoy your holiday celebrations guilt free.

• Plan your meals ahead of time to control that grumbling stomach all day. Start by mapping out the day and when your largest meal will be. If you over eat at a meal, try to make the next meal lighter. Also it is best not to arrive to the party on an empty stomach.
• Survey the food options before as to not overload the plate with high calorie foods. This will also help with controlling portion sizes.
• Remember this is a time for family so try and engage in conversation with others while eating more slowly to savor the flavor. It gives your brain more time to realize it is satisfied and delays the urge to overeat.
• Bring/make a healthy dish so you can spoil yourself on a less calorie dense item. Try to include: fruits, nuts, whole grains, vegetables, low-fat dairy products, and/or limit the amount of salt in the dish. This not only gives back control but will sure be a crowd pleaser at any event.
• Stay active even though the chilly season may bring out the couch potato in all of us, planning to exercise will burn off those unwanted pounds. Indulge in winter activities like sledding, ice skating, a brisk walk before the sun goes down, or become involved at a community center for a game of basketball.
• Treat yourself with desserts. Tempting as it is, try a treat or two in small portions instead of a full serving. The line to the dessert table may be a mile long, so cut out the stress by going last. The less options will make choosing healthy alternatives easier. Just limit the amount of toppings.

Recipe:

These Gingerbread applesauce waffles will keep you full all day until it is time to feast.

3 cups all-purpose flour
4 teaspoons baking powder
2 teaspoons ground cinnamon
2 teaspoons ground ginger
1/2 teaspoon freshly grated nutmeg
4 large eggs
2/3 cup packed dark brown sugar
1 cup canned pumpkin puree
1 1/4 cups low fat milk
1/2 cup molasses
1/2 cup Applesauce, chunky works too!
Lite Syrup, whipped cream or fresh fruits for topping, to pass at table

In a large bowl combine flour, baking powder, cinnamon, ginger, nutmeg. In a medium bowl, beat eggs and brown sugar until fluffy, then beat in pumpkin, milk, molasses and applesauce. Stir the wet into dry until just moist. Do not over stir the waffle batter. Brush the iron with a little melted butter and cook 4 waffles, 4 sections each. Serve with toppings of choice.

Each year, 1.4 million Americans are diagnosed with diabetes making it the 7^th leading cause of death, which is more deadly than AIDS and breast cancer combined.  In FY 2016, approximately 30% of the MANNA client population had diabetes as either a primary or coexisting condition making it one of the most common chronic illnesses served.  It is MANNA’s mission to help lessen the comorbidities and complications associated with diabetes that can become severe by providing nutrition counseling and our diabetic diet modification through our home-delivered meals service. Many of the complications of diabetes are common and can cause serious, long-term consequences including: hypoglycemia, hypertension, dyslipidemia, cardiovascular disease (death rates are 1.7 times higher with diabetes), heart attack (1.8 higher hospitalization rate with diabetes), stroke (1.5 higher hospitalization rate with diabetes), blindness, kidney disease (diabetes is the primary cause of kidney failure in 44% of all new cases) and amputations (73,000 in 2010 alone, accounting for 60% of all non-traumatic lower-limb amputations).

By balancing the food you eat, taking medications, and incorporating daily exercise you can lower your risk and control the disorder leading to a happy, healthy life. Eating healthy is the key to maintaining weight and preventing the onset of diabetes. But where should you start? Make small steps and goals to achieve a healthier lifestyle over time. Start by picking a few goals listed below every month and once you have succeeded try a few more:

1. Make half your plate full of a variety of fruits and vegetables
2. Be physically active for 30 minutes a day like walking, jogging, or biking.
3. Decrease the amount of sodium in your diet by removing the salt shaker from the table, prepackaged foods, and/or rinsing all canned items.
4. Buy whole grain products like brown rice and whole wheat pastas and breads
5. Incorporate leaner protein options like chicken and turkey in your meals
6. Try starting every meal with a salad
7. Avoid smoking and excessive alcohol use
8. Relieve the everyday stress that may buildup
9. Become informed on medications that can raise your blood sugar
10. Check your blood sugars routinely or your A1C monthly

American Diabetes Association Step Out Walk to Stop Diabetes

Stay healthy and make a difference in your community by teaming up against diabetes and joining MANNA’s team on November 5, 2016 for the Step Out Walk to Stop Diabetes event. It can be as easy as donating toward the MANNA team or you can join them and participate in the 5K walk or run! Register here.

Firing up the grill and enjoying a sunny BBQ with friends and family is a part of American culture. Having a cookout with friends and family is fun and delicious! Grilled steaks, burgers and veggies, when marinated just right, are packed with tons of flavor. Grilling is also a healthy alternative to frying food with oils. We encourage everyone to grill on but to do it safely. Unfortunately, acquiring a foodborne illness is not uncommon in the summer season. The humidity and heat of summer allow bacteria to grow faster in food. Please review and share these food safety tips to keep your friends and family healthy at your next gathering!

Thaw Properly: Use the refrigerator or sealed packages in cold water for slow, safe thawing. For quicker thawing, use the defrost setting in a microwave. Never thaw meats at room temperature.

Marinate in the Refrigerator: Marinate in the refrigerator, rather than the counter. Poultry and cubed meat or stew meat can be marinated for up to two days. Beef, veal, pork, and lamb roasts, chops, and steaks may be marinated up to five days. If you want to use some marinade for a sauce on cooked food, reserve a portion in advance. Don’t reuse marinade that’s been used on raw meat.

Keep Everything Clean: To prevent foodborne illness, don’t use the same platter and utensils for raw and cooked meat and poultry and keep foods separate. Promptly refrigerate any leftovers. The cold temperature will slow the growth of harmful bacteria.

Cook Thoroughly:  Meat and poultry cooked on a grill often browns very fast on the outside. Therefore, it is best to use a meat thermometer to check for safety and doneness. Large cuts of beef like roasts may be cooked to an internal temperature of 160°F for medium. Poultry should reach 165°F. Never partially grill meat or poultry and finish cooking later.

Keep Hot Food Hot and Cold Food Cold: Keep meat and poultry refrigerated until ready to use. Only take out the meat and poultry that will immediately be placed on the grill. After cooking meat and poultry on the grill, keep it hot until served at 140 °F or warmer. Keep cooked meats hot by setting them to the side of the grill rack, not directly over the coals where they could overcook.

Recipe: Grilled Chicken with Blackberry Sweet and Sour Sauce

July is not only National Grilling Month — it is also National Berry Month! Combine the two with this grilled chicken and blackberry recipe.

Servings: 4      Prep Time: 5 minutes      Cook Time: 15 minutes

Ingredients:

4 chicken breasts
1 tablespoon cooking oil
salt and pepper to taste
1/4 cup blackberry jam
2 tablespoons cognac
2 tablespoons rice vinegar
1 teaspoon grated fresh ginger
1 teaspoon soy sauce
1/2 teaspoon kosher or sea salt
6 ounces fresh blackberries
1 teaspoon fresh mint, minced

Directions:

Preheat grill to high heat. Brush each side of chicken breasts with the cooking oil and season with salt and pepper. Grill 3 minutes on each side, then turn the heat to medium-low and cover to cook for an additional 5 minutes or until cooked through.

In a saucepan or skillet over medium high heat, add all ingredients and stir to combine. Smash half of the berries with a fork to release the juices. Let the mixture cook down for approximately 2 minutes, stirring constantly. Pour over grilled chicken and serve immediately.

Recipe options:
-Use thick cut pork chops or salmon instead of chicken.
-If you don’t have cognac, use alcohol of your choice: rum, brandy, whiskey, red wine or white wine. I love cognac the best in this recipe!
-Instead of rice vinegar, substitute with cider vinegar, white vinegar or red vinegar

Recipe by Jaden Hair, SteamyKitchen

Nonprofits who are fortunate enough to have effective boards tend to be successful nonprofits. A good board is made up of diverse, skilled professionals whose expertise helps to guide and advocate for the nonprofit’s mission. The members are volunteers of the highest level, willing to give of their time, resources and passion to see the organization they love succeed. At times, they must also be willing to make difficult decisions in order to help the nonprofit remain efficient, yet productive and impactful. MANNA’s growth in recent years, and its bright future, are due in large part to the efforts of the members of its Board of Directors. They are leaders and champions of nutrition. They are people like Cathy Weiss.

Cathy was originally introduced to MANNA as a program officer at the William Penn Foundation and shortly thereafter became a regular at MANNA’s A Show of Hands art auction. While Cathy and her husband Ed loved the annual event, it was MANNA’s mission that truly stuck with her. So when she had the opportunity to support MANNA again, now as the Executive Director of the Claneil Foundation, she did so enthusiastically. Cathy valued MANNA’s work because it provided a unique service to the region, it is evidence-based, and it addressed a root cause, rather than a systemic dysfunction. “Nourishment is essential to healing and to be able to improve health, reduce medical costs, and provide the opportunity for hundreds of volunteers to contribute to the well-being of their neighbors is the ultimate trifecta,” explains Cathy.

Cathy was asked to join MANNA’s Board of Directors the day she announced her retirement from Claneil Foundation. While she had often remarked that MANNA’s proposals were among the best she had read in her career, she told CEO then Richard Keveaney to “call me in 6 months.” As she recalls, he did just that 6 months to the day. Cathy had been professionally involved with MANNA during its more difficult years and was impressed by the ability of its Board and executive team to make tough decisions while maintaining a focus on the mission.  When the call came, she knew it was time to become connected in a more personal way.

During her 7 years on the Board, Cathy made many contributions to MANNA, but when asked, claimed her proudest accomplishment was advocating for the initial research that has proven the efficacy of the MANNA model. Additionally, she is pleased to have been active in the recruitment of quality board members who truly understand the power of MANNA’s work. Beyond her board work, Cathy has often donated her time by volunteering in the kitchen, speaking at special events and making special monthly “thank you” calls to donors. While her favorite MANNA event is Shut Up & Dance, she told us that she

Cathy, whose term ended in June, hopes that as MANNA moves to its new facility and expands its client base, the Greater Philadelphia community will come to better understand the depth and breadth of MANNA’s work. “MANNA is a national thought leader in the nutrition field, and a jewel in Philadelphia’s crown. I am going to miss being able to say that I sit on the board of this organization,” says Cathy.

We will certainly miss having Cathy as a Board Member but are so very thankful for her time and for the legacy she has left  behind. We have no doubt we will see her again soon as she has pledged to continue to support MANNA and Food is Medicine. Thank you Cathy!