The future of food security
Guest Lisa Goldman Rosas is an authority on public health who says that food insecurity goes deeper than hunger and can lead to chronic diabetes, heart disease, and even anxiety and depression.
Rosas champions a concept she calls “nutrition security,” which focuses on food’s health value over mere calories. She discusses her work with “Recipe4Health,” an Alameda County-led program that issues produce prescriptions, offers health coaching, and integrates electronic health records to improve diets and well-being. Food is medicine, Rosas tells host Russ Altman on this episode of Stanford Engineering’s The Future of Everything podcast.
Transcript
[00:00:00] Russ Altman: This is Stanford Engineering's The Future of Everything, and I'm your host Russ Altman. I thought it would be good to revisit the original intent of this show. In 2017 when we started, we wanted to create a forum to dive into and discuss the motivations and the research that my colleagues do across the campus in science, technology, engineering, medicine, and other topics. Stanford University and all universities, for the most part, have a long history of doing important work that impacts the world, and it's a joy to share with you how this work is motivated by humans who are working hard to create a better future for everybody. In that spirit, I hope you will walk away from every episode with a deeper understanding of the work that's in progress here, and that you'll share it with your friends, family, neighbors, coworkers as well.
[00:00:48] Lisa Goldman Rosas: You could imagine like produce prescriptions where your physician says, I really want you to be eating more fruits and vegetables. I'm gonna write you a prescription for produce. That prescription goes to a local farm or a food bank or an organization that will either give you a voucher or deliver produce to your door, or you know, have a pickup location near your house or something like that. And that's really appropriate for people who are like preventing disease or maybe have one chronic disease or something like that, and eating more produce would be really effective for them.
[00:01:24] Russ Altman: This is Stanford Engineering's The Future of Everything, and I'm your host, Russ Altman. If you're enjoying the show or if it's helped you in any way, please consider sharing it with friends, colleagues, family, anybody you like, because personal recommendations are the best way to spread word about the podcast and The Future of Everything. Today, Lisa Goldman Rosas from Stanford University will tell us that many people in the United States do not have the resources to eat healthy, and as a result, they are at increased risk for many diseases and the healthcare costs go up. It's the future of food security. Before we get started, a reminder to tell your friends, neighbors, family, anybody you like about The Future of Everything podcast, and your enjoyment of it. Personal recommendations are the best way to spread the news.
[00:02:15] Everybody knows that when you're hungry you have to eat, but the quality of the food that is available to you can be correlated to your resources. Of course it is. And so there are folks, it's estimated about 14% of US households that do not have enough resources to buy and eat healthy food. This leads to choices that are totally understandable to just get the calories anyhow, anyhow, they can do it. And that leads to choices about food that are often high salt, high fat, low fiber, and just not healthy. Okay, so that's unfortunate. Too bad. It's more than that. These households are at increased risk for many diseases, including cardiovascular disease, diabetes, even some cancers, and yes, mental health disorders. It all contributes to their high stress and food decisions that are not optimal for their health. Well, Lisa Goldman Rosas is a professor of epidemiology and population health, medicine and pediatrics at Stanford University, and she's an expert at food medicine, food as medicine, food with medicine, and food security and food insecurity. She has studied the chronic disease consequences of lack of access to high quality food, but more importantly, perhaps, she's been part of programs to try to address this. You won't be surprised to learn that when people are given a trial of healthy food, some incentives, they try it, many times, they like it, they learn new habits, it helps their health. In addition, there are both state programs and local programs that can incentivize healthy eating and help people address their food insecurity.
[00:03:56] Lisa, to start out, why did you decide to focus your career on food, food medicine, and food insecurity?
[00:04:05] Lisa Goldman Rosas: Ah, well thanks so much for that question, Russ. That's actually kind of an interesting story. You know, as an undergraduate I cared a lot about the environment, and I majored in environmental science. Um, and I was really excited about that. And still, until I started doing research in environmental science and realized it was a little isolating. There was a lot of counting bugs, there was a lot of wading in rivers, and you know, I realized I really wanted to do something with people. And, uh, I speak Spanish. And so I went to my career center and said, you know, what can I do in, in public health? And, you know, I speak Spanish. Is there anything I can do? And I, I ended up in this job, uh, working as a community outreach worker with migrant farm workers and their families. And I actually followed the migrant stream.
[00:04:49] Um, you know, I was in the northern part of the east coast in the summers. Um, and then I would go down to Florida in the winter, much like folks from Michigan might go down and, and, and spend the winter in Florida. And, you know, uh, certainly I spent a lot of time doing education around pesticide safety and working with farmers and things like that. Um, but what really impacted me was that the folks who were harvesting the fruits and vegetables that we enjoy here in the United States don't actually have access to them. And predominantly they're impacted by diet related chronic diseases like diabetes and heart disease, um, which is actually true of, of most of America. And so that was, you know, so poignant to me, um, that access to fruits and vegetables and healthy foods is actually such a challenge, um, that it led me down this path to focus on food insecurity, diet and, and diet related chronic disease, what I've been doing ever since.
[00:05:46] Russ Altman: That is a great story and I'm just gonna insert that today is the 90th birthday of my father-in-law who was a migrant worker as a kid.
[00:05:54] Lisa Goldman Rosas: Wow. Wow.
[00:05:54] Russ Altman: So shout out to father-in-law, you know who you are. Okay. So, um, that's a great, that's a great setup. So, uh, and you, and you, you said so many interesting things there. So, um, do we need to define what food security or food insecurity is just for the conversation?
[00:06:11] Lisa Goldman Rosas: I think so because, you know, we live in the United States and it might seem hard to believe that people would be going hungry, and in fact, that might not be the case like it would've been, you know, many decades or centuries ago. So food insecurity refers to having access to the food you need to live a healthy life. It's generally about quantity, but it also has to do with maintaining your health. And I think that focus on health is why we have started to refer to a new term called nutrition security. This is really just emerging in the last few years, but nutrition security builds on that idea around food insecurity and adds that component of, you know, preventing chronic disease, managing, you know, any chronic diseases or health issues that you have, and even potentially being able to effectively treat some of your conditions. We don't really monitor nutrition security like we have over many decades’ food insecurity in the United States. But I think that might be coming.
[00:07:12] Russ Altman: Okay. So I know that in the world, in the general world, there's definitely people who are literally at risk for starving. Uh, and, and I can imagine that in the United States, I'm sure there are some people like that, but I think there's a middle tier or a different tier of people, like the ones you described who maybe the balance of their diet wasn't good or the choices of food. So can you, can you paint, so, so this becomes real 'cause we're gonna then talk about the diseases that you're an expert at that as a result. Paint a one or two scenarios of the types of foods or food habits that people might have that you as a researcher and a, and person looking at them says, okay, this is not ideal.
[00:07:49] Lisa Goldman Rosas: Sure. So, you know, when a household, and we actually measure it at the household level, when a household, um, is classified as food insecure, meaning they don't have enough access to the healthy foods they need to, to support their activities, it, it usually means that they're reaching for those calories that are the cheapest possible. Which is totally understandable. That is what any logical person would do. What we know in the United States is that cheap calories are usually unhealthy calories, so you can imagine calorie per dollar, you know, Cheetos are gonna be much more cost effective than buying carrots and broccoli.
[00:08:27] Russ Altman: Uh, yes, of course.
[00:08:29] Lisa Goldman Rosas: Yeah. The other thing that happens is food insecure families tend not to have enough time to turn healthy foods into meals for their family. They might be managing multiple jobs, they might have multiple priorities that they're dealing with. Um, I think the other thing that happens is that you can go through these kind of binge cycles where you have resources and you can buy a lot of food, and you're motivated to buy those cheap calories so that you have access to them for longer periods of time. Um, and that's generally not gonna be the healthy foods we might imagine, like fruits and vegetables.
[00:09:03] Russ Altman: Gotcha. Okay. So that, that is, thank you. That gives me the picture of the type of decisions and pressures that would be on these folks. So now let's go to the medicine part. And not, I know you've also, and I want to get to food as a medicine, which is a very intriguing idea, but let's talk about the consequences of a food insecurity for the people who are experiencing it. And I know you've studied many areas, some of them are quite surprising where, um, where the manifestations of this, um, uh, then display themselves as medical diagnoses. So how would you kind of describe the risks that are associated with these diets?
[00:09:39] Lisa Goldman Rosas: Sure. So, you know, there's a lot of data that shows us that coming from a food insecure household increases your risk for what we call diet related chronic conditions. That'll be like diabetes, heart disease, you know, for example, hypertension. You can kind of imagine. What I think is more surprising is that they're strongly correlated with mental health outcomes as well. So anxiety and depression, you might not think of those as diet related chronic conditions, but certainly you can imagine if you're stressed about where your next meal is gonna come from, you know that that could lead to anxiety and depression.
[00:10:16] Russ Altman: Have, have people studied if there's a causal relationship between the food and the mental health, or if they're like both the results of, of a very stressful life?
[00:10:24] Lisa Goldman Rosas: Yeah, I mean I, people certainly have, and I think it's difficult, um, epidemiology to disentangle of course. And you know, I think there are likely multiple paths through which food insecurity leads to those mental health outcomes. I think you also have to think about kind of a life course perspective. So if you're exposed to food insecurity as a small child, how does that set you up for life to think about, you know, what your thoughts are about, um, where your next meal is gonna come from and how you approach eating.
[00:10:54] Russ Altman: Yes, yes. Okay, great. Uh, and, and, and so, um, are there particular mental health disorders that are more common in these settings?
[00:11:02] Lisa Goldman Rosas: You know, the ones that we measure most frequently are anxiety and depression. Because we're usually measuring these in general healthy adults, so you can measure increased symptoms of both anxiety and depression associated with kind of moderate levels of food insecurity and certainly more, more severe levels.
[00:11:18] Russ Altman: And I've also noticed you've done some writing about sleep and insomnia.
[00:11:22] Lisa Goldman Rosas: Yeah. So that's a complicated one, right? Um, so sleep can be impacted by a number of factors as probably you have experienced.
[00:11:34] Russ Altman: A recent guest on The Future of Everything was talking to us about it, yes.
[00:11:37] Lisa Goldman Rosas: Yeah. Yeah. So sleep can be impacted by a number of things. Um, you know, first of all, not having enough time to sleep because you're, you know, busy working multiple jobs to make ends meet, can also be related to other socioeconomic conditions and living conditions. Um, I'm not sure if anyone's documented, like a direct tie between food insecurity and, you know, sleep quality or quantity. But I can imagine that they really co-occur.
[00:12:04] Russ Altman: Yes. Yes, me too. And of course if you're, if, if you're very hungry, that's an easy one. But even if you, you're taking in bad calories, high salt, high fat, you could imagine all kinds of interactions. Okay. So that was very helpful. So now we understand what food insecurity is and we, you've painted a picture of what kind of, um, eating patterns we might be seeing and some of the health, um, health consequences. Okay. So now I know you're also interested in being part of the solution. So what, what can we do? What can the healthcare system do or society or whoever, what are, what are the things that need to happen and what, what are the, um, advances we've been making, if any?
[00:12:42] Lisa Goldman Rosas: Yeah, absolutely. I'm so glad you asked that question. So I think there's a number of things we can do, um, from a policy perspective. And so if you can think about as kind of a range of interventions from, you know, very high-level policies we can do, to more individually focused interventions that we need to be thinking about. Um, and, you know, the nutrition, uh, experts across our country have been working on this for decades. It's not entirely new, but at a fundamental level, we need to make sure that all Americans have access to the resources they need to buy the food to support their health, right? So programs like SNAP or here in California it's called CalFresh. Some people think of them as food snap, food stamps, um, are really critical for supporting, uh, resources that families have to purchase food. Uh, the special nutrition program for women, infants and children is perhaps, uh, another one to mention, uh, a really important policy focused specifically on pregnant women, moms, and young children. And so those are kind of some examples of higher-level policies for the whole population to ensure that,
[00:13:47] Russ Altman: If I can just interrupt and ask, excuse me. But do those programs, I just don't know a lot about them. Do they have rules about the kind of food you can buy with those credits?
[00:13:59] Lisa Goldman Rosas: Good question. Good question. So, uh, food stamps has some regulations. Um, you can't buy anything you can find in a supermarket, but they don't restrict, for example, the types of calories. Like it doesn't restrict, uh, whether you can only buy produce or only whole grains, for example.
[00:14:15] Russ Altman: And you really could imagine people being very irritated if you were overly invasive about, you know, they have enough issues in their life, please just let me buy my food and, but on the other hand, right, then you wanna say, but can we nudge you in certain directions?
[00:14:28] Lisa Goldman Rosas: Absolutely. Absolutely. And so, WIC is an example where only specific foods, um, are supported by the, the WIC program. Um, and they do have wonderful incentive programs, um, to, you know, double your bucks to be able to buy food at, at farmer's markets and things like that, um, to supplement those programs. So they use more of the carrot, I suppose, the stick, if you wanna say.
[00:14:53] Russ Altman: Carrot. Beautiful word.
[00:14:55] Lisa Goldman Rosas: Yeah.
[00:14:55] Russ Altman: Great. Okay.
[00:14:56] Lisa Goldman Rosas: Yeah, so moving from policy, then we can think about, um, you know, programs that might be supporting families or individuals, and that's where food is medicine is kind of this new term that people are using, honestly for programs we've been doing for a long time. Um, I do
[00:15:13] Russ Altman: A little rebranding every now and then is okay.
[00:15:15] Lisa Goldman Rosas: Is very effective and I, you know, I, what I really like about the term is that it explicitly focuses on the connection between healthcare and nutrition programs. And I think healthcare has really been left out of the nutrition focus for a long time. For example, uh, physicians hardly get any training on nutrition.
[00:15:35] Russ Altman: Oh my goodness.
[00:15:35] Lisa Goldman Rosas: When they're in medical school.
[00:15:36] Russ Altman: I can vouch for that.
[00:15:38] Lisa Goldman Rosas: Yes. And uh, I actually had the chance last week to join a class at Stanford, um, in culinary medicine where some of our medical students were learning how to cook whole grains and, and, uh, plant-based, uh, you know, entrees, which was really amazing. Um, so I think that's changing. Uh, but nevertheless, uh, most physicians in practice today didn't get a lot of training in nutrition. And so food as medicine is addressing that by saying, okay, we get it. Uh, you know, we're not gonna solve all your nutrition programs in that short time you have with the physician, but we can support referral to nutrition programs based on the health needs that you have, which I think is just excellent. Um, so it's really an umbrella term for nutrition programs in conjunction with health care. And you know, you can think of it as kind of a tiered system. I hate to use the pyramid because, you know, we had our,
[00:16:33] Russ Altman: Food pyramid, there were a lot of questions in third grade about the food pyramid, and then I was told that the food pyramid wasn't a thing anymore. I said I, I memorized it.
[00:16:43] Lisa Goldman Rosas: It's not a thing anymore, but you know, I think nutrition experts are a little stuck with the pyramid. So you can imagine it like a pyramid where at the base we have programs that are really effective for everybody. Actually, the women, infant, and children WIC program is kind of like the original food as medicine program 'cause you usually get referred during prenatal care. Um, so anyway, uh, you could imagine like produce prescriptions where your physician says, I really want you to be eating more fruits and vegetables. I'm gonna write you a prescription for produce. That prescription goes to a local farm or a food bank or an organization that will either give you a voucher or deliver produce to your door or, um, uh, you know, have a pickup location near your house or something like that. And that's really appropriate for people who are like preventing disease or maybe have one chronic disease or something like that, and eating more produce would be really effective for that.
[00:17:34] Russ Altman: Yes, yes. I love this. I love this. I've, I've always thought when I, when I was practicing medicine more often, I was always impressed that some patients, if you just gave them a prescription, even for something ridiculous, like, and not a medication, but like carrots one time I,
[00:17:49] Lisa Goldman Rosas: Go on a walk.
[00:17:50] Russ Altman: Yeah, go on a walk. A motivated patient can use that and they can wave it in front other people to kind of help get what they need. Um, I one time, I prescribed a baseball game because, it's a long story, I won't tell it. But I decided that it was in the, it was in the interest of the patient to watch a San Francisco Giants game, and I wrote it on the prescription and the nurses, it was, this a hospitalized patient. They couldn't believe what they were seeing. Uh, but they did it. It, it was, you know, the patient and the family appreciated it. And then the local news found out about it. So now there is a videotape of young Russ Altman explaining why he prescribed baseball. But, but I am a big fan that food, prescribing food sounds like a great idea to me.
[00:18:31] Lisa Goldman Rosas: Absolutely. And um, I think the other end of the spectrum that you're probably familiar with is like, uh, medically tailored meals is the technical term. But imagine like Meals on Wheels. We know that home bound seniors or potentially people coming out of the hospital, you know, they might, uh, benefit from having some meals, uh, delivered at least for some short period of time. Um, and then, you know, I think a question that's logical to follow, okay, you give these patients some produce, you give these patients some medically tailored meals. It's only a short time then what, right?
[00:19:04] Russ Altman: Right.
[00:19:05] Lisa Goldman Rosas: And I think, uh, we like to think about it as like a, you know, critical window or a unique teachable moment. Let's say we're giving you produce for 12 weeks. That's a time where you can try out some new vegetables, kind of risk free. We know individuals who have limited income, limited resources for food. They're not gonna risk it on buying an unknown, you know, squash or a beet or a couscous or whatever it is, right? Because who knows if their kids are gonna eat it and then they've wasted it. But this gives you kind of a window to try out some new things, see what you like, and then we can help you connect to resources in the community to find them later. So we call it Try it, Like it, Find it. And that's kind of our goal during the time period that you're getting the food as medicine.
[00:19:50] Russ Altman: And I like, uh, the, the 12 weeks that you pointed out, that seems to be enough time that if it, if it increases your sense of wellbeing and your sense of health, that might be enough time where you would, uh, you would notice that. You know, you would notice like your bathroom habits might be better or in whatever that means, and everybody knows what it means, uh, and or, or you feel better or you feel more energy in the morning. And so I, I love this idea of a trial period and then especially giving them the, the tools and knowledge to how do you extend this beyond exactly where we can help you explicitly.
[00:20:20] Lisa Goldman Rosas: Exactly.
[00:20:21] Russ Altman: This is The Future of Everything with Russ Altman. We'll have more with Lisa Goldman Rosas next. Welcome back to The Future of Everything. I'm Russ Altman and I'm speaking with Professor Lisa Goldman Rosas from Stanford University. In the last segment, we've defined what food insecurity was, we looked at all of the diseases that are increased in patients who don't have good food security, and we learned about some of the programs that exist to try to help folks out. In this segment, we're gonna learn about a exciting program called Recipe4Health, which prescribes food, gets food, and teaches healthy living behaviors. And guess what? It works. We're also gonna talk about some diseases that cause food insecurity because they're so expensive. And then finally we'll end up with some tips for anybody who wants to think about how to improve their own food security.
[00:21:27] In this segment, I wanted to ask you about an exciting program that I saw in your work called Recipe4Health with a for as a number. Um, tell me about Recipe4Health.
[00:21:36] Lisa Goldman Rosas: Yeah, I'm so glad you asked about that. So, Recipe4Health is a comprehensive produce prescription program. I think it's a great example of the food is medicine programs that we were talking about. Um, and you've seen that nutrition folks love food analogies. So I'll tell you, it has three ingredients. Um, so Recipe4Health,
[00:21:56] Russ Altman: Stay on brand, I love it.
[00:21:59] Lisa Goldman Rosas: Starts with the health clinics and does work with the staff and the providers to train them how to incorporate nutrition in the work that they do. They also do some alterations in the electronic health record to make it super easy to press a button and refer patients to Recipe4Health. And then Recipe4Health has two components. So it has a food farmacy that's pharmacy with an F, like farmacy.
[00:22:22] Russ Altman: Oh my goodness.
[00:22:24] Lisa Goldman Rosas: Which is a produce prescription, um, from a local farm. So they get fruits and vegetables. It, we often say vegetables and fruit 'cause it's mainly vegetables that are grown here locally. Um, and then a behavioral pharmacy in which they get kind of health coaching to support their health goals, help them learn how to take that produce and turn it into meals. Um, and so we've been implementing it in Alameda County. Um, they've really been at the forefront in Alameda County of implementing food as medicine. And, and this has been amazing to see, and we got the opportunity to evaluate their program, uh, which was really great and we are continuing to evaluate it to this day.
[00:23:04] But in our first evaluation, we found that participants in Recipe4Health increased their fruit and vegetable consumption, actually increased their physical activity as a result of participating in the health coaching, they decreased their food insecurity, so that went significantly down. And we were even able to look at labs in the electronic health record, um, and see that improvements in hemoglobin A1C, improvements in their lipid levels, um, you know, uh, decreases in healthcare utilization that we don't wanna see. So really exciting preliminary outcomes from that study that we're continuing to follow up on.
[00:23:41] Russ Altman: Yeah. Uh, that is exciting. And of course I'm sure that the expense of it is important, but knowing that there are grocers who are selling more vegetables gives you hope that there can be an economic model that works for everybody.
[00:23:53] Lisa Goldman Rosas: Absolutely. I think it's important to think about the economics, uh, more broadly, like the local farms who are getting to serve more folks and, you know, some of those folks even continue buying the produce from those farms after the program, which is exciting.
[00:24:07] Russ Altman: Right. So I wanted, another thing that you've written a little bit about is how sometimes, we've been talking about how food insecurity can cause health problems, but I, I know that you also think about how health problems can cause food insecurity. So what, what's that all about?
[00:24:21] Lisa Goldman Rosas: Yeah, that's another reason I think food as medicine is so important, is for patients who are dealing with costly chronic conditions, and diabetes is a good example, but you could also think about cancer, very costly treatment for many cancers. That can actually cause folks to become food insecure and have to make really tough choices about medicine and food or housing and utilities and food. And so it's a really complex cycle that you have to think about, which is why I think it makes sense for healthcare to be getting involved in addressing food insecurity.
[00:24:53] Russ Altman: Yeah. That, that really makes sense. Uh, the, the, especially with the expense, the cost of some of the new diabetes medications. Which are very effective but are very expensive. Anybody with cancer knows that the chemotherapy is a huge financial burden. And of course, that rent and food would be the things that would be threatened is, is my guess. And then many other things as well. Um, you mentioned all these, um, programs, uh, WIC and its, and its siblings. I was wondering if there were any other kind of, um, policy level innovations that have happened that give you kind of hope as you look at food insecurity as a systemic problem?
[00:25:28] Lisa Goldman Rosas: Yeah, so, uh, Recipe4Health wouldn't be continuing, I don't think, without the support of some state level policies. So many states, California included, have what's called a Medi-Cal waiver, uh, which allows Medicaid funding to be, to go towards food. Well, actually go towards many community supports, food being one of them. And so when a provider says, you know, I think you need a produce prescription and writes you that, that prescription for, for your fruits and vegetables for the week, that can actually be reimbursed as a Medicaid, um, expense. And so I think that will support a lot of communities in implementing food as medicine more widely.
[00:26:07] Russ Altman: Wow. And, and did you say, how many states have done this?
[00:26:10] Lisa Goldman Rosas: So, uh, I believe it's 14 states now.
[00:26:13] Russ Altman: Okay. So this is a good chunk.
[00:26:14] Lisa Goldman Rosas: Absolutely. And it's increasing all the time.
[00:26:16] Russ Altman: And they will be telling their fellow states whether it's working or not. And, you know, they, they're looking at the state expenditures on healthcare, so they will benefit if, for, from effective interventions.
[00:26:26] Lisa Goldman Rosas: Absolutely.
[00:26:27] Russ Altman: Um, one other systemic question I wanted to ask, uh, was, um, and, um, I could guess this answer, but I don't want to guess, I want to ask, um, is there also, we've been talking about governmental interventions, but there's also private industry and in fact there's some people making a lot of money selling food, not always the most healthy food. Do you see any movement in those companies towards helping with food insecurity, or is that just too much to ask or just not happening for whatever reason?
[00:26:54] Lisa Goldman Rosas: You know, I think it would take pressure, you know, government, uh, and, and consumer pressure to do more. Right now, we do see that some of those big, um, uh, food companies are getting in the business of food as medicine, uh, you know, which does push them to think about which foods would be healthier. So we have a project with Instacart and one of the great things that they've done on their platform is indicated which foods are eligible for food as medicine by calling them fresh funds. And so this tells the consumer, you know, that's generally a healthy food that you can choose. And so these are small, you know, changes that are being made.
[00:27:34] Russ Altman: Yeah, no, labeling at a minimum, like that's easy and it helps. Uh, that's great, that's a great example where, you know, some of your food is gonna maybe be reimbursed by this program, but we're gonna help you know, which it is, so you can just make these choices easier. It just lubricates, okay. That's good. I'm glad I asked. So, uh, finally, we, we have, we have a couple minutes. Um, I just wanted to ask if you have advice for people, so everybody lives, lives on a, on a spectrum, right? And some people have, they don't have any financial barriers, but for whatever reason, they're maybe not eating as well as they'd like to. So they're acting like they're food insecure, even though they're not money insecure. And then there are people who are truly resource insecure and they have challenges that may even be similar. Uh, and so I'm just wondering if, uh, through, through your work there are like tips for people who, who wanna think about eating more healthy, pushing back all of these disease associations that they don't wanna get. Um, how should they approach this and kind of take personal responsibility for some of this?
[00:28:32] Lisa Goldman Rosas: This is such a great question, and we get this all the time. I mean, this is what we're in the business for. And you know, I always say don't let perfect be the enemy of the good. So some people think I need to eat all fresh produce, I need to make sure it's organic, um, and so on. And actually, you know, you can get the same nutrients, and you can make it taste really good by buying frozen, uh, produce, which is a lot more cost effective. You can also think about which ones do you really wanna spend money on being organic, you know, if you're gonna peel the banana or peel the orange, maybe it's not as, as, as important. Um, and the other thing is always to start small. Don't think you have to do everything all at once. Uh, if you wanna eat more whole grains, try replacing just one meal a day, whole grains instead of refined grains.
[00:29:19] Russ Altman: Yeah, that's fantastic. And the only other thing I'll ask in case there's anything is what about different demographics? Um, there's been a lot in the news about elderly, uh, eating protein for breakfast type things. Uh, you know, and don't ask me why I know that. Uh, but, but are there important, um, like age specific things that you would want to get out to the public as, yeah, this really is something worth worrying about, or do you think a lot of this is a little bit not important?
[00:29:45] Lisa Goldman Rosas: Yeah. I think in our work, what we're really trying to do is focus on these larger shifts of getting people to eat more produce, more plant-based foods, as opposed to getting into the nitty gritty of you need to eat a hundred grams of protein, which by the way, you probably don't.
[00:30:02] Russ Altman: Right, exactly. Exactly.
[00:30:04] Lisa Goldman Rosas: So focus more on, think of my plate, make half your plate fruits and vegetables, a small piece of protein. Think about a couple times a week not having it be, uh, meat and, and think about whole grains instead of refined grains.
[00:30:19] Russ Altman: Okay, so then this will be my final question. What is it about those vegetables and fruit that is so good?
[00:30:26] Lisa Goldman Rosas: So tons of vitamins and minerals, lots of fiber, uh, helps your gut, uh, really important, low calorie, uh, so you're getting full on fewer calories.
[00:30:39] Russ Altman: Thanks to Lisa Goldman Rosas. That was the future of food security. Thank you for listening to the episode. Don't forget, we have a lot of episodes in the back catalog, and you can spend days and days and days, while eating healthy, listening to old episodes of The Future of Everything on a wide variety of topics. If you're enjoying the show or if it's helped you, please consider rating and reviewing it. We would love to get a 5.0 if we deserve it. These reviews and ratings make a huge difference in allowing the search engines to spread the news about The Future of Everything. You can connect with me on many social media platforms @RBAltman or @RussBAltman. That includes LinkedIn, Threads, Bluesky, Mastodon. You can follow Stanford Engineering @StanfordSchoolOfEngineering or @StanfordENG.
