Food is Medicine: A Shared Decision-Making Model for Frailty in Older Adults With Heart Failure

Frailty is prevalent in older adults and affects up to half of people living with heart failure, contributing to functional decline, hospitalisation, poor quality of life, and mortality. Malnutrition manifests in frail older adults with heart failure, making nutrition a central determinant of altering the frailty trajectory. Nutritional care is commonly considered an ancillary service rather than a therapeutic component of care in multimorbid conditions. This perspective, informed by evidence, argues for repositioning "food is medicine" as a shared, preference-sensitive therapeutic strategy for frailty prevention and reduction in people with heart failure. "Food is medicine" is an intentional approach shifting beyond nutrient supplementation, positioning diet as a first-line, patient-centred intervention that supports dignity, muscle preservation, symptoms management, and functional resilience. Coordinated action across clinical practice, policy, and research is necessary to ensure nutrition is recognised and delivered as core therapy for frail individuals with heart failure.