Today’s Dietitian
Vol. 28 No. 1 P. 34
Nutrition education plays a critical—yet often invisible—role in reentry success for individuals leaving the prison system. Incarcerated populations have disproportionately high rates of chronic disease, food insecurity, and disordered eating behaviors, yet few reentry programs offer structured nutrition support. As community-based and corrections organizations expand services to support successful reintegration, RDs and community health workers (CHWs) are uniquely positioned to fill this gap.
This article explores the emerging interest in bringing CHWs and RDs into reentry and correctional health spaces through education, counseling, and curriculum development. Ideal for dietitians looking to expand their reach into underserved populations, evidence-based nutrition counseling can not only support individual health but also reduce recidivism and promote public health equity. The Food Trust (TFT), a nonprofit located in Philadelphia, has a robust community-based program that delivers nutrition education and is featured as a case study for nutrition reentry education.
According to Sandy Sherman, EdD, EdM, MS, nutrition advisor at TFT, “The Food Trust’s mission is to increase access to healthy food and the information to support healthy eating. Those who are incarcerated and returning to their communities have a great need for improved food access and education.” Health, housing, and employment dominate reentry discussions, but nutrition is overlooked.
Per the United States Department of Justice, over 650,000 people are released from prison annually.1 Wayne Williams, project manager of community-based programming at TFT, was once one of those people and knows firsthand how difficult it can be to transition from incarceration back into the community. His interest in reentry work began when “I became interested in the cause of incarceration—lack of resources, attitude, behavior, and education level of incarcerated individuals.” He started out working with nonprofits and created Outside, a reentry organization that addresses the obstacles facing individuals returning to the community after years of incarceration, in 2018. He currently teaches a six-week nutrition education series and offers workforce development in the form of ServSafe Food Handler and Managers Certificate for participants in TFT’s Inside Out program; Sherman also helps to teach the series. Sherman is responsible for codeveloping the curriculum and other nutrition programming, as well as collaborating with a Temple University researcher to evaluate the program and to disseminate the results.
A Critical Window for Nutrition Education
Reentry is a transitional moment as individuals are facing new autonomy and responsibilities postrelease. In terms of nutrition, they have often been limited in the decisions they can make about how they nourish themselves while incarcerated and may face uncertainty about how to do so depending on financial and housing resources. Many individuals are eager to make lifestyle changes but lack the immediate tools. According to the Prison Policy Initiative, the unemployment rate for formerly incarcerated individuals is 27%; the rate of homelessness and those with insecure housing make up another 5,700 per 100,000 people.2 Compounded by the fact that most reentry programs focus on more immediate needs like housing, health and nutrition education are often overlooked.3
From a public health perspective, this is a cyclical problem: better overall health leads to improved reintegration, which can lead to reduced recidivism. Over 64% of individuals aged 45 and older in state and federal prisons self-report a medical problem and are 1.5 times more likely to have a chronic condition.3 When reintegrating, they may also face social stigmas that make them less likely to rely on family support, thus making them more open to and reliant upon reentry programs.3 A review in Healthcare found that when health education was provided through conversations, assigned reading, lectures, and group conversations, it positively impacted decision making, particularly in regards to preventative decision making.4
Common Health and Food Access Challenges
Incarcerated individuals are likely to suffer from chronic diseases, including diabetes, CVD, and hypertension.4 Other commonly reported nutrition related health conditions include anemia, stomach ulcers, liver disease, and bowel disorders.5 Mental health can also be negatively impacted.
A 2022 study published in the International Journal of Prison Health found that foods served to the incarcerated population did not meet the dietary recommendations for specific micronutrients like magnesium, omega-3s, and vitamin D, all of which support mental and physical health.6 A 2025 paper published in Nutrition Review supported this data and expanded on it, finding that many menus provided an excess of calories, saturated fatty acids, sodium, sugar, and cholesterol.7 Supplementation is not common across the prison, local, or county jail settings.6
Sherman and Williams agree that they have worked with many individuals who struggle with chronic disease and weight gain/obesity due in part to limited access to nutrient dense foods. They see this in both meals served and in what is available to purchase from the commissary. According to a shopping list from the Federal Bureau of Prisons, these food items are mostly packaged and overly processed, and rich in sodium, fats, and added sugar.8 The more nutrient-dense items on the list, like shredded chicken breast, are also among the more expensive items.8 There is no nutrition information provided on the shopping list, which can make choosing food difficult if someone is looking to restrict sodium or limit saturated fat.
Food insecurity is also common in this population and is often the result of several factors. Limited income, housing instability, and poor food environments are the big three, with 91% of recently released individuals reporting food insecurity per the Impact Justice report.9 Food insecurity impacts far more than just health and nutrition status. AIDS Education and Prevention notes that food insecure individuals are more likely to engage in unsafe behaviors that could potentially increase their future risk of arrest.10 This also applies to children whose parents are incarcerated. A study in Family Systems of Health found a link between food insecurity in children and parents who are incarcerated as well as an increased risk of developing chronic health conditions in these children.11 The built environment is also a consideration, as a 2018 study published in Public Health Nutrition indicated that formerly incarcerated individuals are less likely to have easy access to stores that sell nutritious foods.12
Intersection of Food Justice and Criminal Justice
People impacted by the justice system face very high rates of food and nutrition insecurity, which can worsen health problems and increase risks for depression and infectious diseases.13 Per a 2022 review in Current Nutrition Reports, barriers like unemployment, housing instability, and limited access to support programs make it harder to get healthy foods.13 Research shows that improving food assistance and employment opportunities is key to supporting this population’s health and well-being.13 By working to eradicate health and structural inequities through public health efforts, the entire community can benefit.14 The Transitions Clinic Network in California successfully supported a reentry health care hotline that was staffed by previously incarcerated individuals. The hotline served over 1,200 individuals, offering public health lessons that focused on improving health equity for those impacted by the justice system.15
Nutrition Education vs MNT
TFT offers general nutrition education. For those returning to their communities, a lack of resources to buy healthy foods and limited options in some halfway houses create challenges for participants to implement some of the recommendations from the lessons. Williams says, “Limited food access and food insecurity impact the nutrition lessons we are teaching and recipes we choose. At the end of each lesson there’s a recipe demonstration. These recipes are impacted by the limited choices participants have when receiving meals or purchasing food items from a commissary.”
Many reentry programs and correctional facilities don’t have on-staff RDs available for MNT or they don’t have the funding to hire one, so CHWs and educators fill gaps. This approach also aligns with Williams’s experience, where a highly effective model utilizes a participant-centered approach where the participants help shape the content of the class.
MNT may be more appropriate (and more easily reimbursable) for transitioning participants who have insurance; Medicaid is the primary insurance available and even then there are specifics regarding allowable services during incarceration.16 If children of incarcerated individuals have insurance, they would also be ideal candidates to receive MNT as well as basic cooking classes and healthy grocery shopping instruction from a health educator. These classes could focus on basics like label reading, emotional eating awareness, and food group/My Plate education; all of which are included in the Inside Out curriculum.
Trauma-Informed and Culturally Relevant Care
Providing trauma-informed and culturally relevant nutrition education can potentially positively impact mental health.17 This type of care centers strengths-based language while honoring food traditions and creating safe spaces to avoid retraumatization. This can include incorporating cultural food preferences into lessons, involving peer mentors with lived experience, and keeping the cost of nutrition programs free or low-cost. In addition to improving health outcomes, this methodology can also reduce mistrust of health care systems. Using a model where lived experience is at the center is crucial, and building around barriers like environment, employment, and community may promote long-term commitment and change.18
Funding, Reimbursement, and Logistical Considerations
Perhaps the biggest and most obvious barrier to nutrition education and access to high-quality, nutrient-dense food is funding.6 TFT’s program is reliant upon two major funding streams. According to Williams, “The services we provide for our incarcerated population are funded through non-SNAP grants. Our work in reentry and recovery houses is covered by SNAP-Ed funding.”
Sherman adds, “Since the SNAP-Ed programming was not funded by Congress for fiscal year 2026, we’ll be using carry-forward SNAP-Ed funds for reentry work this year and then hoping to identify additional funding. We don’t receive state funding, only private funding.” It’s essential to help funders understand the need for nutrition education, as improved nutrition status can lead to improvements far beyond one individual’s health.
Creative future opportunities for reentry funding may include a Food is Medicine approach, Medicaid expansion, and integrating RDs into food justice/public health collaborations. Opening conversations with a variety of organizations to bring awareness and promote collaboration is also key. According to Williams, “As a Board member for the Center for Science in the Public Interest; Yale School of the Environment; Coalition for Carceral Nutrition; Food Behind Bars in London, England, and Wales; Impact Justice; and Farm to Institution New England, I meet bimonthly to discuss advocacy and prison food policies throughout the United States. In addition, I meet once a year with medical students from George Washington University School of Medicine and Health Sciences to discuss how to improve health outcomes for underrepresented communities with a particular focus on justice involved individuals.” Sherman agrees, highlighting the importance of local partnerships. These could include the city department of prisons, the office of reentry partnerships, Department of Public Health, state-specific prison societies, halfway houses, behavioral health programs, and Cities for Better Health.
In terms of logistics, following a model like The Food Trust’s would include the following:
- surveys to assess nutrition education, beliefs, and behaviors both before and after the classes;
- 90-minute sessions for six weeks where education is provided (in this case, the Returning to Health: Inside Out curriculum they developed);
- weekly food demonstrations where the participants help prep the recipes and everyone eats together;
- weekly food journals that were a self-reflection tool; and
- a 10-question evaluation regarding the program accessibility and feasibility.
On a practical level, space for the group education to take place is needed, along with food demonstration supplies and handouts/journals. The need for additional research to determine theoretical frameworks for programming is strong.19 What few programs exist are vastly different, and many lack a holistic approach that may benefit participants.19 Including a workforce component, complete with practical skill building, may also encourage participation.
Policy Opportunities and Advocacy
Linking policy to advocacy begins with identifying barriers. For example, if there are a lack of healthy food retailers available, a first step may be looking for ways to bring healthy food into the community to support nutrition education. This could be done through initiatives like the Healthy Food Financing Initiative as well as opening conversations with city planners and exploring a mobile feeding program.12 Using a systems approach like this allows for a potential increase in systemic, sustainable, and collaborative change that is supported by multiple levels of infrastructure. Promoting these initiatives and making them easily accessible to potential participants is also important, as research shows that similar services created to combat food insecurity are underutilized.20
Reentry programs have the potential to be immensely impactful if social determinants of health like food access, income, housing, community support, and health literacy are taken into account.3 Efforts can be made at a community level, but the most effective way to revamp prison nutrition and impact the re-entry population is through policy development.21 Interested RDs can join nonprofits, corrections, and reentry agencies to expand access while understanding that the biggest barrier they are likely to face is funding.
Nutrition education is about more than food—it’s about second chances, dignity, and equity. When combined with lived experience and a structured educational approach, there is likely to be high engagement, though systemic barriers remain.
— Alexandria Hardy, RDN, LDN, is a writer, early intervention therapist, and the owner of Pennsylvania Nutrition Services, an insurance-based private practice located in Lancaster, Pennsylvania.
References
1. Prisoners and prisoner re-entry. United States Department of Justice website. https://www.justice.gov/archive/fbci/progmenu_reentry.html. Accessed September 17, 2025.
2. Reentry and recidivism. Prison Policy Initiative website. https://www.prisonpolicy.org/research/reentry_and_recidivism/. Accessed September 17, 2025.
3. Sneed RS, El-Alamin L, Thrower M, Nadrowski J, Habermehl K. Harnessing education and lifestyle change to support transitional health for returning citizens: a feasibility study protocol. Pilot Feasibility Stud. 2023;9(1):141.
4. Bonato PPQ, Ventura CAA, Maulide Cane R, Craveiro I. Health education initiatives for people who have experienced prison: a narrative review. Healthcare (Basel). 2024;12(2):274.
5. Udo T. Chronic medical conditions in US adults with incarceration history. Health Psychol. 2019;38(3):217-225.
6. Mommaerts K, Lopez NV, Camplain C, Keene C, Hale AM, Camplain R. Nutrition availability for those incarcerated in jail: implications for mental health. Int J Prison Health. 2023;19(3):350-362.
7. Vetrani C, Verde L, Ambretti A, et al. Nutritional interventions in prison settings: a scoping review. Nutr Rev. 2025;83(2):397-404.
8. United States Penitentiary Commissary Shopping List. Federal Bureau of Prisons website. https://www.bop.gov/locations/institutions/atw/atw_commlist.pdf?v=1.0.2. Updated June 29, 2023. Accessed September 26, 2025.
9. Eating Behind Bars: Release 6. Oakland, CA: Impact Justice website. https://impactjustice.org/wp-content/uploads/IJ-Eating-Behind-Bars-Release6.pdf. Accessed September 17, 2025.
10. Wang EA, Zhu GA, Evans L, Carroll-Scott A, Desai R, Fiellin LE. A pilot study examining food insecurity and HIV risk behaviors among individuals recently released from prison. AIDS Educ Prev. 2013;25(2):112-123.
11. Muentner L, Burnette CB, Shlafer R. Parental incarceration and adolescent food insecurity. Fam Syst Health. 2024;42(3):386-391.
12. Testa AM. Access to healthy food retailers among formerly incarcerated individuals. Public Health Nutr. 2018;22(4):672-680.
13. Abosy JA, Grossman A, Dong KR. Determinants and consequences of food and nutrition insecurity in justice-impacted populations. Curr Nutr Rep. 2022;11(3):407-415.
14. Mohammmad S, Bahrani A, Kim M, Nowotny KM. Barriers and facilitators to health during prison reentry to Miami, FL. PLoS One. 2023;18(10): e0285411.
15. Divakaran B, Steiner A, Lin S, Fennix S, Shavit S. A novel reentry hotline led by community health workers to address the health needs of people returning from incarceration: transitions clinic network, California, June 2020—June 2023. Am J Public Health. 2025;115(4):477-480.
16. Reentry services for incarcerated individuals. Medicaid website. https://www.medicaid.gov/medicaid/benefits/reentry-services-for-incarcerated-individuals. Accessed September 26, 2205.
17. Poulter M, Coe S, Graham CAM, Leach B, Tammam J. A systematic review of the effect of dietary and nutritional interventions on the behaviours and mental health of prisoners. Br J Nutr. 2024;132(1):77-90.
18. Vaiciurgis VT, Charlton KE, Clancy AK, Beck EJ. Nutrition programmes for individuals living with disadvantage in supported residential settings: a scoping review. Public Health Nutr. 2022;25(9):2625-2636.
19. Almoayad F, Benajiba N, Earle J, et al. A scoping review of nutrition education interventions applied in prison settings. Curr Nutr Rep. 2023;12(4):845-863.
20. Jordan T, Sneed R. Food insecurity among older adults with a history of incarceration. J Appl Gerontol. 2023;42(5):1035-1044. 21. Van den Bergh BJ, Gatherer A, Fraser A, Moller L. Imprisonment and women’s health: concerns about gender sensitivity, human rights and public health. Bull World Health Organ. 2011;89(9):689-694.