Food as medicine 2.0: Why doctors are switching their lab coats for chef's jackets
While many doctors are trained to use a scalpel, far fewer are professionally proficient with a chef’s knife. Some aren’t even comfortable discussing how diet and nutrition can help their patients.
But that’s changing as more physicians, medical residents, nurses and other healthcare professionals are learning culinary medicine, which combines evidence-based nutrition science and hands-on cooking classes, giving them the knowledge to help people transform their health through their diets.
“Let food be thy medicine and medicine be thy food,” said Hippocrates, the Greek physician known as the “father of medicine.” But it took until the 21st century for his philosophy to germinate. Read on to learn more about food's evolving function.
Photos courtesy of Pixabay
A joint effort
The Goldring Center for Culinary Medicine at Tulane University (GCCM) in New Orleans, established in 2012, is equipped with the first dedicated teaching kitchen at a medical school that provides hands-on training for medical students focused on culinary medicine. Through an exchange program with Johnson & Wales University, culinary students work side-by-side with medical students, providing doctors-in-training with the culinary knowledge and skills to help them talk with their patients about how their food choices can impact health.
“The core of our curriculum and coursework is an eight-module series and hands-on cooking component. We have developed another 22 modules that cover topics such as disease and specific conditions,” says Dr. Timothy S. Harlan, associate dean for clinical services at Tulane University School of Medicine and executive director of GCCM. Harlan is also a chef and owned a restaurant before becoming a board-certified internist.
Culinary medicine is now a requirement for Tulane’s medical residents. GCCM provides continuing medical education credits (CME) in culinary medicine for practicing physicians, nurses, dietitians and other healthcare professionals and offers community cooking classes for the public.
Another example is Healthy Kitchens, Healthy Lives, a collaboration between the Culinary Institute of America (CIA) and Harvard University’s T.H. Chan School of Public Health, launched in 2006. Held annually at the CIA’s Greystone campus in Napa, Calif., the leadership conference brings together healthcare and institutional foodservice professionals from around the nation to participate in hands-on cooking classes led by CIA chef-instructors and seminars led by Harvard scientists. Attendees take what they learn back to their institutions to apply in their work.
In 2016, the CIA and Harvard introduced the Teaching Kitchen Collaborative, a group of more than 30 leading organizations that operate teaching kitchens, including hospitals, universities, senior living centers and community organizations. Through the Collaborative, these early adopters will learn about one another’s facilities and outline best practices for replication and scalability of these emerging programs.
Deanne Brandstetter, vice president of nutrition and wellness for Compass Group North America, says the foodservice company has sent more than 65 operators to Healthy Kitchens, Healthy Lives over the past 12 years. The operators have applied the lessons to help meet demands for healthier, more sustainable menu items. “Changes range from increasing produce on the plate while rescuing imperfectly delicious produce to help reduce waste, reducing sodium in the ingredients we source and in recipe formulation, by adding more whole grain options to our cafes and shifting our focus to plant-forward menus,” Brandstetter says.
In addition, Compass’ participation with the Teaching Kitchen Collaborative has resulted in the launch of teaching kitchens in several of the company’s sectors, Brandstetter says. Those efforts include 93 pop-up teaching kitchens in 14 states reaching 4,500 students, training over 340 culinary professionals in plant-forward cooking techniques and introducing more plant-forward menu items into Chartwells Higher Education while reducing red meat by 10%.
Jim Perko, executive chef for the Cleveland Clinic Wellness Institute and Center for Integrative and Lifestyle Medicine in Ohio, has applied what he’s learned as an inaugural member of the CIA’s Teaching Kitchen Collaborative to the clinic’s culinary medicine teaching kitchens. The Clinic’s Lifestyle 180 program teaches participants to shop for and prepare healthy meals, along with how to manage stress and exercise better.
“Responses from most all patients and participants have been overwhelmingly positive,” Perko says. The clinic reports participants have experienced an average weight loss of 15 pounds; an average 6% reduction in LDL (bad) cholesterol and 17% decrease in triglycerides; decreased waist size and blood pressure; and a reduced need for medication.
Opportunities and challenges
“There’s a renaissance of interest in developing national nutrition education standards in medical schools. We’re working to find ways to incorporate nutrition into the medical curriculum,” says Dr. David Seres, director of medical nutrition and associate professor of medicine at the Institute of Human Nutrition at Columbia University Irving Medical Center in New York City.
“It’s also a challenge,” he adds. “A doctor’s main mission is to save lives. Nutrition has been more of a side dish. First, a beating heart is more compelling to a physician than discussing nutrition and lifestyle, which can take many years to have an impact. Second, the effect of nutrition on health is still poorly understood, as evidenced by our frequently changing dietary guidelines.”
Access to teaching kitchens is another challenge, Seres says: “Hospitals don’t have the budgets to build kitchens and hire culinary staffs.”
That’s where culinary schools and foodservice management companies can work in tandem with medical schools and healthcare providers.
An example is a collaboration between Spectrum Health and The Secchia Institute for Culinary Education at Grand Rapids Community College in Grand Rapids, Mich., is also bringing together doctors, residents, culinary students, dietitians and other specialists.
“Spectrum Health, the largest healthcare employer in Western Michigan, licensed the curriculum from Tulane. We provide the classrooms, kitchen lab and culinary students,” says Werner Absenger, assistant professor and director of the Secchia Institute. Continuing education and classes for residents are taught by Dr. Kristi Artz, medical director for lifestyle medicine at Spectrum Health, Krista Gast, a Spectrum registered dietitian, and Absenger. Culinary students provide hands-on staffing.
Spectrum Health was recently awarded two grants, which the college will use to teach nutrition and healthy cooking to patients with serious health conditions such as cardiac disease, as well as obese or at-risk children in underserved communities and their care providers, says Absenger. “Spectrum Health will collect data on the health outcomes, which will hopefully help reduce risk for obesity and diabetes,” he says.
Nutrition tech for healthcare institutions
Susan Bratton, founder of Savor Health, watched a friend struggle to eat while undergoing treatment for a malignant brain tumor. The former investment banker made it her mission to find solutions to help patients stay nourished during their treatment. Savor Health’s patent pending technology provides personalized and clinically appropriate nutrition recommendations unique to each patient and condition. Institutions can license the technology and offer it through their website or patient portal on a branded or white label basis.
“Research shows that properly nourished patients experience better and faster wound healings and response to treatment. And patients who are well-nourished have a 54% lower rate of readmission and shorter length of stay,” Bratton says.
But despite research supporting the benefits of providing nutritional support and guidance, healthcare systems typically don’t offer this support to patients, she says. For one, nutrition is not taught in most medical schools. Secondly, there is generally no reimbursement code for nutritional counseling, “so nutrition is considered a cost center and not a revenue center,” says Bratton. Finally, there is a shortage of registered dietitians, especially ones with disease-specific credentials, to fill this role at hospitals.