Imagine visiting a doctor for the first time. If you’re suffering from weight issues and seeking help with your exercise and eating habits, it’s only natural to fear you’ll get harangued with judgment. You may anticipate questions like “What do you eat?” and “How often do you exercise?”
But thanks to a new wave of physicians versed in culinary medicine, you’re more likely to hear this question: “What do you like to eat?”
“I think patients are afraid to talk about what they’re eating for fear they’ll be judged or scolded,” says Dr. Brian Nagle, a resident at MedStar Georgetown University Hospital.
Healthy discussion about one’s diet changes the dynamic of a visit and opens up a dialogue, making doctors and patients collaborators in creating a path to wellness without sacrificing the foods someone loves.
If you’ve never heard of culinary medicine, it’s probably because the field is only about six years old.
Culinary medicine picks up where basic (and brief) med school nutrition education leaves off. It’s nutrition with context. Immersive, holistic and food-focused, it takes place in the kitchen as well as the classroom, with med students working side by side with chefs and dietitians.
“That becomes a powerful moment when you can bring all of those people together,” says Dr. Tim Harlan of Tulane University School of Medicine.
Now serving as executive director of Tulane’s Goldring Center for Culinary Medicine, Harlan helped pioneer culinary medicine as part of Tulane’s med school curriculum in 2012. Since then, over 50 medical schools across the country have licensed Tulane’s programming, including the University of Southern California, George Washington University and, most recently, the University of Central Florida in Orlando.
Nagle just graduated from the University of Central Florida College of Medicine, where culinary medicine is taught as a fourth-year elective. Like Harlan, Nagle already had a passion for cooking prior to his medical studies. He grew up baking with his mother and grandmother and made close to 100 meatballs for his fraternity, which earned him the name “The Meatball King.” Martha Stewart even recognized him on her show when he was in college.
But not every future doctor can catch Martha’s attention. In fact, one University of Central Florida med student who shall go nameless has admitted to burning stovetop mac and cheese. And that’s OK.
“We’re not trying to create chefs,” says Dr. Robert Karch, associate professor of pediatrics at the med school. Instead, culinary medicine instructs physicians in a key area that Western medicine frankly needs to work on ― communication.
That’s the program’s strength, says Harlan. “It’s great to play in the kitchen, but we’re also providing practical strategies to take all the stuff we learn in the first couple years of medical school and translate that into a conversation you’re going to have in the examination room with your patient. ‘What are you doing for breakfast? Have you tried eating this? Let me give you a recipe.’”
Since its beginnings, Tulane’s med school has expanded its culinary medicine program exponentially, adding modules for children, seniors, expectant mothers, summer camp and a Spanish language course. But at the core, its focus is still communication and kitchen literacy. “Food,” says Harlan, “is our universal experience.”
“It’s great to play in the kitchen, but we’re also providing practical strategies to take all the stuff we learn in the first couple years of medical school and translate that into a conversation you’re going to have in the examination room with your patient.”
Patients average a mere 17 minutes with their doctor per visit. Culinary medicine enables doctors to make the most of that time, talking with patients ― not to them ― about how nutrition and food choices affect their health and prescribing easy, actionable, edible solutions.
That kind of communication and outreach is baked right into programming. Students take the lessons they’ve learned, like nutrient-dense makeovers of favorite foods, portion control, kitchen sanitation and deciphering food labels, and teach free community culinary medicine classes.
“They’re old teachings we kind of lost,” says Karch, who watched his students gain confidence week by week as they taught at the local YMCA. “The young generation has no idea how to prepare food or where it comes from. So we’re teaching these things again in modern society.”
“It’s easy to get bogged down with medical terminology. Speaking with patients and cooking with people in the community made the information sink in with me,” says Dr. Shalini Allam, another University of Central Florida culinary medicine alum. More than that, it inspired her. “Seeing people motivated to learn, to change their diet, was mind-blowing for me. If patients know what they need in their day, they can make informed decisions.”
One of the great course takeaways for the doctor and those who attended her YMCA classes? Overnight oatmeal.
“With walnuts and almonds and raspberries ― very filling,” says Allam. “Or use a little cupcake tray and make mini omelet things with spinach. The egg has a good amount of protein and the spinach doesn’t taste like grass. Little tricks like that are really helpful in the morning.”
These little tricks “over time positively influence behavior and health,” says Karch. “Breakfast, for some reason, is the one thing people don’t vary a lot. It’s the one thing we eat over and over again. If we can make that meal nutritious, we’re going a long way.”
As a pediatrician at Nemours Children’s Hospital in Orlando, Karch sees the critical role that nourishing food plays in the lives of his young patients. Many are living proof of the staggering rise of childhood obesity, which puts them at risk for a range of illnesses, including asthma and heart disease. He also treats children with diabetes, as well as undernourished infants and toddlers showing a failure to thrive and food insecure patients and families struggling to get by on WIC and SNAP programs.
Both Tulane and the University of Central Florida have begun longitudinal research to measure the effects of culinary medicine on both patients and medical students. Nagle and Allam aren’t waiting, though. They’re already putting their culinary medicine teachings into practice, sharing tips and recipes online and with patients.
The course offers a powerful takeaway for the doctors in their own lives as well. “Physicians have a hard time staying healthy despite the knowledge we have,” says Allam, who represents the third generation of doctors in her family. “My dad is busy, he does critical care medicine. My mom is the one who made sure he wasn’t eating doughnuts at the hospital too much.”
“The young generation has no idea how to prepare food or where it comes from. So we’re teaching these things again in modern society.”
Since studying culinary medicine, “I’m more aware at the grocery store,” says Nagle. “I’m looking at where things are coming from, reading food labels, especially with the new ones coming out.” He’s also learned to dial down the amount of mayo in his tuna salad.
In one particular case, it turned out that both Nagle and a patient had a thing for black beans. But the issue was the white rice the patient always paired with them.
Rather than going with white rice, a simple carb with the nutrients stripped away with the bran, Nagle suggested brown rice because it has more fiber and more nutrients. Nagle’s patient, who is Latina, was skeptical.
Nagle worked out a deal: “Half brown and half white. You’re getting the taste you like but who knows? You might switch over to the brown rice eventually.”
One thing Nagle and all the culinary medicine doctors prescribe is doing a little home cooking. “For starters, you have more control,” he says. “You know what ingredients have gone into it.”
“It’s cheaper,” adds Harlan. “It’s just as fast, it’s better for you and it tastes better. Every time.”
The doctor will feed you now.