“Let food be thy medicine,” the Greek physician Hippocrates is said to have declared, thousands of years ago. Wouldn’t you know it, today, science is confirming that wisdom. There’s increasing evidence that how we eat is one of the most important steps in potentially heading off heart disease, cancer, Alzheimer’s, and diabetes. A poor diet is the most significant risk factor for premature death and disability in the United States, according to a 2018 report in the journal American Family Physician.
Unfortunately, many doctors receive insufficient training in a topic so crucial to their patients’ health. To help close that knowledge gap, a new field is emerging: culinary medicine. The idea is that better patient health begins in the kitchen. It’s being applied in a smorgasbord of ways: Doctors and medical students are learning how to cook nutritious meals, and pass that wisdom on to patients, while hospitals are offering patients hands-on cooking classes to help them make healthier meal choices at home.
Rather than offering vague recommendations to “eat more fiber,” culinary medicine-trained health practitioners teach patients practical food knowledge skills, such as how to select and cook veggies, and how to prepare brown rice. “It’s about empowering health care providers to change the dialogue with their patients about food. We need to translate nutritional knowledge and talk about how to actually eat and cook,” says Timothy Harlan, MD, a physician and former restaurateur in New Orleans who is now the executive director of the Goldring Center for Culinary Medicine at Tulane University.
There, medical students and residents take intensive hands-on courses about how diet can improve patient health. They might discuss a case study of a patient with hypertension, for instance, then cook up a delicious, low-sodium, veggie-heavy soup in the teaching kitchen. This kind of training, Harlan says, can prepare a physician to suggest to a diabetic what they might make for breakfast to help keep blood sugar more stable, for example.
According to Harlan, Tulane’s groundbreaking curriculum has so far been adopted by 40 medical schools, 12 residency programs, and three nursing schools, and the numbers continue to climb. Meanwhile, similar projects that bring doctors into the kitchen are cropping up elsewhere around the country. At the University of Michigan’s East Ann Arbor Health and Geriatrics Center, for example, patients can take special cooking classes to address chronic liver disease, diabetes, and irritable bowel syndrome. In Grand Rapids, M, Kristi Artz, MD, lead Culinary Medicine specialist at Spectrum Health, teaches community classes such as “Seasonal Plant-Based Cooking” alongside a trained chef. “Someone attending might have survived cancer,” she says. “Another might be well, but wants to learn how to cook in ways that will keep them healthy.”
Often what holds people back from eating healthier is confusion. “People know they should get more fiber or eat less sodium. But what do you actually make for dinner tonight or put in a lunch box?” says Julia Nordgren, MD. In her own practice, the pediatrician and Culinary Institute of America-trained chef counsels families whose children have conditions such as high cholesterol and obesity. “These are diseases that are preventable and treatable through lifestyle changes,” she says. One of her messages to families: Healthy food can be delicious.
Want to harness the healing power of food in your own kitchen? We asked our experts for some simple shifts with big payoffs that you can make right now.
Pump up the produce. Rather than worrying about everything you shouldn’t have, start by adding more plant foods. How much? “Half of your plate should be fruits and vegetables at every meal, not just at dinner,” advises Nordgren. At lunch, she says, when you’re hankering for something savory, consider substituting pickles and olives for chips. “Produce is nutrient-dense and filled with healthy phytochemicals. They are low-calorie and their fiber means you won’t be as hungry for other things.”
Make your own. Research suggests that highly processed foods are a mainstay of the American diet. They are low in nutrients and typically jammed with salt, sugar, fat, and calories. “Cutting back on prepared foods and cooking for yourself with real ingredients is one of the most important ways to improve your health,” says Harlan, who posts healthy recipes on his personal website, drgourmet.com. “For example, some commercial sweet teas have 12 teaspoons of sugar dissolved in one glass. It is much better to make your own tea at home and add a teaspoon or two of sugar.” Another bonus? “It’s almost always cheaper,” Harlan says, “to make your own stroganoff or mac and cheese compared to buying the packaged kind.”
Reform your favorites. Culinary medicine is about tailoring recommendations to a patient’s preferences so they are more likely to stick with changes. Opt for healthier, less-processed variations of your treasured go-tos. “If you’re partial to a sweet breakfast, I would suggest substituting yogurt and fruit, or steel-cut oatmeal and raisins, for your sugary cereal,” says Harlan. If you’re a savory lover, swap out your regular afternoon snack of packaged peanut-butter crackers for a handful of heart-healthy almonds or peanuts, he says.
Change the ratio. When she teaches the course “The Doctor Is In…the Kitchen,” to medical students at Stanford University, Nordgren explains the “protein flip.” Rather than serving meat as the main event, Nordgren says, use it as a flavorful garnish. So, instead of eating a steak with a side salad, munch on a big spinach salad with a topping of steak — a few slices of lean, marinated flank steak adds flavor and protein, she says. (Or even better, top with brain-fueling salmon chunks instead.) Or tweak your favorite recipes to sneak in more veggies, suggests Holly Hill, RDN, a certified culinary medical specialist. “If you have a favorite pasta dish that includes vegetables in the sauce, reduce the amount of pasta and increase the veggies. Grate them fine if you have picky eaters. You will be enjoying the same flavors but you’ll give the dish a better nutritional profile.”
Stock your kitchen. Eating out often can be expensive and unhealthy. Hill makes sure to stock nutritious pantry staples so she can whip up an at-home meal on the fly. “I always keep a variety of canned beans on hand. One quick favorite: Scoop canned drained pinto beans on a corn tortilla, top with a little cheese, place under the broiler for a few minutes, then top with whatever you have around — avocado, salsa, tomato, lettuce.” Another of Hill’s must haves: Frozen berries. “I can eat them as a snack or throw a handful on cereal. Frozen can be cheaper and are typically processed at their peak to maintain nutrients.” Nordgren counsels families to cook up a big batch of lentil or minestrone soup every week which stands ready to serve for several meals.
Boost the flavor. Many herbs and spices are loaded with cancer-preventing compounds. They can also help you add zing to a dish without having to douse it with a lot of salt. Says Harlan: “My favorite spice is smoked paprika. If you sprinkle some on your eggs, it will give you the smoky flavor you are craving if you are avoiding bacon.” Hill incorporates fresh herbs whenever possible. “I’ll toss a handful of parsley on a salad or fold into a wrap sandwich.” Nordgren squeezes fresh lemon to finish recipes, from soups to cooked veggies. In addition to a hit of Vitamin C, “The acid elevates the dish’s taste and opens up your taste buds.”
Is culinary medicine making an impact? Research is in the pipeline, Harlan says, to find out how efforts to teach doctors healthy cooking techniques are affecting patient outcomes.
But the field’s foundation is evidence-based, says Harlan. And Harlan and his peers’ recommendations make a lot of sense. Students in the Tulane program, for example, learn about the well-studied Mediterranean Diet — a plant-based regimen heavy on fruits and vegetables, whole grains, beans, and legumes, healthy fats like olive oil, and limited in red meat and dairy.
While patients coping with specific conditions might be most motivated to seek dietary guidance from a doc, “As Americans we are all at risk for a poor diet,” says Artz. In other words, we can all benefit. To find a provider trained in culinary medicine near you, try the field’s clearing house healthmeetsfood.com, or look for cooking classes through your local health care system or medical school.
JENNIFER KING LINDLEY