Culinary Medicine: A Recipe for Better Health
To fight disease, some physicians are putting food on the same level as pharmaceuticals.
NEW ORLEANS – IN A nondescript, seen-better-days neighborhood not far from the French Quarter, advocates who say their emerging discipline can fight disease, reduce medical costs and potentially heal broken communities held a small reception this fall to demonstrate their work.
Near the entrance of a Whole Foods grocery store, guests sauntered past ice buckets of organic beer and wine into what looked like a small restaurant with an open, commercial kitchen. Inside, they sampled tasty finger foods: grass-fed beef meatballs, bright slices of tomato-basil bruschetta, trays of sliced fruits and miniature cups of rich chocolate pudding made with avocados.
The delicious hors d’oeuvres, served to invited health care administrators, educators and nutritionists, actually were a demonstration of sorts by the host, the Goldring Center for Culinary Medicine – an arm of the Tulane University School of Medicine and the epicenter of a movement putting food on the same level as pharmaceuticals.
Produced by Goldring Center staff on-site, the noshes were unambiguously healthy, made from lean protein, fresh produce and a minimum of processed ingredients or sugar. Rich in nutrients and healthy fats, the dishes also were a reminder of the center’s mission: to teach doctors, nurses and anyone who wants to learn that food, mindfully selected and prepared, can be a powerful medical tool.
A secondary message, however, was made clear by hungry guests: Food that’s good for you doesn’t have to taste bad.
Food is “an essential part of how we keep our health,” Dr. Timothy Harlan, the Goldring Center’s executive director and a practicing internist, told the gathering. With the proper training and techniques, he said, health care providers can treat some hypertension and diabetes patients with a cookbook and a saute pan instead of a prescription.
But Harlan, a chef-turned-medical practitioner and scholar, also issued a caveat: Don’t confuse culinary medicine with alternative medicine or wellness concepts that, say, treat turmeric as a cure-all.
Though it’s easy shorthand for what he does, “we don’t actually like the phrase ‘food as medicine’ very much, to be honest with you,” Harlan says. The Goldring Center’s approach, he says, is scientific – just like the math, biology or chemistry any student must understand before graduating from medical school.
Once on the fringes of health care, the culinary medicine movement is on the rise. In recent years, at least 10 U.S. medical schools have offered culinary medicine to undergraduates as an elective. Tulane, home to one of the movement’s flagship programs, developed and licensed a curriculum used by at least seven other medical schools, and Harlan says several nursing schools, hospitals and community clinics have adopted the programming as well.
“What we do is evidence-based,” Harlan tells U.S. News in an interview after the reception. “We take the nutrition literature and translate it for the American kitchen. Basically, we’re doing what we call ‘translational nutrition.'”
Dr. Timothy Harlan, executive director of the Goldring Center for Culinary Medicine in New Orleans, cooks up a holiday meal with roasted pork loin, savory stuffing cranberries and fresh rosemary.
Though the discipline is new, many people already know the culinary medicine concept from the bromides our parents told us – repeatedly – when we were children. Eat your vegetables to grow big and strong. You are what you eat. An apple a day keeps the doctor away.
While empirical research on culinary medicine is hard to come by and positive results are mostly anecdotal, researchers have linked obesity – itself tied to illnesses like diabetes and cardiovascular disease – with a dearth of home cooking. Study results indicate people who often prepare their own meals tend to eat more fruits and vegetables, consume fewer calories and maintain a healthier weight than those who do so less frequently.
Dr. John La Puma, a physician and trained chef considered among the fathers of culinary medicine, defined the discipline in a 2016 article. Writing in the journal Population Health Management, La Puma described the approach as “a new evidence-based field” that “blends the art of food and cooking with the science of medicine.”
But if a patient’s meal doesn’t taste good, or isn’t gladly shared with others, he wrote, the practitioner is doing it wrong.
“Special attention is given to how food works in the body as well as to the sociocultural and pleasurable aspects of eating and cooking,” La Puma wrote. “The objective … is to attempt to empower the patient to care for herself or himself safely, effectively, and happily with food and beverage as a primary care technique.”
Dr. Rani Polak, a physician, chef and research associate at Harvard Medical School, says no one knows precisely who was the first doctor to translate mom’s dinner table advice into a prescription for patients. His own epiphany came when he dropped out of medical school in the late 1990s and decided to become a chef.
“I was kind of disappointed in my medical education, so I left medical school and went to culinary school,” says Polak, who is also founding director of the Culinary Health Education Fundamentals Coaching program, which aims to teach health care professionals about cooking and nutrition and how to translate that knowledge and skill to patients. The CHEF program is embedded in the Institute of Lifestyle Medicine at Spaulding Rehabilitation Hospital Boston.
“When I learned how to cook,” he says, “I realized these two professions can be combined.”
Returning to Israel to finish his medical training, “I Googled this stuff, as much as Google was available back then, 10 to 15 years ago,” Polak says. “I looked to see if others are doing this stuff. I don’t know how it started, but several people had the same way of thinking, more or less at the same time, which is really interesting.”
Polak says even obese, chronically ill patients know the basics: Healthy food is good, junk food is bad, weight loss can improve health. Yet some patients struggle to translate that knowledge to specifics around mealtime, and doctors don’t have the tools to teach them.
“Most of the discussion about nutrition is in science language,” he says. “Clinicians usually talk with patients about vitamins, minerals, saturated fat and cholesterol. You do not buy this stuff in the grocery store. You buy food, you buy vegetables, you buy grains, you buy fish. That’s the way we think to communicate with patients.”
“Because it’s nice to know that they know they need to consume quinoa,” he says. “But unless they know how to cook it, they probably will not consume it.”
That’s where education comes in, says Harlan, of the Goldring Center.
“In my day job, I’m associate dean for clinical services, and really what that means is I’m medical director for our faculty practice,” he says. “I still practice half-time. I just came from the clinic. I spent a significant amount of my time this morning talking to patients about food and about their consumption habits and how they can make changes.”
Besides teaching patients who have been referred to the institute by their doctors, Harlan says Tulane medical students – as well as doctors, nurses and nutritionists – come to the Goldring Center to learn how to cook and how to pass along those skills to their patients. Harlan has helped export that knowledge by creating the culinary medicine curriculum that medical schools, teaching hospitals or nursing schools can adopt.
“Our mission in many ways is … helping folks understand how they can launch this programming at their school or hospital or nursing school,” he says, noting that institutions from Houston to New Jersey have adopted the curriculum. At the same time, he says, some community organizations have worked to bring teaching kitchens into neighborhoods, just as the Goldring Center has.
That includes Church Health, a Memphis, Tennessee-based nonprofit that has adopted the Goldring Center’s curriculum and holds classes for those who want to learn how to cook and eat healthier. Count Olga Page, a retired audiologist working to manage her hypertension, among them.
A vegetarian who admits she was “rather inept” in the kitchen – “I didn’t have to worry about cooking meat, so I steamed everything,” she says, chuckling – Page, 69, says she started taking classes last year because “I wanted to learn how to cook at home and I wanted to increase my knowledge about healthy cooking techniques. I wanted to live a healthier lifestyle.”
During the first class, there were still doubts. “That did go through my mind at first: Can I do this?” she says. But the instructors, some of whom she’d met at Church Health, and her friendly fellow novices helped put her at ease.
Before long, Page says, she was comfortable enough to cook for friends on a weekend getaway. She’s also accumulated a collection of cookbooks.
“I feel like I can complete a task by myself,” she says. “I feel independent in cooking. I feel better going to the grocery store. I feel better prepared in what I buy.”
And, Page says, she’s living proof that culinary medicine can improve health.
“From a personal standpoint, it certainly has helped me become a better cook for myself,” she says. “I’m eating healthier, and that’s impacted my life.”
Joseph P. Williams, Writer