The Doctor Is Cooking

This is very good news, albeit a little late in the game. Hippocrates' edict: "Let food be thy medicine and medicine be thy food" is no less true today than it was 2400 years ago. It's painfully obvious that we are far removed from food as medicine--sugar drinks (10 tsps.), burger bombs, additive-laced processed foods and the rest of it. No one in their right mind would maintain that such items could possibly bestow "medicinal benefit". We are now (begrudgingly) forced to admit that our food is causing a great deal of illness and dis-ease. Let's also consider the flip side--"let thy medicine be thy food". Without entering a broad discussion of allopathy I will simply point out that when the doctor gives you a a drug for psoriasis which warns that side effects may include nausea, dizziness, rash, palpitations, danger of stroke or liver damage, that medicine is probably NOT nutritionally beneficial. Worse yet, it might cause considerable dis-ease. "Let food be thy medicine and medicine be thy food". "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." And "Whenever a doctor cannot do good, he must be kept from doing harm." Hippocrates--from your lips to God's ears. Imagine...if we paid heed to those ancient words...

Health-conscious eaters have always been ahead of clinicians in culinary medicine. Dr. Michael Roizen and were privileged to teach the first med school course in it at SUNY Upstate in 2003. It remained just there until 2006. Then the national cable Lifetime TV network began airing the first ChefMD.com cooking and shopping segments on its weekly, honored series "Health Corner". Hundreds of thousands of emails sent to me from 2006-2011 asked "what do I eat for this?" And I wasn't the only one. Patients all over the U.S. prompted their doctors to learn more by asking if and how food can work like medicine, for their condition, but still taste like food. And indeed, it can. As highly processed food became increasingly suspect, the farm-to-table movement gained steam and more people soured on taking a drug if they didn't have to. Clinicians began to get the message: food can cause disease, but it can also prevent and even reverse it. And still taste great. Medicine now needs to catch up: about its own conference and hospital food, about food insecurity, about food's metabolic effects, and about the pleasure of food and cooking. So happy to see this update on the culinary medicine movement, and grateful for the citation to my work on its mission and vision. Food can be some of your best medicine!

Seeing what we all see in the Food Channel, there should be a program there for healthy recipes, and this " Doctor Cooking" would be a great title. And healthy food can taste great.

I just want to echo previous comments recommending Registered Dietitians. Utilize and refer to the less expensive health profession who has extensive training in these areas already. No one expects a doctor to provide PT or OT, so why nutrition? Increased nutrition education hopefully leads to MDs appreciating the value of nutrition, reinforcing the message with patients, and referring to a dietitian. We ultimately need better insurance reimbursement for nutrition counseling for disease prevention.

There are RDs and there are RDs. About 15 years ago when my son (at 9) was literally starving to death because everything he ate went right through him - he was skeletal and weighed as much as a toddler - the pediatrician referred us to an RD. Her only suggestion was to try Ensure and blue Jello. Needless to say, her advice (for which we paid several hundred dollars out-of-pocket) had no effect on improving my son's health. I had to do my own research (not easy at the time) and demand specific lab tests which would show what was happening with the gut.

How did the "healthy" food taste?

Why do we consistently ignore the fact that 20 to 30 countries are healthier than we are. Could it be due to the increased chemicals that we allow in all our foods while other countries ban them. Additives like Nitrates in bacon and Azodicarbonamide in all our breads. It may be that our bad health is directly caused by a ongoing effort of the government to feed us as cheaply as possible. Thus they have invented everything from HFCS to aspartame to fake butter and fake fat and then they promote these items on a unsuspecting public.

For a decade and a half, The Culinary Institute of America’s Greystone campus in California has been the home of the most remarkable, annual gathering of 450 physicians and allied medical professionals, chefs, and educators who come from all over the world to attend the Health Kitchens, Healthy Lives conference highlighted in the opening of Amitha Kalaichandran’s article. Co-presented by the Harvard T.H. Chan School of Public Health—Department of Nutrition and The Culinary Institute of America, attendees hear directly from top research scientists forging the future of the nutrition field, then head into our world-class kitchens to experience and learn how to create “healthy deliciousness” which in turn inspires them to become change agents in their own clinical practices, in hospitals, and elsewhere. Many of these doctors return year after year with stories of inspired co-workers, recently built teaching kitchens brimming with patients learning new life skills, and communities transformed. It reminds us of the William Gibson quote, “The future is already here. It’s just not very evenly distributed.” Greg Drescher Vice President—Strategic Initiatives and Industry Leadership The Culinary Institute of America

At least a dozen years too late, but it's a start! Now, how do I enroll my PCP?

A good idea, but they could do even more good if they were not laboring under the delusions of vegan religious ideology. Humans (in general) are adapted to eat an omnivorous diet, for literally millions of years. Meat, fish, and eggs are delicious, nutrient-dense foods which support health.

Health Canada states diet is the number one risk factor for chronic disease. An important aspect of physicians enhancing their nutrition knowledge is they are more likely to prioritize referrals to registered dietitians. Dietitians have 5 years of science background in nutrition and are dedicated to staying on top of all the latest research. Regular follow up with dietitians has been proven to improve diet quality and physical and mental health.

I've read of several such opportunities for physicians, including some local conferences and lectures here in NYC. I don't understand why the emphasis is on training physicians -- they have enough to stay on top of as it is -- when a discipline full of well-trained professionals already exists. Registered dietitians are ready and available and, speaking for myself, providing nutrition therapy in partnership with physicians is a career opportunity that I'd jump at. However, very few physicians employ RDs in their offices or use them as specialists for referrals. It makes no sense to spend time and money training doctors when RDs are trained and counseling patients NOW. Doctors are simply not using us as a resource -- that is what they need to learn to do.

I am a first-year medical student, and I am in the Culinary and Lifestyle Medicine track at my school (West Virginia University School of Medicine). I will be attending the Health Meets Food conference in June. WVU created the track just this year to help address the problem of chronic disease in West Virginia. I was very excited to learn about it, because I entered medicine with the goal of promoting healthy diet and lifestyle to my future patients as a way to manage and prevent chronic disease, and the track was a perfect fit for me. It’s wonderful to see that this movement is gaining traction all around the country. Thank you Dr. Kalaichandran for this article!

Registered Dietitians are experts in nutrition and every physician should be required to have a dietitian in their office to counsel patients on importance of heathy eating. Physicians need to utilize resources that are available.

So glad to read this article and applaud all these efforts. Licensed naturopathic doctors have had a decades-long understanding of the essential role of food and diet in the prevention and treatment of chronic disease. Nutrition has long been our first line treatment for many patients who are ready and happy to learn that food is their best medicine. To read about the advanced nutritional training naturopathic doctors receive, see http://bit.ly/2pbOfJi .

My brother-in-law co-chairs, teaches in and is an MD-PHD, thus always writing grants. During my last visit, we talked about a particular professional development grant he was preparing. A small piece addressed PD around student 'burn-out.' We agreed there are many causes for burn out, including not prioritizing and promoting self care and nutrition to improve the level of student wellness. I thought, how great would it be for the MD-PHD students to be required to make the time to attend a cooking/nutrition course once a week. Such a course would have the additional benefit of addressing student socialization. Adding courses requires jumping through many hoops, but maybe justifying sending students to a conference is the answer, at least for now.

I wonder if the best way to push healthier food habits for the general public is in the physician's office: https://www.washingtonpost.com/posteverything/wp/2017/01/05/why-is-healt... ("Why is healthy food so expensive? Maybe because we expect it to be." 5 Jan 2017). I am not saying that this shouldn't be part of medical education, but I wonder how many of those "eager physicians" will have time during busy office schedules to transmit what is needed to the wider public. Hence this becomes a public education issue. Here in the USA, where access to reasonable and affordable health care is limited for so many people, the idea of dietician referrals--creating yet more medical expense--is fraught. The same would not be true for most people in Canada and other nations with a stronger safety net (i.e. almost all developed nations besides here in the USA). With mobile devices and internet so ubiquitous (noting that some are still left out), there should be better ways of disseminating this information, but there have to be ways for the consumer to gage the accuracy of information they get. We do not need a marketing free-for-all as to which nutrition plan is the latest and greatest. People need to understand how to economically sustain a healthy diet.

It's heartening to see the Teaching Kitchen movement gathering steam! I work at Turner Farm, an organic farm near Cincinnati that is home to one of the nation's premier teaching kitchens. We are working with the University of Cincinnati medical and allied health schools to expose med/nursing/pharmacy students to the "food is medicine" concep.

Bravo for this long-overdue medical trend and this informative article about it. Similar trends would be welcome in schools, colleges, and workplaces where employers try to incentivize workers to stay healthy. Creating a healthier America requires all hands on deck.

FINALLY!!! These are all great starts! What you eat makes a HUGE difference to your health. Why are doctors so reluctant to discuss diet and nutrition with their patients? Research studies have shown that about 80% of our chronic diseases and conditions are caused by our poor lifestyle -- which starts with our terrible Standard American Diet (SAD). Check out nutritionfacts.org, a non-profit which reviews the scientific literature published in peer reviewed journals and presents the results in easily understood videos -- with links to the articles discussed.

This article should have mentioned the role of Dieticians in patient health. Many insurance plans pay for doctor directed consultation with dietitians who are school trained and licensed. The consultation provides advice on the patients specific dietary needs which doctors can not take the time for. https://en.wikipedia.org/wiki/Dietitian

I'm not opposed to learning new things - it's part of my professional obligation as a family medicine physician. The thing is I'm not sure that I can learn enough in 3 days (on top of the other knowledge I need to maintain year round) to be able to provide good quality counseling and patient education to my patients that improves health outcomes, in the middle of dozens of other competing priorities at any given visit while satisfying the requirements of my employer, my patient, their health insurance career and my electronic health record vendor. "Allied health workers" like Registered Dietitians have more years of nutrition oriented training but the only way to access them in a somewhat affordable fashion is to get a referral from a physician for treatment of a specific medical condition. That's not to say that as a physician I shouldn't learn the role of "food as medicine" and other related topics, but in a system that still devalues prevention, it's probably not the most important topic for me. Maybe easing access to RDs and other allied health workers (and access meaning not only being able to schedule an appointment but to also potentially utilized health insurance or flex spending) is a more sustainable and patient-centered approach.

One is not sure how any of this would translate as a practical matter into direct improvement in patient health outcomes. It is an intriguing "hook" of a headline, but there are too many incentives, financial and otherwise, working against an incremental approach to health that requires education, discipline, unflagging attention to detail (let's see these folks complete an actual certificate in culinary arts, involving knowledge of cost control along with other technical things), and motivation. Americans don't seem to be wired up to do much more than take pills for things that ail them and avoid exercise as much as possible (there is a lot of data about the latter;most adults don't exercise regularly).

I hope these physicians will put these lessons to use in their own hospitals. My mother recently suffered a long illness in an internationally-famous Boston hospital. I was truly horrified by the food available. It was like 1980s TV dinners. And the cafeteria for staff and visitors was no better. I resorted to walking 10 blocks to a supermarket to get fresh fruit and vegetables. What is the point of delivering millions of dollars of medical care and then feeding the patients Grade D fast food? How are they supposed to heal when they aren't getting good nutrition?

I'm surprised that, in noting how difficult it is to research nutrition, you didn't mention Dr. Michael Grieger's nutritionfacts.org. This website is an excellent place to find science-based analysis of nutrition generally, and many foods and diseases specifically. The basic research articles can be accessed too. Of course, Dr. Grieger is himself a vegan and promotes plant-based nutrition, which the American medical community just can't seem to accept. But if you have an open mind, check it out!

Oft times I read of the lamentable lack of nutrition training for physicians. Au contraire, since nutrition ed falls into two categories, unscientific and antiscientific, the less, the better.

It's called food as medicine and it is hardly an emerging field. Chinese medicine Ayrveda naturopathic medicine have used food as medicine for thousands of years. The arrogance comes with allopathic medicine together with corporate care will now figure out how to make still more record profits on information that is basically ancient wisdom and available for free. Go back to school at your community college and learn more about nutrition than your doctor knows and will charge you big bucks for. Take control of your own health, do not depend on doctors and corporate medicine to educate you about what you can learn for free.

Encouraging. But will take years. My various doctors (over a long lifetime) have expressed no interest in diet, and indeed have expressed disdain for the topic.

Getting physicians to understand nutrition is only a first step. Much has changed regarding the understanding of what constitutes a "healthy" diet. Much conventional wisdom, based on unproven inference has vilified healthy components to our food selection such as saturated fat. Unfortunately the Academy of Nutrition and Dietetics lags behind in this matter and continues to resist.

Functional Medicine a “non mainstream” approach to wellness, identifies an individual’s unique ability to make use of nutrients on a cellular level, and literally prescribes diet and supplements as a way of improving gut health (which research indicates is the key to mantaining overall health). In 2011, two gastroenterologist told me the only way to handle my IBS with severe constipation was to have my colon removed. While researching alternatives, I learned that Jews of Ashkenazic descent often have severe allergic reactions to dairy, causing chronic constipation. I stopped all dairy and within a week, was no longer constipated. Follow up with a Functional Medicine MD identified ways I could further change my diet to improve overall health. Cooking lessons are a start, but it’s time MD’s are taught “food is medicine” and, before reaching for the surgical knife or the pills, prescribe the produce section of the supermarket.

It's interesting that Stanford is mentioned in this article. In my experience, having been forced to spend two nights at that hospital, the food choices were worse than terrible! Not just from a nutritional or culinary standpoint. But downright terrible for a type 2 diabetic. Even the "hospitalist" in charge of my care expressed helplessness - he said it was the "system" and that they could not change it. Doctors and hospitals are the worst sources of information about food!