“Let food be thy medicine and medicine be thy food.”
–Hippocrates, 431 B.C.
This famous quote by the very father of western medicine is a testament to the healing power of food. Consuming trending foods like avocado toast, quinoa, pulses and golden milk lattes, as we know, can accord many health benefits. But, can such foods also extend the life of the human body already afflicted with heart disease, metabolic syndrome and even cancer?
The short answer is a resounding yes.
According to the 2012 census conducted by the Centers for Disease Control and Prevention, 117 million adults — roughly half of the U.S. adult population — suffer from at least one chronic health condition such as Type 2 diabetes, heart disease, obesity and cancer. Diabetes alone is the leading cause of kidney failure and blindness in adults. In fact, the average yearly cost of hemodialysis treatment for chronic kidney disease is over $87,000 per patient per year. It is no surprise then that these chronic conditions are among the most costly in the United States. It is encouraging, however, to know that these same conditions are also considered some of the most preventable.
A 10-year NIH-AARP diet and health study found that a strong adherence to the Mediterranean diet in healthy patients was associated with a decreased risk of death by cancer by 12% and death in general by 20%. Moreover, adhering to just two additional recommendations of the nine given by the Mediterranean diet can result in a dramatic 25% reduction in mortality from all causes, including heart disease and cancer.
In a four-year study conducted with diabetic patients, researchers compared those who adhered to a Mediterranean diet to those that were on a low-fat diet recommended by the American Heart Association. After four years, only 44% of patients in the Mediterranean diet group needed medication to combat their diabetes, as compared to 70% of patients in the low-fat diet group. That is, adherence to a Mediterranean-style diet alone was responsible for a 26% decrease in medication needed to control diabetes.
Small changes to one’s diet — such as adding one large apple to one’s daily lunch or snacking on low-sodium peanuts two to three times a week — can thus lead to lasting health benefits. Given that incorporating a healthy diet into our lifestyle is both cost and life saving, culinary medicine offers a uniquely successful approach to addressing our chronic disease crisis. And it ought to be promoted by healthcare providers today.
Culinary medicine is an evidence-based, lifestyle approach to medicine. It goes beyond “healthy eating” by combining diet, nutrition and culinary art to treat and prevent metabolic disease. It is a field of medicine that promotes health and wellness through one of our most basic needs. Moreover, it encourages us to couple food with medicine, nutrition with cooking and necessity with creativity.
Importantly, by incorporating knowledge of nutrition into how we prepare meals we systematically transform critical advice into common practice. This practice enhances our ability to create balance with foods and flavors, to eat healthier portions and to include anti-inflammatory spices in our cooking. It is these spices that naturally give us the robust, meaty flavor we crave from our favorite processed foods. Practice over time leads to creative cooking and a new family activity. Culinary medicine thereby ensures a collective investment in nutrition and health through food.
The model of culinary medicine is an exciting one. It seems, however, to break down when dealing with patients who have little access to adequate food stores. It is no secret that the increased prevalence of metabolic disease and obesity stems largely from the ever-growing supply of processed foods. But for many of the 117 million Americans suffering from these diseases and living in such food deserts, processed food becomes the easy, available and affordable option for the dinner table. This stark reality begs the question: can one even promote recommendations of a Mediterranean diet if their patients lack access to foods like fruits, vegetables and whole grains?
The short and long answer is yes, absolutely.
Over time, small, positive changes can lead to long-lasting benefits. That said, it is crucial to reassure patients that making healthy changes to their diet and lifestyle will help break some habits without breaking the bank.
Consider lentils: a high-protein, high-fiber legume. A one-pound bag of lentils at the nearest convenience store costs around $2. It can be cooked in bulk one night and then prepared in smaller portions throughout the week. Gram-for-gram, lentils contain more protein than red meats like beef. So, substituting $2 of lentils for $8 of red meat per week not only saves money but also saves patients from the harmful cholesterol and saturated fat found in red meat. Likewise, corn tortillas are significantly lower in sodium and fat than flour tortillas and are packed with fiber. They are widely available at most dollar stores in 12-count packs sold at $1 each. Not only are they inexpensive and a good source of whole grains, but they also have a longer shelf life than flour tortillas.
This past summer, I attended the Health Meets Food Conference at the Goldring Center for Culinary Medicine at Tulane School of Medicine. As a student attendee, I was struck by the combined power of food and culinary knowledge, one that could curb the growing epidemic of chronic disease. The Goldring Center works to transform the theory of culinary medicine into a fruitful, enduring practice for its patients and for anyone else wanting to make changes to their diet and lifestyle. They offer free community cooking classes to adults and children that cover basic culinary practices, construction of flavorful spice palettes and other health-related concepts.
The class, however, goes beyond cooking. Students learn how to effectively meal plan, budget and shop for their family at their closest grocery store. The Center also focuses on making incremental changes with respect to the students’ food preferences. This focus shows community members and patients just how easily small changes can be made. With once-a-week classes throughout the working week and weekends, The Goldring Center aims to maintain accessibility and consistent attendance. They also partner with community-based urban gardening organizations giving folks the tools to sustainably grow produce that might not be readily accessible in their neighborhoods.
As a pre-med student still years from becoming a practicing physician, though, I asked myself — what is my role? As a future medical student, would I even have the power to enact change in this area?
“Practice what you preach” was an obvious suggestion from the physicians and dieticians I spoke to. To be a good doctor is to be empathetic. To empathize with your patients is to have experienced similar challenges. Have you tried substituting half of a red meat sauce with lentils when making dinner for your family of four? If you can relate to your patient who also cooks for her diabetic husband, then you can achieve a common ground in your relationship. Such empathy humanizes your advice as a doctor and, through a shared vulnerability, helps you strengthen your bonds with your patient.
The integration of nutrition, culinary knowledge and lifestyle medicine, however, should go beyond doctor-patient relationships. It should be formally incorporated into medical school curricula as both a way of treating patients and keeping them healthy. According to the American Medical Association, only 27% of medical schools actually offer the bare minimum of 25 hours of recommended nutrition education to address symptoms of metabolic diseases that affect 117 million adults in the United States today. It is critical that medical students receive more hours of training so they can better advise patients on improving their health and diet.
Teaching kitchens like those at The Goldring Center allow medical students to complete nutrition modules in hands-on cooking classes. This kind of specialized, experiential learning helps cultivate strong connections between the culinary and health sciences. Ultimately, it gives future physicians the tools and confidence to give effective dietary advice to their most vulnerable and often most frequent patients.
As future doctors, we must advocate for a more integrated nutrition and lifestyle medicine education, one that is based not just in healthy eating, but also in the reversal of a global chronic disease epidemic. Let healthy food be thy guide to a happy body and soul.
Pre-Medical Guest Writer
Washington University in St. Louis
Kriti Prasad is a pre-medical student with a Bachelor’s degree in Philosophy-Neuroscience-Psychology with a minor in French from Washington University in St. Louis (Class of 2017). Her interdisciplinary undergraduate education has fueled her passion for a more integrated, holistic, and socially responsible medicine. As a future physician, she hopes to transform this passion into purpose to better address the health needs of our underserved communities. In her free time, Kriti enjoys dancing, traveling, and cooking.