On this episode of the Academic Medicine Podcast, guests Courtney Newman and Jaclyn Albin, MD, join host Toni Gallo to discuss culinary medicine and its role in teaching nutrition, nutrition counseling, and hands-on cooking skills to medical students. The conversation also covers how culinary medicine programs build connections and community and improve the well-being of students, faculty, and patients.
This episode is now available through Apple Podcasts, Spotify, and anywhere else podcasts are available.
A transcript is below.
Read the article discussed in this episode: Newman C, Yan J, Messiah S, Albin J. Culinary medicine as innovative nutrition education for medical students: A scoping review. Acad Med. 2023;98:274-286.
Transcript
Toni Gallo:
Hi everyone. I’m Toni Gallo, host of today’s episode. Lifestyle, including diet, plays an important role in the health of individuals and populations, and can be an important risk factor for a number of diseases. Yet many physicians have not received adequate nutrition education to discuss diet related changes with patients. To fill this gap, one nutrition education model that some medical schools have adopted in the last decade or so is culinary medicine, which aims to increase medical students’ knowledge about nutrition and its role in disease prevention and management and improve students’ ability to provide nutrition counseling to patients. Culinary medicine programs also aim to equip students with practical, hands-on cooking skills.
Toni Gallo:
Today, I’m joined by Dr. Jaclyn Albin and Courtney Newman, who are the authors of a recently published scoping review entitled “Culinary Medicine as Innovative Nutrition Education for Medical Students.” Their article is included in the February issue, and I’ll put the link in the notes for today’s episode. We’ll be talking about the role of culinary medicine programs in teaching nutrition, nutrition counseling, cooking skills, and more to medical students, the findings of Jaclyn’s and Courtney’s scoping review, and where the academic medicine community can go from here.
So let’s start off with some introductions. Jaclyn, would you like to go first?
Jaclyn Albin:
Sure. I’m Jaclyn Albin. I’m an associate professor of internal medicine and pediatrics at UT Southwestern Medical Center in Dallas, Texas. And I also founded and co-direct, along with my dietician partner, the culinary medicine program here at UT Southwestern, where we deliver education, patient care, and do a lot of research and community engagement around the powerful role that food and cooking can play in our health.
Toni Gallo:
Thank you. Courtney?
Courtney Newman:
My name is Courtney Newman. I am a fourth-year medical student in the dual degree program, getting my MD and MPH at UT Southwestern. And I’m currently applying into obstetrics and gynecology.
Toni Gallo:
I’m so glad you both could be on the podcast today. Thank you. I thought we could start with a little bit of context for our conversation. I wonder if you can tell us: What is culinary medicine? And how is it maybe the same or different from some other models of nutrition education?
Jaclyn Albin:
I think the simplest way to define culinary medicine is the intersection of the science and evidence that we have in the medical field with the practice and science and evidence in nutrition and medical nutrition therapy, traditionally an expertise of dieticians, and then really bringing in culinary arts, and how the intersection of these three fields brings food that’s on our plate to a very personal and social experience, where we can dive into: What does it mean to eat and live in a way that promotes thriving and not just surviving?
Jaclyn Albin:
And then really, what I love about it, it brings so much more to the table than just what’s on your plate. It also brings interprofessional education. How do we take doctors and PA students and physical therapy students and dietetic students and more, and bring them to the same space, where they share ideas, and they figure out how to collaborate early on their journeys? And then also, something I’d love to hear Courtney speak to, it’s about personal wellness of our trainees. It’s about: How do you eat well as an individual, so that you can then be equipped to apply that knowledge to patient care, either through your conversations or through innovation in how we deliver care.
Courtney Newman:
Yeah. I think one of the things is just getting a lot of the practical skills for cooking, so how to chop an onion. How do you efficiently cut something like a bell pepper? Because these are things that you may pick up along the way when you have to cook for yourself in college, or maybe in the beginning of medical school or graduate school. But when you learn how to do these things efficiently, when you have a difficult or demanding schedule for medical school, you’re able to kind of impart these skills to your patients when you’re giving them nutrition counseling or tips when you’re trying to give them actual ways that they can increase or … give them actual ways that they can better their nutrition and make actual changes, rather than giving them kind of these vague … oh, you should incorporate more vegetables … giving them actual changes that they can make within their diets that you’ve actually learned to incorporate within your own diet.
Jaclyn Albin:
That is so key, Courtney. I love that you said that. Please eat more vegetables, the most useless advice ever. Has that been working for people? No. People want the everyday: How do I do this with my busy life, with my job, with my kids, with the fact that maybe there’s not a great grocery store near me? So it’s about equipping students to say: How do you do that for yourself? And then how do you individualize the way you talk to people about this? And the way my dietician colleague, Milette Siler, always phrases it, she says, Meet people where they eat, where they shop. And if we don’t understand where people are coming from, we can’t really enter into that space with them and make it personalized.
Toni Gallo:
Courtney, I wonder if you could tell us a little bit about what it was like to go through the culinary medicine program. What did you take away from it? How do you think it has changed the way you cook and eat, and then maybe how you’ll work with patients in the future?
Courtney Newman:
Yeah. So I actually have a funny story. The culinary medicine elective is actually so popular at UT Southwestern that I tried for three semesters and didn’t actually get in. So it’s a lottery system, and every semester that I tried to get in, I was actually not able to get in, so I had to look for other avenues to get involved within the arena of culinary medicine. That’s kind of how I got involved within the scoping review, but then also, there’s a fourth-year elective that kind of allowed me to get in kind of on the tail end of my education. It’s really great because it was kind of more self led. You get to do a lot of self led reading, but also more kind of incorporating on your own. And there were options to incorporate kind of going through and looking at different recipes that you could incorporate, and sharing with the class what you had cooked and how you kind of plan to move forward and kind of take the things that you learned from maybe that recipe, whether you’re going to incorporate it with certain populations that you planned on working with.
Courtney Newman:
For me specifically, obstetrics and gynecology patients, so a lot of patients that are dealing maybe with gestational diabetes, and who have never dealt with those kind of dietary restrictions, and how they have to make those changes because they really care for the baby that they’re now carrying. And they’ve never dealt with these kind of restrictions before, so making those changes and being able to give those kind of dietary changes based on the kind of readings that we were doing, the changes that we were making in our own diet. So I think having that kind of on the tail end, after already doing this kind of scoping review was a really great experience to have.
Courtney Newman:
And I think the fact that we have the opportunity to have the experience of kind of preclinical students before you get to have these interactions with patients, but then also this kind of capstone experience as a fourth year after you’ve already gone through the clinical rotations have been able to be kind of how you maybe don’t have the experience that you necessarily want to talk to these patients about nutrition, and maybe not being able to answer these questions as you want, kind of having that experience at the end, so kind of moving forward into your residency training after the fact.
Toni Gallo:
Any favorite recipes or takeaway recommendations you want to share with listeners that you learned from the program?
Courtney Newman:
Yeah. Actually, one recipe, and I think we’re actually planning to make it this week. But there’s a vegetarian chili that we found in one of the, I think, PDFs that was included in some of the resources from the fourth-year elective. But it’s really easy and it’s something that I never thought I would include in kind of my week-to-week recipes, and something that my partner never thought that we’d include either. One of the big takeaways from both being a part of just culinary medicine in general and the elective as a fourth year is you don’t have to make those changes all at once. I don’t consider myself vegan or vegetarian, but we still kind of make meals where we incorporate more vegetables than we had previously. But you can slowly make those changes by incorporating more vegetables.
Courtney Newman:
You don’t have to make the changes all at once. You don’t have to cut those things out all at once, which I think is a misconception that I maybe had before getting more involved in culinary medicine and learning more about kind of more plant based diets. I think that’s something that often a lot of our patients will have that misconception as well, so I think that’s something that I really had as one of my big takeaways, and something that I hope to impart to my patients with nutrition counseling as well.
Jaclyn Albin:
I love that you brought that up, Courtney, because it’s not about defining a perfect diet. It’s about finding ways that everybody can make progress towards getting the nourishing foods that their body craves. And the recipe that you alluded to, a vegetarian chili, is actually not very hard to make, but it also has an alternative option where you use mostly frozen vegetables because we love to celebrate foods that are easy access, and sometimes help speed up the process of cooking for busy families. And most of the ingredients on there are things that people might be able to get from a food pantry if they need nutrition support. And so it’s celebrating legumes and the role that high fiber from that plays in the diet, so that’s such a great example of: How do we give someone something that’s practical and doesn’t feel out of reach for them? That’s the goal, is those everyday skills that make this doable and sustainable.
Courtney Newman:
And the great thing is there’s an option to do it where you can do it on the stove. But sometimes we’ll just do it in the microwave. So, like, if you have time constraints, you have that easy option as well. If you’re a busy family, you have that option as well, and you don’t have to let it kind of simmer on the stove all day. So there are lots of different options within it beyond just incorporating more vegetables into your diet.
Jaclyn Albin:
So you can capture the vision that students like Courtney, they make multiple different recipes that they get to try at different classes they attend. In our typical culinary medicine class, there’s six to eight recipes made in one evening across different teams. And then everyone gets to try what everyone else made, and they get to present what the experience was like, and then talk about: Why is this a better choice? Why does this small tweak on a traditional taco make this higher protein, higher fiber, lower saturated fat? The things that we’re looking for. But we’re not talking macros or specific nutrients for very long. We’re focusing on the colorful food on your plate because that’s what patients and people relate to, is the food on their plate.
Jaclyn Albin:
And then Courtney can go to clinic, and instead of telling somebody how many grams of carbohydrates to eat, while there’s a role for that, it’s so much more powerful to say: Here’s this recipe that I made. It was good. It only took 20 minutes. Now can you do that? Maybe that’s your SMART goal for that patient is try a new recipe twice this week and every week until I see you next. Here’s some ones to get you started.
Toni Gallo:
Yeah. As you were talking about here, you also mentioned in your paper, this very practical approach that you take, whether that’s working it into a patient’s busy schedule, thinking about what resources do they have access to. Do they have access to fresh fruits and vegetables? Do they have other cultural dietary practices that you need to work with in that context? I wonder if you can talk a little bit more about both from your experience with the culinary medicine program, and then from your review, what you found in terms of the importance of that sort of practical approach to teaching nutrition and counseling patients.
Jaclyn Albin:
I’ll just speak broadly to this, and then I’d love for Courtney to dive in maybe to more of the details that we covered across the different programs that we looked at in the review because in general, everyone’s program is practical and hands-on. That is what makes this impactful. And I would say this is really something that started as a fringe movement with some brilliant ideas of people who wanted to see food in medical education, and it has grown exponentially in a small amount of time with very few resources. And that’s because the learners get how much this matters, and they basically demand that faculty, educators, and … actually, some of these courses are taught by students … that people are making this happen because the practical element is so meaningful.
Jaclyn Albin:
And we often think about what should be included in medical school real estate, and it’s hard to squeeze new things in. But I couldn’t imagine something more useful than addressing practical strategies for the top risk factor for early death in the US, which is food. And the US burden of disease collaborators showed us that this is ahead of smoking. And then also, when we look at the other top risk factors, elevated cholesterol, elevated blood sugar, elevated blood pressure, those are all influenced by food. So we could have an incredible impact across the scope of a patient’s health conditions with something that’s so human and that connects us, and that can be the solution even as it is also the problem, a big part of the problem.
Jaclyn Albin:
And so that everyday realness, that let’s all get into the kitchen … And I just want to share a funny anecdote. One of our classes that we recently taught to the pediatric gastroenterology fellows on our campus, had faculty, fellows, all together. And the way we do those courses is we work closely with the fellows and we say, “What topics are relevant to your patient population? And what articles in the literature do you want to discuss journal club style? And then what cases can you bring to the table?” So we come together, and it’s making food that you might recommend to this patient population, and then now we’re going to talk about what’s in the literature, and then maybe what’s missing in the literature. So we get those research wheels turning too.
Jaclyn Albin:
But in that practical moment, one of the faculty was cutting a vegetable and really struggling. And so I kind of came over, gave him a few tips, and then all the fellows were laughing. And you could see how it just broke down the hierarchical barriers that are so common in medicine, when you have your senior attending who can’t chop the vegetable, even though he’s the one that you seek all the tips on for patient care. And it shows us what value there is in coming together as a team and just being humans together in the way that we deliver care. So I think that’s huge, that authenticity and that humanness really come out in a hands-on practical class like culinary medicine. So Courtney, I’ll pass it to you, if you want to talk a bit about what we found in the other programs that we reviewed.
Courtney Newman:
Yeah. Some of the programs and their actual content, they actually had core competencies that were specifically based around cultural competency. And it wasn’t all of the programs that were the ones that we included within the scoping review. And some of them, they weren’t actually included within core competencies, but there were specific lessons that were based around it. There was actually one program that I remember. I think the final lesson was based around where they had to actually … The students within the culinary medicine course for that final kind of lesson, they had to actually kind of come together and make a culturally competent meal for a family. And they had kind of some of these specifications. They had to make kind of a meal within financial kind of boundaries, cultural boundaries, for that specific family, for the specific number within that family.
Courtney Newman:
So there were programs that kind of had those boundaries that they had to take into account for the students for that kind of final lesson within that course. And then there were some programs that we looked at that were kind of more throughout, as opposed to kind of a final specific lesson, where they would kind of incorporate new cultural components kind of throughout each new lesson within the program if they had multiple sessions. So there was kind of a variance across programs like that. There wasn’t a single kind of way that they incorporated cultural competency, and some did it more than others. And I think another way that they also kind of incorporated it was in the way that they applied the lessons after having the culinary medicine kind of coursework with the medical students, with also the way that they had the students apply what they learned within the coursework after the fact.
Courtney Newman:
And while not all of the programs had kind of more of a structured way for the students to go out and apply, the ones that did, they often had ways, whether it be through students, whether high school students, sometimes middle school students, but they’d have ways in which they’d have to kind of incorporate the cultural competency that they had learned, whether it was within the core competencies or kind of worked in throughout. So they’d have to apply the things that they’d learned in kind of different levels in that manner.
Jaclyn Albin:
And that really brings up the great point that service learning is a key way in which this is often taught, where you equip a group of students with this knowledge, and then they take it to the communities that you serve locally. And another element to this that I think is huge and important to note is that this is not a top-down model. We all, just like the joke about the gastroenterologist with the poor knife skills, or room for growth, room for growth on the knife skills, we don’t come to the table with all the same skills and all the same dietary preferences and all the same backgrounds. And so I think the students teach each other as much as we teach them. And so students from diverse backgrounds who take this course, they come to us and they say, “Can I introduce this exotic fruit or vegetable from my culture? Can I share a recipe? Can I bring something unique to the table?” And that is the best part because then, we add to everyone’s learning through listening to the stories. Our plates are our stories.
Jaclyn Albin:
And we listen to that from each other, and it teaches us to do that with our patients, so that instead of coming in and having a prescriptive, “Patient, I want you to eat this,” you say, “Hey, tell me about what you love. Tell me where cooking comes into your culture and your family experience. What foods do you celebrate with?” And then how can we also give respect and celebration around those different dietary patterns and let people come to their own goals, give them the self efficacy to make the changes within their own food preferences, not us telling them what to do. And I think our students have a much better lens on how to do that.
Jaclyn Albin:
But a key challenge, which we should talk about, is most of these programs are assessed by self perceived counseling confidence and self perceived competency. That’s how these programs are measured in the literature right now. And we need to do some work to take that to a higher level.
Courtney Newman:
Yeah. I think one of the things that we found within the scoping review is the way that these programs are evaluated, and the fact that we were only able to find 12 programs that had evaluations in general. We know the fact that there aren’t just 12 programs out there, we know the fact that there are kind of these licensed programs that different schools across the United States are using, but just the fact that programs aren’t publishing the kind of outcomes of their culinary medicine programs makes it difficult to share what’s working, what’s not working, which makes it hard to grow as a field. That’s definitely one of the limitations that we’re finding and something that kind of we need to come together as a field to make sure that we can grow and kind of move forward as a field within culinary medicine.
Toni Gallo:
You both just mentioned, and this was actually one of my favorite parts of your paper, was how you looked at the ability of cooking and food to bring people together and to really foster community. And it sounds like that’s both within your institution among students or participants, but also then with patients. You can come together around both eating together and talking about food and cooking. Wonder if you can just tell us a little bit more about what that’s like participating in the program, and also what you found in your review around the ability of food to really foster community.
Jaclyn Albin:
We all seek community, and I think in the busy pace of medicine and in medical education, sometimes we don’t slow down enough to do it intentionally. So there’s something really powerful about a model that is a win-win across, I’m learning something I need to learn, I’m eating because I have to do that anyway, and I’m building connection and community. And I personally will often show up to class worn down or exhausted from either an administrative task or something else that’s been on my plate that’s frustrating me. And I invariably leave every class uplifted because there’s such joy in preparing and sharing food together, and sharing a bit about our personal stories through that food experience.
Jaclyn Albin:
And we have seen in our patient application of this, so traditional, we’ve done this in food pantry settings. So we’re doing it in an environment where people often have lower access to food. But it’s just as beautiful and important and powerful to everyone, no matter what barriers they face to putting the food on the table that they want for their families. And so that’s a gift to be able to set an environment where people can come together and build community. And I see that as treatment not only of maybe their diabetes or their high blood pressure, but also of loneliness, and also of building up that community support where someone might have a new person to turn to if they get a challenge that they’re not sure how to address.
Jaclyn Albin:
And so we’re beginning to increasingly bring this into patients care settings, and hope to equip the next generation of physicians and dieticians who can work as teams to deliver this as an innovative care model because I think it addresses so many different domains of what our community is craving. And the pandemic just threw an additional layer onto awareness around how vital it is for us to come together and to combat loneliness and to combat feeling as though we’re facing things without a team, without a community. So that’s what it means to me, and I love being in a kitchen with other people. I actually especially love it when someone else is doing the cooking, and then I get to reap the fruits of their labor at the end. What about you, Courtney?
Courtney Newman:
Yeah, I think along similar lines. I didn’t have the experience being in the culinary medicine courses. But I think for me personally, it’s always been a part of my family life, but also within this field and kind of moving forward within my patients, having conversations about food, whether it be in a kind of nutrition counseling setting, but also just talking about food as connecting with my patients. Just a few weeks ago, I think it was around the holidays, and talking with a patient who was having a lot of nausea, vomiting, was not able to enjoy the pie that she painstakingly made around Thanksgiving, being able to kind of talk to her about that and hoping that she could enjoy pie around Christmastime and the holiday time with her family.
Courtney Newman:
So even if it’s not in kind of a nutrition counseling setting, you can have a connection with our patients because she was feeling that sense of loneliness because she was not able to eat what she had cooked. She was not able to go spend time with her family, even just because she was feeling sick during that specific time. So I think using it as a connection even outside of the nutrition counseling sense.
Jaclyn Albin:
I also wanted to add that mental health is a key element here. And we have a mental health crisis, and we particularly look at youth. They are facing such lack of needs being met by the current structures that we have in place to address mental health. And there’s clear literature that shows coming together as a family just five times a week reduces rates of depression, of suicidality in teens, and multiple other health outcomes. And we have that foundational data that even just having a conversation, even just about sitting down at the table and eating together, not even what they cook or how they cook, but just sitting together at a table five times a week is really powerful for families. And we can have that conversation if we say, “You know what, you might not have time to cook after a busy night. But can you come together at breakfast? Or is there another way that we can get your family together around a table?” It’s a powerful experience.
Toni Gallo:
So we’ve talked a little bit about some of the findings from your review already. But I wonder if there’s anything else that you want to mention that you found with the programs that are in the literature, or gaps that you identified, just kind of anything to call attention to for our listeners.
Courtney Newman:
Yeah. I think one of the biggest things that we found was the fact that we’re very reactive overall when it comes to nutrition in general with medicine overall, when we can be kind of proactive and just take more of a preventative approach. And the biggest thing is a lot of people within the field of medicine, it’s going to take a big overhaul of changing the way that we think about things, and I think change in general is very difficult, and it’s like steering a large ship. It’s going to take a long time to get there. But I think this might be one of the ways to kind of start making that change. There are a lot of aspects to that, both financial, taking more of the education approach. But I think that there are kind of multiple aspects, and I don’t know if Dr. Albin maybe wants to chime in.
Jaclyn Albin:
Sure. I think that it’s an exciting time. So many people may be aware that the White House held the first nutrition conference in the fall in over 50 years. And the last nutrition conference really formed the foundation of a lot of our safety net nutrition programs and educational programs across our communities. And so this latest conference, I was thrilled that the AAMC and the osteopathic medical school body, and then also the ACGME, are coming together in March for a summit on nutrition in clinical practice, where groups of stakeholders, we’re going to get together, and we’re going to ask these hard questions and say, “What needs to happen for this to be a reality?” And not just the a la carte approach, which as grateful as we are for all of the programs doing amazing work, and we’re proud of the review that we have done to document that, everyone is kind of using what they have.
Jaclyn Albin:
And it may mean that it’s a public health educator, they might have a chef. They might have physician. Physicians are across all different specialties when they’re doing this. There’s not consistency there. And there’s student led courses. And so one take home there might be that lots of different people could be equipped to teach this. Another take home is that students are interested in this. These electives are competitive, even unintentionally. And most of the electives are limited in size because of lack of resources. So how do we prioritize this nationally as an educational strategy? And then also, what should that foundational level of nutrition education look like?
Jaclyn Albin:
I see culinary medicine as going a bit deeper, going a bit more nuanced in equipping people. But we also need what I like to think of as a “do no harm” foundation, where we are teaching students and residents to practice in a way that isn’t judgmental, that’s culturally sensitive, that leaves people feeling empowered and not discouraged. And we have a long way to go with that. So the outcomes are encouraging that these programs are beloved, despite lack of resources and lack of consistency around exactly what’s being taught. Another variable that we saw was dose. Dose is quite a wide range, where some programs, it’s a single experience. And other programs, it might be eight classes.
Jaclyn Albin:
So the medical education community, we have to come together and we have to decide what is the right dose. When should it be delivered? Who should be the team? And how do we sustain this model? And I think a key element to that is integration with research and clinical missions, and health equity missions, so that we bring all of it to the table because our population is getting sicker. And we’re spending more without results, and we need a new set of strategies as a workforce to address that.
Toni Gallo:
You touched on it a little bit. But what other things can medical schools or the academic medicine community as a whole really be thinking about as important next steps here? I think earlier, you mentioned better evaluation of programs too. What are some other things that you think would be important?
Jaclyn Albin:
Well, I think what we hit on earlier with personal wellness, it has to be the entry point because you have to believe this matters for you to be able to then live it and authentically apply it to your patients. So that’s a great starting point. Every single medical school and residency program has to have attention to the wellness of their trainees. We teach them about sleep. That’s a requirement. So we also need to teach them about the role that nutrition plays in their health, their cognitive function, their performance at work. All of those things are affected by what we eat.
Jaclyn Albin:
And then we also need to be investing in that. So are we ordering food at conferences that reflects the kind of diet that we’re telling our patients to eat? Because guess what, that’s actually how I got into teaching this, was because I was the only internist in a group of 40 who didn’t eat the free lunch and brought my own food from home. And they said, “Hey, Jaclyn, you probably know something about nutrition since you don’t eat this food.” And that should not be the reflection. We’re very hypocritical about how we want to tell our patients. And the same happened back in the days of smoking cessation, where doctors were smoking in the back and then telling their patients to quit. So we have to live it. We have to believe in it. We have to live it, so that’s a great starting point. What does that look like for your institution?
Jaclyn Albin:
And then the next step is ask the learners. They know. They’re in the community already. They’re volunteering, and partnering with community organizations who are already doing the great work is a wonderful way to have low resource investment in this. You go to an organization in your community. We have a wonderful partner called Crossroads Community Services that basically revolutionizes food pantry process through ordering and investment of dieticians and data collection, and helping people gain financial skills. We partner with them on lots of things. And everyone has community organizations doing food as medicine work. And just starting there with those service learning opportunities can build the momentum to say, “What does this look like in our curriculum?”
Toni Gallo:
I have one more question for you both then before we wrap it up, and it’s about nutrition or food misinformation. And there’s a lot of information out there on the internet about fad diets, or trends, or things you should or shouldn’t be doing. And I’m curious if culinary medicine, how it addresses those, and how it maybe equips participants to counsel their patients around finding good food information or figuring out what’s not actually a healthy trend. Is that part of the programs that you’ve found?
Courtney Newman:
I think the biggest thing is trying to hit on the misconceptions because I think that’s a lot of the thing about a lot of these fad diets, is the misconceptions and kind of trying to give them the best sources for their information. So I think a lot of the misconceptions that even some of the medical students might have, like having to make these big changes all at once to see these big changes in your nutrition and your health, showing them that they can start by making these small changes and they don’t need to make them all at once. And I think that’s the biggest thing starting off, that you kind of need to show them … incorporating the fruits, the vegetables, and giving them those kind of specific things they can change within their diets, as opposed to kind of these broad, big statements that I think a lot of the fad diets will do. Making sure that they’re still getting the kind of things that their bodies need, because I think that’s one of the things that fad diets are leaving out.
Courtney Newman:
They’re giving you kind of these quick things that give you quick results, but they’re not sustainable. And I think that’s one of the things that the culinary medicine programs and the kind of things that we talk about, a lot of the things that we touch on are kind of sustainable changes. And I think that’s something they can take with them, making those changes, the healthy changes that are sustainable, as opposed to kind of those quick changes that a lot of the fad diets are throwing at them, that once they stop those non-sustainable, quick things that they’re doing, they’ll see the weight that they lost, it’ll come right back. And then they’ll just kind of be in the yo-yo, back and forth with their weight. And I know that Dr. Albin has a lot more with this area, talking to patients, and actually in the courses, so if she wants to kind of add to that.
Jaclyn Albin:
Sure. Fundamentally, this is about giving people a healthy relationship with food. That’s the biggest gift we can give them, is that there’s no longer shame. There’s a healthy relationship with indulgence, keeping it in its place, teaching people that, yes, you can treat yourself, but not five times a day. And we’ve got to get back to a space where we have a healthy relationship with what food is supposed to do and be in our bodies. And just like I use this analogy a lot with teenage boys that resonates, if you put diesel gas in a regular engine of a car, and then go to your mechanic like, “I don’t know what happened here,” they’re going to laugh at you because we have to understand the kind of fuel that is necessary to equip our bodies to be at their best.
Jaclyn Albin:
And the science around this is actually pretty simple, and I think that fad diets take advantage of people’s vulnerability and genuine desire to do the right thing and to be well. And it tries to say, “Oh, this is actually so complicated that we have to tell you what to do,” or there’s an oversimplification where it’s back to eliminate X, Y, Z, and all your dreams will come true. I like to tell my patients if it sounds too good to be true, it probably is. And if someone’s trying to sell you something, please don’t take their advice right away until you’ve checked with other sources. And so how do we teach our students that?
Jaclyn Albin:
And I want to say as a sport analogy that I’ve become fond of, if you have a sports team, and the players are all struggling, and the team loses every game, you have to look at the coaching strategy. And that is where medicine is at. Our players are struggling. The team is losing despite spending more money. We are not making people healthier. So we have to take ownership of the fact that patients are confused because we have not been leading the narrative. So my vision is to create a generation of clinicians interprofessionally, dieticians, physicians, and all the other health professionals who care about this, bedside nurses, another huge part of this conversation. How do we equip them to lead the narrative with evidence? And it’s a yes/and approach with conventional medicine. This is not alternative to conventional medicine. This is yes, please take your statin, and we can try to lower your risk through diet, through soluble fiber, through other things. And we hope to reduce medication burden for most of our patients. But we’re not here to say this is the answer to everything. And our patients are craving food based support.
Jaclyn Albin:
They are going to the media and people without evidence based behind their claims because we have not had evidence based answers for them. So that’s really the charge. How do we ensure that the future workforce has the evidence base, the passion, the personal experience, the cultural humility, to apply this in a way that is lasting and that creates thriving communities?
Courtney Newman:
And I think that’s one of the biggest takeaways, and the fact that culinary medicine is just so well taken by a lot of the students is that we don’t have a lot of education, that we don’t feel comfortable talking about these subjects with patients because we feel like we’re going to slip up or tell them something wrong. We just don’t talk about it. And I think that’s something that this approach, it gives us practical skills that we can tell them, “Oh, this is what I do.” And the fact that we’re incorporating actual practical things that improve our own nutritional habits, that we can then kind of impart upon the patients that we’re talking to, along with the kind of background knowledge and the kind of evidence based that Dr. Albin is talking about. That combination of things is something that will both make us feel more comfortable having these conversations with patients, but also make those conversations more valuable to patients.
Jaclyn Albin:
And when we stay humble about it, knowing that things in medicine always change, we also regain the trust of our patients. And it’s okay to be wrong about these things, and it’s okay to say, “You know what, this approach works for most people, but we have to individualize it for you for these reasons.” People feel seen and they trust us again, and I think that’s another big piece of what we need to be thinking about moving medicine forward, is how public health messaging can build trust and can create a community of people who want to listen to us about all of their health needs because we have confidence, but we also understand that there’s room for growth, that we all keep learning and doing better as we continue to gain more knowledge and experience in applying food as medicine.
Toni Gallo:
I think that’s a great call to action to end our conversation on here today. I want to give you each a chance if you have any final thoughts that you want to leave listeners with. Maybe Courtney, do you want to go first?
Courtney Newman:
I think the biggest thing, just being open to new ways of learning, especially as a medical student who was very naïve to the field of culinary medicine coming into medical school, and honestly, nutrition overall, kind of as Dr. Albin touched on being open to the fact that I was not knowledgeable about this field, that I felt uncomfortable talking about this area of medicine with my patients, but then taking that as kind of a starting point and that I needed to get better, that I could be a part of this movement in both educating myself and then helping to educate others within the field to better the field overall, both educators and patients. And I think culinary medicine is a great avenue to do that. Being open to being wrong and kind of moving forward and learning with our patients kind of hand in hand.
Jaclyn Albin:
I’ll just speak to educators, educational leaders, and say if this is something that feels overwhelming, or you don’t know where to begin, that’s where it’s such a team effort, and you look for a few colleagues or community organizations to partner with in taking it to the next level. And then you find out what your learners are already doing because a lot of them are already doing this work in small ways, and we just need to collate and align mission, not only in our individual institutions, but across the country. We need to come together and say, “Hey, we have a really amazing thing here that brings joy back to practice for those of us who are tired or feeling like we’re not helping our patients as much as we want.” And it also is something that brings great joy to our communities and connection.
Jaclyn Albin:
So how can we all come together and define the best way forward for training the next generation to be equipped to have those hard conversations and to meet people where they are, where they eat, and hopefully see the results with thriving communities that have less disease risk and are able to do the things that they care about? Because that’s really what the work that we do is all about.
Toni Gallo:
I want to thank you both for spending some time with us today. I appreciate you being here. And I want to encourage listeners to look for Jaclyn and Courtney’s scoping review, which is out now in Academic Medicine. Thanks, everyone.
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