871922

research-article2019
AJLXXX10.1177/1559827619871922American Journal of Lifestyle MedicineAmerican Journal of Lifestyle Medicine

vol. 14 • no. 1 American Journal of Lifestyle Medicine

Kimberly Parks, DO, FACC , and Rani Polak, MD, MBA

Culinary Medicine: Paving the

Way to Health Through Our Forks
Abstract: Recent findings reveal ingredients as a panacea to disease; habits is through instruction on home
that suboptimal diet is responsible for rather, it is an evidence-based cooking. Data have shown that home
more deaths than any other risk factor approach that includes simple nutrition cooking is associated with higher-quality
nationally and globally. It is estimated education and instruction in nutritious nutrient intake and reduced calorie
that with improving eating behaviors, cooking skills, including shopping, intake overall.8 An analysis of the
1 in 5 deaths can be prevented, meal planning and preparation, and National Health and Nutrition
underscoring the urgent need for food storage. Examination Survey data showed that
effective dietary interventions. In the past decade, there have been a individuals who cook 6 to 7 dinners at
growing number of educational home per week consumed an average of
Keywords: cooking; nutrition; initiatives that focus on culinary medicine 137 calories less per day than those who
culinary medicine; lifestyle medicine; and are designed for clinicians or directly ate 0 to 1 home-cooked dinners/wk
diet for patients and communities.3 These (P < .05).11 Interestingly, this difference
range from Continuing Medical was kept even among a subgroup of
Overview
Culinary medicine is an emerging, . . . one way to help implement
evidence-based discipline, which aims
to positively affect public health by
change in dietary habits is through
improving eating behaviors through instruction on home cooking.
integrating nutritional science with
food preparation. Although a
consensus definition of culinary Education trainings4,5 and formal medical individuals who did not try to lose
medicine is yet to come, the definitions school curricula6 to outpatient shared weight.6,12 Furthermore, a recent
proposed by existing programs include visits,7 live online courses, and remote publication looked at the differences
reducing the global burden of video coaching.8 between adults who ate 3 meals a day of
nutrition-related disease1,2 and health ultraprocessed food and those who eat
care costs through delivery of basic minimally processed food. It showed that
The Nutritional Benefits
nutrition information combined with eating ultraprocessed food until libitum,
of Home Cooking
instruction in practical food related results in consuming 500 calories/d
skills. The intention is to help create According to the Centers for Disease more, compared to eating unprocessed
positive behavior change by not just Control and Prevention, 36.6% of adult diet, which was matched for presented
providing knowledge, but by teaching Americans dine at fast food restaurants calories, sugar, fat, fiber, and
specific skills that may aid in creating on a daily basis.9 Given that fast food macronutrients.13
lasting change. Culinary medicine is dining is associated with poor dietary In addition to improved nutrition,
not a practice that uses alternative quality and high intake of calories,10 one home cooking is also linked to health
approaches, such as specific foods or way to help implement change in dietary benefits.14 For example, analysis of the

DOI: 10.1177/1559827619871922. Manuscript received August 1, 2019; accepted August 5, 2019. From the Division of Cardiology, Massachusetts General Hospital,
https://doi.org/

Newton Wellesley Hospital, Harvard Medical School, Boston, Massachusetts (KP), and CHEF Coaching Program, Institute of Lifestyle Medicine, Spaulding Rehabilitation
Hospital, Harvard Medical School, Boston, Massachusetts, and Lifestyle Medicine Center, Sheba Medical Center, Tel Hashomer, Israel (RP). Address correspondence to:
Kimberly Parks, DO, FACC, Synergy Private Health, 300 Boylston Street Suite 201, Chestnut Hill, MA 02467; e-mail: [email protected].
For reprints and permissions queries, please visit SAGE’s Web site at https://us.sagepub.com/en-us/nam/journals-permissions.
Copyright © 2019 The Author(s)

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 American Journal of Lifestyle Medicine Jan • Feb 2020

Nurses’ Health Study (121 700 female the conversation about diet and risk: (1) about the legume salads in Central
registered nurses aged 30-55 years)15 and “There is some new information about America, the whole-grain salads of the
the Health Professionals Follow-up Study the impact of food on our health, is it ok Mediterranean (like the salads below),
(51 529 male health professionals aged if I share some of this?” and (2) and the rice and soba noodle salads from
40-75 years)16 data found that people “According to recent studies, dietary Asia.
who ate 11 to 14 home-cooked lunches habits are responsible for more deaths
and dinners per week had a 14% lower than any other modifiable risk factor, Ingredients
risk of developing type 2 diabetes than including smoking and obesity. If you Serves 8/Serving size: 3/4 cup
those who ate only 6 or fewer home- would like, we can review your dietary 1 cup pearl barley, rinsed and drained
cooked lunches and dinners per week17 habits and determine if there are things 2 cups water
and that this association was partly you can do to help improve your risk.” Pinch Atlantic sea salt, or to taste
attributed to less weight gain linked with The patient then has an objective 2 medium Persian style or English style
this dining behavior. Furthermore, recent measure of their risk from which to build cucumbers cut into cubes
articles showed that the opposite dietary goals. Next, an action plan can 1 cup diced button mushrooms
behavior, consuming ultraprocessed be developed, and recipes that support 1 medium avocado, ripe but firm,
food, was attributable to cardiometabolic the plan can be shared. peeled, pitted, and cut into 1/2-inch
diseases,18 overall cancer risk, and breast Below is a featured recipe that can cubes
cancer risk.19 help improve whole grain consumption. 3 tablespoons chopped fresh thyme
Please feel free to try it also yourself 1/2 cup chopped fresh parsley
because providers who adhere to best 4 tablespoons extra-virgin olive oil
Starting a Nutrition
practices themselves are most likely to 4 tablespoons fresh lemon juice
Conversation
impart knowledge to their patients. 1 clove garlic, chopped
Only 38% of physicians discuss diet 1 teaspoon honey
during routine office visits,20 which is Pinch ground black pepper
Featured Recipe
perhaps a reflection of the lack of
nutrition medical education21 or the lack Avocado and Pearl Directions
of self-adherence to healthy practices. Barley Salad In a small pot over high heat, bring
Even when patients are counseled about Many of our patients are interested to pearl barley, water, and salt to a boil.
diet, compliance remains a challenge, learn more about whole grains. It is Reduce heat to low and cook for 20
and sustainable change can be difficult important to note that whole grains have minutes or until liquid is absorbed. Rinse
to achieve22 because change in dietary significant benefits over refined grains. with cold water, drain, and transfer to a
intake requires a change both in attitudes Once a grain is refined (processed), it medium bowl.
regarding food and personal habits. can lose more than half of its nutrients, Add cucumbers, mushrooms, avocado,
There are a number of options to start including fiber. thyme, and parsley, and toss together
incorporating culinary medicine into Of the many available whole grains, until combined. Add oil, lemon juice,
your practice. The conversation about barley is the highest in fiber. It contains garlic, and honey, and mix until
food and health can be integrated into a important phytonutrients and is an combined. Let sit for 30 minutes for
patient’s annual health maintenance visit excellent source of B vitamins and other flavors to blend. Season with salt and
or as a separate visit. In our practice, the nutrients. In addition to their health pepper before serving.
patient is given a Food Frequency benefits, these whole grains are To make vegan, substitute maple syrup
Questionnaire (FFQ), which assesses excellent in cold salads, thanks to their for honey. To make gluten free,
their Mediterranean Diet Score. FFQs can naturally crunchy texture.26 For substitute wild rice or quinoa. Olive oil
assess long-term dietary habits and have example, the next time you prepare a can be eliminated if desired.
been shown to predict long-term health pasta salad, try making it with whole-
risk.23 The Mediterranean diet score has wheat pasta. The result will be of a
Authors’ Note
been validated24,25 and can assess the much higher nutritional and culinary
dietary risk factors that have been quality. Let the salad sit for a few Dr Parks is the owner of a culinary medicine practice. Dr Polak
receives author royalties from Penn Publication (self) and
associated with high mortality, which minutes after all the ingredients have
provides professional training in culinary medicine.
include diets high in sodium, low in been mixed, so that the grain has a
whole grains, low in fruit, low in nuts chance to absorb all the flavors.
and seeds, low in vegetables, and low in Borrow ideas for interesting salads with Declaration of
omega-3 fatty acids.2 grains and legumes from the ACLM/ Conflicting Interests
Once the assessment has been ACPM culinary medicine resource The author(s) declared no potential conflicts of interest with
completed, here are a couple of section,27 peer-reviewed publications,26 respect to the research, authorship, and/or publication of this
examples of how a provider might begin and from international cuisines. Think article.

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 vol. 14 • no. 1 American Journal of Lifestyle Medicine

6. Birkhead AG, Foote S, Monlezun DJ, et al. two prospective cohort studies. PLoS Med.
Funding Medical student-led community cooking 2016;13:e1002052.
The author(s) received no financial support for the research, classes: a novel preventive medicine 18. Mendona RD, Pimenta AM, Gea A,
authorship, and/or publication of this article. model that’s easy to swallow. Am J Prev et al. Ultraprocessed food consumption
Med. 2014;46:e41-e42. doi:10.1016/j. and risk of overweight and obesity:
amepre.2013.11.006 the University of Navarra Follow-Up
Ethical Approval 7. Kakareka R, Stone TA, Plsek P, Imamura (SUN) cohort study. Am J Clin Nutr.
Not applicable, because this article does not contain any
A, Hwang E. Fresh and savory: integrating 2016;104:1433-1440.
studies with human or animal subjects.
teaching kitchens with shared medical 19. Fiolet T, Srour B, Sellem L, et al.
appointments. J Altern Complement Med. Consumption of ultra-processed foods and
2019;25:709-718. cancer risk: results from NutriNet-Santé
Informed Consent 8. Polak R, Pober DM, Budd MA, Silver JK, prospective cohort. BMJ. 2018;360:k322.
Phillips EM, Abrahamson MJ. Improving
Not applicable, because this article does not contain any 20. Sinclair J, Lawson B, Burge F. Which
patients’ home cooking—a case series of
studies with human or animal subjects. patients receive advice on diet and
participation in a remote culinary coaching
exercise? Do certain characteristics affect
program. Appl Physiol Nutr Metab.
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2017;42:893-896. doi:10.1139/apnm-2017-
Trial Registration Fam Physician. 2008;54:404-412.
0053
Not applicable, because this article does not contain any 21. Devries S, Agatson A, Aggarwal M, et al.
9. Fryar CD, Hughes JP, Herrick KA,
clinical trials. A deficiency of nutrition education
Ahluwalia N. Fast food consumption
and practice in cardiology. Am J Med.
among adults in the United States, 2013-
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2016. NCHS Data Brief. 2018;(322):1-8.
ORCID iD 22. Weber B, Bersch-Ferreira ÂC, Torreglosa
10. Todd JE. Changes in consumption of food
Kimberly Parks https://orcid. CR, et al. Implementation of a Brazilian
away from home and intakes of energy
org/0000-0003-1907-2576 AJLM Cardioprotective Nutritional (BALANCE)
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