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Landry MJ, Ward CP, Koh LM, Gardner CD. The knowledge, attitudes, and perceptions towards a plant-based dietary pattern: a survey of obstetrician-gynecologists. Front Nutr 2024; 11:1381132. [PMID: 38895659 PMCID: PMC11183291 DOI: 10.3389/fnut.2024.1381132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
Background Obstetricians-gynecologists (OB/GYNs) play a critical role for their pregnant patients during their perinatal period, but research on OB/GYNs knowledge, attitudes, and perceptions regarding plant-based dietary patterns (PBDP) and how this may influence recommendations to patients is lacking. An online cross-sectional survey was conducted to examine OB/GYN's knowledge, attitudes, and perceptions towards a PBDP. Methods Postcards were mailed in June 2023 to a convenience sample of 5,000 OB/GYNs across the US using a mailing list provided by the American College of Obstetricians and Gynecologists. Postcards had a brief study description and a QR code that linked to an online survey asking questions about demographics, behavior (e.g., nutritional habits), and other factors that may influence knowledge, attitudes, and perceptions towards a PBDP for their patients. Results Ninety-six OB/GYNs completed the full questionnaire (~2% response rate). Most (92%) felt that it is within an OB/GYN's role to incorporate nutrition education and counseling within practice. However, 72% felt inadequately trained to discuss nutrition and diet-related issues with patients. Despite a perceived lack of nutrition training, 86% reported that a PBDP was safe and health-promoting, and 81% reported that a well-planned PBDP could adequately meet all nutritional needs of pregnant and lactating patients. Conclusion Findings suggest that OB/GYNs are generally knowledgeable about the components and health benefits of a plant-based diets. However, nutrient adequacy misconceptions and lack of sufficient training to discuss nutrition with patients may result in OB/GYNs not recommending PBDPs to patients. These findings underscore the need to enhance OB/GYN graduate medical education and training by integrating education on PBDPs, therefore improving a clinician's ability to confidently and effectively counsel pregnant persons on this aspect of perinatal care.
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Affiliation(s)
- Matthew J. Landry
- Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, CA, United States
| | - Catherine P. Ward
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Linda M. Koh
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Christopher D. Gardner
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
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Gunsalus KTW, Mixon JK, House EM. Medical Nutrition Education for Health, Not Harm: BMI, Weight Stigma, Eating Disorders, and Social Determinants of Health. MEDICAL SCIENCE EDUCATOR 2024; 34:679-690. [PMID: 38887425 PMCID: PMC11180054 DOI: 10.1007/s40670-024-02025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 06/20/2024]
Abstract
Effective nutrition training is fundamental to medical education. Current training is inadequate and can cause harm to students and patients alike; it leaves physicians unprepared to counsel on nutrition, places undue focus on weight and body mass index (BMI), can exacerbate anti-obesity bias, and increase risk for development of eating disorders, while neglecting social determinants of health and communication skills. Physicians and educators hold positions of influence in society; what we say and how we say it matters. We propose actionable approaches to improve nutrition education to minimize harm and pursue evidence-based, effective, and equitable healthcare.
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Affiliation(s)
- Kearney T. W. Gunsalus
- Department of Biochemistry and Molecular Biology, Augusta University/University of Georgia Medical Partnership, Athens, GA USA
| | - Jordan K. Mixon
- Augusta University/University of Georgia Medical Partnership, Athens, GA USA
| | - Ellen M. House
- Department of Psychiatry and Health Behavior, Augusta University/University of Georgia Medical Partnership, Athens, GA USA
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Domper J, Gayoso L, Goni L, de la O V, Etxeberria U, Ruiz-Canela M. Culinary medicine and healthy ageing: a comprehensive review. Nutr Res Rev 2024; 37:179-193. [PMID: 37605999 DOI: 10.1017/s0954422423000148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Culinary medicine (CM) represents a novel strategy to promote healthy ageing, as it improves adherence to healthy dietary patterns by providing nutritional education and training in cooking skills. We conducted a comprehensive review of the current scientific literature (2011-2022) concerning CM programmes implemented among participants over the age of 40. This review includes fourteen culinary-nutritional interventions. Each CM programme was analysed according to seven variables: health goal, study design, theoretical basis of the intervention, intervention duration, main outcomes, culinary intervention and the effectiveness of intervention. Although CM programmes showed low effectiveness in achieving positive results on psychosocial outcomes, they were successful in improving dietary intake and health-related outcomes. The interventions lasting for at least 5 months and employing study designs with two or more groups seemed to be important factors associated with achieving significant results. Significant results were observed regardless of the prevention phase defined as the health objective of the CM programme. The use of theoretical frameworks as an educational resource did not influence the effectiveness of the interventions. Other variables such as the inclusion of culinary outcomes, the optimisation of the culinary curriculum taught to the participants and the participation of a chef in the intervention are factors that should be taken into account. In addition, several educational components (cooking classes, hands-on cooking, free food delivery, individualized counselling) were promising for achieving health outcomes in ageing people. Our review has shown that CM programmes can be a powerful tool to improve the health status of ageing people.
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Affiliation(s)
- Jara Domper
- Basque Culinary Center, Faculty of Gastronomic Sciences, Mondragon UnibertsitateaDonostia-San Sebastián, Spain
- BCC Innovation, Technology Center in Gastronomy, Basque Culinary Center, Donostia-San Sebastián, Spain
| | - Lucía Gayoso
- Basque Culinary Center, Faculty of Gastronomic Sciences, Mondragon UnibertsitateaDonostia-San Sebastián, Spain
- BCC Innovation, Technology Center in Gastronomy, Basque Culinary Center, Donostia-San Sebastián, Spain
| | - Leticia Goni
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
- Consorcio Centro de Investigaciones Biomédicas en Red (CIBERObn), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Victor de la O
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Usune Etxeberria
- Basque Culinary Center, Faculty of Gastronomic Sciences, Mondragon UnibertsitateaDonostia-San Sebastián, Spain
- BCC Innovation, Technology Center in Gastronomy, Basque Culinary Center, Donostia-San Sebastián, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain
- Consorcio Centro de Investigaciones Biomédicas en Red (CIBERObn), Institute of Health Carlos III (ISCIII), Madrid, Spain
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Albin JL, Thomas OW, Marvasti FF, Reilly JM. There and Back Again: A Forty-Year Perspective on Physician Nutrition Education. Adv Nutr 2024; 15:100230. [PMID: 38705195 DOI: 10.1016/j.advnut.2024.100230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/12/2024] [Accepted: 04/02/2024] [Indexed: 05/07/2024] Open
Abstract
Medical education faces an urgent need for evidence-based physician nutrition education. Since the publication of the 1985 National Academies report "Nutrition Education in the United States Medical Schools," little has changed. Although several key efforts sought to increase nutrition content in undergraduate medical education over the past 40 y, most medical schools still fail to include the recommended minimum of 25 h of nutrition training. Without foundational concepts of nutrition in undergraduate medical education, graduate medical education unsurprisingly falls short of meeting patient needs for nutritional guidance in clinical practice. Meanwhile, diet-sensitive chronic diseases continue to escalate, although largely preventable and treatable by nutritional therapies and dietary lifestyle changes. Fortunately, recent recognition and adoption of Food is Medicine programs across the country increasingly connect patients with healthy food resources and nutrition education as core to their medical care, and physicians must be equipped to lead these efforts alongside their dietitian colleagues. Filling the gap in nutrition training will require an innovative and interprofessional approach that pairs nutrition with personal wellness, interprofessional practice, and community service learning. The intersectional benefits of connecting these domains will help prepare future physicians to address the social, behavioral, and lifestyle determinants of health in a way that recognizes nourishing food access as a core part of clinical practice. There are numerous strategies to integrate nutrition into education pathways, including didactic and experiential learning. Culinary medicine, an evidence-based field combining the culinary arts with nutritional science and medicine, is 1 promising educational framework with a hands-on, interprofessional approach that emphasizes community engagement. Advancing the critical need for widespread adoption of nutrition education for physicians will require support and engagement across societal stakeholders, including co-leadership from registered dietitian nutritionists, health system and payor reform, and opportunities for clinical innovation that bring this essential field to frontline patient care.
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Affiliation(s)
- Jaclyn Lewis Albin
- Departments of Internal Medicine and Pediatrics, the University of Texas Southwestern Medical Center, Dallas, TX, United States.
| | | | - Farshad Fani Marvasti
- Department of Family, Community, and Preventive Medicine, University of Arizona College of Medicine-Phoenix and School of Nutritional Sciences and Wellness, College of Agricultural, Life and Environmental Sciences, University of Arizona, Tucson, AZ, United States
| | - Jo Marie Reilly
- Clinical Family Medicine and Population and Public Health, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
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Hildebrand CA, Patel MB, Tenney AB, Logan JA, Luong KH, Crouch MJ, Osta AE, DeRoo C, Gilliland KO, Harlan TS, Ammerman AS. Culinary Medicine Experiences for Medical Students and Residents in the U.S. and Canada: A Scoping Review. TEACHING AND LEARNING IN MEDICINE 2024:1-27. [PMID: 38686837 DOI: 10.1080/10401334.2024.2340977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024]
Abstract
PHENOMENON Despite the importance of diet in the prevention and management of many common chronic diseases, nutrition training in medicine is largely inadequate in medical school and residency. The emerging field of culinary medicine offers an experiential nutrition learning approach with the potential to address the need for improved nutrition training of physicians. Exploring this innovative nutrition training strategy, this scoping review describes the nature of culinary medicine experiences for medical students and resident physicians, their impact on the medical trainees, and barriers and facilitators to their implementation. APPROACH This scoping review used the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist as guides. Eligible publications described the nature, impact, facilitators, and/or barriers of nutrition and food preparation learning experiences for medical students and/or residents. Additional inclusion criteria were location (U.S. or Canada), allopathic or osteopathic, English, human subjects, and publication year (2002 or later). The search strategy included 4 electronic databases. Two reviewers independently screened titles/abstracts and a third reviewer resolved discrepancies. The full-text review consisted of 2 independent reviews with discrepancies resolved by a third reviewer or by consensus if needed, and the research team extracted data from the included articles based on the nature, impact, barriers, and facilitators of culinary medicine experiences for medical trainees. FINDINGS The publication search resulted in 100 publications describing 116 experiences from 70 institutions. Thirty-seven publications described pilot experiences. Elective/extracurricular and medical student experiences were more common than required and resident experiences, respectively. Experiences varied in logistics, instruction, and curricula. Common themes of tailored culinary medicine experiences included community engagement/service-based learning, interprofessional education, attention to social determinants of health, trainee well-being, and cultural considerations. Program evaluations commonly reported the outcome of experiences on participant attitudes, knowledge, skills, confidence, and behaviors. Frequent barriers to implementation included time, faculty, cost/funding, kitchen space, and institutional support while common facilitators of experiences included funding/donations, collaboratives and partnerships, teaching kitchen access, faculty and institutional support, and trainee advocacy. INSIGHTS Culinary medicine is an innovative approach to address the need and increased demand for improved nutrition training in medicine. The findings from this review can guide medical education stakeholders interested in developing or modifying culinary medicine experiences. Despite barriers to implementation, culinary medicine experiences can be offered in a variety of ways during undergraduate and graduate medical education and can be creatively designed to fulfill some accreditation standards.
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Affiliation(s)
- Caitlin A Hildebrand
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition at Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- University of North Carolina Center for Health Promotion and Disease Prevention, Chapel Hill, North Carolina, USA
| | - Meghana B Patel
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alyssa B Tenney
- Larner College of Medicine at The University of Vermont, Burlington, Vermont, USA
| | - Julia A Logan
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Khanh H Luong
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Miranda J Crouch
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Amanda E Osta
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Courtney DeRoo
- Department of Health Policy and Management at the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kurt O Gilliland
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Timothy S Harlan
- George Washington University School of Medicine, Washington, D.C., USA
| | - Alice S Ammerman
- Department of Nutrition at Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- University of North Carolina Center for Health Promotion and Disease Prevention, Chapel Hill, North Carolina, USA
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6
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Staffier KL, Holmes S, Karlsen MC, Kees A, Shetty P, Hauser ME. Evaluation of the reach and utilization of the American College of Lifestyle Medicine's Culinary Medicine Curriculum. Front Nutr 2024; 11:1338620. [PMID: 38567252 PMCID: PMC10985187 DOI: 10.3389/fnut.2024.1338620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Despite the growing interest in "food as medicine," healthcare professionals have very limited exposure to nutrition as part of their training. Culinary medicine (CM), an evidence-based field integrating nutrition education with culinary knowledge and skills, offers one approach to fill this training gap. The American College of Lifestyle Medicine published a complimentary Culinary Medicine Curriculum (CMC) in 2019, and the objective of this study is to evaluate its reach and utilization, as well as to collect feedback from users. Methods Individuals who downloaded the CMC prior to March 1, 2022 (N = 6,162) were emailed an invitation to participate in an online, cross-sectional survey. The survey included both multiple choice and free-text questions about whether CM sessions were conducted, if and how the CMC was used, if and how it was modified for use, and additional requested resources. Free-text responses were inductively coded, and quantitative data was summarized using descriptive statistics. Results A total of 522 respondents provided consent, indicated that they had downloaded the curriculum, and completed the survey. Of the 522, 366 (70%) reported that they had not led or created any CM sessions. The top-reported reason for not leading a session was lack of time (29%). The remaining respondents who did create a CM session did so across various settings, including academic, clinical, coaching, and other settings, and a variety of professionals delivered the CMC sessions, including physicians (50%), registered dietitian nutritionists (30%), and chefs (25%). The majority of respondents (81%) modified the CMC in some way, with many using the curriculum for guidance or ideas only. Patient education materials (66%) and cooking technique instruction videos (59%) were among top requested resources. Discussion The CMC is a versatile resource that can be successfully adapted for use across various settings and by various types of health professionals and practitioners. Future research should investigate whether training in CM results in improved health outcomes for patients/clients. The curriculum will continue to grow to address the needs of users by expanding to include more digital content such as curriculum videos and cooking technique videos.
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Affiliation(s)
| | - Shannon Holmes
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | | | - Alexandra Kees
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | - Paulina Shetty
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | - Michelle E. Hauser
- Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, United States
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, CA, United States
- Internal Medicine-Obesity Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
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Sharma V, Sharma R. Food is Medicine Initiative for Mitigating Food Insecurity in the United States. J Prev Med Public Health 2024; 57:96-107. [PMID: 38487843 PMCID: PMC10999299 DOI: 10.3961/jpmph.23.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/03/2024] [Accepted: 01/14/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVES While several food assistance programs in the United States tackle food insecurity, a relatively new program, "Food is Medicine," (FIM) initiated in some cities not only addresses food insecurity but also targets chronic diseases by customizing the food delivered to its recipients. This review describes federal programs providing food assistance and evaluates the various sub-programs categorized under the FIM initiative. METHODS A literature search was conducted from July 7, 2023 to November 9, 2023 using the search term, "Food is Medicine", to identify articles indexed within three major electronic databases, PubMed, Medline, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Eligibility criteria for inclusion were: focus on any aspect of the FIM initiative within the United States, and publication as a peer-reviewed journal article in the English language. A total of 180 articles were retrieved; publications outside the eligibility criteria and duplicates were excluded for a final list of 72 publications. Supporting publications related to food insecurity, governmental and organizational websites related to FIM and other programs discussed in this review were also included. RESULTS The FIM program includes medically tailored meals, medically tailored groceries, and produce prescriptions. Data suggest that it has lowered food insecurity, promoted better management of health, improved health outcomes, and has, therefore, lowered healthcare costs. CONCLUSIONS Overall, this umbrella program is having a positive impact on communities that have been offered and participate in this program. Limitations and challenges that need to be overcome to ensure its success are discussed.
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Affiliation(s)
- Vidya Sharma
- Department of Nutrition & Dietetics, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Ramaswamy Sharma
- Applied Biomedical Sciences, University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, USA
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Croxford S, Stirling E, MacLaren J, McWhorter JW, Frederick L, Thomas OW. Culinary Medicine or Culinary Nutrition? Defining Terms for Use in Education and Practice. Nutrients 2024; 16:603. [PMID: 38474731 DOI: 10.3390/nu16050603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
Examination of how terms such as culinary nutrition, culinary nutrition science, culinary medicine, culinary nutrition professional, culinary nutrition intervention, culinary nutrition activity, and culinary nutrition competency are used in practice, and the creation of consensus definitions will promote the consistent use of these terms across work areas and disciplines. Thirty leading practitioners, academics, and researchers in the fields of food and nutrition across Australia, the United States, Canada, United Kingdom, Europe, and Asia were approached by investigators via email to submit definitions of key terms using a Qualtrics survey link. Further participants were reached through snowball recruitment. Initial emails were sent in October and November 2021 with subsequent reminders between November 2021 and March 2022. Two researchers undertook content analysis of the text answers for each of the terms and generated definitions for discussion and consensus. Thirty-seven participants commenced the survey and twenty-three submitted one or more definitions. Agreed definitions fell into two categories: practice concepts and practitioners. Further discussion amongst investigators led to the creation of a visual map to demonstrate the interrelationship of terms. Culinary nutrition science underpins, and interprofessional collaboration characterizes practice in this area, however, further work is needed to define competencies and model best practice.
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Affiliation(s)
- Sharon Croxford
- Melbourne Campus, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia
| | - Emma Stirling
- Melbourne Campus, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia
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Ring M, Mehta DH, Majd I, Balabanova Shannahan A. FOODWISE (Fostering Optimal Outcomes through Dietary Wisdom, Integration, Spirituality, and Emotionality): A New Model of Integrative Culinary Medicine. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:95-98. [PMID: 38265807 PMCID: PMC10886423 DOI: 10.1089/jicm.2023.0751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Affiliation(s)
- Melinda Ring
- Osher Center for Integrative Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Darshan H Mehta
- Harvard Medical School, Boston, MA, USA
- Department of Medicine, Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, USA
- Osher Center for Integrative Health, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Iman Majd
- Osher Center for Integrative Health, University of Washington, Seattle, WA, USA
| | - Anna Balabanova Shannahan
- Osher Center for Integrative Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Thomas OW, Reilly JM, Wood NI, Albin J. Culinary Medicine: Needs and Strategies for Incorporating Nutrition into Medical Education in the United States. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241249379. [PMID: 38711830 PMCID: PMC11072074 DOI: 10.1177/23821205241249379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/08/2024] [Indexed: 05/08/2024]
Abstract
In the past decade, medical education has increasingly incorporated evidence-based lifestyle interventions as primary strategies for preventing and managing noncommunicable diseases. This shift embraces the growing recognition of the significant impact of lifestyle on health outcomes, driving diseases including obesity, diabetes, heart disease, and cancer. Now deemed "food is medicine" (FIM), diet-related interventions witnessed integration into healthcare systems and recognition in the United States' White House Conference on Hunger, Nutrition, and Health in 2023. As FIM gains traction, investigating optimal strategies for team-based education becomes essential. Healthcare teams need the necessary knowledge and tools to effectively administer FIM services and collaborate across disciplines, ultimately enhancing disease prevention, chronic disease management, health quality, value, and overall wellness. Culinary medicine (CM), a vital component of FIM, bridges nutrition education, pragmatic culinary skills, and conventional strategies to improve chronic disease management. CM involves experiential learning, imparts practical skills, and encourages behavior change by addressing food-related determinants of health and promoting equitable access. Teaching kitchens serve as physical or virtual learning spaces and as a didactic and experiential method (skills lab), playing a crucial role by integrating culinary, lifestyle, integrative, and conventional medicine. A growing number of medical schools in the United States and globally offer CM education via diverse methods including interest groups, electives, and specialty tracks, encompassing didactic sessions, hands-on kitchen education, and virtual teaching methods. Given the rising demand for CM programs, this article aims to describe, map, and compare existing CM education types in medical education. It provides actionable recommendations for medical schools to establish and expand CM programs by fostering service-learning partnerships, clinical innovation, and interdisciplinary research. As FIM gains prominence, cultivating a robust foundation of educational strategies is vital to ensure seamless integration into both medical education and collaborative medical practice.
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Affiliation(s)
- Olivia W. Thomas
- Director of Nutrition Innovation and Implementation, Boston Medical Center, Boston, MA, USA
| | - Jo Marie Reilly
- Professor of Clinical Family Medicine and Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Nathan I. Wood
- Instructor of Medicine and Medical Education Fellow, Yale School of Medicine, New Haven, CT, USA
| | - Jaclyn Albin
- Combined Internal Medicine and Pediatrics Residency; Culinary Medicine Program, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Donovan K, Thomas OW, Sweeney T, Ryan TJ, Kytomaa S, Zhao M, Zhong W, Long M, Rajendran I, Sarfaty S, Lenders C. Eat to Treat: The Methods and Assessments of a Culinary Medicine Seminar for Future Physicians and Practicing Clinicians. Nutrients 2023; 15:4819. [PMID: 38004212 PMCID: PMC10674360 DOI: 10.3390/nu15224819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/25/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
Nutrition-associated chronic disease is an epidemic in the United States (US), yet most medical schools lack adequate nutrition education. We developed a six-session culinary medicine (CM) seminar entitled "Eat to Treat: A Nutrition Course for Future Clinicians" that teaches culinary skills, nutrition science, and counseling techniques to improve clinical nutrition management. The seminar was offered in-person to first-year medical students in a medical school-based teaching kitchen from 2017 to 2019. A virtual three-session course was also offered to practicing clinicians in 2020. Voluntary self-efficacy questionnaires were collected at the beginning of the first and last sessions of the student seminar, and paired t-tests determined the course's effect on survey items. A total of 53 first-year medical students attended the program over five semesters, and 39 students (73.6%) completed both surveys. All except one measure of self-efficacy were significantly higher at session 6 than session 1 (p < 0.05). A post-course survey was utilized for the clinician seminar and of the 31 participants, 14 completed the surveys; 93% and 86% of respondents agreed the course was clinically relevant and improved their confidence, respectively. We developed a CM curriculum that improved nutrition knowledge and confidence among a professionally diverse cohort and may represent a scalable education model to improve nutrition education in US medical schools.
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Affiliation(s)
- Kate Donovan
- Department of Pediatrics, Boston Medical Center, Boston, MA 02218, USA
- Department of Food and Nutrition, Boston Medical Center, Boston, MA 02218, USA
| | - Olivia W. Thomas
- Department of Food and Nutrition, Boston Medical Center, Boston, MA 02218, USA
| | - Ty Sweeney
- Department of Medicine, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02218, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Tyler J. Ryan
- Department of Medicine, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02218, USA
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA
| | - Sonja Kytomaa
- Department of Medicine, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02218, USA
| | - Molly Zhao
- Department of Medicine, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02218, USA
| | - Wayne Zhong
- Department of Medicine, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02218, USA
| | - Michelle Long
- Section of Gastroenterology, Boston Medical Center, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02118, USA
| | - Iniya Rajendran
- Department of General Internal Medicine, Boston Medical Center, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02118, USA
| | - Suzanne Sarfaty
- Department of General Internal Medicine, Boston Medical Center, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02118, USA
| | - Carine Lenders
- Department of Food and Nutrition, Boston Medical Center, Boston, MA 02218, USA
- Department of Pediatrics, Pediatric Nutrition and Fitness for Life, Boston Medical Center, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA 02118, USA
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Dahl WJ, Nagao-Sato S, Riccardo C. Culinary Medicine and the Promotion of Plant-Based Diets: Is Caution Needed for Older Adults? JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:771-772. [PMID: 37949522 DOI: 10.1016/j.jneb.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
- Wendy J Dahl
- Professor and Extension Specialist, Food Science & Human Nutrition Department, University of Florida, Institute of Food & Agricultural Sciences, Gainesville, FL
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13
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Böttcher S, Schonebeck LJ, Drösch L, Plogmann AM, Leineweber CG, Puderbach S, Buhre C, Schmöcker C, Neumann U, Ellrott T. Comparison of Effectiveness regarding a Culinary Medicine Elective for Medical Students in Germany Delivered Virtually versus In-Person. Nutrients 2023; 15:4281. [PMID: 37836565 PMCID: PMC10574049 DOI: 10.3390/nu15194281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/30/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: The Culinary Medicine elective at the German medical schools of the universities of Göttingen, Giessen, and Brandenburg is a teaching kitchen-based elective aimed at training medical students on how to improve patient counselling on nutrition and lifestyle medicine topics. This curriculum was either delivered virtually (2021) or in-person (2022/2023). Changes in teaching effectiveness were evaluated. (2) Methods: The elective included seven modules in the teaching kitchen for 3 h each. It consisted of a short introduction and a hands-on interactive cooking part illustrating important dietary principles in different disease groups. The elective was conducted virtually in 2021 in a fully interactive setup using videoconference tools. Students in this cohort attended from their private kitchens whereas students in the in-person cohort (2022/2023) attended the same classes in the teaching kitchen. Standardized comparative self-assessment questionnaires on counselling competencies, nutrition knowledge, eating habits, and mental well-being (WHO-5) before and after the elective were used to determine teaching effectiveness. Paired and unpaired t-tests were performed to evaluate results. (3) Results: A total of 70 students (mean semester 6.3) were included in the virtual cohort, and 80 students (mean semester 6.3) were in the in-person cohort. In both, counselling competencies on 25 nutrition and lifestyle medicine topics increased significantly. Significant changes also occurred in most nutrition knowledge categories. Subjective well-being as well as personal attitudes towards nutrition counselling in medical practice improved significantly during the elective. Healthy eating habits improved in both groups as students ate significantly less unfavourable foods. There were no significant differences between the two groups apart from minor differences in nutrition knowledge. (4) Conclusions: The elective in Culinary Medicine improved students counselling competencies, nutrition knowledge, attitudes, well-being, and eating habits with no relevant difference between virtual and in-person teaching.
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Affiliation(s)
- Selina Böttcher
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
| | - Louisa Josefa Schonebeck
- Institute for Nutrition and Psychology, Georg-August-University Göttingen Medical Centre, Humboldtallee 32, 37073 Göttingen, Germany;
| | - Laura Drösch
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, 93053 Regensburg, Germany;
| | | | - Can Gero Leineweber
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
| | - Seraphina Puderbach
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
| | - Charlotte Buhre
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
| | - Christoph Schmöcker
- Medical Department, Division of Gastroenterology, Oncology, Hematology, Rheumatology and Diabetes, ukrb, Brandenburg Medical School, Theodor Fontane, 16816 Neuruppin, Germany; (C.G.L.); (S.P.); (C.B.); (C.S.)
- Faculty of Health Sciences, Joint Faculty of the Brandenburg, University of Technology, Brandenburg Medical School and University of Potsdam, 14469 Potsdam, Germany
| | - Uwe Neumann
- Culinary Medicine Germany e.V., 48341 Altenberge, Germany;
| | - Thomas Ellrott
- Institute for Nutrition and Psychology, Georg-August-University Göttingen Medical Centre, Humboldtallee 32, 37073 Göttingen, Germany;
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Ring M, Ai D, Maker-Clark G, Sarazen R. Cooking up Change: DEIB Principles as Key Ingredients in Nutrition and Culinary Medicine Education. Nutrients 2023; 15:4257. [PMID: 37836541 PMCID: PMC10574195 DOI: 10.3390/nu15194257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/24/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
The integration of diversity, equity, inclusion, and belonging (DEIB) principles into healthcare education is essential to ensure culturally sensitive and equitable healthcare delivery. In the domain of nutrition, food, and health, these principles are particularly vital, as diet and food choices are strongly linked to cultural identities and socioeconomic conditions. Despite a growth of DEIB initiatives in undergraduate and graduate medical education, there is a significant gap regarding guidelines for implementing DEIB principles in education around nutrition and food, including that for dietitians, allied health and medical professionals. A literature review was conducted, analyzing peer-reviewed articles and current practices in academic medical education to understand DEIB in nutrition, food, and health. The outcome was the creation of a three-tiered checklist titled "Checklist for Culturally Competent Education in Nutrition". It serves as a roadmap to cultivate culturally competent, equitable, and inclusive healthcare professionals that emphasizes avoiding bias, enhancing awareness, and building practical skills for DEIB implementation around nutrition.
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Affiliation(s)
- Melinda Ring
- Osher Center for Integrative Health, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - David Ai
- Baylor College of Medicine, Houston, TX 77030, USA;
| | - Geeta Maker-Clark
- NorthShore University Health System, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA;
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Maker-Clark G, McHugh A, Shireman H, Hernandez V, Prasad M, Xie T, Parkhideh A, Lockwood C, Oyola S. Empowering Future Physicians and Communities on Chicago's South Side through a 3-Arm Culinary Medicine Program. Nutrients 2023; 15:4212. [PMID: 37836495 PMCID: PMC10574476 DOI: 10.3390/nu15194212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/15/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
The purpose of this pilot evaluation was to assess the impact of a university culinary medicine program on participating medical students and community members, which included individuals managing chronic illness and public middle school students. A total of 59 program participants enrolled in the study. Data were obtained using pre- and post-course surveys and qualitative interviews from September 2021-July 2023. Results show increased confidence in medical students' ability to provide nutrition counseling, with a high significance in their ability to provide counseling regarding chronic conditions. Participants managing chronic conditions demonstrated significant increases in self-reported confidence in their understanding of overall chronic disease management and care and in their kitchen skills, with participants who attended five or more classes having significantly higher means. Qualitative feedback from middle school students highlights their knowledge and willingness to try new foods after engaging with the curriculum. Findings add to the growing literature on culinary medicine and provide insight into the effectiveness of culinary medicine programming to increase knowledge and promote positive changes among future healthcare professionals and community members. However, more extensive research across a longer time span is needed to confirm the potential for sustained change.
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Affiliation(s)
- Geeta Maker-Clark
- Department of Family Medicine, NorthShore University HealthSystem, Evanston, IL 60201, USA
| | - Ashley McHugh
- Department of Family Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Hannah Shireman
- Department of Family Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Valeria Hernandez
- Department of Family Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Megha Prasad
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Tiffany Xie
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Arianna Parkhideh
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Carlin Lockwood
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Sonia Oyola
- Department of Family Medicine, University of Chicago, Chicago, IL 60637, USA
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16
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Charles JA, Wood NI, Neary S, Moreno JO, Scierka L, Brink B, Zhao X, Gielissen KA. "Zoom"ing to the Kitchen: A Novel Approach to Virtual Nutrition Education for Medical Trainees. Nutrients 2023; 15:4166. [PMID: 37836450 PMCID: PMC10574391 DOI: 10.3390/nu15194166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/06/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
While nutritional interventions are first-line therapy for many chronic diseases, most medical trainees receive minimal nutrition education, leaving them unprepared to address nutritional issues with patients. An interactive, single-session, virtual nutrition curriculum was taught online to 80 physician assistant (PA) students. Topics included plant-based nutrition, dietary history-taking and counseling, and culinary medicine. Students were surveyed before, immediately after, and four weeks after the curriculum to assess changes to nutrition-related knowledge, attitudes, confidence, and personal dietary behaviors. Seventy-three PA students (91%) completed the pre-survey, 76 (95%) completed the post-survey, and 42 (52.5%) completed the delayed post-survey. Knowledge scores increased immediately post-intervention (48.9% to 78.9%; p < 0.001) and persisted four weeks later (78.9% to 75.8%; p = 0.54). Post-intervention, students felt more confident in dietary history-taking (55% vs. 95%; p = 0.001) and nutrition counseling (53% vs. 84%; p = 0.003) and agreed that dietary changes alone could reverse type 2 diabetes (74% vs. 97%; p = 0.027) and coronary artery disease (66% vs. 92%; p = 0.039). Curricula using virtual teaching kitchens may be a scalable approach to nutrition education for medical trainees.
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Affiliation(s)
- Justin A. Charles
- Department of Family Medicine and Public Health, UC San Diego Health, San Diego, CA 92093, USA
| | - Nathan I. Wood
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA; (N.I.W.); (J.O.M.); (L.S.)
| | - Stephanie Neary
- Physician Assistant Online Program, Yale University School of Medicine, New Haven, CT 06520, USA;
| | - Jorge O. Moreno
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA; (N.I.W.); (J.O.M.); (L.S.)
| | - Lindsey Scierka
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA; (N.I.W.); (J.O.M.); (L.S.)
| | - Benjamin Brink
- Department of Internal Medicine, Brown University-Rhode Island Hospital, Providence, RI 02912, USA
| | - Xiwen Zhao
- Yale Center for Analytical Sciences, Yale University School of Public Health, New Haven, CT 06511, USA;
| | - Katherine A. Gielissen
- Division of General Internal Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA;
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17
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McGuire MF, Chen PM, Smith-Morris C, Albin J, Siler MD, Lopez MA, Pruitt SL, Merrill VC, Bowen ME. Redesigning Recruitment and Engagement Strategies for Virtual Culinary Medicine and Medical Nutrition Interventions in a Randomized Trial of Patients with Uncontrolled Type 2 Diabetes. Nutrients 2023; 15:4124. [PMID: 37836408 PMCID: PMC10574259 DOI: 10.3390/nu15194124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
In-person culinary medicine (CM) can improve health behaviors, but its translation to virtual platforms and impact on diabetes outcomes are not well described. We designed a pragmatic trial comparing the effectiveness of virtual CM (eCM) to Medical Nutrition Therapy on diabetes outcomes among patients with uncontrolled diabetes within a safety-net healthcare system. All participants were provided cooking equipment and food from a food pantry. Due to low initial eCM participation, recruitment was paused, and eight semi-structured interviews were conducted to solicit feedback on study appeal, operations, and barriers to participation. Rapid thematic analysis was used to modify study operations. We found that participants were interested in the study and motivated by health concerns. While they valued food distribution and cooking equipment, they highlighted transportation barriers and conflicts with the pick-up time/location. Some eCM participants expressed discomfort with the virtual platform or preferred to observe rather than cook along. Study operations were modified by (1) moving supply pick-up to a familiar community clinic and diversifying food pick-up locations; (2) offering an in-person orientation to the program to increase comfort with the virtual platform; (3) emphasizing the credibility and relatability of the eCM instructor and encouraging participation of family members. This redesign led to the recruitment of 79 participants, of whom 75% attended at least one class. In conclusion, participant feedback informed pragmatic changes in study operations that increased engagement in this ongoing trial and may inform future eCM program design.
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Affiliation(s)
- Molly F. McGuire
- University of Texas Southwestern Medical Center, Division of General Internal Medicine, Dallas, TX 75390, USA (M.E.B.)
| | - Patricia M. Chen
- Peter O’Donnell Jr. School of Public Health, Dallas, TX 75390, USA
| | | | - Jaclyn Albin
- University of Texas Southwestern Medical Center, Division of Combined Internal Medicine and Pediatrics, Dallas, TX 75390, USA
| | - Milette D. Siler
- University of Texas Southwestern Medical Center, Division of General Internal Medicine, Dallas, TX 75390, USA (M.E.B.)
- Moncrief Cancer Institute, Fort Worth, TX 76104, USA
| | | | - Sandi L. Pruitt
- Peter O’Donnell Jr. School of Public Health, Dallas, TX 75390, USA
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA
| | - Vincent C. Merrill
- University of Texas Southwestern Medical Center, Division of General Internal Medicine, Dallas, TX 75390, USA (M.E.B.)
| | - Michael E. Bowen
- University of Texas Southwestern Medical Center, Division of General Internal Medicine, Dallas, TX 75390, USA (M.E.B.)
- Peter O’Donnell Jr. School of Public Health, Dallas, TX 75390, USA
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Wood NI, Stone TA, Siler M, Goldstein M, Albin JL. Physician-Chef-Dietitian Partnerships for Evidence-Based Dietary Approaches to Tackling Chronic Disease: The Case for Culinary Medicine in Teaching Kitchens. J Healthc Leadersh 2023; 15:129-137. [PMID: 37520178 PMCID: PMC10378677 DOI: 10.2147/jhl.s389429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023] Open
Abstract
Since the middle of the 20th century, the American food environment has become increasingly ultra-processed. As a result, the prevalence of chronic, diet-related disease in the United States has skyrocketed. Meanwhile, physicians are still poorly trained in nutrition. A recent innovation that aims to address this is "culinary medicine" programming taught by teams of physicians, chefs, and registered dietitian nutritionists. Culinary medicine is an evidence-based, interprofessional field of medicine that combines culinary arts, nutrition science, and medical education to prevent and treat diet-related disease. It employs hands-on learning through healthy cooking and is typically taught in a teaching kitchen, either in-person or virtually. It can be dosed either as a patient care intervention or as experiential nutrition education for students, medical trainees, and healthcare professionals. Culinary medicine programs are effective, financially feasible, and well-received. As a result, healthcare systems and medical education programs are increasingly incorporating culinary medicine, teaching kitchens, and interprofessional nutrition education into their patient care and training models.
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Affiliation(s)
- Nathan I Wood
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Theresa A Stone
- Department of Internal Medicine, MedStar Health, Washington, DC, USA
| | - Milette Siler
- Moncrief Cancer Institute, University of Texas Southwestern Medical Center, Fort Worth, TX, USA
| | - Max Goldstein
- Digestive Health Center, Yale New Haven Health, New Haven, CT, USA
| | - Jaclyn Lewis Albin
- Departments of Internal Medicine and Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Eisenberg DM, Pacheco LS, McClure AC, McWhorter JW, Janisch K, Massa J. Perspective: Teaching Kitchens: Conceptual Origins, Applications and Potential for Impact within Food Is Medicine Research. Nutrients 2023; 15:2859. [PMID: 37447185 PMCID: PMC10343805 DOI: 10.3390/nu15132859] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
There is a need to identify innovative strategies whereby individuals, families, and communities can learn to access and prepare affordable and nutritious foods, in combination with evidence-based guidance about diet and lifestyle. These approaches also need to address issues of equity and sustainability. Teaching Kitchens (TKs) are being created as educational classrooms and translational research laboratories to advance such strategies. Moreover, TKs can be used as revenue-generating research sites in universities and hospitals performing sponsored research, and, potentially, as instruments of cost containment when placed in accountable care settings and self-insured companies. Thus, TKs can be considered for inclusion in future health professional training programs, and the recently published Biden-Harris Administration Strategy on Hunger, Nutrition and Health echoes this directive. Recent innovations in the ability to provide TK classes virtually suggest that their impact may be greater than originally envisioned. Although the impact of TK curricula on behaviors, outcomes and costs of health care is preliminary, it warrants the continued attention of medical and public health thought leaders involved with Food Is Medicine initiatives.
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Affiliation(s)
- David M. Eisenberg
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.S.P.); (K.J.); (J.M.)
| | - Lorena S. Pacheco
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.S.P.); (K.J.); (J.M.)
| | | | | | - Kate Janisch
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.S.P.); (K.J.); (J.M.)
| | - Jennifer Massa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.S.P.); (K.J.); (J.M.)
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Albin JL, Siler M, Kitzman H. Culinary Medicine eConsults Pair Nutrition and Medicine: A Feasibility Pilot. Nutrients 2023; 15:2816. [PMID: 37375720 DOI: 10.3390/nu15122816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
The global impact of diet-sensitive disease demands innovative nutrition education for health professionals and widespread, reimbursable clinical models to apply nutrition to practice. Interprofessional collaboration across disciplines and the optimization of emerging telemedicine consultation strategies, including electronic consultation (eConsult), merge to deliver vital innovation in the delivery of nutrition-based clinical care. Aligning with an existing eConsult infrastructure in the institutional electronic health record (EHR), a physician-dietitian team developed a novel Culinary Medicine eConsult. During a pilot phase, the service was introduced to primary care clinicians, and a response algorithm for eConsults was created. During the 12-month pilot phase, the Culinary Medicine team completed 25 eConsults from 11 unique primary care clinicians with a 76% (19/25) insurance reimbursement rate. Topics varied from dietary strategies for preventing and managing common metabolic diseases to specific dietary influences on microbiome health and disease flares. Requesting clinicians reported time saved in their clinic encounters and high patient satisfaction with expert nutrition guidance. EConsults in Culinary Medicine promote the integration of interprofessional nutrition care into existing clinical structures and empower enhanced access to the vital domain of dietary health. EConsults deliver timely answers to clinical questions and create opportunities for further innovation in care delivery as communities, health systems, and payors seek solutions to the growing burden of diet-sensitive diseases.
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Affiliation(s)
- Jaclyn L Albin
- University of Texas Southwestern Medical Center, School of Medicine, Departments of Internal Medicine and Pediatrics, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Milette Siler
- Moncrief Cancer Institute and the University of Texas Southwestern Medical Center, 400 W Magnolia Ave, Fort Worth, TX 76104, USA
| | - Heather Kitzman
- University of Texas Southwestern Medical Center, Peter O'Donnell Jr. School of Public Health, Dallas, TX 75390, USA
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Craven K, Kolasa KM, Smith B, Kramer S. Creating Teams of Family Medicine Residents and High School Culinary Students Reduces Some Barriers to Implementing a Culinary Medicine Hands-On Workshop. MEDICAL SCIENCE EDUCATOR 2023; 33:369-374. [PMID: 37261031 PMCID: PMC10226968 DOI: 10.1007/s40670-023-01773-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 06/02/2023]
Abstract
Background Barriers to implementation of culinary medicine in resident training include lack of facilities, administrative support, and community engagement. Activity Twenty-five family medicine residents were teamed with 17 high school culinary arts students to prepare recipes aligned with the Mediterranean diet (MED) and the USDA low, moderate, and liberal cost food plans. Results The workshop took place in the high school teaching kitchens. A pre-survey informed the planning committee's design of a 4-h hands-on workshop that was considered a success. Discussion Post-surveys documented improved resident confidence and skills in recommending MED to their patients and interaction with their own peers and high school students, as well as enjoyment by all participants of this hands-on approach.
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Affiliation(s)
- Kay Craven
- Department of Family Medicine, Brody School of Medicine at East Carolina University, 3080 Dartmouth Drive, Greenville, NC 27858 USA
| | - Kathryn M. Kolasa
- Department of Family Medicine, Brody School of Medicine at East Carolina University, 3080 Dartmouth Drive, Greenville, NC 27858 USA
| | - Brittany Smith
- Department of Family Medicine, Brody School of Medicine at East Carolina University, 3080 Dartmouth Drive, Greenville, NC 27858 USA
| | - Shiann Kramer
- Department of Nutrition Sciences, East Carolina University, Greenville, NC USA
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