SEKISUI Diagnostics’ previous blog talked about the food-as-medicine movement, that is, the effort on the part of physicians and medical institutions to make food a formal part of treatment, rather than relying solely on medications. In this blog, we explore how advocates of “food as medicine” are bringing the concept out of the textbook and into the homes of people with chronic and other diseases.
Overwhelming evidence supports the potential relationship between dietary factors and diet-related diseases such as ischemic heart disease, diabetes, and certain cancers.1 Evidence also suggests that while diet has the potential to contribute to disease, it is also capable of building, maintaining, and restoring health.
Despite all that is known about food and health, poor diet is still responsible for more deaths globally than tobacco, high blood pressure, or any other health risk, leading to the deaths in 2017 of almost 11 million people, or 22% of all deaths among adults.2 One reason may be a lack of focus on diet and health on the part of organized medicine, beginning in medical school. Another is food insecurity.
Culinary Medicine
Traditionally, medical students have not been required to take basic nutrition courses, contributing to a lack of confidence among healthcare providers when speaking to patients about using food as a treatment to manage disease.1 That may be changing.
The growing field of culinary medicine explores the links between food and health, applying the foundations of nutritional science along with traditional medical interventions in clinical care.3 An example is the University of Michigan Food for Life Kitchen at Michigan Medicine, a dedicated, hands-on learning space which serves as a hub for several programs where food and health intersect.
Another is the Goldring Center for Culinary Medicine at Tulane University’s School of Medicine in New Orleans, Louisiana, which provides hands-on training for medical students and residents.4 The Center also offers continuing medical education classes for licensed medical professionals including physicians, physician assistants, nurses, nurse practitioners, dietitians, and pharmacists.
A third example is the Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania.5 The college launched its culinary medicine program in 2013, when orthopedic surgeon Beth Dollinger M.D., decided to investigate teaching nutrition to medical students. The culinary medicine program has also incorporated the FoodRx program to focus on addressing food insecurity seen in clinics.
“The growing field of culinary medicine explores the links between food and health, applying the foundations of nutritional science along with traditional medical interventions in clinical care.”
Does incorporating culinary medicine training into medical school curricula achieved desired results? Researchers at the University of Maryland School of Medicine asked themselves that question after the school mandated culinary medicine training for all 2019-2020 first-year medical students.6 Pre-/post session questionnaires assessed nutrition knowledge, skills, and attitudes as well as nutritional counseling confidence. All nutritional and patient counseling outcomes improved. Also noted were themes of being better prepared to address healthy eating barriers in patient care and personal ability to make healthy dietary changes.
Food Insecurity
Perhaps an even bigger barrier than lack of medical professionals’ knowledge or experience with “food as medicine” may be food insecurity, that is, limited access to nutritious food owing to cost.
In the United States, approximately 20% to 30% (6 million to 9 million) of Americans with diabetes report food insecurity each year.7 A healthy diet may be the cornerstone of diabetes management, but food insecurity incents the consumption of inexpensive, calorie-dense food of little nutritional value. Poor dietary quality among individuals with diabetes and food insecurity, as assessed by the Healthy Eating Index 2010 (HEI 2010) score, is associated with worse glycemic control and increased diabetes complications. Further, food insecurity is associated with increased risk of hypoglycemia, a serious adverse event related to diabetes therapy.