You’re probably asking yourself, “What is culinary medicine?” Before starting this elective in my senior year of medical school, I had a general sense of what we would be doing over the four-week course. However, when my classmates and I were asked this question on our first day, I had to think. We tried to be very scientific about it, describing disease-specific diets, macro- and micronutrients, and other buzzwords we had encountered during medical school. But it was not quite so convoluted and technical. “Culinary medicine is making healthy food in a delicious way.” It was so simple, but I think it really highlighted why many physicians have such a difficult time helping their patients to improve their health through nutrition. We learn the benefits of specific diets for different diseases: low-carb for diabetics, low-salt for hypertension, etc. We learn about all of the nuances of macronutrients and how the human body metabolizes them. We learn the various biochemical reactions that require different micronutrients to function properly and how deficiencies in these result in various maladies. So, we are trained to think of nutrition from a purely medical perspective, when food is so much more than that. We forget how integral food has been in our own lives before medicine.

If you take a step back, food is central to cultures around the world. With food being so intimately tied to our cultures and identities, it is no surprise that ideas about food can be as deeply ingrained in people as their cultural beliefs and values. These are positively reinforced by the joy we get from eating. As you may have noticed from some of my posts, food and cooking are a big part of my family. I cannot think of any family gathering from my childhood that didn’t include a meal. The Fourth of July centers around grilling bratwurst. Christmas is the prime rib roast. Easter wouldn’t be the same without the spiral cut ham and scalloped potatoes. Birthdays necessitated blowing out candles nestled in a favorite cake or pie. Putting a spoonful of comfort food into your mouth kicks off a cascade of signals in your brain that release neurotransmitters, giving you that feeling that takes you back to your childhood or reminds you of a special person or moment in your life. In fact, areas of the brain that increase in activity when you eat are the same areas that can light up during sex or from drugs with a high potential for addiction. This is why for some patients divulging their diet can be as intimate as discussing their sexual history.

We are wired to enjoy eating and to recognize those foods that will get us the most bang for our buck. It was evolutionarily beneficial to know which foods would get you the most calories and nutrients to make it until you were able to hunt down or gather your next meal. Afterall, that’s what tastebuds are doing. They are telling us that the sponge cake with buttercream frosting will give us more calories than the kale salad. The problem is that we are no longer foragers who need to eat calorie-dense foods to keep us nourished for an unknown amount of time until the next meal. And while there are still areas of the world where people are undernourished, the quantity of food they are consuming is not adequate, the problem in more developed countries is more often malnourishment, which is not a problem with the quantity of food, but rather the quality of the food. We see this in the US with issues like food insecurity due to socioeconomic factors and food deserts, which both contribute to the obesity epidemic. Thus it’s important for doctors to be equipped to help patients to improve access to and make better choices about food.

As we neared the end of our medical school education, many classmates were traveling to distant countries and their social media posts invariably included at least one dish popular to that country or region. Walk into any bookstore and you’ll find an entire section dedicated to cookbooks filled with recipes from around the globe. The internet has made it even easier for people from across the world to connect and share recipes and cooking techniques. Videos on YouTube have taught me techniques for such things as Italian gnocchi, Mexican mole sauce, Eastern European chicken paprikash and Vietnamese pho. The most beautiful thing is that by simply watching the ingredients someone uses and watching their various cooking techniques you don’t even have to necessarily speak the language to learn techniques for cooking. Food can bridge language gaps and allow individuals a means to communicate beyond language. We can learn a lot from each other about food and this isn’t limited to the kitchen. Research has been examining diets in specific regions of the world that have better health outcomes compared to others. This is how we have come to learn a great deal about the Mediterranean diet. I will go more into this later, but it highlights the idea that what we can learn from various cultural diets bridges the gap between kitchen and doctor’s office.

Over four weeks we learned concepts and techniques to adapt recipes to be healthier while maintaining taste and texture. Our course was based on the curriculum developed at the Goldring Center for Culinary Medicine at Tulane University. During classroom lectures, we learned about the science behind the recipes. In the kitchen, we got hands-on experience making and tasting our recipes. We discussed the different components of the dish, our thoughts on it, and sometimes modified the recipes to ensure it maintained its taste or texture. Armed with our newly acquired knowledge and skills, we went into the community and shared all we had learned in the form of cooking demonstrations, one-on-one discussions, and, most importantly, samples of the recipes to taste for themselves. While culinary medicine was a nice break from the usual classes we take in medical school, I came away from it with a wealth of knowledge to share with patients. I have already had a few instances where I have been able to share information with patients in the clinical setting about ways to improve their diet. I have come away from the experience with a much greater appreciation for the wealth of knowledge that registered dietitians offer. I hope that the healthcare system recognizes their value and broadens the criteria for reimbursing their services to more than a select group of patients.

So, what is culinary medicine? The simple answer is that it’s making healthy food in a delicious way. But if we did a bit deeper, it’s more than just that. It is recognizing registered dietitians and the science they bring to make food healthy. It is learning the art to keep delicious from professional chefs. Culinary medicine is physicians working collaboratively with these two professions with the common goal of sharing this information with patients and members of the community to improve health and wellness for everyone. Early practitioners of medicine like Hippocrates and Galen had some interesting ideas about how the body works, such as balancing the four humors. It’s funny that we laugh at many of their ideas, brushing them off as silly. However, we find ourselves in a position now where we must look to the Father of Medicine and recognize that he was onto something when he said, “Let food be thy medicine and medicine be thy food.”