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CONTRIBUTED PHOTO BY METRO SOURCE -- The Goldring Center for Culinary Medicine at Tulane University teaches doctors basic, real-world nutrition.

You might not feel comfortable discussing your diet with your doctor. 

The feeling is probably mutual. 

Most doctors don't think they have enough training to counsel their patients about diet, according to a study in the Journal of the American College of Nutrition, which found 94 percent of physicians believe that nutrition counseling should be a part of primary care visits, but only 14 percent felt they were educated enough to do it. 

"It's not even broached. We're trying to change that," said Leah Sarris, a chef and the program director of the Goldring Center for Culinary Medicine at Tulane University, which teaches doctors basic, real-world nutrition. 

Today, researchers better understand the toll that food can have on health. About one-third of Americans are considered obese, and about half of adults have high cholesterol, high blood pressure or smoke — all risk factors for stroke or heart disease, according to the Centers for Disease Control.

More than 30 years ago, the National Academies of Science recommended that every medical student receive a minimum 25 hours of nutrition education. But American medical schools offer just 19.6 hours of nutrition education over four years, according to a 2010 report from the journal Academic Medicine. 

Tulane University is working to reverse that trend. 

When the Goldring Center for Culinary Medicine began five years ago, it offered a few elective courses for medical students. Now all students take three hands-on classes in their first two years of medical school.

The future doctors learn to cook healthy meals with low-cost ingredients — the kind of information that has real meaning for patients.

"We want them to change their own lifestyle, but we also are teaching them how to use this information to talk to patients about food and how patients can change their food intake and habits in order to change their health," Sarris said.

The Center for Culinary Medicine's curriculum, created with the College of Culinary Arts at Johnson & Wales University, is spreading to other campuses. It is now licensed by 28 medical schools and two nursing schools, Sarris said. 

So, instead of doctors talking about nutrients like carbohydrates and proteins, they learn to talk about whole foods — pasta and rice and chicken and steak. If they tout the benefits of monounsaturated fats, they talk about olive oil and avocados, the foods and ingredients that contain them.

Medical students will usually view an online lesson before their classes, then arrive ready to cook lunch and then discuss ways to create healthy meals. In one class, they make chicken salad and substitute commonly used ingredients for healthier options. For instance, Sarris' recipe calls for yogurt instead of mayonnaise and vegetables, fruits and herbs and seasonings in place of salt and pepper. 

These doctors are encouraged to offer their patients improved versions of the foods they already eat instead of an entirely new diet.

"It’s all about meeting people where they are and making small changes so we are teaching them to teach the patients short simple messages repeated over and over," Sarris said. "Then once they meet those goals, they can move on to new goals. It’s not like trying to throw a bunch of stuff on them at once."

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A doctor might talk to a patient recently diagnosed with diabetes or high cholesterol about changing one meal at a time, focusing on a better breakfast. Then, after a month or two, at a follow-up appointment, the doctor might discuss ways to improve lunch or dinner. 

The goal is to focus on individual foods and an overall healthy lifestyle, Sarris said. 

"There’s no diet for diabetes. There’s no diet for cholesterol," Sarris said. "It’s all about a healthy balanced diet that we should all be following."

Dr. Susan Warner, a pathologist in Memphis, Tennessee, said the continuing education courses at the Center for Culinary Medicine led to an "aha moment." In medical school she learned the biochemical side of nutrition without learning what a healthy diet actually looks like.

Merging medical science with cooking could revolutionize American medicine, she said.

"This union has the potential to radically impact health care through making strides in chronic disease prevention, altering the lifestyle of individuals, and improving the overall health of this nation," she said.

In addition to educating future doctors, the center also teaches continuing education courses for physicians and community cooking classes. Doctors can even prescribe classes for their patients. 

To learn more about classes at the Goldring Center for Culinary Medicine or to find recipes for healthy cooking, visit culinarymedicine.org.


What diet is best?

Program director Leah Sarris and the staff at the Goldring Center for Culinary Medicine recommend the Mediterranean Diet over all others. It includes lots of plant-based foods such as fruits, vegetables, legumes and whole grains. It limits red meat and encourages fish. Olive oil and healthy fats are used instead of butter and other fats.  

"It is the most largely researched way of eating anywhere and anytime in the world," Sarris said. "We know that it is good for us."

To follow the Mediterranean Diet, aim to eat: 

  • Seven to 10 servings of fruits and vegetables per day
  • Whole grain bread and pasta 
  • Nuts such as almonds, cashews and pistachios
  • Olive oil instead of butter or margarine
  • Fish a few times a week instead of red meat

Follow Kyle Peveto on Twitter, @kylepeveto.