9-19-24 MSC Perspectives on Medicine - Dr. Nathan Wood

Transcript

• 00:04Hello?
• 00:05Hello, everyone.
• 00:06We're gonna get started.
• 00:17We're gonna get started. Everyone
• 00:19can keep grabbing food,
• 00:22and just sit down whenever
• 00:23you're ready.
• 00:25Alright.
• 00:26Okay.
• 00:28Good afternoon, everyone,
• 00:30and welcome to the first
• 00:31of four presentations this year
• 00:32of the Medical Student Council
• 00:34perspectives on medicine
• 00:35lecture series.
• 00:37It's so good to see
• 00:38everyone in person.
• 00:40We've been doing this over
• 00:41Zoom for the past couple
• 00:42years, so it's nice to
• 00:43see a good showing here.
• 00:44Hope you're enjoying the lunch.
• 00:47My name is Jordan Shaqued,
• 00:48and I'm a second year
• 00:49medical student here at Yale
• 00:50as well as the vice
• 00:51president of the medical student
• 00:52council.
• 00:54I'll be filling in for
• 00:55the MSC president, Gabe, Carrillo
• 00:58today as he's away at
• 00:59a conference.
• 01:01This series was created to
• 01:02offer fresh perspectives
• 01:04on pivotal topics in the
• 01:05magical
• 01:06not magical. In the medical
• 01:08field.
• 01:09Magical too.
• 01:11And this year, we're excited
• 01:12to focus on a theme
• 01:13that is incredibly relevant to
• 01:15us all, medical education.
• 01:17Throughout this series, we'll hear
• 01:19from individuals who are not
• 01:20only shaping the way medical
• 01:22education is delivered,
• 01:24but are also actively contributing
• 01:25to the future of how
• 01:26we train health care professionals.
• 01:29Before we begin, I'd like
• 01:30to take a moment to
• 01:31acknowledge the incredible efforts of
• 01:33those who made this lecture
• 01:34series possible.
• 01:35A special thank you to
• 01:36Barbara Watts, Dean Ment, and
• 01:38my fellow members of the
• 01:39Medical Student Council, Gabe Carrillo,
• 01:41Amanda Jerrod, and Marion Berry
• 01:43for their hard work in
• 01:44organizing this event and bringing
• 01:45such important voices to our
• 01:46community.
• 01:48It is fitting that we
• 01:49start this series with today's
• 01:50speaker, doctor Nate Wood, whose
• 01:52innovative work in culinary medicine
• 01:54and nutrition education
• 01:55embodies the forward thinking approach
• 01:57we hope to highlight throughout
• 01:58these,
• 01:59lectures.
• 02:00Doctor Wood is an instructor
• 02:01of medicine and the inaugural
• 02:02director of culinary medicine at
• 02:04the Yale School of Medicine
• 02:05and the Irving and Alice
• 02:06Brown Teaching Kitchen at Yale
• 02:08New Haven Health.
• 02:09He is board certified in
• 02:10both internal medicine and obesity
• 02:12medicine and also serves as
• 02:13a primary care physician,
• 02:15core faculty member in the
• 02:16Yale primary care residency program,
• 02:18and coleader of the weight
• 02:19management clinic at the New
• 02:21Haven Primary Care Consortium.
• 02:23I personally had the opportunity
• 02:24to attend one of doctor
• 02:25Wood's culinary medicine teaching sessions
• 02:27at the Teaching Kitchen last
• 02:28May, and I was struck
• 02:29by how engaging and informative
• 02:31the experience was. I walked
• 02:32away with new culinary skills
• 02:34and a deeper understanding of
• 02:35how food can be a
• 02:36powerful tool in patient care.
• 02:38Doctor Wood's unique career path
• 02:40reflects his passion for combining
• 02:41the science of medicine with
• 02:42the art of food.
• 02:43He arrived as, he earned
• 02:45his med MD from Wayne
• 02:47State University School of Medicine,
• 02:49completed his residency and fellowship
• 02:50here at Yale, and most
• 02:52recently finished the master's of
• 02:53health science degree with a
• 02:54focus on medical education.
• 02:56However, his journey hasn't stopped
• 02:58there. Prior to his medical
• 02:59career, doctor Wood studied at
• 03:01the Institute of Culinary Education
• 03:02in New York, bringing together
• 03:04his love for food and
• 03:05his belief that a healthy
• 03:06diet can also be
• 03:07delicious.
• 03:08Doctor Wood is a strong
• 03:10advocate for the food as
• 03:11medicine movement and has made
• 03:12significant
• 03:13contributions to the field of
• 03:14culinary and obesity medicine.
• 03:16His work extends beyond patient
• 03:18care and medical education to
• 03:20include media outreach, where he
• 03:21aims to educate both health
• 03:23care professionals and the general
• 03:24public on the powerful link
• 03:26between diet and health.
• 03:28Today, doctor Wood will be
• 03:30presenting his talk titled culinary
• 03:32medicine and the future of
• 03:33nutrition education for patients and
• 03:35health care professionals,
• 03:49Thank you so much for
• 03:50that lovely introduction.
• 03:52What an honor it is
• 03:53to be here today. They
• 03:54reached out and asked me
• 03:56to do this, and I
• 03:56thought, okay. Cool. That sounds
• 03:57fun. I know people will
• 03:58come for the free lunch,
• 03:59and it sounds kinda low
• 04:00key. And then I read
• 04:01about it online, and said
• 04:02previous speakers include surgeon general
• 04:04Vivek Murthy. I thought, okay.
• 04:05This bar is a little
• 04:06higher than I thought it
• 04:07was.
• 04:07So hopefully, it prepared an
• 04:09engaging talk, that that you'll
• 04:10enjoy today. I could talk
• 04:11about food all day, but
• 04:12I'll try to keep myself
• 04:13to forty minutes or so.
• 04:16So my story is that
• 04:17I grew up loving to
• 04:18eat. My favorite hobby still
• 04:20to this day is eating,
• 04:22and that love of eating
• 04:23blossomed into loving to cook.
• 04:25You can see me making
• 04:26my bagel in the morning
• 04:28at age three.
• 04:29And then that led me
• 04:30eventually into a combination of
• 04:32food and medicine. I broke
• 04:33my leg in eighth grade
• 04:34playing soccer, said, god, why
• 04:36me? And then ended up
• 04:37in, medical school.
• 04:39Loved what I was learning
• 04:40in medicine, but really felt
• 04:42that my passion for food
• 04:43was getting kind of squeezed
• 04:44out of my life. You
• 04:45know how medical school is,
• 04:46many of you. So I
• 04:47ended up taking a year
• 04:48off. And as Jordan said,
• 04:49went to, the Institute of
• 04:50Culinary Education and and worked
• 04:52in restaurants in New York.
• 04:53Came back to medical school
• 04:55and started combining those in,
• 04:57the form of culinary medicine,
• 04:58teaching classes both in the
• 04:59community in Detroit and then
• 05:01to fellow medical students at
• 05:02Wayne State. That led me
• 05:03here where I continued teaching
• 05:05culinary medicine classes and then
• 05:06in July assumed the role
• 05:08of director of culinary medicine
• 05:09here, which is a new
• 05:10a new role here at
• 05:11Yale, which is really exciting
• 05:12that Yale is so forward
• 05:13thinking that they that they
• 05:14support this.
• 05:16Happy to talk more about
• 05:17my journey. But today, what
• 05:18I really wanna talk about
• 05:19is the prevalence and impact
• 05:21of diet sensitive diseases here
• 05:23in the United States, how
• 05:24we do nutrition and medical
• 05:25education currently, and what we've
• 05:27done in the past. We'll
• 05:28talk more about what is
• 05:29culinary medicine. It's probably a
• 05:31question some of you have.
• 05:32We'll talk about the work
• 05:33that we do at our
• 05:34teaching kitchen here at Yale,
• 05:35and then this new field
• 05:36that's really only five or
• 05:38ten years old, which is
• 05:39called food is medicine or
• 05:40sometimes food as medicine.
• 05:43So I'm gonna start by
• 05:44telling you something you probably
• 05:45don't need to be told,
• 05:46which is that diet sensitive
• 05:47diseases in the United States
• 05:48are highly prevalent. So cardiovascular
• 05:51disease, if you include hypertension,
• 05:53hypertension afflicts almost one in
• 05:54two Americans and has been
• 05:55the number one killer every
• 05:57single year even throughout COVID
• 05:58since nineteen twenty one.
• 06:01About a third of the
• 06:02population in the United States
• 06:03has prediabetes and over ten
• 06:05percent of us have diabetes.
• 06:06You can see that's increased
• 06:07quite precipitously since the nineteen
• 06:09sixties along with obesity. Again,
• 06:11by twenty thirty, one in
• 06:12two adults are expected to
• 06:14have obesity, and this has
• 06:15increased a lot since the
• 06:16nineteen sixties, roughly.
• 06:19There are lots of other
• 06:20diet sensitive diseases. This new
• 06:22term for fatty liver disease,
• 06:23which seems to change every
• 06:24five years, cancer, dementia,
• 06:27IBD, IBS, celiac, there's so
• 06:29many other diseases that are
• 06:30sensitive to our diet.
• 06:33Diet, in fact, is the
• 06:34third leading risk factor for
• 06:36morbidity in the United States,
• 06:37and it is the leading
• 06:38risk factor for mortality. So
• 06:40notably, this is higher than
• 06:41tobacco. Right? High BMI, high
• 06:44and
• 06:45the other things that you
• 06:46see here. This is a
• 06:46major cause of both morbidity
• 06:48and mortality here in the
• 06:48United States. And despite that,
• 06:48as doctors, we really don't
• 06:49do
• 06:50much with nutrition. So this
• 06:51was first recognized as an
• 06:52issue long ago in the
• 06:581980s and nineteen eighty five,
• 07:00the national academy of sciences
• 07:01said, listen, our medical students
• 07:03in their preclinical years should
• 07:05get about twenty five hours
• 07:06of nutrition education.
• 07:08Do you any any guess
• 07:09what the national average is
• 07:11currently?
• 07:14We we see some fours.
• 07:15Yeah. So Yale gets about
• 07:17four,
• 07:18at in nineteen eighty five,
• 07:19the average was twenty one
• 07:20and the average today is
• 07:22eleven. So things have gotten
• 07:23much worse, not better.
• 07:25And really we're not providing
• 07:26adequate nutritional education in medical
• 07:28school. And then when people
• 07:29get to residency, only about
• 07:31a quarter of providers, receive
• 07:32education in nutrition. So really
• 07:34poorly educated.
• 07:36As a result of that,
• 07:37we don't deal with nutrition
• 07:38very well. We don't really
• 07:40value sometimes our registered dietitian
• 07:41colleagues, cardiologists, you know, what
• 07:43specialty could rely more heavily
• 07:46on dietitians than cardiologists,
• 07:48but most cardiologists refer very
• 07:50few of their patients to
• 07:51register dietitian nutritionists.
• 07:53And in surveys repeatedly,
• 07:55ten years apart here, we're
• 07:56finding that fourteen percent of
• 07:58physicians feel that they're adequately
• 08:00pr trained to provide nutrition
• 08:02counseling to patients.
• 08:03We did a similar study
• 08:04here with our Yale primary
• 08:05care residents and found a
• 08:06similar number. So about seventeen
• 08:08percent felt that their training
• 08:10to date had been sufficient.
• 08:12Very few felt that they
• 08:13had the nutrition knowledge and
• 08:14skills necessary to provide dietary
• 08:16counseling to patients. And despite
• 08:18all of that, nearly a
• 08:19hundred percent, essentially all but
• 08:21two people felt that if
• 08:22we were to provide them
• 08:23additional training and nutrition that
• 08:25they would be able to
• 08:25provide better clinical care for
• 08:27patients. So clearly, a gap
• 08:29here.
• 08:31Recently, this has been realized
• 08:32to be a systemic issue.
• 08:34This is perhaps an ethical
• 08:35lapse to fail to address
• 08:37the contributions of food to
• 08:38health and could be viewed
• 08:40even in and of itself
• 08:41as a structural contributor to
• 08:43diet related disease. So in
• 08:44the past decade or so,
• 08:45people have really started to
• 08:47pay more attention to this
• 08:48realizing that we can no
• 08:49longer ignore this in the
• 08:50medical community.
• 08:53So a lot of things
• 08:54have changed recently in twenty
• 08:55twenty two, a house resolution
• 08:57passed, which is, you know,
• 08:58in the, in the national,
• 09:00government, which was to say
• 09:01that,
• 09:02essentially in Medicare, we've shunned
• 09:04those Medicare dollars to pay
• 09:06for residency programs. Right? And
• 09:07they said, low key, if
• 09:08you guys don't teach nutrition,
• 09:09we're gonna threaten to take
• 09:11away your Medicare dollars. Right?
• 09:12So they said, this is
• 09:13really important that we teach
• 09:14this and we have a
• 09:15lever that we can pull.
• 09:16So that kind of lit
• 09:17the fire a little bit.
• 09:18In September of twenty twenty
• 09:20two, we had the first
• 09:21White House conference on hunger,
• 09:22nutrition, and health in over
• 09:23fifty years. Again, this really
• 09:25catalyzed things in the field
• 09:27of nutrition education and in
• 09:28medical education.
• 09:30In March of twenty twenty
• 09:31three, we had the first
• 09:32ever summit on nutrition and
• 09:33medical education, which was co
• 09:34hosted by the American Association
• 09:36of Medical Colleges and the
• 09:38ACGME, which oversees residency programs.
• 09:40So they got together, and
• 09:41they said, okay. We need
• 09:42to teach nutrition. What should
• 09:43be taught in medical school?
• 09:45What should be taught in
• 09:46residency and how are we
• 09:47gonna do that? So really
• 09:48our first
• 09:49comprehensive view of that coming
• 09:50out, just last year.
• 09:52One month later, the NIH
• 09:54came out and they said,
• 09:54we're about to pump a
• 09:55whole bunch of money into
• 09:56this field of food as
• 09:57medicine,
• 09:58including nutrition and culinary medicine
• 10:00education
• 10:00for our future health care
• 10:02professionals.
• 10:03And then earlier this year,
• 10:04the American College of Culinary
• 10:05Medicine was founded.
• 10:07And so things as I'm
• 10:08showing you are changing really,
• 10:09really rapidly,
• 10:11especially given that we first
• 10:12realized this was a problem
• 10:13in nineteen eighty five.
• 10:15So I wanna talk a
• 10:16little bit more about culinary
• 10:18medicine. Culinary medicine is both
• 10:20for patients and for health
• 10:21care professionals, but we're first
• 10:22gonna focus on health care
• 10:23professionals given the theme of
• 10:25medical education.
• 10:27So culinary medicine, essentially, the
• 10:28goal is to take nutrition
• 10:30science, culinary arts, medical education,
• 10:32medicine, you combine it all
• 10:34together. It's an interprofessional evidence
• 10:36based field, and you bring
• 10:37people into a teaching kitchen,
• 10:38whether that's a virtual teaching
• 10:39kitchen or it's a physical
• 10:41teaching kitchen, and you teach
• 10:42them the science of healthy
• 10:44eating through hands on cooking.
• 10:46So one way to think
• 10:46about this is, you know,
• 10:47you have bio lecture in
• 10:49undergrad and then you go
• 10:50to bio lab. Right? So
• 10:51here we have nutrition lectures,
• 10:53and then we bring them
• 10:54immediately into the lab, which
• 10:55is the teaching kitchen, and
• 10:56you really bring it to
• 10:57life. It's one thing to
• 10:58say you need to eat
• 11:00more broccoli. It's another thing
• 11:01to say you need to
• 11:02eat more broccoli. Let's cook
• 11:04it together at four hundred
• 11:05degrees in the oven with
• 11:06a little bit of salt
• 11:07and lemon juice, and look
• 11:08how delicious it tastes. Right?
• 11:09People go home with recipes,
• 11:10and they're more interested in
• 11:12eating this healthy diet because
• 11:13we've increased their self efficacy
• 11:14and their interest in doing
• 11:15it.
• 11:17So culinary medicine, of course,
• 11:19includes hands on cooking, but
• 11:20when we're thinking specifically of
• 11:21pedagogies in culinary medicine, there's
• 11:23also lectures. We definitely do
• 11:24lectures like the one I'm
• 11:25giving here. We do small
• 11:26group work or we break
• 11:27them up into small groups
• 11:28and do journal clubs. We
• 11:29do case based learning.
• 11:31I mentioned the journal clubs
• 11:32and then practice with standardized
• 11:34patients. Right? So if we
• 11:35think that culinary medicine might
• 11:36help people better counsel their
• 11:38patients in nutrition, why don't
• 11:40we give them practice doing
• 11:41that with standardized patients, right
• 11:43next to the teaching kitchen?
• 11:44So that's something we did
• 11:45in the project earlier this
• 11:46year and is becoming more
• 11:47common.
• 11:49So culinary medicine, also a
• 11:51pretty new field, but a
• 11:52little older than this revamped
• 11:53nutrition education idea. So the
• 11:55first cooking and nutrition elective
• 11:57was taught at a medical
• 11:58school in two thousand three
• 11:59at SUNY Upstate.
• 12:01There's this amazing conference that
• 12:03all of you are eligible
• 12:03to go to if you'd
• 12:04like to called healthy kitchens,
• 12:05healthy lives. It's between the
• 12:07culinary institute of America and
• 12:08the Harvard TH Chan School
• 12:10of Public Health. I've been
• 12:11trying to get in for
• 12:12years, and I finally this
• 12:13year got in. It's in
• 12:14Napa Valley in February. Amazing.
• 12:16So I'm going to that
• 12:18and looking forward to it.
• 12:19But, again, learning how to
• 12:20cook healthy food to improve
• 12:21health.
• 12:22This term culinary medicine was
• 12:24first coined in two thousand
• 12:25nine by another chef internist.
• 12:27His name is John Lapuma,
• 12:28amazing guy. He wrote this
• 12:29book. He had a PBS
• 12:31show, and this was when
• 12:31the the the term culinary
• 12:33medicine first came to be.
• 12:35And then things really took
• 12:36off in twenty twelve when
• 12:38the first ever center for
• 12:39culinary medicine at a medical
• 12:40school was established at Tulane.
• 12:43I I trained when I
• 12:44was in medical school at
• 12:45Tulane. They developed curricula. It
• 12:46has since grown into the
• 12:47American College of Culinary Medicine.
• 12:49They have patients in the
• 12:50New Orleans community come in
• 12:51and take cooking classes. They
• 12:52teach culinary medicine to their
• 12:54residents and to their medical
• 12:55students, and they really kicked
• 12:57off this movement.
• 12:58Now, you know, if this
• 13:00just started essentially ten, twenty
• 13:01years ago, now we have,
• 13:03I would guess, a hundred
• 13:04to a hundred and fifty
• 13:06academic medical centers, community,
• 13:08programs,
• 13:09local hospitals, and medical schools,
• 13:11etcetera, teaching culinary medicine. So
• 13:13it's really taken off very,
• 13:15very quickly.
• 13:17So what does culinary medicine
• 13:18seek to do? All of
• 13:19these things have been demonstrated
• 13:21in the literature. It increases
• 13:22knowledge of nutrition and cooking,
• 13:24obviously. It increases
• 13:26confidence and competence or at
• 13:27least perceived confidence and competence
• 13:29in providing nutrition counseling to
• 13:31patients. It improves interprofessional collaboration,
• 13:33which is a huge goal
• 13:34of medical education,
• 13:36increases folks' motivation to eat
• 13:38healthily, and actually improves dietary
• 13:40behaviors. So in one of
• 13:41my first studies that I
• 13:42conducted at Wayne State, we
• 13:43showed that pre versus post
• 13:45or post versus pre, I
• 13:46should say,
• 13:47that the people who participated
• 13:48in the culinary medicine intervention
• 13:50cooked more of their meals
• 13:51at home afterwards. And other
• 13:53studies have shown greater adherence
• 13:54to a Mediterranean diet.
• 13:56So if all this has
• 13:57been demonstrated, that's cool, but,
• 13:59like, what do we hope
• 14:00is the outcome for patients?
• 14:02We hope that we're providing
• 14:03nutrition counseling to our patients
• 14:04more frequently and that it's
• 14:06of higher quality.
• 14:07We want people to refer
• 14:08to registered dietitians more, and
• 14:10we want our providers to
• 14:11walk the talk, essentially. There's
• 14:13a lot of research to
• 14:14suggest that those who practice
• 14:15they themselves,
• 14:16healthy lifestyle behaviors are more
• 14:18likely to talk to their
• 14:19patients about it.
• 14:22So that brings us to
• 14:23our work in the Yale
• 14:24New Haven hospital teaching kitchen,
• 14:26Yale New Haven health teaching
• 14:27kitchen, I should say. It
• 14:28opened,
• 14:29formally, I would say, like,
• 14:30in in April of last
• 14:31year, but we really opened
• 14:32our doors to learners in
• 14:33June, and then we had
• 14:34our first patients in August.
• 14:36I was just telling Jordan
• 14:37that at this time last
• 14:38year, we had, like, patient
• 14:39classes and they had, like,
• 14:40two people in them. It
• 14:41was, like, kind of hard
• 14:42to get people to come
• 14:44around to this idea of
• 14:45going to a medical appointment
• 14:46where you're basically just cooking.
• 14:48Right?
• 14:49And then, now we have
• 14:50classes so packed that we
• 14:52have to kinda limit, you
• 14:53know, people bringing guests. We
• 14:54have to start overbooking less.
• 14:55We're booked out for months
• 14:56essentially looking at twenty twenty
• 14:58five now with our patients.
• 14:59This has gotten really,
• 15:01popular really fast. So I'll
• 15:02tell you more about the
• 15:03patient impact later, but we
• 15:05also have lots of health
• 15:05care professionals here in the
• 15:07teaching kitchen. So we've had
• 15:08physician associate students. They come
• 15:10through once a year as
• 15:11second years. This is a
• 15:12mandatory experience for them. Our
• 15:14medical students, we've had three
• 15:15classes in the past year
• 15:17or so, and we're gonna
• 15:18do six more, this coming
• 15:19year. So stay tuned if
• 15:20you're a medical student.
• 15:22All of our primary care
• 15:23residents come through once a
• 15:24year. This is a mandatory
• 15:25experience for them. Same with
• 15:27our pediatrics residents throughout their
• 15:28three year residencies.
• 15:30We recently had our first
• 15:31group of surgery residents. We
• 15:32have nurses who come in
• 15:33and do wellness classes. We
• 15:35had my fellow Yale primary
• 15:36care faculty come in. So
• 15:38as you can see, this
• 15:39really benefits a lot of
• 15:40people, and in the future,
• 15:42we hope to have public
• 15:43health students, APRN students, practicing
• 15:45clinicians in the community,
• 15:47more residents, medical educators staff,
• 15:49and you. If you're interested
• 15:50in coming in, reach out
• 15:51and we can find a
• 15:52way.
• 15:55So I wanna answer this
• 15:56question of why culinary medicine.
• 15:57Right? Because if the goal
• 15:59is to teach more nutrition,
• 16:00why don't we just do
• 16:01nutrition lectures? Why do you
• 16:02have to bring people into
• 16:03a teaching kitchen? And this
• 16:05is kind of an unanswered
• 16:06question in the literature currently.
• 16:08Right? Because lectures are standard,
• 16:10they're low resource, and if
• 16:11you have a nutrition expert
• 16:12at your medical school, which
• 16:13again is is quite rare
• 16:15honestly,
• 16:16then they're probably trained to
• 16:18give lectures. Whereas culinary medicine,
• 16:20not normal, high resource, and
• 16:21people generally aren't trained to
• 16:23teach culinary medicine. So the
• 16:25question then, why culinary medicine?
• 16:27Really, if you wanted to
• 16:28answer that question, you would
• 16:29need a randomized control trial.
• 16:31Right? People get randomized and
• 16:32you say, what is the
• 16:33benefit of one potentially over
• 16:34the other? And there are
• 16:36no randomized control trials among
• 16:38medical trainees to really answer
• 16:39this question.
• 16:41So that's what I did
• 16:42during my fellowship. So we
• 16:43ran the first ever randomized
• 16:44controlled trial of a culinary
• 16:45medicine intervention among medical trainees
• 16:47to try to start answering
• 16:49some of these questions.
• 16:50We took our Yale primary
• 16:51care residents. We,
• 16:53randomized them into two groups,
• 16:55an intervention group and a
• 16:56control group, and then we
• 16:57surveyed them at three different
• 16:58time points.
• 17:00Now I felt really bad
• 17:01because this was a mandatory
• 17:02experience for all of our
• 17:03residents, and then I randomized
• 17:04half to receive the intervention
• 17:06curriculum. So I wanted it
• 17:07to still be beneficial. So
• 17:08a lot of the components
• 17:09are the same. So in
• 17:11both groups, they participated in
• 17:12a discussion of this Yale
• 17:13office based medicine chapter on
• 17:15dietary counseling and primary care.
• 17:18They both participated in a
• 17:19one hour lecture I gave
• 17:20on the, connection between diet
• 17:22and cardiovascular
• 17:23disease. And then the next
• 17:24section was different. So if
• 17:26they were in the intervention
• 17:27group, I said, okay. You
• 17:28have fifteen minutes. Grab these
• 17:29groceries, go home, get on
• 17:31Zoom, and we're gonna cook
• 17:32together in a virtual teaching
• 17:33kitchen. This was before the
• 17:34teaching kitchen was established here.
• 17:36And we made this plant
• 17:37based lentil bolognese and talked
• 17:38about how we made recipe
• 17:39modifications to improve its heart
• 17:41healthiness and how this could
• 17:42apply to patients.
• 17:44In the control group, they
• 17:45watched some videos
• 17:46on the connection between diet
• 17:47and health. I felt very
• 17:49bad for them, but this
• 17:50is the standard of care
• 17:52and I'll tell you that
• 17:53we used to have this
• 17:54curriculum that was used in
• 17:55a large plurality of medical
• 17:57schools called,
• 17:59I think it's called nutrition
• 18:00and medicine, but it was
• 18:01based in Flash Player and
• 18:02DVDs. And the DVDs have
• 18:03been destroyed and Flash Player
• 18:04is now defunct. So I
• 18:05reached out to them. I
• 18:06said, can I use this
• 18:07in my curriculum? And they're
• 18:07like, no. It doesn't exist
• 18:08anymore. So I looked for
• 18:10one that could be similar,
• 18:12and this is the one
• 18:12I landed on because as
• 18:14some of you may know,
• 18:15if you are interested in
• 18:16nutrition at Yale, they say,
• 18:17great. There's a set of
• 18:18DVDs in the library. Feel
• 18:20free to check them out.
• 18:20And that can be your
• 18:21nutrition education. And that is
• 18:23what I made my residents
• 18:24watch.
• 18:25So that was the one
• 18:26hour that they got. I
• 18:27can tell you they didn't
• 18:27really like it, and they
• 18:28spent a lot of time
• 18:29writing patient notes.
• 18:31We then in both groups
• 18:32spent some time discussing how
• 18:33this knowledge applies to patients,
• 18:35and they had a q
• 18:35and a with a registered
• 18:36dietitian. So as you can
• 18:38see, the intervention and the
• 18:39control,
• 18:40quite similar, but with a
• 18:41key difference.
• 18:43We evaluated them on their
• 18:44knowledge, their skills, their attitudes,
• 18:46and behaviors at each of
• 18:47the three time points, and
• 18:48I'm just gonna briefly go
• 18:49through some of the results
• 18:50with you.
• 18:51So we gave him a
• 18:52five, five question nutrition quiz.
• 18:54At each of the three
• 18:55time points, they were different
• 18:56questions, but the same learning
• 18:57objectives, essentially, like, what is
• 18:59the impact of refined grains
• 19:01on triglycerides?
• 19:02What is the impact of
• 19:03saturated fat on LDL? Right?
• 19:04And we would ask it
• 19:05in kind of food centric
• 19:07ways. And as you can
• 19:08see in both groups at
• 19:09baseline, scores were quite low.
• 19:11You know, they were getting
• 19:11half ish of the questions
• 19:13right. That that increased dramatically
• 19:15in both groups after the
• 19:16intervention and then at the
• 19:17eight week follow-up time point,
• 19:19those scores were still high.
• 19:20So people learned from this
• 19:21intervention and that knowledge was
• 19:22maintained over time in both
• 19:24groups, the lecture group and
• 19:25the culinary medicine group, and
• 19:27there was no difference between
• 19:28the two groups.
• 19:31We also asked them about
• 19:32their confidence. And so several
• 19:34aspects of providing dietary counseling
• 19:36you can see on the
• 19:36left, and then we surveyed
• 19:38residents pre and post in
• 19:40both groups to see how
• 19:41their perceived level of confidence
• 19:43changed. And as you can
• 19:44see, their confidence increased across
• 19:46all five domains in the
• 19:47intervention, the culinary medicine group,
• 19:49whereas it went up in
• 19:50only two of the five
• 19:51domains in the control group.
• 19:55We did this cool recipe
• 19:56modification activity. So in the
• 19:57field of medical education scholarship
• 19:59in culinary medicine right now,
• 20:00we have this big question
• 20:01of how should we even
• 20:02be assessing
• 20:03the efficacy of our curricula.
• 20:05And this is a method
• 20:06that I developed that I
• 20:07I think is fun, and
• 20:08we'll see if people care
• 20:09about it when I publish
• 20:09it. But we basically said
• 20:11you saw a patient in
• 20:11clinic yesterday. You asked them
• 20:13what they ate for dinner
• 20:13as part of a twenty
• 20:14four hour dietary recall. They
• 20:16told you that they ate,
• 20:17you know, burrito casserole or
• 20:19a pad Thai. You look
• 20:20up the list of ingredients.
• 20:21Here they are. And then
• 20:22we give the residents the
• 20:23list of ingredients. And then
• 20:24I said,
• 20:25make three suggestions for substitutions
• 20:27or additions that you could
• 20:28make to this recipe to
• 20:29make it more heart healthy.
• 20:31So you couldn't just say
• 20:32use less oil, take out
• 20:33the soy sauce, use less
• 20:35cheese. Right? You'd have to
• 20:35say instead of beef, use
• 20:38tofu, add in broccoli, you
• 20:40know, these types of suggestions.
• 20:41So we saw how good
• 20:42they were at doing this
• 20:43before and after the intervention.
• 20:45Those in the culinary medicine
• 20:46group, their ability to do
• 20:47this increased pre versus post.
• 20:49And in the control group,
• 20:50there were no differences pre
• 20:51versus post.
• 20:54There's also this validated survey
• 20:56that basically assesses how important
• 20:58the learners think it is
• 20:59to incorporate nutrition into routine
• 21:01patient care. Higher scores are
• 21:02better. It's a maximum of
• 21:03forty on the eight point
• 21:05scale.
• 21:06And as you can see,
• 21:06scores in both groups were
• 21:08pretty high at baseline, but
• 21:09there was a statistically significant
• 21:10increase in scores in the
• 21:12intervention group that was not
• 21:13seen in the control group.
• 21:14So they thought it was
• 21:15more important,
• 21:16to incorporate nutrition into primary
• 21:18care.
• 21:20We asked them about how
• 21:22they're doing dietary counseling. And
• 21:24so whether they're providing dietary
• 21:26counseling for dyslipidemia,
• 21:27whether they're providing educational resources
• 21:30and pre versus post in
• 21:31the intervention group alone, we
• 21:33saw that those residents were
• 21:34providing more educational resources after
• 21:36the intervention, again, not seen
• 21:38in the control group.
• 21:41And then finally, we said
• 21:42just really point blank. Has
• 21:44this changed how you provide
• 21:45care essentially in all but
• 21:47one resident in the control
• 21:48group? So across both groups,
• 21:50all residents, except for one
• 21:51person said that this had
• 21:52impacted how they provide care
• 21:54to patients.
• 21:55And some of their quotes
• 21:56here you can see,
• 21:57warmed my heart. So really
• 21:58improving the care they provide
• 22:00to patients as a result.
• 22:02So what does this mean?
• 22:04So both culinary medicine and
• 22:07lectures,
• 22:08they are both effective in
• 22:09many ways. They can be
• 22:10feasible. They can be well
• 22:11received. They can achieve knowledge
• 22:13based learning objectives. Remember those
• 22:15nutrition scores went up in
• 22:16in both groups, and they're
• 22:18promising and their potential to
• 22:19impact patient care.
• 22:21But in some ways, perhaps
• 22:22culinary medicine is better, improving
• 22:24attitudes about how important it
• 22:26is to address nutrition with
• 22:27patients,
• 22:28increasing confidence in providing patient
• 22:30counseling, and this skill in
• 22:32modifying recipes for heart healthiness,
• 22:34which we hope would translate
• 22:36into providing more concrete,
• 22:38dietary recommendations for patients.
• 22:41And the, kind of significance
• 22:43of this is that the
• 22:44ACGME is actually considering instituting
• 22:46mandatory nutrition education for residents
• 22:48as early as twenty twenty
• 22:50six. This was announced in
• 22:51October of last year.
• 22:52And so it's kind of
• 22:54like, again, that lever that
• 22:55they can pull with Medicare
• 22:56funding. People are like, oh,
• 22:57gosh. We need to get
• 22:58ready, like, now for when
• 22:59this happens. And so the
• 23:01good news is if you're
• 23:02at an institution that really
• 23:04can't provide culinary
• 23:05medicine education, you don't have
• 23:06dietitian, chef, physician, combos who
• 23:08can teach, you don't have
• 23:09a teaching kitchen, you don't
• 23:10have funds to pay for
• 23:11food, that's okay. Lectures can
• 23:13still be really effective. But
• 23:15if you do have all
• 23:16of those resources, culinary medicine
• 23:17is is probably better, and
• 23:18it's definitely more fun.
• 23:21So that's culinary medicine for
• 23:23health care professionals, but really
• 23:24no conversation about culinary medicine
• 23:27is complete without talking about
• 23:28how it can impact patients
• 23:29because the impact on patients
• 23:30is so great.
• 23:32So for patients,
• 23:33we do not think to
• 23:34be clear that culinary medicine
• 23:36is the answer to solving
• 23:38our our our issues with
• 23:39food in this country. And
• 23:40so this is from a
• 23:41paper we published last year,
• 23:42and we really think it's
• 23:43a important piece of the
• 23:44puzzle. So if you look
• 23:45on the right side of
• 23:46the screen, our ultimate goal
• 23:48is chronic disease prevention and
• 23:50treatment. Then we're gonna walk
• 23:51back step by step. How
• 23:52do you get there? You
• 23:53have to empower your patients
• 23:54to follow a nutritious diet.
• 23:56Okay. I don't always eat
• 23:57a perfectly nutritious diet as
• 23:59I'm sure, all of you
• 24:00can attest to also. And
• 24:02then our patients are the
• 24:02same. Right? So how do
• 24:03we empower folks to follow
• 24:05a nutritious diet? Well, of
• 24:06course, they should be seeing
• 24:07a dietitian,
• 24:09to get medical nutrition therapy,
• 24:10which is highly evidence based.
• 24:11They should be following up
• 24:12with their primary care doc
• 24:13to have a treatment plan
• 24:14kind of put together and
• 24:15talk about it with them.
• 24:16But then really the sinew,
• 24:17how we think we bring
• 24:18this to life, how we
• 24:19tie all of this together
• 24:20is culinary medicine in teaching
• 24:22kitchens. It's one thing to
• 24:23be told by your doctor,
• 24:25you know, to lose weight,
• 24:26essentially, right, or to eat
• 24:28less salt.
• 24:29But to actually figure out
• 24:30how to do that in
• 24:31a teaching kitchen is a
• 24:31whole another matter. So we
• 24:32really think that's an important
• 24:34part.
• 24:35Notably, looking on the far
• 24:36left here, this is not
• 24:38effective if people do not
• 24:40have access to healthy food.
• 24:41Right? So step number one,
• 24:42people need access to affordable
• 24:44and nutritious food. We have
• 24:46a lot of food insecurity
• 24:47in this country and even
• 24:48greater nutrition insecurity. Right? And
• 24:50so there are different levers
• 24:52and systemic solutions that need
• 24:54to be enacted if we
• 24:55want to solve those things.
• 24:56And then culinary medicine plays
• 24:57an even more important role.
• 24:59But I just want to
• 24:59acknowledge that that's an important
• 25:01piece of the puzzle and
• 25:02not only having access to
• 25:03this food, but having time
• 25:04to cook it. Right. So
• 25:05we live in a stressed
• 25:06out America where we have
• 25:07access to ultra processed foods
• 25:08and potentially not money or
• 25:09transportation to buy healthier foods.
• 25:11And we're working all the
• 25:12time and,
• 25:13you know, a lot of
• 25:14folks have kids and this
• 25:15really constrains their ability to
• 25:16have have time to cook
• 25:17that healthy food in the
• 25:18first place. And so again,
• 25:19there are other things that
• 25:20really we need to do
• 25:21to address,
• 25:23those kinds of underlying issues
• 25:24to make culinary medicine even
• 25:26more effective. But we do
• 25:27think it's important piece of
• 25:28the puzzle.
• 25:30And we've seen that in
• 25:31the research. So some outcomes,
• 25:33for culinary medicine among patients,
• 25:35it can lower all these
• 25:36things, a one c, blood
• 25:37pressure, cholesterol, BMI. It increases
• 25:39their fruit and vegetable intake,
• 25:40their adherence to a Mediterranean
• 25:42diet, and then these kind
• 25:43of softer outcomes, which mean
• 25:44potentially much more to patients,
• 25:46psychological well-being, improved quality of
• 25:48life. Right? Improve self efficacy.
• 25:51So really, patients can learn
• 25:53a lot from culinary medicine.
• 25:55They enjoy it. It improves
• 25:56their life, and it improves
• 25:57their health.
• 26:00So we have patients in
• 26:01our teaching kitchen,
• 26:02two or three nights a
• 26:03week. So we do it
• 26:04in the evenings because it
• 26:05we find that's easiest for
• 26:06patients. Right? The classes are
• 26:07about two and a half
• 26:08hours,
• 26:10and they can take a
• 26:11kind of myriad of classes.
• 26:12Culinary
• 26:13medicine
• 26:15class, and then they can
• 26:16take these other kind of
• 26:16more specific themed classes as
• 26:16you see here. The snacks
• 26:16one is my personal favorite,
• 26:16really fun.
• 26:17Each class lasts about two
• 26:19and a half hours and
• 26:20notably
• 26:26totally free for patients. So
• 26:27it sounds too good to
• 26:28be true, but it's it's
• 26:30not. The patients do not
• 26:31have to be documented to
• 26:33have insurance. They don't pay
• 26:34co pays. They don't pay
• 26:35for these classes. You are
• 26:36referred by an NP, a
• 26:38PA, an MD, or a
• 26:39DO through Epic, and then
• 26:41patients can come take classes
• 26:42for free, and that is
• 26:43it. It's paid for by
• 26:44philanthropy and Yale New Haven
• 26:46Hospital. It's an amazing, an
• 26:47amazing resource, really
• 26:50unlike anything I've seen in
• 26:51in the nation. So it's
• 26:52really exciting. And as you
• 26:53can see, patients, really enjoy
• 26:55it, and they, have really
• 26:57good health outcomes outcomes as
• 26:58a result. And we've only
• 26:58been doing this for a
• 26:59year. So really, really exciting.
• 27:03So now I wanna this
• 27:05is me dressed up as
• 27:06a wizard in in, third
• 27:07grade with my sister. So
• 27:09here's me and my crystal
• 27:10ball trying to tell you
• 27:10what the future of nutrition
• 27:12education is going to look
• 27:13like in medicine.
• 27:16So how many of you
• 27:17have heard of this field
• 27:18of food is medicine?
• 27:21Yeah. Oh, that's great. Okay.
• 27:22Great. If I asked you
• 27:23that five years ago, no
• 27:23one would have raised their
• 27:24hand. This so this is
• 27:25catching fire really, really quickly.
• 27:27So I'm gonna spend some
• 27:28time on this slide because
• 27:29this is really important. This
• 27:30is the food is medicine
• 27:31pyramid.
• 27:32This is from Mazafarian's work.
• 27:34He's a cardiologist at Tufts.
• 27:36They have the first ever
• 27:37food is medicine institute there
• 27:38at Tufts. Great work that
• 27:39they're doing. And this is
• 27:40addressing that food and nutrition
• 27:42and security that I touched
• 27:43on earlier.
• 27:44So I wanna walk us
• 27:45through this. You notice that
• 27:46it's a pyramid, which means
• 27:47it's broader at the base
• 27:48and smaller at the top.
• 27:50This is think of the
• 27:51broadness as how many people
• 27:53it would be appropriate for.
• 27:55Okay? And then you see
• 27:56on the left, there's prevention
• 27:57at the bottom, treatment at
• 27:58the top. So as you
• 27:59move up, it's less for
• 28:00prevention and more for treatment,
• 28:02and it's, tailored for a
• 28:04smaller number of people. So
• 28:05at the base, we have
• 28:06population level healthy food policies
• 28:08and programs. Right? So everyone
• 28:10could benefit from nutrition education
• 28:12in k twelve. We know
• 28:13we need to increase that.
• 28:14Perhaps we need to bring
• 28:15home ec back so that
• 28:16people learn how to cook
• 28:18again,
• 28:19in schools.
• 28:20Perhaps we need to have
• 28:22more of these soda taxes
• 28:23or perhaps instead of the
• 28:25government subsidizing commodity crops like
• 28:26soybean and corns, we subsidize
• 28:29healthy fruits and vegetables to
• 28:30decrease the cost for the
• 28:31everyday American. Right? So these
• 28:33population level healthy food policies
• 28:35and programs are helpful for
• 28:37everyone
• 28:37and are really helpful in
• 28:39prevention. Right?
• 28:40If you move up a
• 28:41level, we're moving into folks
• 28:42who perhaps experience nutrition insecurity.
• 28:45So maybe they have enough
• 28:46food, but they can't afford
• 28:47to buy healthy food. Right?
• 28:49Or maybe they have food
• 28:50insecurity, and they can't even
• 28:52afford to buy enough food,
• 28:53enough calories to feed their
• 28:54family. Right? And so this
• 28:55is where programs like SNAP,
• 28:56WIC, and school meals are
• 28:58super helpful. Again, a smaller
• 28:59number of patients will benefit
• 29:01from this, but still a
• 29:01large number of people. And
• 29:03again, the goal is to
• 29:04prevent chronic disease in the
• 29:05first place by ensuring adequate
• 29:07access to food and nutrition.
• 29:09Moving up a little bit
• 29:10further, we have produce prescription
• 29:12programs. And so this is
• 29:13either,
• 29:14you know, like at Grady
• 29:15in Atlanta, you can go
• 29:17into the lobby and pick
• 29:18up in their, like, pharmacy,
• 29:20fresh fruits and vegetables that
• 29:22your doctor prescribes for you.
• 29:23Right?
• 29:24So that's really helpful. In
• 29:25other places, they'll give you
• 29:26a card, and this card
• 29:27can be redeemed at your
• 29:28local grocery store. It's loaded
• 29:29with fifty, hundred, two hundred
• 29:31bucks a month, and you
• 29:32can only spend it on
• 29:33healthy fruits and vegetables, whole
• 29:34grains, and things like that.
• 29:35Right? So perhaps these produce
• 29:37prescription programs could be helpful
• 29:39for someone who has, like,
• 29:40say, prediabetes
• 29:42or they're just starting their
• 29:43first blood pressure medication. They're
• 29:44eating enough food, but they're
• 29:46not really eating fruits and
• 29:47vegetables, and they're not really
• 29:48interested in eating fruits and
• 29:49vegetables. But if you give
• 29:50them fruits and vegetables for
• 29:51a while, then they start
• 29:52incorporating it. You'll you get
• 29:53that behavior change set in
• 29:55after the six weeks it
• 29:56takes to really establish new
• 29:57habits. They see improvements to
• 29:59their health. Their family gets
• 30:00used to eating broccoli. Right?
• 30:01And then you can see
• 30:02these benefits in folks who
• 30:04have start to have disease,
• 30:05and you're really moving away
• 30:06from prevention into early treatment.
• 30:09A step above that, which
• 30:10is even more intensive, are
• 30:11medically tailored groceries. So perhaps
• 30:13someone,
• 30:14has had many strokes or
• 30:16they have type two diabetes,
• 30:18or they have fatty liver
• 30:19disease. Right? And then,
• 30:20it's not just about giving
• 30:22them fresh fruits and vegetables.
• 30:23It's about giving them groceries.
• 30:25And so they're gonna go
• 30:26home and cook these groceries,
• 30:28and it's not just giving
• 30:30them fruits and vegetables,
• 30:31but also meats,
• 30:33that are lean and and
• 30:34low fat dairy and whole
• 30:36grains, really kind of a
• 30:37more comprehensive,
• 30:40food subscription that helps them
• 30:42cook healthy food at home.
• 30:44And then at the very
• 30:44top is medically tailored meals.
• 30:46Medically tailored meals get a
• 30:47lot of press because they
• 30:48are highly effective, because they
• 30:50are our most intensive intervention,
• 30:52and we've been studying them
• 30:53for the long for a
• 30:53long time.
• 30:54These really came out during
• 30:55the AIDS epidemic, and then
• 30:57folks were like, we have,
• 30:58you know, young men
• 31:00waste wasting away from AIDS
• 31:01and wanted to provide them
• 31:03with sustenance in, you know,
• 31:04kind of their final months.
• 31:05So kind of this tragic
• 31:06reason that medically tailored meals
• 31:08started. But then as we
• 31:09got more effective treatments for
• 31:10HIV, these folks who had
• 31:12really gotten good at providing
• 31:13medically tailored meals said what
• 31:15should we do now? So
• 31:15they kind of shifted over
• 31:16to providing meals for cancer
• 31:18patients, and now we provide
• 31:19them for folks with advanced
• 31:21chronic diseases. So let me
• 31:23tell you about the perfect
• 31:23patient who could benefit from
• 31:24this. Imagine an eighty year
• 31:26old guy who has congestive
• 31:28heart failure
• 31:29and he's widowed and never
• 31:31really learned to cook
• 31:33and he's quite debilitated and
• 31:35he's frequently ending up in
• 31:36the emergency room and admitted
• 31:38to the hospital for heart
• 31:39failure exacerbations.
• 31:40And at home, he's really
• 31:41eating frozen fast foods and
• 31:44canned soup, things like this.
• 31:45Right.
• 31:47Imagine instead of that vicious
• 31:49cycle, we sent him medically
• 31:50tailored meals that he could
• 31:51heat up on the stove,
• 31:52in the oven, in the
• 31:53microwave twice a day
• 31:55and keep him out of
• 31:56the hospital.
• 31:57This is a cheap and
• 31:59safe intervention. It saves the
• 32:01health care system and taxpayer
• 32:02dollars via Medicare, saves money,
• 32:05and,
• 32:05promotes health, essentially.
• 32:07And, so these medically tailored
• 32:09meals, not for everyone, but
• 32:10for a select patient population
• 32:11will be extremely helpful.
• 32:14So all of these things
• 32:15have kind of been swimming
• 32:17around in people's heads for
• 32:18five or ten years, but
• 32:19we're starting to get really
• 32:20good data on them. And
• 32:21to answer the question of,
• 32:22okay. Well, what about culinary
• 32:23medicine? Do we not need
• 32:24that anymore? It fits in
• 32:26so well with, like, all
• 32:27of these levels
• 32:29except for medically tailored meals.
• 32:30You know, if someone is
• 32:31receiving all of their medically
• 32:32tailored meals and there's, you
• 32:33know, debilitated such that they
• 32:34don't have the functionality to
• 32:36cook at home, then, you
• 32:37know, culinary medicine is probably
• 32:38not gonna be beneficial for
• 32:39them. But for everyone else,
• 32:41I think culinary medicine has
• 32:43a role.
• 32:44So the Aspen Institute is
• 32:45one of the leaders nationally
• 32:47in the food is medicine
• 32:48movement, and they're bringing together
• 32:49thought leaders in the coming
• 32:50months to say, how can
• 32:51we fit the fields of
• 32:52food is medicine and culinary
• 32:53medicine together? And that really
• 32:55is, I think, the next
• 32:56frontier to combine nutrition education
• 32:58with the provision of healthy
• 33:02food. So let me tell
• 33:03you how I see this,
• 33:04in the future being applied
• 33:06culinary medicine to patients, health
• 33:07care providers, and then we'll
• 33:08wrap up.
• 33:09So for patients, you're going
• 33:11to see more and more
• 33:12physical teaching kitchens, like like
• 33:13the one we have here
• 33:14at Yale. This, as you
• 33:15could see, makes the news,
• 33:17right, when when a place
• 33:18builds something like this, in
• 33:19ten years, this will be
• 33:20passe. There will be teaching
• 33:21kitchens everywhere. Right? So you're
• 33:23gonna con continue to see
• 33:24patients being referred, to physical
• 33:25teaching kitchens, and insurance companies
• 33:26will pay for this. There
• 33:28are ways to get insurance
• 33:29companies to pay for group
• 33:30visits and teaching kitchens, which
• 33:31really it's not gonna be
• 33:32some big money making scheme,
• 33:33but you can break even.
• 33:34Right? So you can make
• 33:35some money,
• 33:36and and kinda keep your
• 33:37programs open to provide this
• 33:39resource to patients in ways
• 33:40other than we do it,
• 33:41which is philanthropy.
• 33:43And then, of course, we
• 33:45had to get good at
• 33:45doing this virtually during the
• 33:46pandemic,
• 33:47because there was no option
• 33:48to do anything in a
• 33:49virtual in a physical teaching
• 33:51kitchen. And so in the
• 33:52future, you're gonna see many
• 33:53more video based curricula. So
• 33:55whether institutional or organizational platforms
• 33:57host asynchronous culinary medicine curricula,
• 34:01like Coursera
• 34:02or these other, like I
• 34:03said, platforms, you're going to
• 34:04have more of these culinary
• 34:05medicine options for patients that
• 34:07are asynchronous.
• 34:08There's going to be more
• 34:09live community culinary classes. We're
• 34:10hosting a couple out of
• 34:11our teaching kitchen this fall
• 34:13on healthy
• 34:14holiday snacks and mocktails and
• 34:16side dishes right around Thanksgiving
• 34:18and the holidays.
• 34:20There's this really cool company
• 34:21called Palm Health which also
• 34:23has an amazing social media
• 34:24presence and they basically partner
• 34:26with insurance companies
• 34:28to have providers
• 34:29refer their patients and then
• 34:30they do these virtual culinary
• 34:32medicine classes with dietitians and
• 34:33chefs. They provide the patients
• 34:35with recipes. They guide them
• 34:36as they kind of cook
• 34:37together and,
• 34:39with knife skills and things
• 34:40like that. And so they're
• 34:41finding a way to turn
• 34:43this into a company, right,
• 34:44to to offer this kind
• 34:46of education. You're gonna see
• 34:47more and more of those,
• 34:48I think, in the future,
• 34:48especially as we move towards
• 34:50value based care.
• 34:51And then this other option
• 34:52is, I think, you know,
• 34:53culinary medicine is about to
• 34:54go mainstream. Like, to a
• 34:55lot of you, this may
• 34:56have been a new term.
• 34:57To most Americans, this is
• 34:58a term they're not familiar
• 34:59with. This is about to
• 35:00go mainstream because just think
• 35:01about how exciting it would
• 35:03be to have someone engaging
• 35:04in the kitchen, cooking healthy
• 35:06food that's also delicious and
• 35:08sharing it with people what
• 35:09they love and talking about
• 35:10how it improves their health.
• 35:11Right? That is something I
• 35:12think people would watch. And
• 35:13so if no one else
• 35:14is gonna do it, I'm
• 35:15gonna do it.
• 35:17The future of culinary medicine
• 35:19for health care professionals, a
• 35:20little less sexy. We wanna
• 35:21establish some core competencies in
• 35:23culinary medicine. We need validated
• 35:25curricular assessment tools. And once
• 35:26we have those two things,
• 35:27we'll be able to develop
• 35:28standardized curricula and test them
• 35:30in multi institutional trials, and
• 35:32then we'll have the high
• 35:32quality data that we need
• 35:34to really get this,
• 35:35more broadly,
• 35:37accepted in medical schools and
• 35:38residency programs.
• 35:40We're currently developing an asynchronous
• 35:42video based culinary medicine curriculum
• 35:44that we got some grant
• 35:45funding for. This is important
• 35:46because a lot of medical
• 35:48schools, for instance, want to
• 35:49do culinary medicine, but they
• 35:50don't have a teaching kitchen
• 35:51and they don't have someone
• 35:53who can teach culinary medicine.
• 35:54So imagine instead you had
• 35:55a video based one where
• 35:56folks can watch the lecture,
• 35:58answer some questions that are
• 35:59embedded in, and then someone's
• 36:01cooking, like almost like a,
• 36:02you know, TV show essentially,
• 36:03but then you're cooking along
• 36:05at home and it'll be
• 36:05like pause the video here
• 36:06until your onion is chopped,
• 36:08you know, then resume the
• 36:08video. And then you kinda
• 36:09cook along with the video,
• 36:11right, with friends in your
• 36:12apartment, you know, your school
• 36:13buys you the groceries. This
• 36:15would be very, very easy
• 36:16to do. And so once
• 36:17we have something like this,
• 36:17it'll be easily scalable. So
• 36:19as I mentioned, we're developing
• 36:20one here and then Michelle
• 36:21Houser who's,
• 36:23a chef, an MD at
• 36:25Stanford and the president-elect of
• 36:26the American College of of
• 36:27lifestyle medicine. She is I
• 36:29know I'm also working on
• 36:30this and they're soon to
• 36:31be released. So this is
• 36:32something you'll see soon.
• 36:35And culinary medicine integrates so
• 36:37well with many other,
• 36:39areas of medicine that are
• 36:40increasing rapidly. So we talked
• 36:42about food as medicine interventions.
• 36:43That's a huge one. But
• 36:44culinary medicine also fits in
• 36:46really well with obesity medicine.
• 36:47So I came from our
• 36:48weight management clinic this morning
• 36:50where we talk about food
• 36:51and medications. We talk about
• 36:53sleep. We talk about social
• 36:54connectedness, avoiding risky substances,
• 36:57and and kind of all
• 36:58these other pillars of lifestyle
• 36:59medicine, which you see as
• 37:00another one of these areas
• 37:01of health care that's improving.
• 37:03All of these things are
• 37:04important to prevent and manage
• 37:06chronic diseases, and culinary medicine
• 37:07as an educational endeavor that's
• 37:09actually fun and promotes behavior
• 37:10change is something that will
• 37:12really partner well with those
• 37:14areas of medicine that are
• 37:15increasing. And then finally, I'll
• 37:17just point out climate and
• 37:18sustainability education. So we know
• 37:20from the Eat Lancet and
• 37:21many others that the food
• 37:23that is best for our
• 37:24body is also the food
• 37:25that is best for the
• 37:26planet, which is to say
• 37:27fruits, vegetables, whole grains, nuts,
• 37:29seeds, legumes,
• 37:31and very little ultra processed
• 37:33foods, meat, dairy, eggs, and
• 37:35seafood. Right? But really focusing
• 37:36on plants. That's sustainable, and
• 37:38it's good for our body.
• 37:39Right?
• 37:41So in summary, chronic diseases,
• 37:43the leading causes of death
• 37:44in the United States, and
• 37:45diet is the biggest risk
• 37:47factor for these diseases.
• 37:49We are not adequately trained
• 37:50in nutrition, whether you're a
• 37:51patient or whether you're a
• 37:52healthcare professional.
• 37:54It has culinary medicine,
• 37:56been shown to positively impact
• 37:57medical education, both for healthcare
• 37:59professionals and for our patients.
• 38:01It improves outcomes
• 38:03And, culinary medicine and food
• 38:05is medicine in the future
• 38:05really is gonna change how
• 38:07we think about healthcare. So
• 38:08you're, you know, if you're
• 38:09in training right now, you're
• 38:10at an interesting time where
• 38:12you know this is coming
• 38:13and probably not receiving adequate
• 38:14nutrient, you know, training in
• 38:16it.
• 38:17I came up in a
• 38:18time where people were not
• 38:19even thinking about these things.
• 38:20And hopefully in twenty years,
• 38:22we will be better training
• 38:23our physicians of the future
• 38:24to address food in the
• 38:25in the, clinical context.
• 38:27So,
• 38:29thank thank you so much.
• 38:29Happy to take questions that
• 38:31folks have,
• 38:32and appreciate your time.
• 38:39We're gonna move on to
• 38:40questions if anyone has any
• 38:42questions for doctor.
• 38:50Thank you. Hi. Thanks so
• 38:51much for your talk. I
• 38:52really liked it. Can you
• 38:53talk about if there are
• 38:54any specific types of pushback
• 38:56that you're that people are
• 38:57getting against implementing these types
• 38:59of programs? Like, are there
• 39:00specific types of doctors who
• 39:02are very against this? Or,
• 39:03like, I could imagine, like,
• 39:04the fast food industry might
• 39:05try to lobby against something
• 39:07like this. Is there anything
• 39:08like like specific groups that
• 39:09really don't want these kinds
• 39:10of things to happen?
• 39:11Yeah. That's a really good
• 39:12question. So a lot I've
• 39:14had really good support here
• 39:15at Yale. I'll say that.
• 39:17Everyone's like, oh, that's really
• 39:18cool that you're doing that.
• 39:19Gold star. You know? Whereas
• 39:20a lot of institutions, they're
• 39:21like, that is not necessary.
• 39:22That is not real medicine.
• 39:24You know, we're not paying
• 39:25for this. You know, that's
• 39:26something that a lot of
• 39:27institutions are telling my colleagues
• 39:29in culinary medicines.
• 39:31I wouldn't say it's any
• 39:32doctors in particular. I'll I'll
• 39:33tell you that, you know,
• 39:34sometimes when I wanna teach
• 39:35nutrition here, they always bring
• 39:36up the,
• 39:38they always bring up the
• 39:39example of orthopedic surgeons. They'll
• 39:40be like, why does an
• 39:41orthopedic surgeon need to know
• 39:42about nutrition?
• 39:43And then I always tell
• 39:44them how frequently I send
• 39:45my primary care patients to
• 39:47get a knee replacement and
• 39:47then they can't get it
• 39:48because they need to lose
• 39:49weight and then the orthopedic
• 39:50surgeon just says, you know,
• 39:51eat less, move more and
• 39:52kicks them out of the
• 39:52office. So that's my pitch
• 39:54back. But, you know, in
• 39:55general, most people are in
• 39:57support of this and I
• 39:58think the ones that people
• 39:59would be worried about are
• 40:00surgeons in general. But there's
• 40:01actually some research to suggest
• 40:02that if you experience food
• 40:04and nutrition security
• 40:05before an operation,
• 40:07your rate of complications
• 40:09is akin to someone with
• 40:10uncontrolled type two diabetes. And
• 40:12so perhaps these medically tailored
• 40:14groceries and and and produce
• 40:16prescription programs that address food
• 40:18and nutrition insecurity could really
• 40:20mitigate costs and improve surgical
• 40:22outcomes even. So really everyone
• 40:24is I think getting behind
• 40:25this.
• 40:26Food companies, they really hate
• 40:27the obesity drugs because that
• 40:29means people are buying less
• 40:30of their food.
• 40:31But in general,
• 40:33in our era of nutritionism
• 40:34where we focus on individual
• 40:36nutrients instead of just saying
• 40:37eat plants, Companies are able
• 40:39to really
• 40:40manufacture products where they add
• 40:42in fiber or they take
• 40:43out a little salt or,
• 40:44you know, they add in,
• 40:45some kind of a plant
• 40:46that helps them sell it.
• 40:47And so I think they're
• 40:47a little less concerned about
• 40:48culinary medicine and would probably
• 40:50even be excited to partner
• 40:51with us if we showed
• 40:52people how to cook their
• 40:54ultra processed foods, which we
• 40:55won't do. But,
• 40:57so I haven't I haven't
• 40:58seen too much pushback there.
• 40:59But in general, lots of
• 41:00support.
• 41:01Yeah.
• 41:11Great talk, by the way.
• 41:12So I feel like nutrition
• 41:14headlines sometimes can be very
• 41:15difficult to parse through both
• 41:16for consumers and also for
• 41:17health care professionals.
• 41:19And, like, basic science and
• 41:20traditional research on nutrition is
• 41:22also very difficult to conduct.
• 41:23So how do you, I
• 41:25guess, navigate that for both
• 41:27people, like, patients who wanna
• 41:28eat healthier, but then also
• 41:30how to teach your, like,
• 41:32residents and med students how
• 41:33to read and, sort of
• 41:35adapt those headlines to then
• 41:36counsel their patients?
• 41:37Great question. So, I'm working
• 41:39on a book. So I'll
• 41:40have you have to read
• 41:40my book when it comes
• 41:41out. But, it's basically, like,
• 41:42I the pitch is, like,
• 41:44I understand that nutrition is
• 41:45so confusing to so many
• 41:47people, and then I have
• 41:48this slide that I sometimes
• 41:49give in a lecture where
• 41:49I show, like, all of
• 41:50these nutrition headlines that totally
• 41:52conflict,
• 41:53and everyone's confused. Doctors are
• 41:55confused. Patients are confused. Everyone
• 41:56is confused about nutrition. But
• 41:58the more you read nutrition
• 41:59science, the more boring it
• 42:00gets because it all says
• 42:02the same thing, which is
• 42:03eat more plants, eat less
• 42:05ultra processed foods. And so
• 42:06I tell people to look
• 42:07at it through that lens.
• 42:08And then whenever they see
• 42:09a new study that comes
• 42:10out, it's always something it
• 42:11you know, there's always some
• 42:13particulars. Like, I saw one
• 42:14recently that was like, oh,
• 42:15study finds that increased
• 42:18consumption of French fries associated
• 42:20with higher risk of,
• 42:22depression. Right? So it's always
• 42:23like this ultra processed food
• 42:25associated with bad outcome. This
• 42:27plant associated with good outcomes.
• 42:29That's all of nutrition. Right?
• 42:30It's that simple.
• 42:32That's ninety five percent of
• 42:33it, I should say. And
• 42:34so, like, that's how I
• 42:35try to that's the the
• 42:37heuristic or the template that
• 42:38I give people when I
• 42:39teach them. And then I
• 42:40say, if you find conflicting
• 42:42info otherwise or if you
• 42:43have specific questions about that,
• 42:44let me know. But if
• 42:45you can follow that guideline,
• 42:47you're ninety five percent of
• 42:48the way there. So that's
• 42:49what I try to do.
• 42:53Alright. Thank you so much
• 42:54for the great talk. I'm
• 42:56wondering if you have any,
• 42:58ideas of how culinary
• 43:00medicine could be,
• 43:02applied to people who have
• 43:03eating disorders,
• 43:04like anorexia nervosa, like, how
• 43:07that could,
• 43:08like, increase their self efficacy
• 43:10or
• 43:11incorporate diet, like, healthy diet
• 43:13and also enough, you know,
• 43:15nutrients to their body? That's
• 43:17a fabulous question. Yeah.
• 43:19I'm not sure I have
• 43:20a great answer for that.
• 43:21We teach, as part of
• 43:22our,
• 43:23curriculum that we teach to
• 43:24residents. We teach one year
• 43:25on cardiovascular disease, one on
• 43:27type two diabetes and one
• 43:28on overweight and obesity. And
• 43:29when we did our needs
• 43:30assessment of residents, they're like,
• 43:31we're excited to learn all
• 43:32that, but we definitely want
• 43:33to know about eating disorders
• 43:34too, because I think they
• 43:35worry that if you counsel
• 43:36someone in diet that you
• 43:37could even trigger an eating
• 43:38disorder.
• 43:39So definitely a valid concern
• 43:41among lots of clinicians.
• 43:43Eating disorders are really hard
• 43:45to treat and, you know,
• 43:46like many other diseases require
• 43:48kind of multimodal therapy, whether
• 43:49it's medications,
• 43:50counseling,
• 43:51various different specialty providers,
• 43:53primary care psychology,
• 43:55psychiatry,
• 43:56and then I think culinary
• 43:57medicine would be a good
• 43:58part of kind of rehabilitation
• 43:59of of learning to
• 44:02I don't know. I don't
• 44:03have the right answer, and
• 44:04I don't want to say
• 44:04anything offensive, but there's something
• 44:06about culinary medicine that helps
• 44:07people to learn to
• 44:09love and enjoy food, in
• 44:11a new way. You know,
• 44:12people, I think, sometimes think
• 44:13food is the enemy, and
• 44:14it's like, oh, I'm tempted
• 44:16by food. Food makes me
• 44:17gain weight. You know, I
• 44:18don't like to go to
• 44:19parties because of the food,
• 44:20you know, and it's like
• 44:21always like the food is
• 44:22the problem. But I think
• 44:23if we can help people
• 44:24fall in love with food
• 44:26that's easy and accessible and
• 44:28delicious,
• 44:28it's it's kind of healing
• 44:30in some way psychologically. And
• 44:31so I would have to
• 44:32talk to some experts in
• 44:33eating disorders, but I think
• 44:34there's really big potential there
• 44:36that I haven't tapped into.
• 44:37So great question. Thank you.
• 44:40Hi, doctor Wood. Thanks for
• 44:41the great talk. Thanks.
• 44:43My question is seeing that
• 44:45food is such a big
• 44:46part of so many different
• 44:47cultures,
• 44:48how do you navigate providing
• 44:50culturally sensitive education and recommendations
• 44:53to patients?
• 44:55And have you ever run
• 44:56into any difficulties with that
• 44:57sort of thing? Yeah. Great
• 44:58question. I have. Yeah. So,
• 45:00I will give a talk
• 45:01frequently on the different types
• 45:03of fats that are healthy
• 45:04and right. So as we
• 45:05know, unsaturated fats better for
• 45:07your LDL than saturated fats.
• 45:09And so I kind of
• 45:09mentioned where do saturated fats
• 45:11come from. They come from
• 45:12meat and then they come
• 45:13from tropical oils like palm,
• 45:14palm kernel and coconut oil.
• 45:16And then I get some
• 45:17feedback from residents like, oh
• 45:18you know in my culture
• 45:19we use a lot of
• 45:19palm oil, like you know
• 45:20why are you telling me
• 45:21I can't have palm oil
• 45:22or you know, we cook
• 45:23growing up with a lot
• 45:24of ghee and, like, now
• 45:25you're telling me I can't
• 45:26eat ghee, you know. And
• 45:27so,
• 45:28this does this does come
• 45:29up. And so what I
• 45:30how I try to frame
• 45:31it is that
• 45:33if you know something is
• 45:34not the most healthy thing
• 45:36ever, that doesn't mean you
• 45:38can't eat it. Those are
• 45:39totally separate things. And so
• 45:40I like to talk about,
• 45:41like, how I grew up
• 45:42in my culture, like, of
• 45:44of of, you know, protestants
• 45:45in the Midwest. A lot
• 45:46of butter, a lot of
• 45:47casseroles, a lot of cream.
• 45:48Right? And so like I
• 45:49know those things not the
• 45:50best for me and so
• 45:51I try to cook with
• 45:52more olive oil a la
• 45:53Rachael Ray, you know, but
• 45:54like sometimes I do cook
• 45:55with butter and I'm not
• 45:56you know I'm I don't
• 45:57feel shame about that. Right?
• 45:59So part of it is
• 45:59separating those two things. The
• 46:01other thing is to just
• 46:02have a diverse set of
• 46:04staff who work with you.
• 46:05So in our our weight
• 46:06management clinic, we have,
• 46:08a pharmacist who's Hispanic. And
• 46:10so we had a Hispanic
• 46:11patient come in, and he
• 46:12was, like, trying to cut
• 46:13back essentially on his rice.
• 46:14And I'm like, you know,
• 46:15let's switch to brown rice.
• 46:16And he's like, I don't
• 46:17wanna do that. And then
• 46:18I'm kinda like, oh, gosh.
• 46:19Like, what should we do?
• 46:20And then my pharmacist is
• 46:21like, my doctor told me
• 46:22the same thing, and I
• 46:23also don't like brown rice.
• 46:24But what I do is
• 46:25I take white rice and
• 46:26I mix in lentils,
• 46:27and then I use that
• 46:29instead. So you increase the
• 46:30fiber. You increase the plant
• 46:31based protein. You still get
• 46:32to eat the white rice,
• 46:33but you have less of
• 46:34the refined carbohydrates.
• 46:35That is something I never
• 46:36would have thought of. So
• 46:37it's just it's important to,
• 46:39incorporate diverse voices. In the
• 46:41teaching kitchen, we use a
• 46:42variety of recipes,
• 46:43Thai, Mexican,
• 46:45Chinese, like lots of different
• 46:46recipes. I would say they're
• 46:47not definitely not the most
• 46:48authentic,
• 46:49which is a criticism I
• 46:50have of the curriculum that
• 46:51we license.
• 46:52And in the future, honestly,
• 46:53what I would love to
• 46:53do is to get recipes
• 46:55from patients where they do
• 46:56like a a six session
• 46:58class, and in the last
• 46:59session,
• 47:00they bring in like one
• 47:01of their family or their
• 47:02cultural recipes,
• 47:03and we cook, like, a
• 47:05healthier version of it together
• 47:07and then to publish those
• 47:08recipes in, like, a patient
• 47:09cookbook and make that available.
• 47:10So that's a dream of
• 47:11mine where I think we
• 47:12could work on that in
• 47:12the future. But,
• 47:14yeah, it's a it's a
• 47:14constant challenge and I think
• 47:16one worth paying a lot
• 47:17of attention to. Thank you.
• 47:20That was a really great
• 47:21talk. Have you thought about
• 47:22applying this to, third world
• 47:24countries where diets are different
• 47:26and maybe
• 47:27specific diseases like tuberculosis?
• 47:29I know there's been work
• 47:30done in that.
• 47:31Yeah. Great thought. Definitely not
• 47:33an expert in global health,
• 47:34but we did pitch a
• 47:35study in Peru where a
• 47:36lot of children have,
• 47:38iron deficiency anemia. We pitched
• 47:40a study and we found
• 47:41a place with a teaching
• 47:42kitchen, which I was all
• 47:43excited about, and we were
• 47:44gonna go down and kind
• 47:45of teach people about iron
• 47:47rich foods and how to
• 47:47cook those foods in the
• 47:48teaching kitchen. So I think
• 47:49that would be, for instance,
• 47:50a great way to incorporate
• 47:52culinary medicine in in, areas
• 47:54of the world that are
• 47:55not the United States and
• 47:56and eating a largely Western
• 47:57diet.
• 47:59And I'm sure there are
• 47:59other opportunities out there. Really,
• 48:02culinary medicine is done in
• 48:03the US. It's done in
• 48:04Australia, and then it's starting
• 48:05to be done in Germany,
• 48:06and that's it. So you
• 48:07can imagine the impact it
• 48:08could have in other places
• 48:09as well. So huge area
• 48:11for future growth. Yeah.
• 48:14Hi.
• 48:14Over here. Sorry. Hi.
• 48:17I so you were mentioning
• 48:18food insecurity before. How do
• 48:19you work with patients that
• 48:21may only have access to,
• 48:23like, McDonald's or Burger King
• 48:24and don't have access and
• 48:25cannot get to grocery stores
• 48:27or really any fresh produce?
• 48:29Yeah. Yeah. That's where these
• 48:31kinda like produce prescription programs
• 48:32and and, medically tailored groceries
• 48:34and things would really come
• 48:35in handy. So I'm constantly
• 48:36on the lookout for grants,
• 48:37and I'm, like, meeting with
• 48:37people from the school of
• 48:38public health about how to
• 48:39address that. So that's you
• 48:41know, these are all Band
• 48:41Aids that we have, and
• 48:43really we need, like, more
• 48:44systemic solutions essentially for systemic
• 48:46problems as a sociologist would
• 48:48say. That's kind of always
• 48:49how I describe it.
• 48:51But we see these food
• 48:53as medicine interventions and what
• 48:54we do in the culinary
• 48:55in the teaching kitchen teaching
• 48:56culinary medicine is kinda like
• 48:57band aids. So we teach
• 48:58about using canned goods that
• 48:59you could get at a
• 49:00bodega. You know, if you
• 49:01can't find the no salt
• 49:02added, you just wash off
• 49:04the, you know, kinda slimy,
• 49:05starchy, salty water to reduce
• 49:07the salt. We talk about
• 49:08buying, fruit in cans with
• 49:10no sugar added. We talk
• 49:11about buying fresh fruits, I'm
• 49:12sorry, frozen fruits and vegetables,
• 49:14which are just as healthy,
• 49:15if not more healthy than
• 49:16fresh, if people have access
• 49:17to a freezer. And then
• 49:18if they truly only have
• 49:20access to kind of fast
• 49:21foods, we talk about, like,
• 49:22harm reduction strategies, essentially, like,
• 49:24oh, you know, instead of
• 49:25choosing the double cheeseburger,
• 49:27try the grilled chicken sandwich
• 49:28or, like, Wendy's, you know,
• 49:29you can get a baked
• 49:30potato
• 49:31with chili, which is gonna
• 49:32be better than, you know,
• 49:33their saucy nugs and fries.
• 49:35So there are kind of,
• 49:37you know,
• 49:38we don't let perfect be
• 49:39the enemy of good, and
• 49:40we work a lot on
• 49:41harm reduction in in various,
• 49:44strengths.
• 49:46But that's a that's a
• 49:47tough question with not a
• 49:48great solution at the moment,
• 49:49unfortunately. Yeah. It's important, though.
• 49:52Yeah.
• 49:53Hi.
• 49:54So I know culinary medicine
• 49:56is, like, kind of new,
• 49:57and, you mentioned that. Yeah.
• 49:58So it's, like, in the
• 49:59US, Australia, and Germany currently.
• 50:01So I'm from Japan, and
• 50:02I did middle and high
• 50:03school there. And, I mean,
• 50:05their, like, whole mech curriculum
• 50:07is very comprehensive. So, like,
• 50:08what you were saying about,
• 50:09yeah, like, a student's, like,
• 50:10creating our own sort of,
• 50:12like, repertoire of, like, course
• 50:14menu,
• 50:15based on, like, balance of,
• 50:16like, different nutritional
• 50:18benefits is, like, something that
• 50:19I've been learning since, like,
• 50:21I was twelve.
• 50:22But I guess my question
• 50:23is, like,
• 50:24do you see a potential
• 50:26for, like, expanding outreach? Because
• 50:27I feel like it's kind
• 50:28of late to start in
• 50:30medical school, and it should
• 50:31also, yeah, be
• 50:33more, like, inclusive than just,
• 50:35like, medical health care personnel
• 50:37who are learning,
• 50:38about culinary medicine. So, yeah,
• 50:40have you thought about potential
• 50:42outreach,
• 50:43from a younger age? Yeah.
• 50:45Yeah.
• 50:46So there's, like, some logistical
• 50:47challenges basically in our health
• 50:49license. We're allowed to teach
• 50:50culinary medicine in the kitchen,
• 50:51but we're not allowed to
• 50:52teach it outside of the
• 50:53kitchen. So we're working on
• 50:54that. But, yeah, the the
• 50:56k through twelve schools locally
• 50:57have expressed interest in, like,
• 50:58having us come in and
• 50:59doing after school programming,
• 51:01which I think really is
• 51:02us volunteering to replace what
• 51:05should already be in schools,
• 51:05which is home ec. Right?
• 51:06So again, a bigger solution
• 51:08would probably be good.
• 51:09But, yeah, we'd like to
• 51:10do this in local schools.
• 51:11We applied for a grant
• 51:12recently to get, like, a
• 51:13mobile teaching kitchen where we
• 51:14have, like, a table and
• 51:15a cooktop and we make
• 51:16little things and hand out
• 51:17recipes and we could go
• 51:18to, like, cultural fairs and
• 51:20community centers and stuff. And
• 51:21then the dream, if I
• 51:22can land a a big
• 51:24donor, is to basically have
• 51:25a motor home that's a
• 51:27teaching kitchen, mobile teaching kitchen,
• 51:29and then we bring it
• 51:30around into the community. So
• 51:31folks who can't get to
• 51:32our teaching kitchen, we say
• 51:33like, oh, pop on the
• 51:34bus, like let's cook healthy
• 51:35food.
• 51:37That would truly be first
• 51:38of its kind. So if
• 51:39I can get a half
• 51:40million dollars, if you know
• 51:40someone, let me know. I
• 51:42would I would love to
• 51:43do that. But there's some
• 51:44other things I think we
• 51:44can do in the meantime
• 51:45if we get our our,
• 51:47our kind of, ducks in
• 51:48a row with the with
• 51:49the health department, but it's
• 51:50something we definitely wanna do.
• 51:51There's a huge need for
• 51:52it. And I'm jealous you
• 51:53got that education in Japan.
• 51:55Yeah. Yeah. Exactly. Like the
• 51:57movie chef. Yes. Take the
• 51:58food truck on the road.
• 51:59Yeah. Yeah. We have time
• 52:01for, like, one or two
• 52:02more questions.
• 52:09So you kinda talked a
• 52:10little bit about this, but
• 52:11there's obviously obviously, the health
• 52:13and nutrition market in the
• 52:15United States is hyper saturated
• 52:16with lots of competing opinions.
• 52:18Yeah. And especially with the
• 52:20rise of disinformation,
• 52:21most of the information the
• 52:23average person has access to
• 52:24about health is completely false.
• 52:27How do we do you
• 52:28have any strategies that we
• 52:29can apply or maybe that
• 52:31should be applied in a
• 52:32more, institutional sense
• 52:34to prevent the good health
• 52:37strategies that we're learning being
• 52:38just straight up drowned out,
• 52:41or ways that we can
• 52:42make our evidence based curriculum
• 52:44louder than all the fake
• 52:46false information out there?
• 52:47It's so hard. Yeah. I
• 52:49think that'll be, like, the
• 52:50big problem of our generation,
• 52:51essentially.
• 52:53So the misinformation
• 52:55is really attractive because it
• 52:57says to people, listen. You
• 52:58can still eat this healthy
• 52:59food and this unhealthy food
• 53:01and be healthy. And it
• 53:02that's the key to these
• 53:03fad diets. Like, oh, this
• 53:05carnivore diet. Right? You can
• 53:06eat steak and bacon and
• 53:08be healthy. Or, like, grass
• 53:09fed butter, guess what? Because
• 53:10it's grass fed, that's super
• 53:11healthy. You get to have
• 53:12butter. You know? And, like,
• 53:13so that's what these messages
• 53:14that we're coming up against
• 53:15are so hard to compete
• 53:16with.
• 53:17But the other problem is
• 53:18really that people who know
• 53:20and understand nutrition, they've siloed
• 53:22themselves into the ivory tower
• 53:23and into the clinics, and
• 53:25they're not out on social
• 53:26media because really universities
• 53:28don't really care if you're
• 53:29in the media. Like, I
• 53:30do media all the time,
• 53:31and that is not getting
• 53:32me promoted. You know? So
• 53:33that needs to change, so
• 53:35that we have real experts
• 53:37out doing media to compete
• 53:38with all these people who
• 53:39don't know what they're talking
• 53:40about, but, like, happen to
• 53:42make really good videos and
• 53:43be attractive. Right? So, the
• 53:45more of us that get
• 53:47out there with the real
• 53:48message, the harder these folks
• 53:50who are peddling this information
• 53:51will have to work to
• 53:52compete with us.
• 53:54But, you know, I used
• 53:54to work for doctor Oz
• 53:55on the doctor Oz show,
• 53:56and so I always tell
• 53:57people I saw the good,
• 53:57the bad, and the ugly.
• 53:58And so we had some
• 53:59really great health experts who
• 54:00had really good information. And
• 54:02then, you know, I signed
• 54:03an NDA. So I'll just
• 54:04say that perhaps the opposite
• 54:05is also true.
• 54:07And,
• 54:08that's what I walked away
• 54:09with understanding is that, like,
• 54:11oh, even if media is
• 54:12not my total huge passion
• 54:14in life, like it's my
• 54:16kind of like moral and
• 54:17ethical responsibility, my civic duty
• 54:19to, like, get out there
• 54:20and talk about this, to
• 54:21combat all that misinformation.
• 54:23And so if we can
• 54:23convince other people that it's
• 54:25their duty also, hopefully that
• 54:27makes a dent, but we'll
• 54:27see. Time will tell.
• 54:29Great question.
• 54:31Thank you for your talk.
• 54:33One question I have is,
• 54:34how would you recommend for
• 54:36medical students or folks in
• 54:38training
• 54:39to learn more about,
• 54:41culinary medicine, lifestyle medicine, and,
• 54:43kind of how to incorporate
• 54:44in our learning?
• 54:46Yeah.
• 54:47So a lot of medical
• 54:48schools are incorporating,
• 54:50lifestyle medicine kind of throughout
• 54:52the curriculum, which I think
• 54:53is important. So for instance,
• 54:54in my medical school, we
• 54:55had each of our disease
• 54:56states that we learned about.
• 54:57And then for one month
• 54:59throughout the four years, we
• 55:00had our nutrition section,
• 55:01not the best way to
• 55:02learn about nutrition. It should
• 55:03be incorporated in the heart
• 55:04disease lectures, the cardiovascular disease
• 55:06lectures, type two diabetes, fatty
• 55:07liver disease, that right. When
• 55:08you do your population health,
• 55:10kind of portion of, of,
• 55:12epidemiology and learning how to
• 55:13critically appraise literature, some of
• 55:15it should be diet and
• 55:16nutrition literature. Right? So there's
• 55:17a way to incorporate it
• 55:18throughout
• 55:19that I think,
• 55:21should be done, and we're
• 55:22looking into that here at
• 55:22Yale. Like, I think that's
• 55:23coming, so that's good.
• 55:25And then there are residency
• 55:26level program curricula like the
• 55:28lifestyle medicine residency curriculum, which
• 55:30is through the American College
• 55:30of Lifestyle Medicine that can
• 55:32be implemented in residency programs.
• 55:34That's really taken off since
• 55:35it was developed about five
• 55:36years ago.
• 55:37Like I mentioned, once we
• 55:38have these asynchronous curricula, those
• 55:40will be more widely available
• 55:41even outside of medical school.
• 55:43They're just gonna be online,
• 55:43and anyone who's interested can
• 55:45learn about culinary medicine through
• 55:46these curricula. So that'll be
• 55:48important.
• 55:49But really it just has
• 55:49to be, like, the institution
• 55:51has to make it a
• 55:52priority to incorporate it throughout.
• 55:54But if in my ideal
• 55:55world, it would be incorporated
• 55:56through those lectures. There would
• 55:58be both nutrition and general
• 56:00lifestyle medicine incorporated throughout, and
• 56:02then all medical students would
• 56:03be in the teaching kitchen
• 56:04once or twice at least,
• 56:06throughout their medical school training.
• 56:08And then maybe once again
• 56:09in residency, and really we
• 56:11would teach foundational nutrition in
• 56:12medical school. We would teach
• 56:13patient counseling skills in residency,
• 56:15and you'd work with standardized
• 56:16patients throughout. So that that
• 56:17would maybe be the gold
• 56:18standard, but hopefully someday we
• 56:20get close.
• 56:22Alright. Thank you all for
• 56:23your insightful questions and for
• 56:25coming out today. And thank
• 56:26you, doctor Nate Wood,
• 56:28for a great presentation and
• 56:29for answering the questions. I
• 56:30think he deserves a great
• 56:31round of applause.
• 56:33Thank you. Thank you.
• 56:36And, yeah, stay tuned for,
• 56:38some more,
• 56:39medical student council perspectives on
• 56:41medicine lectures. There's one next
• 56:43month. So
• 56:44thank you.
• 56:47Awesome. So we got the
• 56:49thought things in it. Appreciate
• 56:51it.
• 56:52Yeah.
• 56:53That was great.
• 56:59You did a great job.