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To improve patient diets, the doctor is in…the kitchen

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    When you go to the doctor, you often leave with a prescription for medicine, but some doctors are experimenting with a new kind of prescription, one for fresh, healthy food.

    And, as the trend grows, more doctors and health professionals are getting more training in the kitchen.

    Special correspondent Allison Aubrey of NPR News has the story.

  • WOMAN:

    We have the minerals and grains that are going to lower blood pressure.


    At Casey Health Institute in Gaithersburg, Maryland, the doctor is in, but your appointment might just be in the kitchen.

    This is called the Physician's Kitchen. And on this night, primary care doctor Nicole Farmer is prescribing food.

  • DR. NICOLE FARMER, Casey Health Institute:

    So, you can see eating whole grains actually is going full circle in terms of helping to control diabetes and blood pressure, but also prevent it too.


    This doesn't mean giving up favorites, like pancakes. Instead, the goal here is to make breakfast foods healthier, using grains like buckwheat and millet.


    I feel like it's important for me to spend my time here, in addition to being in the exam room. If I teach you how to cook, you're going to improve the types of food that you eat, and then ultimately that is what is going to prevent chronic disease for you.


    The most recent evidence comes from a study published in "The Journal of the American Medical Association." Researchers found that, here in the United States, about one out of every two deaths from heart disease, stroke and type 2 diabetes is linked to a poor diet. That's 1,000 deaths every day.

    Paula Fischthal knows that all too well. Her dad died early of a heart attack, and her mom had diabetes. With this strong family history, she was really concerned. That's how she ended up here.


    When I first came here, Dr. Farmer diagnosed me with pre-diabetes. And I really didn't want to take medication.


    Fischthal has changed her whole relationship with food. She tossed out processed snacks, and she's cooking with fresh ingredients.


    I have gradually gotten rid of the starch that goes with dinner. It's more vegetables and protein.


    She also started taking yoga classes. And over the last year, she's lost weight. Now her blood sugar has returned to normal. And this means she's no longer considered to have pre-diabetes.

    Her story fits with the conclusion of the most comprehensive study ever on diabetes prevention. It was a federally funded study carried out by the National Institutes of Health, with collaborators at 27 sites across the country. They found, when people change their diet to lose weight and become more active, it can be more effective than medication in preventing the disease.

    Dr. Farmer tells all her patients about it.


    The diabetes prevention study taught medical science that we don't need to jump the gun when it comes to prescribing medications to prevent diabetes, and that the most effective thing we can do is to promote a healthier diet and to promote them to engage in regular exercise.

    The porridge could be a daytime snack, if you want it to.


    And meeting patients here in the kitchen, Farmer says, is the best promotion.

    The idea that you can bring doctors and other health care professionals into the kitchen to teach people that changing their diets can actually help them prevent disease is starting to catch on.

    Inside this stone fortress is the Culinary Institute of America's Napa Valley campus. Here, some 500 doctors and health professionals recently got a crash course in how to build food and nutrition into their medical practices. They spent four days sauteeing, slicing and tasting.

    It's put on by the Harvard School of Public Health and the Culinary Institute, as well as a few dozen food service companies who sponsor the event.

    DR. DAVID EISENBERG, Harvard T.H. Chan School of Public Health: At this conference, we bring in some of the top nutrition scientists in the world to say, look, here's the evidence that eating these foods either keeps you healthy or reduces your risk of disease, whereas eating these foods really speeds up your risk of disease, heart disease, cancer, diabetes.

    Second,the chefs at the Culinary Institute, who are not just great chefs, but great teachers, say, let me show you how to do that.


    Dr. David Eisenberg from Harvard's School of Public Health is master of ceremonies and founder of this event. It's called Healthy Kitchens, Healthy Lives.

    One thing he's trying to change may be surprising. Most doctors, he says, aren't taught much at all about nutrition.


    Today, most medical schools in the United States teach less than 25 hours of nutrition over four years. The fact that less than 20 percent of medical schools have a single required course in nutrition, it's a scandal. It's outrageous. It's obscene.


    Primary care doctor Helen Delichatsios is speaking at the event. She's been teaching her patients about nutrition and cooking for seven years now, at Massachusetts general hospital in Boston.

  • DR. HELEN DELICHATSIOS, Primary Care Physician:

    Many people come to their doctor and have high blood pressure and high cholesterol. One somewhat easy answer is to send them away with one prescription for their blood pressure, one prescription for their diabetes, one prescription for their cholesterol, when, in reality, if you work on the underlying root problem, which may be poor diet and physical inactivity, both of which are tied together, fixing those can address all of the concerns at once.


    Delichatsios has figured out how her practice can get reimbursed for all the cooking and nutrition instruction. And she's sharing this information with other doctors at the conference.

    Dr. Joseph Wetterhahn's hospital just installed a teaching kitchen. He's a primary care doctor in a rural area of Upstate New York.

  • DR. JOSEPH WETTERHAHN, Primary Care Physician:

    Part of our education here is, they do teach how to do the correct coding and the correct billing, so that you can do this at a break-even.


    After attending this conference a few years back, Sanjeet Baidwan was so inspired, she convinced Yale Medical School to let her teach a new class called Culinary Medicine. She's a primary care doctor at Yale's Medical Center in New Haven, Connecticut.

  • DR. SANJEET BAIDWAN, Yale University Medical School:

    When dealing with medical school, I often felt that residents were ill-equipped, or they would say to me, well, I don't know that. Maybe we should send them to a nutritionist, or would kind of maybe give some really broad-stroke nutrition information like off the cuff.

    But I would say that a lot of patients come in just really desperate for good information, good direction.


    Eisenberg's vision goes way beyond just doctors in the office.


    If we're going to build teaching kitchens in hospitals, maybe we should also think about building them in K-12 schools, and why stop there? How about corporate workplaces and retirement communities?


    One of the largest food service companies in the world is already on board. Compass Group USA Runs food services at schools, nursing homes and corporate offices. They're planning to build 20 teaching kitchens this year.


    We have the polyphenols in grains that are going to lower pressure.


    Back in Gaithersburg, Maryland, physician Nicole Farmer says one stumbling block for her patients can be cost. But she shows them that healthy choices aren't necessarily more expensive.


    We got a whole bag of millet for less than $2. And this contains about three to four servings, so about enough for three to four meals.


    So, what about this farro here? This is a little bit pricier than a brown rice, right?


    So, a box of farro will cost about the same price as a good-quality brown Rice.


    Farmer says you may have to shop around a little bit or go online to buy these grains, but they are available, including in stores that accept SNAP benefits, or food stamps.

    Over the last decade, Eisenberg says he has watched as this movement has started to take off.


    There are now hundreds of teaching kitchens. And I think the idea has found receptivity across the country.

    We have now got Cleveland Clinic. We have got Kaiser Permanente. We have got Harvard, and Princeton, and the University of Texas, and 20 other university systems making this available to their patients or their trainees.


    I'm Allison Aubrey of NPR News for the PBS NewsHour in Napa Valley, California.


    Online, if you're looking for healthy recipes approved by both chefs and doctors, we have some for you to try. You can find five ideas at pbs.org/newshour.

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