Many Americans rely on food prepared away from home as a regular part of their diet, with about 61 percent reporting in a Gallup survey that they ate out at least once in the past week. And about 16 percent were frequent diners, eating dinner out three or more times a week. When people dine out and consume commercially prepared food, it is often linked to the obesity that affects about one-third of American adults.
But the flip side can provide some solace. The more people cook at home, the healthier their diet, the fewer calories they consume and the less likely they are to be obese or develop type 2 diabetes. By providing easy-to-follow culinary instruction and education, physicians can help their patients improve the quality of food preparation at home.
“There is a huge gap between the nutritional knowledge that we educate our patients with and what they know how to do,” said Rani Polak, MD, during the American College of Preventive Medicine (ACPM) Annual Meeting in Chicago earlier this year. “Physicians should bridge that gap between the knowledge and skills patients have.”
Dr. Polak has an unusual background. He left medical school and became a Le Cordon Bleu-trained chef before medicine. He trained in family medicine and completed a fellowship in the relatively new specialty of lifestyle medicine. Dr. Polak is the founding director of the Culinary Healthcare Education Fundamentals (CHEF) Coaching program at the Spaulding Rehabilitation Hospital’s Institute of Lifestyle Medicine in Boston. Dr. Polak is also a research associate at Harvard Medical School’s physical medicine and rehabilitation department.
Here are three pointers Dr. Polak offered to physicians and other health professionals seeking to incorporate a bit of what he calls “culinary coaching” into practice.
It’s not just about what you eat, but where you eat it and who makes the food. Dr. Polak cited literature showing that home cooking has fallen by 25 percent in the last 40 years in the U.S. By defining and emphasizing the importance of home cooking, physicians send a strong message about what a big difference it can make.
Just by cooking at home, said Dr. Polak, patients can experience a variety of benefits, including portion control. Patients can also consume less calories, additives, fats, sugars and salt. Cooking at home even improves ingredient quality—more vegetables and healthier fat—and creates healthier dietary patterns through family meals.
To show how easy it is to make a healthy meal, Dr. Polak led a cooking demo to a crowd of eager physicians. He cooked grilled zucchini in mint vinaigrette, beet and kohlrabi cubes with parsley sauce and red tahini spread. When physicians understand how easy it is to cook at home, they can share their knowledge and experience with their patients.
When recommending home cooking for patients, identify some of the barriers they might encounter, such as limited time, skills and cooking confidence. As physicians, by understanding what these barriers are, you can better help your patients.
“If you think about yourself, time is often the biggest barrier,” said Dr. Polak. “Explore alternative cooking skills to address barriers because you don’t just tell the patient to cook—you help them.”
For example, Dr. Polak recommended sharing videos from ACPM’s culinary medicine webpage that can help patients cook. The instructional videos also address the time barrier through batch cooking. These free culinary videos are available for patients and physicians and provide tips that make healthy cooking at home easy and manageable.
Imparting elementary culinary knowledge is essential. For example, one of Dr. Polak’s patients said she understood the importance of cooking at home, but complained that she did not have the time to buy fresh food frequently. To help her overcome this, Dr. Polak discussed options for buying food, freezing it for storage and then defrosting it later to cook and eat. That doesn’t just apply to meat and vegetables but to bread, Dr. Polak told his patient.
“The patient was so excited to know that fresh bread could be frozen and defrosted,” he said. “This knowledge was lacking, but it was not unusual. Try to imagine the gap between the recommendations provided for patients and their ability to implement them.”
The Institute for Lifestyle Medicine offers educational programs on lifestyle and culinary medicine for physicians and other health professionals, and offers a “CHEF Coaching program” geared toward patients.
Among other things, the courses for clinicians cover what and how patients should cook, shopping checklists, kitchen tools and ingredient use, cooking on limited time or budget, and the use of motivational interviewing techniques to encourage reluctant patients to cook more.
The AMA Education Center offers CME modules on nutrition science and helping patients understanding nutritional labels, among other topics.