March 27, 2023

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In the early 2000s, my body appeared to be turning on itself — plagued by gnawing abdominal pains, a deep and yawning fatigue that made me fear getting behind the wheel of my car some days, and rashes that inflamed my skin as though something had been hiding inside me and suddenly wanted out.
I visited doctor after doctor, underwent test after test until, finally, I had a few labels to tag onto my symptoms: Epstein-Barr virus, ulcers, anemia, chronic fatigue. The doctor sent me on my way with what felt like a nebulous prescription: reduce stress, get more sleep, take iron supplements that won’t upset the stomach.
Relieved that my issues were not life-threatening, I was, nonetheless, determined to improve my quality of life. I read whatever I could get my hands on (which wasn’t much back then) about autoimmune diseases and how to heal naturally, becoming particularly obsessed with ridding my diet of yeast, wheat, meat and sugar. I got better — much better —but the changes were too swift and drastic and so, as soon as life got more complicated (a new job, pregnancy, new motherhood), I fell off my healthy-food-only wagon.
Health professionals know that when it comes to lifestyle changes, we need guidance and ongoing support to be consistently successful. But the doctor’s office has not been the place to get nutritional support tailored to our health needs.
“In medical school we get very little nutritional training, but patients think, ‘Oh, my doctor should know what I should eat, what diet I should follow,’ ” says Nimisha K. Parekh, M.D., a University of California, Irvine gastroenterologist who directs the UCI Health Inflammatory Bowel Disease Program. “We’ve been ill-equipped in our curriculum and, unfortunately, that’s a detriment … but if you look at Western medicine, it is focused on ‘What’s the disease and how do we treat it?’ There is a preventive arm, but the [medical] culture is slowly building to that.”
In 2016, David Kilgore, M.D., acted on his vision to move the needle on that slow culture shift at UCI, where he served as director of the integrative medicine track and fulfilled other roles. He launched a culinary medicine program to help teach medical students how to marry the science of medicine and the art of healthy cooking, which meant, yes, medical students donning aprons and getting in the teaching kitchen.
Kilgore has since retired, but the program continues to build, with Parekh now at the helm. UCI’s new Susan & Henry Samueli College of Health Sciences building is scheduled to open in October, and the culinary medicine program will expand from just classes that medical students can take to cooking classes that the community will be able to enjoy in a state-of-the art teaching kitchen: the Nutrition Education Center.
Parekh and the rest of the culinary medicine staff, which includes another doctor, a chef, registered dieticians and a mindfulness coach, are excited about expanding into community education. “In culinary medicine, you have the option to focus on the preventive arm, to help people try to control some of their prediabetes, pre-hypertension before they have to go on medicine, with changes in their diet,” Parekh says.
While classes and programs in what has been coined “culinary medicine” have popped up at some traditional medical institutions around the country in recent years, the main focus has been on educating medical students, physicians, nurses and other health care providers. To date, more than 200 first- and second-year medical students have completed the culinary medicine elective at UCI.
“The reason I love this philosophy is because patients will model the behavior of their health care providers,” Parekh says. “So, I can say to my patients, ‘Hey, I make this salad every day, and if I can find the time to meal prep, how about I help you?’ ”
Instead of overwhelming students with complicated recipes, Chef Jessica VanRoo’s first class centers on knife-wielding skills. From there, she teaches students how to make a well-balanced salad — with greens, proteins and grains, mixing and matching to their taste — as well as how to make their own salad dressings. Class two advances to the stove with a simple stir-fry recipe. “People get intimidated by cooking. In culinary medicine, we try to break it down and make it easy — building blocks,” Parekh says.
VanRoo uses the Mediterranean diet — plenty of vegetables, fish rich in omega-3 fatty acids, nuts, whole grains and spices that possess anti-inflammatory properties — as a kind of road map that can be adapted to other cuisines, keeping people’s cultural preferences front and center.
When the meals are ready and the table is set, the “medicine” continues. “You don’t just start eating. We practice mindful eating — looking at all the colors of the foods on our plates, paying attention to the smells and textures,” says the Samueli Integrative Health Institute’s Karen Lindsay, Ph.D., a registered dietician with a doctorate in nutrition. This kind of “slow eating” can help decrease stress levels in the body and “may affect how we actually metabolize food as well as food digestion.”
To slow the eating process even more, the coach sometimes directs students to eat with their non-dominant hand. “You’re a little bit more clumsy that way,” Parekh says. “By slowing down, it allows you to enjoy your food better, and the way the hormones work in your brain, it fills you up quicker.”
Witnessing medical professionals bridge holistic practices that have existed in alternative health and wellness communities often at odds with the medical world certainly feels like a different universe from just 20 years ago, but Parekh stops short of some wellness speak.
“Food alone cannot be the only solution,” she says. “Some people need a combination approach, and I think that’s what culinary medicine says: ‘Hey, still talk to your doctor, still take your medicine if you need it. Here’s a component that focuses on your well-being and lifestyle changes to help improve your quality of life.’
“I think one of the dangers could be people saying, ‘I can just cure my cancer with a diet.’ That’s not what we’re teaching. We’re integrating diet into part of your management or treatment plan. It’s not your sole treatment. That’s the danger when we use phrases like ‘food is medicine.’ People think it’s a substitute, and it’s not always a substitute. It’s an adjunctive therapy, like herbs and supplements. That’s why we try to focus on the evidence and what’s the science behind it.”
Some of that science indicates that food can be healing — some of the time. “I think it definitely can, and it very much depends on the disease, the condition,” Lindsay says. “For example, diabetes, which is such a huge one in our society now. Prevention is always better. It’s easier to catch things and then prevent it; that’s the goal, but sometimes we are too late with that. With Type 2 diabetes, which is glucose intolerance with insulin resistance, it is entirely reversible through diet and lifestyle, but it takes a lot of motivation and diligence and change on the part of the individual. With the right support systems and medication, it is feasible. There are many reports of complete reversal of diabetes through lifestyle changes.”
Other conditions, such as rheumatoid arthritis and other autoimmune diseases, she says, can’t necessarily be cured but will often go into remission through diet and exercise. “By going on an anti-inflammatory diet, people can get really amazing results.”
For now, UCI officials are still rolling out the knots on how community cooking classes will look — whether they will start with patients in a certain group, such as diabetes, or have classes more widely available to the general public.
But culinary medicine begins long before the kitchen. Like schools, access to quality, organic food is not equitable across the SoCal region. To address access and affordability issues, Lindsay tells medical students and her patients about the many farmers markets that saturate the area, and stresses that many of them will accept benefits such as Medical and CalFresh. “A real structural change needs to happen in certain populations because right now their ability to eat healthily is definitely hampered. It’s a total injustice.”
Conscious of the high cost of organic foods, the program doesn’t focus exclusively on organic produce. “We get The Environmental Working Group’s updates each year on the top 12 foods that are considered the most sprayed. If possible, buy those organic. The ones in between – and fruits with hard outer skin that can be peeled off — don’t need to be organic. But even if organic produce is out of the picture, just eating more fruits and vegetables is still better for your health as opposed to relying on processed food and fast food.”
The chef recommends her favorite spots for picking up seasonal fruits and vegetables, as well as fresh fruit. The staff also teaches students the “map” of traditional grocery stores: fresh produce, fresh meat and dairy are laid out on the perimeters, whereas pantry staple foods and heavily processed foods sit in the middle aisles.
“The general guideline is that the more you can shop around the perimeter, the more fresh ingredients, the more real whole foods you’ll end up putting in your shopping cart,” Lindsay says.
And the middle aisles?
“Mostly avoid those aisles.”
As the medical profession works to catch up to a more holistic approach to treating patients, those who have worked in healthy food preparation, activism and education outside medical walls are watching with interest as they continue to use social media, events and blogging to spread their own messages of healthy cooking and eating.
“I think it’s an absolute travesty that diet and nutrition have been overlooked for so long by the medical industrial complex but am overjoyed that we are now entering a more food- and nutrition-conscious world,” says Camila B. Casañas, a chef, herbalist and founder of Camila Creates in L.A.’s Highland Park neighborhood. She offers a private chef service centered on “enhancing the ethical integrity of food choices by implementing sustainable, eco-specific food plans.” She is one of the chefs who cooks for kids at the annual summer camp at Moonwater Farm, an urban farm in Compton that aims to educate children about farm life and healthy eating.
“I teach the kids how to make healthy and easy nutritious meals, and some basic herbal medicine making,” Casañas says. “The kids really enjoyed making veggie burritos using super wholesome ingredients like butterfly blue pea-infused rice, slow-cooked black beans, roasted vegetables, grass-fed cheddar cheese and spinach tortillas. We’ve also done herb-infused honeys using plants and herbs picked straight from the Moonwater Farm garden.”
She credits her childhood experience of growing up in Yosemitewith influencing her culinary career, which has included working as a chef in San Francisco restaurants before moving to L.A. in 2015 to study holistic nutrition and herbalism. She fused these studies into her cooking while treating her mysterious illnesses that she believes were rooted in autoimmune issues.
“Growing up in Yosemite, it was impossible not to be connected to all of the lush and soulful land around me,” she says. “There was a significant presence of native Miwuk folks there as well. Every year, my father was invited to go on “the walk,” what the tribe described as a spiritual journey where tribal members, family and invited friends reconnect to their traditional homeland, walk together, pray together and honor the land and ancestors who walked before them.”
Casañas views food as just one component of good health. “We are so unique in our biology and physiology that it’s truly a process of learning about our own bodies, doing research and understanding what works for us individually to make the right choices about our health.”
In 2017, Stephanie Weaver, an author and health and wellness coach based in San Diego, published “The Migraine Relief Plan: An 8-Week Transition to Better Eating, Fewer Headaches, and Optimal Health” and recently published a follow-up cookbook, “The Migraine Relief Plan Cookbook: More Than 100 Anti-Inflammatory Recipes for Managing Headaches and Living a Healthier Life.” In the introduction of her latest book, she reveals that when the first book was published, some doctors considered her writings about food triggers controversial.
“While food triggers in migraine may never be fully studied, all doctors in the headache field agree an anti-inflammatory diet like mine is beneficial for migraine patients,” she says. “I know one neurologist who ‘prescribes’ my book to all his patients, even ones without migraine disease, because he’s seen such benefit from the anti-inflammatory aspect of the plan.
“I’m thrilled that conventional medicine is finally incorporating nutrition into both medical school curriculum and as a tool for patient treatment and health. Doctors can only prescribe what they know. Treating the whole patient via nutrition, movement and lifestyle is so important.”
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