Because we
have people viewing
from around the world
in our live stream,
we will begin the program.
I'm Gina Vild.
I'm the Associate Dean for
Communications and External
Relations for Harvard
Medical School.
And I'm thrilled to welcome
you to our talk at 12:00.
If you're watching
through the live stream,
we welcome you as
well as our full house
here in the Harvard
Medical School auditorium.
I'm sure you've
heard the expression,
"You are what you eat."
Have you thought about this?
How true is this for you?
How much time have
you spent thinking
about the food you consume
and the effect they
have on your body?
During the next
hour, we're going
to hear what's new
in the emerging
field of culinary medicine and
how nutrition and diet directly
affect your health
and well-being.
At the end of this program, our
speaker will take questions.
So we will have a microphone
for those in the audience.
If you are watching us
through the live stream,
please write your question in
the comment box on Facebook
or on our YouTube channel.
Before I introduce our
speaker Dr. Rani Polak.
I want to tell you a little
bit about his field of study--
culinary medicine.
Did you know that
it's been nearly
40 years since a new
enthusiasm emerged in medicine?
An enthusiasm to
investigate the role of food
as a determinant of
our overall health.
Recent studies have
shown that when
you're trying to maintain
a healthy lifestyle
or working to lose
weight, the meals
you prepare in the kitchen
are equally as important
as your exercise routine.
And in this day of
increasing health care costs,
food and a proper diet can
be just as vital as medicine
when you're dealing with chronic
diseases, such as diabetes,
cardiovascular
disease, and obesity.
So what foods should we
include in our daily diet?
How do we grocery shop
for healthy eating?
And importantly,
how do we order when
we're eating in a restaurant
to make sure that we're
eating healthy foods?
Dr. Polak will answer
these questions
and offer helpful tips on how
to create your own recipes
for good health.
Dr. Polak is a Research
Associate in Physical Medicine
and Rehab at Harvard Medical
School and the Founding
Director of the Chef
Coaching Program--
a program I did not know until
today existed at Harvard--
in the Institute of Lifestyle
Medicine at Spaulding Rehab
Hospital.
His current work concentrates
on culinary coaching,
an innovative
telemedicine approach that
utilizes evidence-based
medicine to help individuals
and professionals efficiently
and cost-effectively improve
nutrition through home cooking.
Thank you for joining us.
Clearly, there are many people
waiting to hear you speak
and we're delighted that
you've made the time.
Thank you.
[APPLAUSE]
Thank you so much
for the introduction
and thank you for
the invitation.
And welcome everybody and
welcome all who join us online.
And we will talk today
about culinary medicine.
So let's start.
We will talk about home
cooking, the science which
is related to home cooking,
and then culinary medicine
is highly related to
nutrition education.
So we will talk
about that, then I
will introduce the field
of culinary medicine
and I will dive into
what we do at Spaulding.
I will share with
you a few resources
that you can share with your
patients and also use yourself.
And I will also share a
little bit of information
about how to expand your
knowledge in this field,
if you feel interest to do so.
So let's start with
talking about culinary--
about home cooking.
So I usually start my
thoughts with the testimonial
of one of my patients.
So this is testimonial
from our first patient.
He is a physician
from Boston area.
He was recently diagnosed
with type 2 diabetes
and he knew he needs to
change his lifestyle.
And he thought,
OK, I know I need
to eat better, I know I need to
move, what I would like to do?
And he thought he would
like to cook more at home.
And when we briefly
discussed his lifestyle,
he told me that he
usually go out for lunch
and buy a huge hub and
then eat it for lunch.
And actually, he would like
to make his own sandwiches.
And when we dived deeper,
he told me, well, I'm
confident to make
my own sandwiches.
I know they will be delicious.
But I don't have time to buy
fresh bread every morning.
And then I ask him if you know
that he can freeze and defrost
bread.
And he said, wow,
I didn't know that.
So and just think about
the huge, huge gap
between the
nutritional information
that we try to educate our
patients to their skills
to implement those guidelines
into their daily life.
Huge gap that usually
we are just ignoring it.
So back to this patient.
Once he knew he can
freeze and defrost bread,
he'd buy bread every week
and freeze his bread,
and defrost a few
slices every morning
and make his own sandwiches.
And he feels great.
And he lost weight.
He's really good.
And several nutrition
publications
went out almost every day,
but this field of home cooking
is kind of ignored
to a certain degree.
And look at the science.
So as you can see that
the home cooking decreased
in the last 40 years
in more than 20%.
The opposite behavior, which
is eating away from home,
increased in more than
40% in the last 40 years.
Does it have any nutritional
or health impact?
So this is a study,
for example, that
underlies the enhanced data.
And look at these
interesting outcomes.
They divided the group
into three groups,
those who cook between
zero to one dinners a week,
those who cook two to
five dinners a week,
and those who cook six
to five dinners a week.
And you can see that as
much as you cook more,
you consume less calories.
This is really interesting.
But actually, the second row
is much more interesting to me.
The second row is of people
that say that they don't' care
about their nutrition.
They eat whatever they want.
Still you can see that as
much as they cook more,
they consume less calories.
So this is really
interesting for me
from a nutrition
education perspective.
The people that just
cook whatever they want
can eat less calories
if they cook at home.
A more recent study from the UK.
And they present two different
groups, but more or less
the same.
Less than three dinners a week,
three to five dinners a week,
and over five dinners a week.
And you can see that as
much as you cook more,
you consume more
fruits, more vegetables,
your diet is more aligned to
the Mediterranean diet, more
aligned with the
DASH diet score.
Nutrition is really better
if you cook at home.
So let's go back to
the previous slide
and think about the science.
This is just a
cross-sectional study.
But what if your home
cooking was better defined?
What if there were calculated
21 meals a day, which most of us
eat.
It's not just dinner.
What if there were measure
home cooking and also adherence
to healthier diet regime?
We think that these differences
might be much more powerful.
Just think about if
we will manipulate
those numbers a
little bit better,
and we were
calculating 21 meals.
and we were analyzing
exactly what is home cooking.
And we would analyze not just
whatever everybody cook, just
healthy ingredient.
So we think that we can really
help people to eat better
by home cooking.
So when you ask people
if they cook at home,
you receive tons of answers.
There are people that
will say yes, only
if they do all scratch cooking.
Others will answer
yes if they will
defrost their hamburger
and microwave it
and eat it at home.
So this is really
quite a vague area
which needs better definitions.
Let's look on the
opposite behavior
of eating processed food.
So this is a really interesting
food classification-- the NOVA
food classification.
And more and more studies
are coming out these years
using this classification.
This is a very
innovative classification
that doesn't look at
the diet regime at all.
They looked only on the level
of the process of the food.
That's all.
It could be rich in
vitamins, it could
be rich in fibers, whatever
considered healthy diet.
If it's processed,
it will be here.
You can eat steaks 24/7.
If you make it
from scratch, so it
will be here-- unprocessed
or minimally processed food.
Really innovative
for classification.
Processed versus cooked.
So the first group
is unprocessed
or minimally processed food.
And as I said, anything
that is raw or minimally raw
would be here--
beef, white flour, whatever
is considered unprocessed
or minimally processed.
The second group will be
processed culinary ingredients.
All these things that you
need to use when you cook.
Usually you do not use a lot--
like salt, pepper,
or a little bit
of fat, sugar, and
stuff like that.
The third group
is processed food.
But these are
usually a combination
of food from groups one and two.
Usually two or
three ingredients--
cheese, bread, tuna fish, canned
tuna fish, and stuff like that.
And the last group is
the ultra-processed food.
These are the food that
combines various ingredients.
Some of them are not considered
food, such as whey or gluten,
all kinds of
non-sugar sweeteners.
And again, even stuff that
might be considered healthy
by many experts.
And in the last few years,
several studies came out
that use the NOVA food
classification that
show that as much as you use
unprocessed food or minimally
processed food, your
weight is better,
your glucose control is better,
your blood pressure is better.
And this is a recent
study that shows
that people who eat
more unprocessed food
are less likely to have cancer.
So this is really premature.
I'm not trying to say that
we need to eat whatever
we want if it's cooked.
But it's a different
way to look on nutrition
that might bring several
new thoughts about how
to help people to
eat healthier, how
to improve their dietary plan.
So let's move to
another area where
we think that culinary
medicine can bring value.
And this is nutrition education.
So I don't know where
all of you work.
I work at Spaulding.
We have an amazing gym, an
unbelievably amazing gym.
However, we do not have
a teaching kitchen.
We do not have a kitchen.
And in many other
hospitals that I
worked for, we have
nice gyms, none of them
had a teaching kitchen.
So why do we think that we need
a huge facility and health care
professionals to help people
to do the right exercise,
and on the other hand, we think
that just by telling people,
oh, you need to eat
more vegetables,
that they will be fine?
I don't know.
I really don't know.
I'm talking about
that with many people
and no one knows why the
exercise guys have such luxury
to have gyms and the guys
that educate about nutrition
needs just to talk
with the patients.
Also, many nutritional leaders
think that nutrition should not
include only knowledge-based
education, but also skills.
I mean, we need to
teach people how
to make the food we
would like them to eat,
if we would like them
to adhere to the diet
that we recommend them.
This makes so much sense.
So even one call
from the Academy
to include culinary
skills education
in children obesity
prevention interventions.
So just think about
the potential benefits
of home cooking.
And cooking is one
concrete behavior.
We try to encourage people to
eat less salt, less sugar, more
vegetables-- several behaviors.
And this is just one behavior
that if we will focus on it,
so many benefits can come.
So just think about what could
result from more home cooking--
better portion control,
usually less calories, usually
less additives and other stuff
that people put in our food,
less fat, less sugar,
less salt, usually
improved ingredient
quality, which
means more vegetables,
healthier fats and, of course,
healthier dietary patterns.
Usually people that cook
at home eat with a family.
So to conclude this section,
, what if institutions
and lifestyle medicine
program will offer hands-on
skills-based
nutrition education?
So in that environment,
culinary medicine grow.
And this is really a
new field, which wasn't
defined appropriately yet.
This is the first two efforts.
The first is by John La Puma.
He's another physician chef.
He works at California.
And he defined culinary medicine
as "A new evidence-based field
in medicine that blends
the art of food and cooking
with the science of medicine."
The second definition is from
the website of Goldring Center
of Culinary Medicine.
It's one of the leading
centers in the country.
It's down at Tulane
at New Orleans.
And they defined
culinary medicine
as "Utilization of unique
combination of nutrition
and culinary knowledge
to assist patients
in achieving and
maintaining optimal health."
So cooking is one,
you can help people
improve their dietary plan
by improving the quality
of the food they eat.
And two, it has also
education benefits.
You can help people
to understand
better how to prepare the
food, what are vegetables,
what are fruits, and so on.
We have a little bit of
science about this field.
I think two systematic
reviews came out.
The first one was in 2014.
The second one
went out last year.
You can say that the
evidence-base is growing.
We have only 28 studies
during over 30 years.
And in the last
five to six years,
we have another 34 studies.
So we are doing better
in evaluating this field,
but still the outcomes
are very modest.
We are only in the beginning
of this very interesting path.
Usually culinary
medicine intervention
results in improved dietary
habits, improved diet quality,
but there's still inconsistent
evidence about health.
And usually, the
methodology is not ideal.
I know, for example, on
two centers-- one, again,
in New Orleans--
the second center is
our center at Spaulding
that has penned the grounds for
randomized controlled studies
with two to four
years evaluation.
So this is the first studies
that hopefully will take place
to see what we can find from
culinary medicine intervention.
But I brought you
two examples just
to get you a little
bit of understanding
of what people are doing.
So this is a study that
was delivered to patients
with type 2 diabetes.
And the location was
teaching kitchen.
They invited them
to teach in kitchen
and actually teach them how to
cook diabetes-friendly recipes.
And you can see very
interesting outcomes.
Improvement in almost all
the dietary measurements.
Better energy, better
fat, better saturated fat,
tons of improvements.
But you also can see that
the methodology is not ideal.
Only post-training evaluation
and without control.
Another example now is for
a health care professional.
This is an evaluation
of program that we did.
And this is another
example which
now it's not only
nutrition specific program,
it's a lifestyle
medicine intervention
that culinary medicine was only
the nutritional part of it.
The location was also
a teaching kitchen.
And you can see that the
public health nurses still
eat better and counsel
about culinary medicine
18 months after
their intervention.
So still better
follow-up, but no control.
So let's move forward and
see what we do at Spaulding.
So before we founded our
Culinary Medicine program,
we looked at what's
going on around the US.
So we reviewed several
programs around the US
that teach thousands
of professionals
and thousands of patients.
And we found some
interesting stuff.
So first of all, we found
that usually providers
that deliver culinary
medicine program
teach people how to cook,
which it makes tons of sense.
But if you can just think for a
few seconds for yourself, what
is your own barrier from
cooking more at home?
So I'm not sure about you,
but most of the people
will say time, not skills.
If I would have more
time, I can cook more.
Well, if you'll teach me
more stuff, I can do better.
But time is an amazing barrier.
So if you teach
people how to cook,
it will not solve
their time barrier.
So if you would like to address
the home cooking behavior,
you should think more
carefully about what
you should teach in the
culinary medicine program.
The second barrier,
a second gap that we
found that none of the program
address behavioral change
issues.
And home cooking is a behavior.
Just as walking, just as
exercising, it's a behavior.
So knowing how to do it
is a great first step,
but if you want to adopt
it on a regular basis,
that's a whole different story.
So we think the program that try
to help people to do more home
cooking should address--
should use any kind of
behavioral change techniques
and topics.
Third, the majority of the
programs use teaching kitchens.
And also, actually the studies
that I showed you before,
both of them was in
a teaching kitchen.
Teaching kitchen
are very expensive.
Very expensive to
build your own kitchen.
Very expensive and complicated
to maintain your kitchen.
And that's definitely
a gap, if we
would like to think about
a public health solution.
And, of course--
well, not of course,
but if you think
about a new field--
so none of the people that
delivered the culinary medicine
program were trained to do so.
So we found the CHEF Coaching,
which is the Spaulding Culinary
Medicine program.
It's a combination of
education and research.
We study what we do.
And once we found an
interesting outcome,
we implement it to our
education component.
And we have the education
component both for patients
and for provider.
So we literally
teach providers how
to deliver better culinary
medicine programs.
So the first principle
that we use--
that we are focusing
on proven barriers
to home cooking and
behavioral change techniques.
So we do not just
teach how to cook.
We also address barriers, such
as time, such as organizing,
and several barriers
and facilitators
that's related to home cooking.
We actually develop a
very interesting approach.
It's called the culinary
coaching approach.
It's a combination of
culinary training and coaching
principle.
We use the coaching principles
as our behavioral change
techniques.
So we combine the
two in order to help
people to do more home cooking
Two, we use a unique
telemedicine approach.
So we do not teach people how
to cook in a teaching kitchen,
which is really interesting.
We use a telemedicine approach,
which include discussions.
And actually, this year
we started to cook--
live cooking classes
with our patients.
So the faculty go live from
his or her kitchen, stream
the culinary class, and
patients or provider literally
log in from their kitchen
using smartphones or laptop,
and following the instruction
in their own kitchen.
So it has a huge educational
benefits and it's very cheap.
I mean, you don't need
a teaching kitchen.
And we decided that for now,
because home cooking can
improve any dietary
plan, so we are not
focusing on any dietary plan.
If you follow the
Mediterranean, great.
Come to us.
We will teach you
how to do it better.
If you're a vegan, great.
Come to us.
We'll teach you how
to do it better.
Most of the dietary plans
focus on plant-based food--
vegetables grains-- so
we can help everybody.
So outcomes are
beginning to come.
So as I said, we have
a program for patients.
So this is the outcomes
of our patient program.
So we have very
preliminary results.
And we found that our program
improved cooking confidence
and improved health outcomes.
Our provider's program also
improved cooking confidence
of the providers.
Providers that
come to us to learn
how to deliver better
culinary medicine programs
improve their own
cooking confidence,
and also, they improve
their competencies
to prescribe nutrition
and culinary medicine.
So from now on, this
is some stuff for you
if you would like
to use this idea,
if you would like to implement
those thoughts in your clinic
or in your practice.
So you should know that we
have an ongoing library of peer
review culinary resources.
So for example, this
is culinary resources
we published at our
clinical diabetes
a few years ago that helps
people to consume more legumes.
It has a principle of
how to cook legumes,
how to shop them,
how to store them,
several tips,
recipes, and so on.
And this is peer reviewed,
which we think is great.
Another thing that we did--
this was done last
year in collaboration
with the American College
of Preventive Medicine--
we developed videos that can
help people and providers
to cook more at home.
And all those videos are
freely available online,
so you can use them yourself
and you can prescribe them
to your patients.
Think how cool it is.
Instead of prescribing
medication, prescribing videos.
And I would like to show you
a few examples of the videos.
And before that, I would like to
share with you that we grouped
the videos into
two groups, which
we think is really important in
understanding cooking behavior.
So one group we called
it culinary videos.
So those are basic recipes,
basic culinary skills.
But as I said, culinary
skills is not enough to cook.
You need to know how to address
the time and other barriers.
So those are here in the
culinary medicine videos.
So here is one example
of a culinary video.
Let's try the next one.
It will take I
think a few seconds.
[VIDEO PLAYBACK]
[MUSIC PLAYING]
- Today, we'll be making
banana and mint granita
with grape chips.
One thing a lot of
people miss when
they're trying to eat a healthy
and balanced diet is dessert.
But you can have
it both ways with
this delicious and
nutritious frozen treat.
Here's all you'll
need to make it.
Medium sized bananas,
seedless grapes, and mint.
You can find a list of
ingredients, exact amounts,
and detailed instructions at
ACPM.com/culinarymedicine.
The first thing
to do is to freeze
the grapes and the bananas.
The bananas should be peeled
and cut into quarters first.
The grapes only
need to be washed,
but make sure you
dry them completely
before they go in the freezer to
avoid excess water and freezer
burn.
While the fruit is freezing,
finely chop the fresh mint
and set it aside.
Once the bananas and
grapes are frozen solid,
remove only the banana
pieces from the freezer
and defrost them at
room temperature for one
to two minutes, just enough
to soften them a little.
Now transfer the pieces
to a food processor
and run it on high
for a few minutes.
Add the chopped mint and
run the processor again
until the mixture is smooth.
If it seems too dry, you can
add just a little bit of water
to help them blend.
Next, get the grapes from the
freezer and then slice thinly
for a perfectly tasty garnish.
To serve, scoop pureed bananas
with a small ice cream scoop
and top with the grape slices.
This recipe series
is brought to you
by the American College
of Preventive Medicine
and the American College
of Lifestyle Medicine.
For more healthy and
delicious recipes go
to ACPM.org/culinarymedicine.
[END PLAYBACK]
So I don't know
if you recognize,
but those were the hands.
[LAUGHTER]
So who thinks this is a recipe
he or she can follow at home?
Awesome.
And who thinks that patients
can follow this recipe at home?
Great.
I mean, this was
the first attempt,
but you have nine
staple recipes that
discuss specific aspects
of healthy cooking
that you are very welcome
to share with patients.
Actually, I think the most
important message to my opinion
is the grapes.
I hope you notice that the
grapes at the end was frozen,
and I chopped the grapes
and garnished the ice cream.
Now it's summertime and
grapes are available.
So if you think
about cold desserts,
so we have few nutrients
that help to defrost dessert.
One is fat.
That's the reason that ice
cream mostly have fat in it.
The other is sugar.
Sugar is a defrosting agent.
Sorbet uses a lot of sugar
to make the nice texture
of the dessert.
So grapes has enough
sugar within it
to allow it not to freeze.
So you can just take grapes
from the supermarket,
put in your freezer, and just
snack it instead of ice cream.
It's unbelievably delicious.
You're very welcome to try it.
And the second video I
would like to share with you
is an example of
the second group
of videos, which is the
culinary medicine videos.
Those are videos that do
not teach specific recipe
or specific skill.
Although it's full of skills,
but not specific skills.
They teach patients how to
overcome common barriers.
[VIDEO PLAYBACK]
[MUSIC PLAYING]
- Welcome to the
American College
of Preventive Medicine
and the American College
of Lifestyle Medicine's
Culinary Medicine Video Series.
In this video, we'll address
four key skills designed
to shorten cooking time.
Batch cooking, first
step items, making food
while you're not
cooking, and repurposing.
Coaching your patients to learn
and implement these skills
will help them make
healthier choices.
With batch cooking, you can
decrease your total cooking
time and increase
your productivity
by making more portions than
you need whenever you cook.
It's about thinking big.
For example, cooking
one cup of lentils
takes the same amount of time
as cooking the whole bag.
But if you cook the
whole bag, then you
have lentils ready to go
for many more minutes.
Anyone can benefit
from batch cooking,
even if you aren't
used to planning out
several meals in advance.
Not sure which dishes
you'll make with them?
It's OK.
Many food items could
be stored in the freezer
for several months, so you can
use them whenever you'd like.
First step items are
cooked recipe components
that can help you prepare
meals very quickly.
Things don't always
go as planned.
So if you unexpectedly need to
serve a meal with very limited
time to cook, you can
use first step items
to significantly
decrease cooking time.
If you're just getting
started with cooking at home,
you can purchase first step
items such as canned beans.
As you take on more
of your own cooking,
make sure to have
pre-cooked first step
items in your freezer,
such as cooked lentils
or even cooked sauces.
Another skill that can help you
consume more home-cooked food
without spending time cooking
is cooking while you are not
in the kitchen.
Many food items might need
preparation time, but not
much attention.
So you can batch cook without
committing a lot of time.
For example, place a pot of
boiling water on the stove
and cook your preferred legumes.
While they cook, you
can work at your desk,
check email, or spend
time with family.
Once the legumes are ready, you
can freeze them in containers
and you'll have
cooked first step
items ready for future meals.
And finally,
there's repurposing.
Repurposing is preparing an
ingredient for one recipe
and using portions for
another recipe later.
If you don't want to eat the
same dish you cooked yesterday,
but don't want to start from
scratch, simply repurpose.
Making lentils so you can
have mujaddara for dinner,
repurpose a portion
for a lentil dip
you can have for lunch tomorrow.
Making bulgur for dinner
tonight, repurpose a portion
and make a tabbouleh
salad for tomorrow.
For more tips and a list
of healthy recipes go
to ACPM.org/culinarymedicine.
[END PLAYBACK]
So I hope you enjoyed
the talk and I
hope that the talk brought
you some new way of thinking
about food.
And if this is
interesting to you,
I brought you some options of
how to expand your education.
So the ACPM-- and this is part
of the project that we did--
has a national core competencies
curriculum for physicians
and other providers.
And it includes the
culinary medicine modules.
We here at Spaulding
offer training
for those who are interested.
The center down at Tulane
offer a very good program
for clinicians also.
And culinary RX is
literally a cooking school,
but they are very
focused on healthy food
and they highly collaborate
with health care organizations.
Another option to
be more involved
in this emerging field--
so there is a teaching
kitchen collaborative.
The leader of this
collaborative is David Eisenberg
from the Public Health School
here at Boston, at Harvard.
The center down in Tulane
also offer a networking group.
Their group is mostly
focused on medical education.
So if you are interested to
develop a medical education
program in your
medical school, so this
would be an interesting
place to check.
And also, I'm leading a
Culinary Medicine Task
Force in the American Congress
of Rehabilitation Medicine.
I think it's the first
professional organization
in the US that are
leading this field
and I'm proud to
lead this task force.
So these are groups that
you are very welcome to join
and I would like to thank
both the educational group
and the research
group that worked
with me to improve the
culinary medicine that we do.
I'm happy to get questions.
Yeah.
[APPLAUSE]
[SIDE CONVERSATION]
So we'll start right here.
Hi, that was an excellent talk.
Thank you.
I had a few questions for you.
One, do you come across
accessibility issues?
So with some of these
videos, many times a lot
of our patients wouldn't
have access to, for instance,
a food processor or perhaps
some of the ingredients that you
might mention, like
the tabbouleh recipe.
That's a little culturally
almost inappropriate
for some of our patients.
So I wonder what
you do with that.
And then secondly-- this
is a very stupid question--
but does freezing decrease
the nutritional properties
in some foods or does it not?
I was just curious.
So two great questions.
So I'll start with
the first one.
So accessibility
is the main issue.
And first of all, I think that
telemedicine is a great step
towards that direction.
So actually, anyone that
has internet can see it.
It's free and people can use it.
And for example, in the
chef coaching program,
we have a special section
for those kinds of issues.
In the American College
of Preventive Medicine,
it was only the first step
to have seven staple videos.
So we did not
address that so much,
although we found that a lot
of food can be ordered online.
And especially, dry food.
And that's the
reason we introduce
new ingredients on purpose
that people can purchase online
very easily.
And about freezing
and defrosting food
and nutritional--
what's happened to the vitamins,
what happened to the minerals.
So there's not tons of
good studies about that.
If you look at the good
studies that most of them
are published from
this institution--
so they looked at vegetable
consumption, either cooked
or frost, or
defrost, or whatever.
So the evidence that we have
is that consuming vegetables
in any way is beneficial
for your health.
So that's what guides us.
Maybe I can read one question.
So can you offer advice
for ordering healthy food
at restaurants?
So yeah, so eating
out is a great topic.
And actually, when I think
how ideal nutrition education
program could be is one, how
to eat outside, and two, how
to cook better food at home.
I mean, that's the two
components of the thing
that we eat.
And this is a very interesting
and important topic.
We usually try to
help people to do as
much as possible home-cooking.
And one of our main topic is
how to prepare a good lunch box.
We have a topic that is called
dinner, breakfast, lunch.
Because usually dinner is
the time that you cook.
And then you can use
leftovers from dinner
to make yourself lunchbox or to
make yourself a quick breakfast
in the day after.
Another one from here?
Yeah.
Hi, thank you for
the terrific talk.
I'm one of the third-year
medical students
and there have been
a number of efforts
among students to initiate
culinary medicine training.
You mentioned the
program at Tulane
and there are countless
others I'm sure you know.
We haven't been
overwhelmingly successful
here starting culinary
medicine training programs
for students or for the
house staff at the hospitals.
And I'm curious to know
why you think that is.
Why it's been difficult
to get that started here
and what you think can
be done going forward?
So that's a great question.
I think that I presented a few
barriers of culinary medicine
program.
And I think that
the availability
of teaching kitchens
and the fact
that you need to purchase
food, and then you
need to clean the staff.
All those are barriers
that needs to be addressed.
And I'm happy to
talk with you later
and happy to help
with any effort.
I know about several
other colleagues
that work in this area here
at HMS, but I'm happy to help.
Hi, I'm over here.
OK.
Thank you for your talk.
It's exciting to see how
food is finally being
more integrated into medicine.
I was wondering how you deal
with the different levels
of economic insecurity in
your patient populations?
And I know that a
screening tool has
been used for screening
for food insecurity
in many other settings.
So there's a lot
that can be done
in the area of
culinary medicine.
This is really,
really premature.
The way that we work
is we train providers
with the understanding
that we can teach them
the new tools of
culinary medicine.
And then with the understanding
of their community
and the barriers
of their community
and the accessibility of
food in their community,
they can take our
program and implement it
in their community.
This is the best
I can share now.
I mean, I agree there's tons
of work that needs to be done.
How to develop programs,
cooking programs that
will address various economic
levels and communities?
This is really important because
those are the communities that
cook less and those are the
communities that are sick more.
We have a look at the kitchens
in these high schools.
Brookline High School
is by your side--
has two or three kitchens.
I'm sure that if you pay to
rent, they would let you use.
They are amazing kitchens.
Yeah, schools have great
kitchens many times.
And actually, schools
are great place
to do cooking intervention.
And there are several studies
on culinary intervention
to children.
And this is really important,
because this is the time
that the kids
learn new behaviors
and you can really teach
them skills for life.
And there was a study
that was published
I think last year that showed
that children that cook more--
I think between 11 and 17 years
old, if I remember correctly--
has better nutrition
intake 10 years later.
So this is really important
work to work with students.
Tons that needs to be done.
I cannot more than agree.
Yes, sure.
So can you speak
about plant proteins?
Should I change my
diet to replace meat
with plant proteins?
So this is a great
question and I
think it's appeared in
almost all my talks.
And I would like to take
these questions to this talk
And just think about,
let's say, soybean
as an example of
plant-based protein.
So you can consume soybean
as the unprocessed food,
as an edamame.
You can consume soybean as a
processed food, probably tofu.
You can consume soybean
as a ultra-processed food,
such as all the vegan
stuff that you can--
frozen stuff that you can buy.
So I would say that if I would
need to follow this science,
I would push into the edamame
from the ultra-processed soy
food.
More from here?
So thank you for that talk.
That was very informative.
So when it comes to the
hundreds, if not thousands,
of recipes that we have access
to via ACPM, the internet,
et cetera, there are so
many different approaches
that are protein-based recipes,
carbohydrate-rich recipes,
legume-based recipes.
So what-- obviously, it may vary
per individual and patient--
how do organizations like
ACPM pick their recipes?
What are the priorities
when cooking at home?
So yeah, thank you
for this question.
This is a great question
that maybe will help me
dive deeper into the science.
So if you look on
dietary plan, so one,
you have your dietary regime.
I mean, as I said,
you can be low-fat,
you can be high protein.
There are several
diets that's around.
And on top of that, you
can cook it at home.
So those are two
different levels
that contribute to
your dietary plan.
So there's thousands
of recipes and you
need to find the one that
fits your dietary regime.
So that's I think to
your first question.
And to your second question,
when we did these first nine
videos, we were looking
on staple videos
that can apply to many diets.
For example, if you look at the
ice cream video that I showed,
so you can use it
if you are vegan--
I think so-- yeah,
if you are vegan.
You can use it if you follow
the Mediterranean diet.
You can use that if you
follow a low-fat diet.
So we really try to
find a recipe that
can apply to many diets.
If you think about future plan--
so if I would have
a library of videos
that I can search by my dietary
regime, that would be ideal.
But it will take time.
There's one more right there.
Yes, please.
Just recently, I've had
several friends talk
about how Blue Apron--
having it delivered to their
home, having the recipe,
having the food,
has really started
them becoming home cooks.
And I wondered if you've
had any experience with this
and what you think.
Does that put it into the
home cooking category?
Oh, sure.
And if you have any
other thoughts about it.
So yeah, Blue Apron is a company
that's working in this area.
Those of you who
are not familiar--
although, I assume everybody
is familiar with Blue Apron--
but those who are not
familiar, this is a company
that you can choose a recipe
you would like to eat for dinner
and they deliver the
ingredients to your house.
And you can go back from
work and cook your dinner.
I mean, if the recipe needs
a half teaspoon of salt,
they will bring you
half teaspoon of salt.
It's a full solution.
So yeah, it's
definitely home-cooking.
I mean, they bring you
from scratch ingredients
and you cook.
What I think is
really interesting is
the fact that when we--
I mean, when we
talk with people--
and we did a lot of
work in this area,
because a lot of companies
are interested to do
like diabetes friendly,
Blue Apron-- this
is a very hot field.
And when you talk with
people, we got the impression
that it's great if you
want to have a nice evening
with your family.
But for most of the
people, it does not solve--
it is not a solution.
And when we talk with
people, they usually
say that it takes a
long time to cook--
the recipe that they provide.
And if you want to take
that to this presentation--
so to my opinion--
Blue Apron does not
solve the main issues
of home-cooking, which is time.
And I think that shopping is
not the main time consumer.
There are several
of times issues.
And for example, if
you do Blue Apron,
you're not batch cooking.
For example, if you want
to eat salmon dinner,
they will provide
you two salmons--
or how many that you will order.
But they will not
double the portion
that you can cook it and
use it tomorrow for dip.
I don't know.
So I don't want to give
them any more advice,
but I think that they help to
overcome the shopping barrier.
But this is just one barrier.
And that's the reason
that it's not a solution.
But that's my opinion.
One last question.
Sure.
How important is chemistry to
the field of culinary medicine?
So chemistry is
amazingly important.
I think Harvard offered
chemistry classes
through cooking.
And people that
understand chemistry
can cook much, much better.
And that's another great idea.
OK, thank you so much.
[APPLAUSE]
