How Culinary Medicine Is Training Future Doctors

Medical residents watch and repeat as a chef demonstrates how to make healthier versions of foods kids love.

They blend veggies into burgers that trick tastebuds, add legumes to tacos, and swap enriched flour pasta for spinach noodles in spaghetti.

Then, they sit down with Rana Assfoura, MD, to sample the food and discuss relevant clinical cases from their rounds at University of Tennessee Health Science Center and Le Bonheur Children’s Hospital and its interdisciplinary Healthy Lifestyle Clinic for children and teens.

University of Tennessee Health Science Center.

Assfoura, a practicing pediatrician and director of the Culinary Medicine Program at the University of Tennessee Health Science Center, is on a mission to shift the focus of medicine from treatment to prevention.

“We, as doctors, know the medical information about proper nutrition, but how to translate that into everyday practice for families is what is needed,” said the certified culinary medicine specialist, who partners with Jordan Ross, MD, to lead the classes.

Residents in the family medicine and internal medicine programs are required to participate in at least one culinary medicine class a year, designed to help them understand and apply nutrition principles in ways that are accessible and actionable for patients.

While the hands-on classes are optional electives for other medical residents and for UT med students, they fill up fast, so Assfoura is working to increase the offerings.

The program uses the American College of Culinary Medicine’s evidence-based curriculum to teach medical trainees how to help patients make sustainable diet and lifestyle changes.

“What we eat affects every single aspect of our life,” Assfoura said. “A cardiologist will have to deal with high blood pressure and heart disease, which has a lot to do with how much sodium and saturated fats someone eats. A GI doctor is going to see patients with reflux and constipation because they’re not feeding their guts the right things. An allergist is going to see kids with food allergies because they don’t know what’s in their foods that may be affecting them.”

Studies show that physician advice can lead to positive behavior change, and Assfoura says well checkups are the perfect starting point for these conversations.

“It can really make a difference when your doctor, who you have a relationship with, tells you, ‘I think this is the best way to approach this. Let’s do it together. I’m here to help you every step along the way,’” she says.

Residents practice motivational interviewing techniques and learn to keep potential patient sensitivities in mind from cultural differences to food insecurity to bullying. They focus on and intentionally use terms like “healthier choices” rather than weight loss.

“I tell my teenage patients we’re not trying to fit in smaller clothes,” Assfoura said. “We talk about how if we don’t feed our body the right things, then we’re more likely to start having problems with high blood pressure and diabetes and need to take medications. And nobody wants to deal with these chronic issues early in their life.”

She said it’s important clinicians encourage patients to take ownership of their health by identifying achievable changes.

“I ask them, especially the teenagers, how their eating habits are and what’s the easiest thing they can do better,” she said. “Very often they come up with the right answer. And I’ll say, ‘You already knew! You didn’t need my help. Do you think you can try?’ It’s a lot of empowering and educating them.”

But there often isn’t much time for nutrition counseling during clinic visits, where pediatricians also address acute issues, immunizations, physical activity, car safety, firearm storage, and more, so Assfoura and a medical resident are creating a basic cookbook with easy, affordable recipes for families to take home.

She’s also exploring ways to share culinary medicine lessons with community members, possibly with in-person cooking demonstrations like the residents do and online videos that teach cooking techniques and how to incorporate healthy ingredients and decipher nutrition labels.

“The cost of treating obesity and diabetes is astronomically high, and we cannot keep going in this trajectory,” Assfoura said. “We have focused a lot on treating diseases, but it’s as important — if not more important — to also pay attention to the source of the problem. Prevention is better than treatment.”

In response to the Make America Healthy Again (MAHA) Commission’s report on child health, the Children’s Hospital Association highlights the ways children’s hospitals are helping children live longer and healthier lives by confronting the root causes of chronic illnesses.