Culinary Health and Medicine Program Improves Medical Students’ Nutrition Knowledge

two women hold up a strand of spiralized zucchini during a cooking class

When your doctor says “eat better,” do you know what that really means? Should you eat more vegetables, or eat more often, or eat more of a specific nutrient? Which diets are safe and effective? How do you make these changes easily and affordably? Chances are, your doctor doesn’t have these answers, either: while medical schools require 25 hours of nutrition training, less than a third of students meet that requirement, leaving future physicians woefully unprepared to address the dietary needs of their patients. Additionally, so much conflicting information about popular dietary advice has left many doctors and patients not knowing what to believe. A partnership between the Institute, our Fellow Dr. Chris D’Adamo, and the University of Maryland School of Medicine sought to address this issue with the Culinary Health and Medicine Program (CHMP), a first-of-its-kind program that created a culinary medicine curriculum as a core requirement for first- and second-year medical students. 

Culinary medicine is a practical, evidence-based approach to nutrition and health that incorporates food, cooking, and science. According to recently published research, the groundbreaking Culinary Health and Medicine Program showed that it is possible and practical to teach medical students a more complete perspective on food and health that will immediately benefit themselves and their patients in myriad ways. One student reported, “I learned about the real-life barriers to accessing or switching diets, which helped frame the perspective of future patients so that I can better address their needs and concerns.” Another said, “Through experiences obtained from culinary medicine, it is easier to relate to future patients and really grasp their needs and the obstacles they are facing. You can become more of a ‘friend’ in the field to the patient, rather than just an ‘expert.’”

This unique approach, and the precisely designed curriculum of the CHMP, taught students to meet their future patients’ dietary needs in budget-friendly, time-efficient ways—and, in turn, gave the students themselves valuable self-care tools to support their busy school years. Utilizing the Institute’s state-of-the-art teaching kitchen, students experienced the benefits first-hand as they tried new recipes, discovered the healing power of different nutrients, and made new connections between health and food. Students learned about different popular diets and how to prepare various healthful meals costing less than $10 each, all while using basic kitchen equipment and easily sourced ingredients, to keep dietary changes as approachable as possible for future patients—and medical students on a budget! 

This program was feasible to implement, immensely popular among medical students, showed improved learning outcomes, and helped students become healthier people and better doctors. Dr. D’Adamo’s message to other institutions is “you can do this and your students are going to love it!” This project provides an ideal model for other institutions to replicate, and underscores the importance of teaching students beyond the traditional disease-focused lens to incorporate food as medicine.

For more, check out University of Maryland School of Medicine’s CHMP video here.

Developing safety, persistence, trust

Healing is facilitated through safety, persistence, and trust.

  • Persistence: “People did not simply progress through this sequence and experience healing. The healing journey was a recursive, back and forth process. They found helpers, used the skills/resources that those helpers provided, found other helpers that provided more resources and used those skills and resources. As this process continued, people experienced a gradual amelioration of their suffering. Although many despaired at times, all demonstrated the quality of persistence—they refused to give up.”
  • Safety & Trust: “To connect to helpers, it was essential for people to feel safe in those relationships and able to trust that the person would be a helper and not a barrier to healing. Persons whose wounds included a violation of trust were especially careful about testing the safety of new relationships.”

Acquiring Resources

Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”

  • Reframing: “A particularly important skill was the ability to reframe—that is to look at suffering through a different lens.” This does NOT mean minimizing trauma or pain, but rather it often means the opposite: understanding what happened was wrong, unfair, or uncontrollable and that we are not to blame for it.
    • “I think I kept trying to convince him I was crazy. And he kept saying, ‘No, you’re not crazy.’ […] You wouldn’t necessarily say a Vietnam Vet was crazy. You’d say they are responding like you’d expect to extraordinary circumstances.”
    • “I’m not the only one who have [sic] this problem. A lots, millions of people, you know. […] They don’t have nothing to do with that. I guess I have to live.”
  • Responsibility: While we don’t have control over what happened to us, we are the only ones who can help ourselves heal. “A third essential resource that people acquired or refined was the ability to take an appropriate amount of responsibility for their healing journeys. They participated actively in the process of healing. Once again, some participants already had developed this skill, and some acquired or refined it from their helpers.”
    “You need a lot of energy and a lot of work … it takes a lot of work. It doesn’t just happen. It’s not like a magic wand.” This patient understood that they had to actively participate in the healing process.
  • Positivity: “Another resource that people acquired or refined during their healing journey was choose to be positive—that is to have some optimism about their situation.” People have varying predispositions to positivity. In the study, positivity was important in helping people heal. This doesn’t mean a toxic positivity, but rather simply finding some good in life and feeling hopeful about our situations.

Helping Relationships

“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad. When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.) “When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”

  • “Moving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.”
  • “Relationships with health professionals were among these but were not necessarily any more important to the healing journey than other kinds of helpers, which included family members, friends, spirituality and their God, pets, support groups, administrators, case workers and supervisors.”

Healing

Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.” Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. Healing, in this sense, does not mean cured—none of the study participants were cured of their ailments—”but all developed a sense of integrity and wholeness despite ongoing pain or other symptoms.” In varying degrees, “they were able to transcend their suffering and in some sense to flourish.” When we begin to heal, we find increased capacity for hope, renewed motivation to help others, and are more able to accept ourselves as we are.

Suffering

Suffering is the ongoing pain from wounding. There is debate about whether or not one actually needs to experience suffering on the path to healing.

Wounding

Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors. “The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”