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Food as Medicine: The Growing Significance of Culinary Medicine

Food as Medicine

Author: Christian Maino Vieytes, B.S. Nutritional Sciences, University of Maryland, College Park, M.S. Candidate, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign 

Why What We Eat Matters 

The power of food to promote healing and a general sense of well-being has long been a known commodity in different cultures.  Eastern cultures, in particular, have harnessed the potential of food as a modality for healing.3, 23 Dietary strategies, dichotomized into either yin or yang, make up an integral part of traditional Chinese and Eastern Medicine and its quest to treat a myriad of ailments.23 Even in Western cultures, we have seen an acknowledgment of the healing potential of food. After all, it was the Greek physician, Hippocrates, who once famously declared, “Let food be thy medicine and medicine be thy food”.28 Yet, we have also realized how destructive diet can be to our health and to the health of a nation as a whole, as a consequence of less nutritious choices and over-eating.  Rising health-care costs, plateauing life-expectancy figures, and escalating rates of chronic illnesses like cardiovascular disease and cancer are a reflection of this. In order to foster a fruitful discussion about culinary medicine and its practical applications into the modern context of healthcare we must acknowledge the successes it has had in historical contexts.

What is Culinary Medicine and Who is it For?

Lifestyle approaches to preventing and treating common chronic illnesses are becoming increasingly popular. Culinary medicine can be thought of as an arm of the integrative model of medicine and well-being. It places an emphasis on modifying nutrition practices to fit within the needs of the individual.5 This can take many shapes and forms. For instance, an individual with rheumatoid arthritis can implement an anti-inflammatory diet to enhance their control over the disease state.17 Another individual without any current illness may adopt a Mediterranean Diet in order to prevent the onset of cardiovascular disease, cancer, or Alzheimer’s later on in life.19

The successful implementation of these lifestyle changes requires close attention and guidance from a healthcare professional. Unfortunately, medical doctors receive very limited education on topics involving nutrition, although younger physicians are realizing the need to seek additional training on culinary coaching and nutrition.2, 4 Counseling with a dietitian is one feasible alternative. Most dietitians possess experience and training in culinary skills and practices that they can pass on to their patients.

A key component of culinary medicine programs is the focus on promoting cooking in the home. With the rise of fast and convenience-food chains and products, we have slowly divorced ourselves from the ceremonial and cultural traditions associated with consuming food and have, as a result, paid the price with our health.14, 15 The scientific literature supports the idea that eating at home is good not only for promoting a healthy well-being but also has the added benefit of reducing expenditures on food.9, 11, 12, 14, 21, 22  Some programs have even demonstrated a capacity to fight food insecurity in low-income households.26 Culinary coaching programs also focus on enhancing grocery shopping and food storage skills.

The effects of culinary coaching have been documented.1, 6, 7, 10, 11, 13, 14, 15, 16, 20 Culinary programs targeted at managing type 2 diabetes and blood sugar levels are demonstrating success, especially those that address and provide solutions to known barriers to home cooking.11, 13 These barriers include limited time, limited cooking skills, and low confidence in cooking.10, 21 A recent study also showed that eating at home is associated with a decreased risk of developing type 2 diabetes in the first place.13 Clearly, there is a lot of potential for these culinary medicine programs. Nevertheless, we should be wary of services offered by uncredentialled individuals and should only take culinary advice from trained health professionals and credentialed chefs.8, 9

Sooner or later, we can expect food prescriptions to become a norm and practitioners to doodle foods on their prescription pads in order to facilitate their patients’ health-related goals.16

To learn more about Culinary Medicine please tune in Jan 24, 2019, at 11:00 am ET.  for a free webinar Culinary Medicine: Where Health Meets Food.  Dietitians earn 1.0 CPEU

Works Cited 

  1. Choi, Evan Y et al. “A plant-based diet and heart failure: case report and literature review” Journal of geriatric cardiology : JGC 14,5 (2017): 375-378.
  1. Danek, Robin L., et al. “Perceptions of Nutrition Education in the Current Medical School Curriculum.” Family Medicine 10 (2017): 803-806.
  1. Jiang, Sandy and Cassandra L Quave. “A comparison of traditional food and health strategies among Taiwanese and Chinese immigrants in Atlanta, Georgia, USA” Journal of ethnobiology and ethnomedicine 9,1 61. 27 Aug. 2013, doi:10.1186/1746-4269-9-61
  1. Kris-Etherton, Penny M et al. “The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness” American journal of clinical nutrition vol. 99,5 Suppl (2014): 1153S-66S.
  1. La Puma, John. “What Is Culinary Medicine and What Does It Do?” Population health management 19,1 (2016): 1-3.
  1. Massera, Daniele, et al. “A whole-food plant-based diet reversed angina without medications or procedures.” Case reports in cardiology 2015 (2015).
  1. Peters, Nancy Champe, et al. “Adherence in a 1-year whole foods eating pattern intervention with healthy postmenopausal women.” Public health nutrition12 (2014): 2806-2815
  1. Polak, Rani, et al. “Credentialed chefs as certified wellness coaches: call for action.” Eating behaviors19 (2015): 65-67.
  1. Polak, Rani et al. “Health-related Culinary Education: A Summary of Representative Emerging Programs for Health Professionals and Patients” Global advances in health and medicine 5,1 (2016): 61-8.
  1. Polak, Rani, et al. “Improving patients’ home cooking–A case series of participation in a remote culinary coaching program.” Applied Physiology, Nutrition, and Metabolism8 (2017): 893-896.
  1. Polak, Rani, et al. “Innovation in diabetes care: improving consumption of healthy food through a “Chef Coaching” program: a case report.” Global advances in health and medicine6 (2014): 42-48.
  1. Polak, Rani et al. “Innovation in medical education: a culinary coaching tele-nutrition training program” Medical education online 23,1 (2018): 1510704.
  1. Polak, Rani, et al. “Preventing Type 2 Diabetes with Home Cooking: Current Evidence and Future Potential.” Current diabetes reports10 (2018): 99.
  1. Reicks, Marla et al. “Impact of cooking and home food preparation interventions among adults: outcomes and implications for future programs” Journal of nutrition education and behavior 46,4 (2014): 259-76.
  1. Reicks, Marla, Megan Kocher, and Julie Reeder. “Impact of cooking and home food preparation interventions among adults: a systematic review (2011–2016).” Journal of nutrition education and behavior2 (2018): 148-172.
  1. Ridberg, Ronit A., et al. “A Pediatric Fruit and Vegetable Prescription Program Increases Food Security in Low-Income Households.” Journal of nutrition education and behavior(2018).
  1. Skoczyńska, Marta, and Jerzy Świerkot. “The role of diet in rheumatoid arthritis.” Reumatologia4 (2018): 259
  1. Smith, Richard. “Let food be thy medicine…” BMJ : British Medical Journal 328,7433 (2004): 0.
  1. Sofi, Francesco, et al. “Adherence to Mediterranean diet and health status: meta-analysis.” BMJ337 (2008): a1344.
  1. Taillie, Lindsey Smith, and Jennifer M. Poti. “Associations of Cooking With Dietary Intake and Obesity Among Supplemental Nutrition Assistance Program Participants.” American journal of preventive medicine 52.2 (2017): S151-S160.
  1. Tiwari, Arpita et al. “Cooking at Home: A Strategy to Comply With U.S. Dietary Guidelines at No Extra Cost” American journal of preventive medicine 52,5 (2017): 616-624.
  1. Wolfson, Julia A., and Sara N. Bleich. “Is cooking at home associated with better diet quality or weight-loss intention?.” Public Health Nutrition8 (2015): 1397-1406.
  1. Wu, Qunli, and Xiaochun Liang. “Food therapy and medical diet therapy of traditional Chinese medicine.” Clinical Nutrition Experimental18 (2018): 1-5

 

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What’s the Best Method to Use When Paying Down Debt?

By Carol Church 

If you or someone you know is carrying credit card debt, they’re far from alone. The Federal Reserve estimates at least half of U. S. cardholders don’t pay their bills in full monthly. Service members are far from immune to this issue. In fact, some research suggests that military members are more likely to have credit card debt (and more of it) than civilians.

For some, this issue may be relatively minor—a few hundred dollars that will get paid off within a month or two. For many others, however, the situation is much more serious. Just as millions are in debt, millions also suffer from bad credit ratings, affecting so many things about their lives and costing them even more money. For service members, debt can be a distraction while deployed and may even result in revocation of security clearance.

Of course, credit cards aren’t the only kind of debt that can cause problems. Car payments (especially those with high interest rates), medical bills, and student loans all also have the potential to become a problem. Many people have more than one type of overdue or problem debt.

Those in this situation may feel like they have no idea where to start with getting the situation under control. However, the first step is to begin thinking about a clear plan of action. There are many possible ways to begin digging out of debt; we’ll discuss some common strategies below.

The Snowball Method

One approach to beginning to eliminate debt is the so-called “snowball” method. With this technique, you “get the ball rolling” on eliminating debt by (of course) making sure to pay the minimum on all debts monthly, but otherwise concentrating all “extra” payment on ONE debt first: your smallest debt. You do this regardless of interest rate.

A man in the distance holding his arm out with a snowball in his hand in the foreground.
StockSnap/Pixabay.com, CC0

The idea is to get this first debt erased quickly in order to enjoy the immense emotional and psychological satisfaction we feel when “zeroing out” a deb. Once the smallest debt is wiped out, you move on to the next smallest debt, and so on and so forth.

This approach to debt is appealing to many due to basic human nature. Getting rid of a debt can feel like a big accomplishment and can provide debtors with motivation to keep going—and as with many things, the key here is to keep going! However, from a dollars-and-sense financial point of view, the snowball method is, at its root, unsound. You will pay more in interest this way!

The Ladder Method

With the “ladder” method, you again make sure to always put at least the minimum payment towards each debt, but concentrate on the debt with the highest interest rate first, regardless of its relative size. Even if it takes years to pay this one off, that is where you pay extra, because that is the debt that is losing you the most money.

Some simple math demonstrates the common sense of this approach, if you think about it. It might feel good to pay off that annoying $1000 student loan with a 5% interest rate, but consider how little that loan “costs” you over the year compared to a $10,000 credit card debt with an 18% interest rate!

The “Kickstart” Method

With this method, you start off paying a small debt in full for the motivation value and then proceed to your highest-interest debt next for the financial “dollars and sense” value. If you’re losing motivation paying on a large, high-interest loan, you can temporarily “downshift” to paying off a small loan again for the emotional payoff, but then go back to the high-interest account.

The “Rising Tide Lifts All Boats” Method

In this method, debtors pay the minimum first, then divide whatever extra amount they have left for debt elimination pretty equally among all their debts. Typically not a particularly intentional strategy, this approach is nonetheless pretty common, and may make debtors feel like they are at least “making progress” on all their obligations.

Which One to Choose?

Many experts advise choosing a method based on knowledge of your own personality. Can you work well within the logic of the ladder? Will you need the emotional satisfaction of the snowball? Is the kickstart method a good compromise? Although those of us who work in finance may feel that the ladder (or at least the hybrid) is always better, be aware that real-life research on the matter suggests that the less mathematically valid snowball method may often work better for people in real life. In an experiment where people “worked” by playing games to “pay off” pretend debt and get real money, those who concentrated their efforts on the account with the smallest balances worked the hardest to “get it done.”

And it does appear that concentrating on one loan at a time, rather than spreading out payments, is often best. Researchers looking at credit card data from nearly 6000 customers found that those who concentrated on paying off one account at a time were more successful than those who distributed their payments equally over multiple accounts. This effect was stronger when the debtors paid off smaller loans first.

Whatever the plan, debtors should make it clear and easy to follow They will benefit from thinking carefully about the best approach, making a plan, and sticking to it.  Paying off debt is not easy, but it can be done.

References:

Boyer, R. (2012). The ‘snowball’ approach to debt. Retrieved from http://www.kellogg.northwestern.edu/news_articles/2012/snowball-approach.aspx

Trudel, R. (2016). Research: The Best Strategy for Paying Off Credit Card Debt. Retrieved from https://hbr.org/2016/12/research-the-best-strategy-for-paying-off-credit-card-debt

Kettle, K.L.  Trudel, R., Blanchard, S. J., & Häubl, G. (2016). Repayment Concentration and Consumer Motivation to Get Out of Debt. Journal of Consumer Research, 43 (3), 460–477, https://doi.org/10.1093/jcr/ucw037