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Culinary Medicine

Dr. Gloria Richard-Davis, Professor, Department of Obstetrics and Gynecology, University of Arkansas Medical Sciences

“Let food be thy medicine and medicine be thy food” is an age old quote by Hippocrates that is finding new meaning in the emerging field of culinary medicine. And it’s not happening any too soon.

A 2016 study published in the International Journal of Fashion Design, Technology, and Education reported that the average American woman actually wears a size 16 to 18, not size 14, as once was assumed. In fact, according to reported statistics from The State of Obesity compiled by US News, the average American weighs about 24 pounds more than in 1960.

And it’s not so easy to shed those extra pounds. When you

want help getting rid of your menopot, who do you turn to for help? If you’re like many women, it’s probably not your doctor.

Dr. Gloria Richard-Davis wants to change that. As a Professor at the University of Arkansas, she serves a community that is one third obese. So she set about starting a new course for the medical students called Culinary Medicine. She hopes to fix the obesity problem by teaching new doctors how to educate patients to choose the right foods and nutrients to eat in the first place.

“I got interested in this because a lot of the population that we serve in the fertility arena are polycystic ovarian syndrome (PCOS) patients. Those patients are really a variant of diabetes. If they do nothing, in 20 years or so, they may become type II diabetic.”

According to Dr. Gloria Richard-Davis, “polycystic ovarian syndrome patients have a combination of irregular cycles, they may have increased hair growth,

We have to fight the subconscious belief that there’s a value to something bigger and cheaper when we eat out.

acne, and they also have infertility. They can also have increased risk of metabolic syndrome or cardiovascular disease, dyslipidemia, and elevated insulin levels.”

Dr. Richard-Davis points out that weight loss for health can be achieved by most people. “Losing as little as five to 10 percent of your body weight can have significant impact on health and response to treatment.”

Translated into pounds, if you are a 150 pound woman, a five percent weight loss would only be about seven-and-ahalf pounds. So a little bit of weight loss can make a lot of difference.

And if you are in perimenopause or menopause, this same seemingly small amount of weight loss moves you in the direction of a better metabolic milieu. It can lower your blood pressure and your blood sugar levels.

According to Dr. Richard-Davis, peripheral fat or adipose tissue has a lot of inflammatory cells that really work against insulin functioning appropriately. And that prevents the insulin produced by your pancreas from moving the sugar from your bloodstream into your cells to make energy.

Too much sugar and too much fat is like putting bad gas in your car. You

don’t get as good a mileage, and the car doesn’t run as smoothly. And putting bad food in your body, causes your cells not to function as well. That’s where the culinary medicine comes in.

“I actually have a nutritionist in my practice to talk to patients about nutrition,” Dr. Richard-Davis says. “I took a nutrition class when I was at Harvard, so I have a pretty good base knowledge of nutrition, and lots of family members who are nutritionists. So I speak the language with them a lot. But most medical school curriculums don’t teach nutrition.”

“When our new Chancellor, Dr. Patterson, arrived, he gave us the seed money to start the culinary medicine curriculum.

Fill half of your plate with vegetables, a quarter with some kind of protein, and a quarter with some kind of a carbohydrate

We modeled after Tulane’s Culinary Institute, which has about 50 modules they’ve created to cover almost every chronic medical condition you can think of.

So if you have somebody who has high blood pressure, you want to focus on the nutritional recommendation for patients who have hypertension. Students watch the modules, and after they complete the module there are actually case studies and a culinary demonstration. So we prepare some meals and dishes.”

It’s kinda like the Cooking Channel for doctors. In Boston there is an organization called Community Servings that started out for people that have HIV. And then they started expanding it into other diseases, like high blood pressure, diabetes, et cetera. They make meals with particular nutritional value for each disease.

According to Dr. Richard-Davis, the culinary medicine course includes basic culinary skills and food safety. Then they added modules for the morecommon diseases like diabetes, hypertension, inflammatory bowel disease, food allergies, OB, and prenatal. Those eight modules makes up the basic composite of what is the culinary course. “We’re not covering everything, but we’re trying to hit the most common things that a physician would see in general practice.”

What do you tell people so they get the best potential source of food for themselves?

Dr. Richard-Davis sites as an example, “with our PCOS patients, our polycystic ovarian syndrome patients, we

focus a lot on carbohydrate choices. It’s eliminating refined carbohydrates that spike your insulin level and shift your calories to fat. Take bread, for instance. A slice of white bread or refined breads, that’s not good. Choose instead a multigrain bread or multigrain pasta.

“I suggest that nothing white should cross their lips: white flour, white sugar, white bread, white potatoes. And that includes French fries. That’s probably the simplest way to talkabout eliminating refined carbohydrates.”

If you’re eating on the run, gather healthy snacks to take along with you that don’t take a lot of preparation; a handful of nuts or some cut or diced vegetables like celery or carrot sticks. And you can add a tablespoon of peanut butter. Having the veggie carb together with the peanut butter protein alters the way that your food gets metabolized.

“Also, eating a plant-based diet is healthier for us,” states Dr. Richard-Davis. “That’s kinda what I encourage my patients to do. You need proteins,

you need healthy carbs like multigrain bread, brown rice or wheat pasta, and it’s okay to have a little fat. You want to avoid refined carbohydrates.”

Dr. Richard-Davis points out that the more fresh food you eat, the less salt you will be adding to your daily intake. The more processed food you eat, the more hidden salt will find its way into your diet. Even a slice of bread has 220 mg of salt. That’s 10 percent of your daily needs.

When we’re talking about specific disease entities like hypertension, then obviously you get more into the issue of sodium. And then looking at nutrition labels is important, because a lot of prepared foods have a tremendous amount of sodium. And restaurant and fast food eateries notoriously use a lot of salt.

One healthy way to lower calorie intake is to order a main course and split it with your companion or just take the

other half meal home. Add a salad for each without a lot of salad dressing and it makes a healthy, balanced meal. It also cuts the price almost in half. Dr. Richard-Davis says we have to fight the subconscious belief that there’s a value to something bigger and cheaper when we eat out.

“The medical students are very excited,” Dr. Richard-Davis says. “We work with Pulaski Tech Community College, and they have a culinary institute and a demonstration kitchen. The students are goingout there and doing some of the cooking classes focusing on healthy eating. They call themselves med chefs. The actual Chefs we are working with are not only Chefs but also Registered Dietitians.”

“The patients who actually followed our recommendations are losing weight and lowering their BMI. For our fertility patients, the better they control their weight, the better they respond to fertility medication, and many can respond to oral medications rather than having to take the stronger, injectable medications. And that’s both less expensive and less risk for them to have a multiple birth.

Some friendly guidelines Dr. Richard-Davis suggests are to fill half of your plate with vegetables, a quarter with some kind of protein, and a quarter with some kind of a carbohydrate, like half a sweet potato, beans or something like that, which also has protein potentially. And then for dessert consider berries like blueberries or strawberries, and add a small dollop of low-cal whip cream.

Dr. Richard-Davis goes on to say that weight loss works best when controlling diet and food choices is combined with increased activity. As a rule, the more fat you have on your body, the less calories you burn because fat metabolizes less amounts of calories than muscle.

“From an activity perspective, I generally say to patients 10,000 steps a day should be your goal. Most of us are running around with a smartphone. I

usually recommend that they get either a Fitbit or a pedometer. It makes you aware of how much or how little you’re moving during the day, because invariably, most of us think that we move more than we do.”

And if you don’t like exercise, there are other things you can do to increase your activities. You can garden, do housework, or go dancing. Sex is also exercise. Even if you’re on the phone, if you stand up instead of sitting you’re

burning more calories. You can have walking meetings where you actually walk around during the meetings rather than sit around a table.

Dr. Richard-Davis also points out that while eating healthy is the cornerstone of weight loss, getting enough sleep and exercise and lowering your stress also help to lose weight. “It’s important to take a comprehensive approach to our culinary medicine program,” she said.

Maybe one day you’ll go to the doctor and get a prescription for a better grocery shopping list and some recipes and videos for how to prepare them.