When Dr. Jeffrey Leman and his family moved to India, they cooked chicken the first night in their new home. That prompted a visit from the landlord who informed the young couple that meat could not be brought onto the premises.
For Leman, now a family practitioner with UnityPoint Health-Methodist, that incident triggered years of learning a new perspective about nutrition. American physicians do not typically study diet and nutrition in medical school. Their training focuses on diagnosis and treatment of illness rather than on diet to prevent illness.
Leman, who grew up in central Illinois, had previously viewed meat as a major focus of meals. He went to India to work in a rural mission hospital and expected to find malnourishment and protein deficiencies. He did not.
After nine years in India, Leman and his family returned to Peoria but have not returned to the American diet. The family eats limited meat, maybe twice a week, and then it’s usually fish or chicken.
Not long ago, Leman read about “Healthy Kitchens, Healthy Lives,” a Napa Valley, hands-on program for physicians devised by the Harvard School of Public Health and the Culinary Institute of America. The program puts kitchen knives into the hands of surgeons and other doctors and combines lectures, cooking and eating.
Leman and colleague Dr. Keith Knepp talked about the Napa Valley program, and they thought, why not try a similar program in Peoria.That was the genesis of a four-part seminar “Cook Well, Eat Well, Live Well” to help physicians and advanced practice providers acquire more knowledge about diet and disease they can then share with patients.
“As physicians, we know we should recommend alternative diets to our patients, but we struggle with how to do that in the context of our culture,” Leman said. “The science is compelling. The evidence is there for consumption of red meat and increased mortality, obesity and pro-inflammatory disease. There is too much processed food, high glycemic index food and sugar in the American diet.”
Six months of work and collaboration with dietitians and whole food advocates culminated in an Oct. 24 workshop “In the Kitchen with Whole Foods” at Illinois Central College North Campus. Only two physicians sliced fingers in the hands-on practice with knife skills and dicing.
Especially adept with a chef’s knife is Dr. Michele Couri who presented the keynote address following a three-course dinner of local food and wine. A graduate of University of Illinois College of Medicine at Peoria with her own ob-gyn practice, Couri recently completed a fellowship program with Dr. Andrew Weil at the University of Arizona Center for Integrative Medicine. She has restructured her Peoria practice to focus on integrative medicine and the healing role of nutritional food.
She said 75 percent of health care costs in this country are spent on preventable disease. To save both money and health, she suggested physicians start considering whole, unprocessed food as part of essential patient care.
“True health care reform starts in the kitchen, not in Washington,” she said.
The challenge facing physicians should be to get their patients passionate about cooking, she said, noting that this theory is not new but dates back to Hippocrates who famously stated “Our food should be our medicine, and our medicine should be our food.”
Couri advocates an anti-inflammatory diet of whole foods rather than processed foods that trigger inflammation and disease and result in obesity, diabetes and cardiac disease. She criticized federal government subsidies that go to some of the unhealthiest foods.
Food, she said, turns genes on and off, triggering or fighting disease. Highly processed food talks to our genetic material and turns on chronic inflammation that is the root cause of disease.
Evidence supporting the link between health and whole food is clear, she said, citing studies and demographic trends. Rather than evaluating carbohydrates as simple or complex, she recommended relying on the glycemic index that measures how fast carbohydrates convert to sugar. Avoid foods high on the glycemic index and eat more low-glycemic index foods.
“Real food does not come with a list of ingredients. This (approach to eating) is not a diet that is temporary; it’s a lifestyle that is permanent,” Couri said. “Patients think diet soda is OK, but even artificially sweetened beverages fuel obesity. Aspartame is metabolized as a toxin to the hypothalamus” and damages the appetite control center.
She urged people to get more of their protein from vegetables and encouraged more consumption of cruciferous vegetables.
“Eat all colors and keep trying new vegetables and fruits,” she said. “And don’t forget the power of spices” particularly turmeric with its anti-cancer, anti-inflammatory properties.
Couri recommended doctors discuss diet with their patients and ask them to start a daily food diary listing all food and exercise. If you don’t have time to talk about nutrition with your patients, refer them to a dietitian, she said.
In designing the seminar series, Leman and Knepp, both family practitioners, reached out to local food advocates Kathy Corso and Anne Patterson who worked with local registered dietitians and the Heart of Illinois Professional Chefs Association.
During an interview several days later, Corso said evaluations from the program were positive and nearly all of the 34 attendees indicated they plan to attend subsequent sessions.
A lifelong advocate of whole, unprocessed food, Corso recounted a client she had as a mental health counselor at a local social service agency. The young, 19-year-old mother had lost two teeth, was unable to walk and suffered chronic fatigue. Corso recommended a complete physical exam but first asked the woman about her diet.
“She grew up never eating a healthy meal. From age 2, she had eaten no vegetables and no fruit. None. She ate three to five bowls of sugared cereal each day and bought most of her food at a drive-through,” Corso said. “She did not cook. Not one physician had ever asked about her diet.”
Leman had a similar experience when a 42-year-old friend had his second heart attack, and Leman asked his friend if his physicians had ever talked with him about diet.
They had not.
“It’s almost criminal to let a patient leave my office without talking about diet,” Leman said. “This is not only a doctor’s job, it’s our obligation.
The next session of “Cook Well, Eat Well, Live Well,” is Jan. 16, 2014, “Eat Your Way Out of Type II Diabetes.” Physicians and advance practice providers can get more information by emailing Janet Hindenburg at: Janet.Hindenburg@unitypoint.org.