Dr Abhinav Bhansali
The team behind Culinary Medicine UK discuss the concept of culinary medicine and how it can expand the conversations healthcare professionals have with patients about food and nutrition.
What's the idea behind 'culinary medicine'?
Culinary medicine blends practical aspects of cooking and the culinary arts with nutrition science and considers the application to clinical practice. This has been an established movement in the US for over a decade, and the Culinary Medicine UK (CMUK) team has worked tirelessly to curate a programme suitable for the UK.
We hope to heighten the importance of food in the management of conditions alongside all other interventions, and allow health practitioners to start more conversations with patients about food. Since our inception in 2018 we have educated over 50 healthcare professionals.
We have three key guiding principles.
Empower healthcare professionals to elevate the conversation around food
There is a need for change in the way we talk and think about food. Educating healthcare professionals offers a sustainable and reliable way of spreading the principles of CM to the wider public. We hope to increase healthcare practitioners' confidence to discuss nutrition alongside current medical practice, and where appropriate refer on to registered dietitians and nutritionists for additional support.
Use the kitchen as an effective classroom
We believe using the kitchen as a classroom is a pragmatic way to consider current evidence and the role food plays in health and disease management in a safe learning environment. Participants consider clinical cases and the challenges their patients may face in changing their eating and cooking practices. This also includes nutrition care, which is realistic within all of the other priorities and time constraints of busy clinical life.
Respect cultural and societal nuances
Our case-led discussions have included a labourer at risk of diabetes but currently relying on fast food, or a single parent with a large family to feed on a budget. We look at what is acceptable and practical for them to eat, and where they can get reliable information and support/follow up.
Our teaching model aims to equip healthcare professionals with the knowledge and confidence to start conversations about food and help answer the question, 'What should I eat?' – frequently asked by patients. We also want to address the un-met needs of patients who may not ask this question.
We believe this is a significant improvement to the few hours of 'nutrition education' offered by traditional medical curriculums. We also want to promote multi-professional working and better social prescribing so there is more clarity in this already confusing space.
What medical issues does culinary medicine address or solve?
There is very little research into the nutrition practices of UK health professionals, but research from the US suggests only 14% of physicians felt confident to discuss nutrition in consultations. Accessing reliable evidence based support is essential to ensure patient safety and quality but surprisingly, only 3% of GP consultations in Australia contain any discussion on nutrition. Patients perceive GPs as a reliable source of nutrition advice and express a preference to receiving nutrition care from their GP. Considering the increase in lifestyle-related chronic diseases, the demand on doctors to provide nutrition care is likely to rise.
Furthermore, we address communication and ideas for supportive, non-judgemental and patient centred conversations. We encourage clinicians to use history taking and listening skills, putting the patient at the centre while respecting individual choice, culture and specific nutrition needs. Clear documentation and use of credible resources is also important from a medico-legal angle when guiding patients in nutrition.
What's the evidence for its success and effectiveness?
The Goldring Centre for Culinary Medicine (GCCM) in the US has shown that hands-on cooking and nutrition education for medical trainees improves their attitudes and competencies when providing nutrition counselling to patients - but also improves their own diets.
Our initial data suggests our course may increase perceived confidence and commitment to include nutrition in future consultations, with attendees keen to attend further sessions. More research is needed in this area to consider what happens after CMUK modules, as well as patient views on what is helpful. However, we are confident that the growing need, our willingness to collaborate with like-minded organisations and our initial proof of concept will help us build a community that could have a real impact on population-lifestyle.
We encourage clinicians to use history taking and listening skills, putting the patient at the centre while respecting individual choice, culture and specific nutrition needs.
How does it benefit patients?
Our ultimate goal is to empower patients with the knowledge and skills to access and prepare meals that are simple, tasty and meet their individual needs; an important component of better self-care. Interestingly, in a single centre small RCT, GCCM has demonstrated statistically significant improvements in biometrics (diastolic BP and total cholesterol) in Type 2 diabetic patients who participated in a medical student-led hands-on cooking and nutrition class. These results suggest subsequent clinical trials are warranted.
Equally urgent is the need for improved nutrition diagnosis, a better understanding of referral pathways for patients to find the correct support, and more meaningful social prescribing. CMUK starts these conversations, which can be brought back to local NHS trusts to help inspire change, from one-to-one patient consultations to addressing policy and processes, and encouraging a more holistic multi-professional view of nutrition care at all stages of the patient journey. Better social prescribing encompasses a number of activities such as walking groups and exercise activities, and cooking is another essential skill that could easily be incorporated into the overall treatment approach.
We recognise these are ambitious aims, and that we are just a part of the bigger change needed. However, starting brief conversations to discuss food and patients' views, advising on first line tips and ideas, and assisting with onward referral all equips professionals with simple tools to ensure safety and improved access to nutrition care for patients.
Where can readers find out more?
Find out more on our website culinarymedicineuk.org, which includes a link to sign up for information on upcoming courses dates.
You can also follow our various social media channels (Instagram, Twitter, Facebook) to stay up to date with all our news - or just get in touch at firstname.lastname@example.org and we would be happy to answer all your questions.
Special thanks to Elaine Macaninch, Dr Moushumi Baruah, Dr Rupy Aujla for their contributions to this article.
Dr Abhinav Bhansali
Dr Abhinav Bhansali, founding director of CMUK, graduated from Imperial College School of Medicine with a first class honours in healthcare management. He has worked for Candesic, a boutique healthcare consulting firm, where he helped develop plans for the first-of-its-kind, state-of-the-art, wellness centre. He is now a GP trainee in Northwest London and strongly believes that our current attitude towards health needs to change. He believes 'driving forward innovations such as CM will help shape the change in population lifestyle needed to curb the burden of multi-morbidity.'
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