Physician assistant students learn how to incorporate culinary medicine into future practice

East Carolina University’s Department of Nutrition Science has piloted a program to teach future health care providers the ins and outs of food, and how to prepare nutritious meals, so they can incorporate culinary medicine into their practices and pass health-promoting food knowledge on to their patients.

Farm2Clinic assistant director Brandon Stroud shares cooking tips with physician assistant students during a culinary medicine class.

Dr. Lauren Sastre, an assistant professor of nutrition science in the College of Allied Health Sciences, said the culinary medicine initiative is important because even well-educated health care students often don’t understand the details of macro- and micronutrients, and how they impact overall health. Likely as important, Sastre said, many people are impeded by not having the tools to budget for health-promoting foods and how to employ basic cooking skills.

Sastre said the idea to expose allied health students to the concept of culinary medicine — combining the art of cooking with the science of nutrition — has been percolating since attending a public health conference nearly 10 years ago, where she was first introduced to the idea, which was being incorporated into the curriculum of a few medical schools across the country.

Allied health professionals’ promotion of culinary medicine isn’t a new concept, but thinking of food as medicine isn’t well incorporated into health care — yet. One notable exception is Jessica DeLuise, a physician assistant who promotes food as key to health as The Wellness Kitchenista on TV and social media.

Sastre and her team have made great strides in recent years with the Farm2Clinic initiative, which brings the concepts of culinary medicine into communities that desperately need to be nudged toward better eating habits.

“One of the important parts of our Farm2Clinic programming is helping people realize it’s not that hard to make food that is healthy and tastes good,” Sastre said. “So, I did a deep dive into the literature, and it was only being done with medical students. You don’t see it being done with PA students or nurse practitioner students.”

Physician assistant students plate food they cooked as part of a culinary medicine experience.

Getting access to physician assistant studies students was relatively easy, as they are part of the same college as the nutrition sciences department, and Sastre has a strong relationship with the College of Nursing, which is right next door on the Health Sciences Campus.

Over the summer Sastre was contacted by a colleague in the physician assistant (PA) program to reconfirm the nutrition training that Sastre had provided to students for several years. Sastre offered an alternative — why not incorporate a more comprehensive food literacy workshop into the time allotted, including budgeting and fundamental nutrient science along with cooking skills?

“I want to ensure that we’re equipping them with information that translates to patient care,” Sastre said. “We have so many nutrition problems in the United States, 90% of what we’re spending in health care is to manage a chronic condition — everyone pretty much has one at this point. These chronic diseases like diabetes and hypertension are driven by poor dietary patterns, and yet we don’t have comprehensive nutrition training for our health care providers.”

Not everyone can afford to see a nutritionist, Sastre said, but they are very likely to receive primary care from a physician assistant or nurse practitioner. Helping to shape how those frontline providers counsel their patients is a good step forward in addressing chronic health conditions.

Closing the Skills Gap

One of the cultural shifts that Sastre identified as contributing to the current health situation in North Carolina and across the U.S. is a near collapse of home economics education in schools — budgeting chief among the skills many adults are lacking.

“We’re decades on from people not even having foundational food skills. We could have a fancy culinary medicine class and teach fancy things, but if someone can’t budget to get healthy food into their household in the first place, we’re not checking the boxes,” Sastre said. “What we did with this pilot class is more comprehensive.”

Kinston’s Raven Breinholt, a public health graduate and research assistant and coordinator for Farm2Clinic, who received her Bachelor of Science in nutrition and dietetics from ECU in 2023, worked with PA students on basic cooking skills during the culinary medicine day, leading her peers in preparing a cabbage and turkey casserole. The simple dish was an example of how a nutritious, balanced meal can be easy to make and easy on the wallet.

Physician assistant students cut vegetables to be used in a meal as part of a culinary medicine class.

“When you are working with patients it’s important to understand the different sociodemographic backgrounds of patients and how that impacts their ability to prepare healthful foods. It’s really hard to buy fruits and vegetables,” Breinholt said, but it can be done.

Couple a lack of kitchen skills with food prices that are out of many people’s reaches, and it’s no wonder that many people turn to cheap, overprocessed, unhealthy foods, Breinholt said. She said an interdisciplinary approach is the best step forward for ECU’s nutrition science faculty and students and their peers in allied health disciplines, nursing and medicine.

“We should be working together as a team to ensure that every patient gets the best care they can, and we need to start building those relationships now,” Breinholt said.

Kendra Brent, a second-year physician assistant student from Bristol, Tennessee, said cooking is a big part of her life, but the demands of the PA program have kept her out of the kitchen far more than she’d like.

She knows that rural parts of North Carolina and her home in Tennessee don’t always have the best eating habits — that “we love all the fried things” — but the opportunity to learn from Sastre and her students how to shift patients’ thought on food was motivating.

“This is really cool because it gives me ideas of how I can educate my patients. It is doable; it is possible,” Brent said.

Brent said the focus on nutrition was a welcome break from the disease-heavy focus of the PA program’s coursework. Working with her nutrition peers, who are in a different program but are just as focused on improving health in the region, helped Brent to feel like they are all on the same team, working toward the same goal.

“It’s been awesome working with them. You see a whole new side of medicine that I never even knew existed. I didn’t know that culinary medicine was a thing until this morning. It’s great to know that they are a resource out there,” Brent said.

Food is a core part of a people’s sense of self, a part of a culture, and Sastre knows that making wholesale changes to most Americans’ food choices will be a challenge.

“To an extent, we’re having to go backwards to go forwards,” Sastre said, but she remains motivated to keep fighting for change along with students representing disciplines across the health care spectrum.

More Stories