Culinary Medicine Research Articles

Comprehensive Lifestyle Modification Intervention to Improve Chronic Disease Risk Factors and Quality of Life in Cancer Survivors.

Healthy lifestyle modifications, including weight management, regular physical activity, prudent diet, and stress relief, have been identified as key components of tertiary cancer prevention. In this study, we evaluate the effectiveness of a comprehensive, lifestyle medicine intervention, Lifestyle 180®, on chronic disease risk factors and quality of life in cancer survivors. Retrospective subgroup analysis of a clinical program. An outpatient medical facility. Lifestyle 180 participants with a diagnosis of past cancer. Sixty-four hours of intensive nutrition, culinary medicine, physical activity, and stress relief practices over a 6-month period, with 9- and 12-month follow-up. Pre-postanalysis (baseline vs. 12 months) included biometrics: weight, body mass index (BMI), waist circumference, and blood pressure; standard laboratory tests: lipids, C-reactive protein, fasting insulin/glucose, and insulin resistance; and empirically validated questionnaires: perceived stress, depression, and quality of life. Fifty-eight cancer survivors participated in Lifestyle 180. Average age was 63 years, roughly 75% of participants were female, and the greatest majority had a diagnosis of breast, prostate, or skin cancer. Diagnosis of hyperlipidemia, hypertension, diabetes, and prediabetes presented in 47%, 57%, 22%, and 50% of patients, respectively. Forty-five percent of patients were obese, 24% were overweight, and 16% were depressed. At 12 months, participants lost an average of 14 pounds (-6.6%, p < 0.001) and 2.6 inches off their waist (-5.9%, p < 0.001). BMI decreased significantly by an average of 2.4 kg/m2 (-6.8%, p < 0.001). Significant decreases from well-managed baseline levels also occurred in most measured biomarkers (average change: high-density lipoprotein +3.3 mg/dL, p < 0.05; triglycerides -23.0 mg/dL, p < 0.01; C-reactive protein -1.3 mg/L, p < 0.01; fasting insulin -4.2 μU/mL, p < 0.05; and homeostasis model assessment-insulin resistance -1.5, p < 0.01; n = 40). Changes in psychosocial variables included significant improvements in perceived stress (-20%, p < 0.01) and quality of life (+54%, p < 0.001). We were unable to detect a difference in depressive symptoms. Cancer survivors participating in a comprehensive intervention could employ the prescribed lifestyle modifications to produce clinically relevant health and quality-of-life benefits. These data support the American Cancer Society (ACS) and American Society of Clinical Oncology (ASCO) recommendations to incorporate healthy lifestyle modifications into long-term cancer survivorship care.

P67 - Farm-to-Clinician: A Culinary Medicine Approach to Healthcare Through a Food Systems Lens

P67 - Farm-to-Clinician: A Culinary Medicine Approach to Healthcare Through a Food Systems Lens

Evaluation of Cytotoxicity and Genotoxicity of Micromeria pulegium (Rochel) Benth Extract in Human Lymphocytes and Gr-M Melanoma Cells in vitro

Micromeria pulegium (Rochel) Benth. is an endemic species of Lamiacea family that includes frequently used plants in culinary and folk medicine. As cytotoxic potential of some species of Micromeria genus has been confirmed, this study aimed to test unknown antiproliferative and genotoxic potential of M. pulegium, endemic bh species, aqueous leaf extract in normal (human lymphocytes) and cancer (human melanoma GR-M) cells in order to protect small populations of native M. pulegium populations or promote its controlled micropropagation or cultivation. Cytokinesis-block micronucleus cytome assay was applied for human lymphocyte cultures, while trypan blue exclusion assay was used for evaluation of cytotoxicity in human GR-M melanoma cells. Results demonstrate no genotoxic effects up to concentration of 0.2 mg/ml in human lymphocyte in vitro but significant reduction of cell viability in human GR-M melanoma cell line cultures treated with 0.3 mg/ml of Micromeria extract.

Antioxidant-mediated neuroprotection by Allium schoenoprasum L. leaf extract against ischemia reperfusion-induced cerebral injury in mice

Background Oxidative stress is strongly implicated in ischemia reperfusion (IR)-mediated functional and neuronal impairment. Therefore, strategies employing antioxidants to reverse the damage due to IR are being investigated. Allium schoenoprasum L. is a culinary medicine whose antioxidant properties are well documented but whose neuroprotective potential has not been examined. Hence, the present study was designed to evaluate the effect of A. schoenoprasum leaf extract (ASLE) on functional deficit against IR-induced cerebral injury in mice. Methods Acute toxicity studies of ASLE were performed following the Organisation for Economic Co-operation and Development Guideline 423. IR injury was induced by bilateral common carotid artery occlusion (BCCAO) for 15 min followed by 24-h reperfusion. Animals were treated for 7 days with ASLE (200 and 400 mg/kg, p.o. once daily) after IR injury. Functional outcomes (memory and sensorimotor functions) were measured using Morris water maze and neurological severity score, respectively. Cerebral infarct size and oxidative stress (thiobarbituric acid reactive species (TBARS), reduced glutathione (GSH), and superoxide dismutase (SOD) activity) were measured in order to elucidate the neuroprotective mechanism of ASLE. Results No toxic effects of ASLE were observed in mice. Oral treatment with ASLE for 7 days significantly attenuated IR-mediated memory and sensorimotor function deficit in the animals. The extract also reduced the cerebral infarct size and rise in brain TBARS levels, and restored the GSH levels and SOD activity. Conclusions The results of the present study suggest that ASLE is safe and effective in improving functional outcomes. It demonstrates neuroprotective effect by enhancing the antioxidant defence against IR injury.

Somatic embryogenesis and plant regeneration from zygotic embryo-derived callus cultures of allium altaicum pall.

Altain onion (Allium altaicum Pall.) grows wildly under different ecological conditions and one of the listed rare plant in Red Data Book of Mongolia. Allium altaicum pall belong to a member of the onion family (Alliaceae) and has been used for both culinary and traditional medicine and a perennial herb.The purpose of this research is to get micropropogated plants in in vitro condition from Mongolian the Allium altaicum Pall tissue culture. Allium altaicum Pall. regeneration from zygotic embryo was 70% in MS medium with 0.5 mg/l 1-Naphthaleneacetic acid, 0.2 mg/l kinetin compare to control. Convenient condition for primary callus induction observed in MS medium with 1 mg/l 2,4-dichlorophenoxyacetic acid, 0.6 mg/l 6-benzylaminopurine, 2mg/l glycine by 50.4%. Regeneration of callus induction was 61.3% and somatic embryos formed plantlets on regeneration 0.1 мг/л 2,4-D 0.1 mg/l 2,4-dichlorophenoxyacetic acid, 1 мг/л BAP 1 mg/l 6-benzylaminopurine.

The Effect of Growth Substrate and Extraction Solvent on Biological Activities of Oyster Culinary Medicinal Mushroom Pleurotus ostreatus (Agaricomycetes).

Agricultural residues can be taken advantage of and be used to produce edible mushrooms through a biotransformation procedure. Mushrooms are beneficial species for humans, acting as antioxidant, antidiabetic, hypo-cholesterolemic, antitumor, anticancer, immunomodulating, antiallergic, nephroprotecting, and antimicrobial agents. The current study analyzed the influence of the origin of the nitrogen source on the antioxidant capacities of the Pleurotus ostreatus mushroom. The substrates were lignocellulosic residues and their moisture, ash, carbohydrate, and lignin content along with pH and antioxidant capacity were determined. Later, P. ostreatus mushrooms were produced in those residues, and their antioxidant capacity was determined. Edible mushrooms of the species P. ostreatus cultured in a mixture of sawdust, oak, and pasture were a viable source of antioxidant substances because their ethanolic extracts possessed an antioxidant capacity of 92.74% 2,2-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) radical assay. Direct influence of the growth substrate on the antioxidant properties of P. ostreatus was found. The use of different solvents (methanol, ethanol, or acetone) had no significant effect on the antioxidant properties of the extract.

Creating Culinary Literacy In Patients With Type 2 Diabetes: A Pilot Study

Background: Culinary medicine is an emerging field that combines the concepts of food and cooking with the science of medicine, to use food as medicine. Culinary literacy (CL) aims to teach not only what to cook, but also how to cook with confidence. To date, a lack of literature exists describing the principles of culinary literacy in Canadian adults with Type 2 Diabetes (T2DM).

Integrating Intergenerational Mentoring into a Culinary Medicine Curriculum

We assessed the feasibility of partnering a medical school with a senior center to integrate elder mentors into a culinary medicine course with 4th-year students. We observed benefits for both students and elders and identified strategies to improve curricular logistics and strengthen bi-directional learning.

Cardamom powder supplementation prevents obesity, improves glucose intolerance, inflammation and oxidative stress in liver of high carbohydrate high fat diet induced obese rats

BackgroundCardamom is a well-known spice in Indian subcontinent, used in culinary and traditional medicine practices since ancient times. The current investigation was untaken to evaluate the potential benefit of cardamom powder supplementation in high carbohydrate high fat (HCHF) diet induced obese rats.MethodMale Wistar rats (28 rats) were divided into four different groups such as Control, Control + cardamom, HCHF, HCHF + cardamom. High carbohydrate and high fat (HCHF) diet was prepared in our laboratory. Oral glucose tolerance test, organs wet weight measurements and oxidative stress parameters analysis as well as liver marker enzymes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) activities were assayed on the tissues collected from the rats. Plasma lipids profiles were also measured in all groups of animals. Moreover, histological staining was also performed to evaluate inflammatory cells infiltration and fibrosis in liver.ResultsThe current investigation showed that, HCHF diet feeding in rats developed glucose intolerance and increased peritoneal fat deposition compared to control rats. Cardamom powder supplementation improved the glucose intolerance significantly (p > 0.05) and prevented the abdominal fat deposition in HCHF diet fed rats. HCHF diet feeding in rats also developed dyslipidemia, increased fat deposition and inflammation in liver compared to control rats. Cardamom powder supplementation significantly prevented the rise of lipid parameters (p > 0.05) in HCHF diet fed rats. Histological assessments confirmed that HCHF diet increased the fat deposition and inflammatory cells infiltration in liver which was normalized by cardamom powder supplementation in HCHF diet fed rats. Furthermore, HCHF diet increased lipid peroxidation, decreased antioxidant enzymes activities and increased advanced protein oxidation product level significantly (p > 0.05) both in plasma and liver tissue which were modulated by cardamom powder supplementation in HCHF diet fed rats. HCHF diet feeding in rats also increased the ALT, AST and ALP enzyme activities in plasma which were also normalized by cardamom powder supplementation in HCHF diet fed rats. Moreover, cardamom powder supplementation ameliorated the fibrosis in liver of HCHF diet fed rats.ConclusionThis study suggests that, cardamom powder supplementation can prevent dyslipidemia, oxidative stress and hepatic damage in HCHF diet fed rats.

An Intergenerational Teaching Kitchen: Reimagining a Senior Center as a Shared Site for Medical Students and Elders Enrolled in a Culinary Medicine Course

In the early 21st century, increases in demographic aging and urbanization and global economic instability, brought on by the worldwide recession and accompanying austerity measures enacted in many...

Barley flour (áleuron kríthinon) in ancient and early Byzantine medicine (I – VII c. AD)

The following article attempts to address two issues. The first one concerns dietetic characteristic of barley flour, which was a very popular product used both in Graeco-Roman and Byzantine culinary art and medicine. The second one deals with the therapeutic role of this product: different forms of remedies made from it, its effects on the human body, and various health problems cured by an application of medicines containing aleuron krithinon. To address these questions we study ancient and Byzantine Greek medical sources written between the 1st and 7th century AD by Dioscurides, Galen, Oribasius, Aetius of Amida, Alexander of Tralles, Paul of Aegina, and the anonymous author of the treatise entitled De cibis.

Health-related Culinary Education: A Summary of Representative Emerging Programs for Health Professionals and Patients.

Background:Beneficial correlations are suggested between food preparation and home food preparation of healthy choices. Therefore, there is an emergence of culinary medicine (CM) programs directed at both patients and medical professionals which deliver education emphasizing skills such as shopping, food storage, and meal preparation.Objective:The goal of this article is to provide a description of emerging CM programs and to imagine how this field can mature.Methods:During April 2015, 10 CM programs were identified by surveying CM and lifestyle medicine leaders. Program directors completed a narrative describing their program's structure, curricula, educational design, modes of delivery, funding, and cost. Interviews were conducted in an effort to optimize data collection.Results:All 10 culinary programs deliver medical education curricula educating 2654 health professionals per year. Educational goals vary within the domains of (1) provider's self-behavior, (2) nutritional knowledge and (3) prescribing nutrition. Six programs deliver patients' curricula, educating 4225 individuals per year. These programs' content varies and focuses on either specific diets or various culinary behaviors. All the programs' directors are health professionals who are also either credentialed chefs or have a strong culinary background. Nine of these programs offer culinary training in either a hands-on or visual demonstration within a teaching kitchen setting, while one delivers remote culinary tele-education. Seven programs track outcomes using various questionnaires and biometric data.Conclusions:There is currently no consensus about learning objectives, curricular domains, staffing, and facility requirements associated with CM, and there has been little research to explore its impact. A shared strategy is needed to collectively overcome these challenges.

Culinary Medicine—Jalebi Adhesions

Culinary terms have been used to describe anatomy (bean-shaped kidneys), pathology (strawberry gall bladder), clinical signs (café-au-lait spots), radiological images (sausage-shaped pancreas), etc. While Indian cuisine is popular all over the world, no Indian dish finds mention in medical terminology. In intra-abdominal adhesions, sometimes, the intestinal loops are so densely adherent that it is difficult to make out proximal from distal and it is impossible to separate them without injuring the bowel resulting in spill of contents-resection is the only option (Fig.1). Jalebi, an Indian dessert, has a single long tubular strip of fried batter filled with sugary syrup so intertwined that it is impossible to discern its ends; if broken, the syrup spills out-the best way to relish it is to chew the whole piece (Fig.2). Because of these similarities between them, I propose to name dense intra-abdominal adhesions as 'jalebi adhesions.'

What Is Culinary Medicine and What Does It Do?

Over the past 35 years, a new enthusiasm has emerged about the relationship of food, eating, and cooking to personal health and wellness.1 Though there are few peer-reviewed publications, grant monies, books, or biomedical journals entitled “culinary medicine,” there are thousands of peer-reviewed publications, found mainly in mainstream medical journals that form its published research base. How can the emerging field of culinary medicine be helpfully described?

CHOP-International: an open access nutrition education tool for physicians, resident doctors, and medical and public health students

Dietary diseases drive some of this century’s most pressing and costly global public health challenges, ranging from malnutrition-related infectious diseases such as HIV infection to overfeeding and linked chronic diseases such as type 2 diabetes mellitus and coronary heart disease. We seek to create clinically meaningful and cost-effective education tools to help treat such conditions in a manner that is both population specific and evidence based. Tulane University School of Medicine’s Goldring Center for Culinary Medicine (GCCM), a medical school-based teaching kitchen and research laboratory, utilized its novel collaboration of clinicians, registered dieticians, chefs, and culinary and medical students to create an open source international nutrition education resource comprised of region-specific recipes based upon the World Health Organization’s Nutrient Intake Goals. Using staple ingredients from three sample Millennium Development Goals regions, GCCM has developed sample recipes from three continents for proof-of-principle testing. The recipes include nutrition facts, interchangeable and optional ingredients, and salient nutrition education discussion points for students and medical professionals to use with a variety of patient conditions. Community-based participatory testing of the efficacy of this tool will allow for the refinement of the complete tool in the United States, followed by global expansion in coordination with physicians and students from Tulane University School of Public Health and Tropical Medicine in Kenya, Indonesia, and Colombia.

Antimicrobial Activity of Extracts of the Oyster Culinary Medicinal Mushroom Pleurotus ostreatus (Higher Basidiomycetes) and Identification of a New Antimicrobial Compound.

Pleurotus ostreatus is an edible mushroom that also has high medicinal values. In this study, P. ostreatus was tested for its ability to inhibit the growth of fungi and bacteria. The freeze-dried fruiting body, broth from submerged culture, and mycelial biomass of P. ostreatus were extracted using alcohols and water as solvents. The extracts were then tested for their antimicrobial activity against the growth of fungi and bacteria. It was observed that the water extract from fruiting bodies had the strongest effect in inhibiting the growth of most fungi. The most sensitive test microfungi to the inhibition were Candida albicans, Cryptococcus humicola, and Trichosporon cutaneum, and the most sensitive test bacteria were Staphylococcus aureus followed by Escherichia coli. Water extracts from culture broth or mycelial biomass were moderately inhibitive to the growth of fungi and bacteria. The alcohol-based solvents from all samples had much less antimicrobial activity against most test microorganisms. An antimicrobial compound was purified from the water extracts of fruiting bodies with Sephadex G 100 column chromatography and characterized by infrared absorption spectrum (IR), nuclear magnetic resonance (NMR), and mass spectroscopic analysis. We have identified this compound to be 3-(2-aminopheny1thio)-3-hydroxypropanoic acid. This purified compound had a minimum inhibitory concentration of 30 µg/mL and 20 µg/mL against the growth of fungi and bacteria, respectively.

Recipe for cancer education: a novel integrated cooking and nutrition education curriculum for medical students and physicians in dietary preventive and supplemental treatment for pancreatic cancer

The poor outcomes surrounding pancreatic cancer (5 % 5-year survival) are rooted in the advanced nature of the cancer at diagnosis, aggressiveness of the tumor, technical challenges for surgical treatment, and the limitations of systemic therapies. Research on pancreatic cancer and diet has focused on the effects of bioactive food compounds upon major pathways in cancerous cell development, particularly with the active components of flavonoids, proteins, and vitamins. Such bioactive components, particularly found in fruits and vegetables, have been associated with increased sensitivity to chemotherapeutic drugs for treating pancreatic cancer and inhibiting angiogenesis and cancerous cell growth. Diet-based approaches to prevention and treatment of pancreatic cancer may thus offer clinical efficacious and cost-effective opportunities to optimize existing modes of treatment (surgery, systemic therapies, radiotherapies, and palliative care), offset rising medical costs for patients, and improve quality of life for patients undergoing treatment. Integration of these findings at the clinical level may require a national, scalable model such as that of Tulane University School of Medicine’s Goldring Center for Culinary Medicine (GCCM) to meaningfully improve the care of health care providers for pancreatic cancer patients.

Medical Student–Led Community Cooking Classes

The obesity epidemic and increasing rates of associated chronic diseases highlight the need for physician competency in clinical nutrition. The importance of this issue notwithstanding, only 19% of graduating U.S. medical students report readiness to offer adequate nutritional education to patients despite its demonstrated efficacy. 1 Spencer E.H. Frank E. Elon L.K. Hertzburg V.S. Serdula M.K. Galuska D.A. Predictors of nutrition counseling behaviors and attitudes in US medical students. Am J Clin Nutr. 2006; 84: 655-662 PubMed Google Scholar , 2 Castry D.C. Samuels M. Harman A.E. Growing Healthy Kids: a community garden–based obesity prevention program. Am J Prev Med. 2013; 44: S193-S199 Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar Tulane University School of Medicine created The Goldring Center for Culinary Medicine as the world’s first known medical school–based teaching kitchen led by a physician and trained chef with a dedicated associated research team for monitoring outcomes. The Center produced an integrated nutrition curriculum with hands-on application via medical student–led community cooking and nutrition classes. Medical students who participated in the first- and second-year Goldring elective learning modules helped lead community cooking classes. In addition, we developed a 4-hour community service training series for students unable to take the elective course. All students may attend third-year disease-specific nutrition seminars and fourth-year away rotation at the College of Culinary Arts in Johnson & Wales University. 3 Kay D. Abu-Shamat L. Leong B. Monlezun D.J. Sarris L. Harlan T. Improving medical student nutritional counseling competency. J Invest Med. 2013; 61: 511 Google Scholar

Just what the doctor ordered: novel medical student nutritional education through community‐based cooking classes

Adams et al. (2010) demonstrated in a survey of 126 US medical schools that most medical nutrition curriculum hours are taught in a passive lecture format rather than within an active clinical context. This may explain Spencer et. al. (2010) who reported that only 19% of graduating US medical students felt prepared to use nutrition counseling in practice. Until this year Tulane University's medical nutrition curriculum was limited to this model. Tulane's newly created Center for Culinary Medicine combined with the medical student service learning program in an effort to improve nutrition education. Students are required to log 50 hours of community service, which they can now spend learning and teaching principles of cooking and nutrition to patients in ambulatory settings in addition to the traditional curriculum. To date approximately 25% of the Tulane medical student body has participated in nutrition service learning. Students who opted to participate will be compared to students who only had the lecture component by examining perceived competence to counsel patients on a wide range of nutrition topics. Research support: Tulane University Center for Culinary Medicine.Grant Funding Source: Tulane University Center for Culinary Medicine

Medical student initiative of monitoring USDA nutritional guidelines adherence with novel application of digital photography in elementary school meals

The rising childhood obesity epidemic exacerbates the challenge of no broadly accepted evidenced‐based monitoring and implementation methods for USDA guidelines regulating elementary school meals (Guthrie 2012). The traditional techniques of obtrusive physical measurements of consumed food and visual estimation (Comstock 1980) flawed by intra‐observer variability are not promising. Tulane University School of Medicine responded to this challenge through its Center for Culinary Medicine. Medical student teams investigated the novel application of digital photography (Williamson 2003) for monitoring USDA guideline adherence at three elementary schools. Compared to visual estimation checklists, digital photography of consumed food showed statistically different results for consumed vegetable and fruit servings. Unlike visual estimation, this latter method accounted for serving variability and allowed calculation of students’ consumed calories, fat, sodium, and vitamins. Further validation of this protocol can produce more accurate monitoring of USDA school nutritional guidelines and improved assessment of targeted nutritional educational interventions for students. Research support: Tulane University Center for Culinary MedicineGrant Funding Source: Tulane University Center for Culinary Medicine