VOICES: If food is medicine, why is healthy food such a hard pill to swallow?

Julia Pangalangan is a graduate student in the Community Health and Prevention Research program at Stanford University. She is passionate about the promotion of the  lifestyle medicine movement to prevent chronic disease and reduce health inequities. (CONTRIBUTED)

Julia Pangalangan is a graduate student in the Community Health and Prevention Research program at Stanford University. She is passionate about the promotion of the lifestyle medicine movement to prevent chronic disease and reduce health inequities. (CONTRIBUTED)

In 2020, the US spent $4.1 trillion on healthcare. Approximately 20% of this monstrous cost was attributed to an unhealthy diet. Diet is the most important factor associated with disease burden in the US, leading to shorter health-spans and unsustainable costs. Patients view physicians as experts in nutrition information. Given these facts, healthcare systems must be doing everything in their power to combat the detriments of the Standard American Diet, right? Not exactly.

  • 42% of academic hospitals have a fast-food chain on campus.
  • Less than half of primary care physicians regularly provide specific counseling for diet and weight management.
  • Only 16% of nurses eat the recommended servings of fruits and vegetables.
  • Of surveyed medical schools, only 27% of the schools met the minimum 25 hours of nutrition education recommended by the National Academy of Sciences.

If we can’t expect healthcare systems to provide and promote healthy food, how can we ask the average American to eat it? This is a multifaceted issue, with lack of nutrition education, a demanding profession and unhealthy workplace environments being some of the biggest offenders. A dynamic solution is necessary — educational Teaching Kitchens and comprehensive behavior change programs in the hospital system can empower healthcare professionals to lead the movement towards eating well. Investing in healthcare worker’s wellbeing will result in positive ripple effects in rates of obesity, chronic disease, and mortality rates. If the wellbeing of millions of people is not enough, it will also save money. A lot of money.

Problem: “Doctor’s orders”

Doctors influence health behaviors. The benefit of healthy clinicians extends far beyond the caregivers themselves. Healthcare workers play a critical role in influencing health behaviors in the community. Physicians have always been a trusted source of information, and they are more likely to discuss lifestyle behaviors with their patients if they themselves practice the behaviors. Unfortunately, not all physicians receive nutrition training and the education in medical schools inadequately equips doctors to promote nutrition to patients. We can change this narrative through the implementation of Teaching Kitchens.

Solution: “See one, do one, teach one”

The solution is the very method that medical personnel have been using for years: See one. Do one. Teach one. Teaching Kitchens provide a hands-on learning environment to promote healthy behaviors in the hospital. Providers and patients can be trained to prepare nutritious food, engage in mindful eating, and develop the skills to live a healthy lifestyle. Teaching Kitchens can increase self-efficacy, and will enable providers to promote healthful eating. Promising culinary medicine programs, such as the program at Stanford University, are beginning to pop up in medical schools across the country. Teaching Kitchens should become standard in every hospital and medical school to positively impact the health of the community.

Problem: Healthcare workers are not immune from the obesity epidemic in our country

In fact, over a third of healthcare workers are obese. Long shifts and job stress contribute to obesity. Unfortunately, these are almost unavoidable for healthcare workers, especially with the recent shortage in healthcare workers. Moreover, in the midst of the pandemic, rates of anxiety, depression, and burnout are rampant. Importantly, stress is associated with unhealthy eating behaviors and chronic stress increases the likelihood of chronic disease.

We cannot eliminate the strain on healthcare professionals, but we can reduce risk of disease through improving healthcare food systems. If we can encourage healthy choices for healthcare providers, we can enhance the wellbeing of the very people caring for the rest of us.

Solution: Make the healthy choice the easy choice

The nature of the profession makes healthcare workers susceptible to weight gain, but healthcare systems can play a significant role in environmental factors. For instance, Premier Health offers their employees comprehensive wellness programs that include health challenges, group workshops on high interest topics such as Eating for Wellness, and Lifestyle Management Programs to address behavior change for disease prevention and management. Premier Community Health also collaborates with other companies to improve the productivity and health of the local workforce.

The Physicians Committee for Responsible Medicine found an association between the health of a hospital’s food and obesity and diabetes prevalence in the state. We don’t know if the chicken came before the egg, but we do know that hospitals have a huge influence on the health of their community. A study utilized a global health model to assess the impacts of dietary change to more plants and less meat. If the world adhered to the global dietary guidelines, we could avoid more than 5 million deaths per year by 2050. It would also save the US billions per year on healthcare. A shift to a healthy diet can drastically benefit wellbeing, and healthcare systems should lead this much-needed movement.

Julia Pangalangan, originally from Dayton, is a graduate student in the Community Health and Prevention Research program at Stanford University. She is passionate about the promotion of the lifestyle medicine movement to prevent chronic disease and reduce health inequities.

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