At the University of Texas Southwestern Medical Center in Dallas, a community culinary service is teaching patients the life skills to pursue a healthy diet with confidence, with the aim of reducing the burden of conditions such as diabetes, obesity, and heart disease. Initial evidence suggests that their approach is not only feasible but also popular with patients.

In a recent report in NEJM Catalyst, lead author Jaclyn Albin, MD, CCMS, DipABLM, director of the Culinary Medicine Program, and co-authors Milette Siler, MBA-HC, RDN, lead culinary dietitian, and Willis Wong, MD, MBA, internal medicine resident physician, described how they set up their program at a local community clinic. The team combined electronic medical record-based written consults with one-to-one clinical consults and shared appointments. Results from the program’s first 2.5 years of operation showed high completion rates, with nearly every patient appointment covered by insurance plans.

Medscape Medical News spoke with Albin, Siler, and Wong about how their approach differs from a standard nutritionist appointment, what patients take away, and why teaching food skills in community settings matters.

How does this kind of service differ from a typical patient encounter with a nutritionist or dietitian?

Albin: From a physician’s perspective, this is first and foremost about access. Most of my patients can’t see a registered dietitian that is covered by insurance and integrated into the health system unless they already have diabetes, kidney disease, or one of the few covered diagnoses. This is a huge gap.

Siler: Dietitians are experts at relaying “what” a patient needs to eat, and “why” it’s relevant to their health and wellness. In a teaching kitchen setting, we can assist those patients who are struggling with implementation: the “how.”

What are you hoping patients take away from the service?

Albin: We seek to empower people to have a long-term, sustainable, healthy relationship with food. This is core to our conversations. We often ask questions that uncover a lifelong struggle of using food for comfort where other things haven’t been addressed. This enables us to build a team to support our patients in optimal mental and physical health.

How central to the service are the community kitchens?

Albin: This is so much more than a space. It’s about partnering with long-standing leaders — in our case, churches and food pantries — to understand what challenges the communities face, how we can partner to help, and even what foods will resonate.

Maybe it’s the convenience of a quick commute and easy parking at a neighborhood location. Maybe it’s about trust, where the partnership gives them the confidence to give us a chance. Maybe it’s about learning life skills in a kitchen that they never before had a chance to learn.

For health systems, it’s about recognizing that you don’t have to start with a beautiful, expensive flagship kitchen to get this off the ground. There are kitchens everywhere, and simplicity might actually be part of the magic.

How important is clinician involvement?

Wong: People overall crave guidance on healthy habits, but because primary care visits are scarce and appointments are too short, physicians rarely get to play this important role. Rather, patients turn to more immediate sources of information such as online or social media, which can sometimes be misleading and not entirely evidence-based. Thus, it’s critical that physicians be engaged in actively counseling patients on healthy habits, of which culinary medicine is only one piece.

Were you surprised payers were so ready to reimburse the service?

Albin: Frankly, I wasn’t. I’m simply using food, nutrition, and other lifestyle principles like movement and mindfulness to treat and prevent chronic and inflammatory diseases. We have decades of evidence that it works.

The real barrier was that so many physicians and other health professionals, including many health system leaders across the US, believe that people don’t want this kind of support or aren’t interested in really changing their diets. We find the opposite to be true: The vast majority of those coming to see us crave what we offer and often show us their gratitude with tears and expressions of renewed hope.

What has been the reception among colleagues?

Albin: We’ve received literally hundreds of emails and messages thanking us for persevering to get this first step accomplished. It’s certainly not rocket science, but we had to prove it because many (if not most) traditional systems didn’t believe it had a place in clinical medicine. I’ve even had colleagues tell me I’m wasting my training by cooking with patients.

How will you assess the impact of your service?

Albin: From a research standpoint, getting quality data for an intervention like this is challenging. We are adding this on top of medical therapy and other interventions, so it’s not easy to isolate and say: “It was the culinary medicine that did it!”

As such, we’ve started with more implementation and qualitative data: Do people show up? Do they like it? What specifically helps them?

Future studies will investigate the impact on blood pressure, A1c, markers of metabolic-associated fatty liver disease, cholesterol, and quality of life. It’s also important to show short- and long-term adherence to the changes people report making.

The study reported receiving no funding.

Albin reported receiving a grant from the American College of Culinary Medicine. Siler and Wong declared having no relevant financial relationships.

Liam Andrew Davenport, MA (Hons), is a UK-based medical journalist and writer with more than 20 years’ experience. He studied medical sciences and anthropology at Emmanuel College, Cambridge, England.