Plant Centered Culinary Medicine
Practical Approaches for Primary Care
October 19, 2023
Krishna M. Desai, MD, FAAFP, ABOIM
Assistant Professor
Associate Residency Program Director
New York Presbyterian Hospital/Columbia University Medical Center
Center for Family and Community Medicine
Danielle Medina, AFAA, ACE, NASM, RYT
Fit N Play Mama LLC
Plant-based Nutritionist
Food For Life Culinary Educator
Corrective Exercise Specialist
PRE TEST
Please complete the PRE-TEST
Funded by Weil Grant.
Recognize the components of a healthful plant centered meal.
Review evidence based research on how plant centered nutrition can reduce the burden of chronic diseases.
Practice plant centered culinary medicine skills using the 4 food groups: fruits, vegetables, whole grains, and legumes.
Acknowledge social determinants of health and structural factors that impact access to healthful nutrition.
Objectives
Danielle Medina, AFAA, ACE, RYT
“Start today with the intention of changing your health for the better.”
Food Prep!
Recognize the components of a healthful plant centered meal
Meet: The Power Plate
The Power Plate
Physicians Committee For Responsible Medicine, 1991
Vegetables. Legumes. Fruits. Whole Grains.
Vegetables. Legumes. Fruits. Whole Grains.
Sancocho. Cacucha. Rice and Peas. Rajma. Spanish rice and beans. Toast and beans.
AHA Recommendations
Average American consumes ~3500 mg sodium and 68 grams sugar per day!
Check on your rice and apple crisp!
10 MIN BREAK!
Barnes LL, et al.. Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons. N Engl J Med. 2023 Aug 17;389(7):602-611.
Jacka FN, et al. A randomised controlled trial of dietary improvement for adults with major depression (the 'SMILES' trial). BMC Med. 2017 Jan 30;15(1):23.
Corley J. Adherence to the MIND diet is associated with 12-year all-cause mortality in older adults. Public Health Nutr. 2022 Feb;25(2):358-367.
Koch CA, et al. Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials. Eur Heart J. 2023 Jul 21;44(28):2609-2622.
Afzaal M, et al. Human gut microbiota in health and disease: Unveiling the relationship. Front Microbiol. 2022 Sep 26;13:999001.
Tuso P, et al. Nutritional Update for Physicians: Plant-Based Diets The Permanente Journal. 2013 Spring;17(2):61-66
Food Is Medicine: Plant Centered Nutrition Reigns Supreme!
Whole foods Plant Based Vegetarian/Vegan MIND
Food Is Medicine: Plant Centered Nutrition Reigns Supreme!
Whole foods Plant Based Vegetarian/Vegan MIND
Food Is Medicine: Plant Centered Nutrition Reigns Supreme!
Whole foods Plant Based Vegetarian/Vegan MIND
Gut Microbiome:
collection of all microorganisms including bacteria, fungi and viruses in the digestive tract.
Zhang F, et al. The gut mycobiome in health, disease, and clinical applications in association with the gut bacterial microbiome assembly. Lancet Microbe. 2022 Dec;3(12):e969-e983.
Manos J. The human microbiome in disease and pathology. APMIS. 2022 Dec;130(12):690-705.
Afzaal M, et al. Human gut microbiota in health and disease: Unveiling the relationship. Front Microbiol. 2022 Sep 26;13:999001.
HOMEOSTASIS
Scher JU, et al. The microbiome and rheumatoid arthritis. Nat Rev Rheumatol. 2011 Aug 23;7(10):569-78.
DYSBIOSIS
-Proinflammatory cytokines
-Immune complex deposition
-Macrophages/fibroblasts/osteoclasts
-Cartilage and bone degradation
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Plant Centric Nutrition
Nutritional Recommendations: Optimize Gut Microbiome
Nelson J, et al.. Do Interventions with Diet or Dietary Supplements Reduce the Disease Activity Score in Rheumatoid Arthritis? A Systematic Review of Randomized Controlled Trials. Nutrients. 2020 Sep 29;12(10):2991.
Healthy Microbiome: not predetermined!
Rothschild D, et al. Environment dominates over host genetics in shaping human gut microbiota. Nature. 2018 Mar 8;555(7695):210-215.
Le Doare K, et al. Mother's Milk: A Purposeful Contribution to the Development of the Infant Microbiota and Immunity. Front Immunol. 2018 Feb 28;9:361.
Only bacteria make Vitamin B12! (our bacteria aren’t so good at it!)
Only bacteria make Vitamin B12! (our bacteria aren’t so good at it!)
Interpretation of vitamin B12 levels is complicated and does not always effectively rule out B12 deficiency
Braised Greens
½ cup serving: Yellow peppers have more vitamin C than oranges!
Take a break!
Social and Structural Determinants of Nutritional Health
SNAP = Supplemental Nutrition Assistance Program
SNAP can be used towards purchasing fruits and vegetables at any local farmers market.
Households no longer have to pass as savings/resource test in order to get SNAP benefits.
marketing of unhealthy foods, disproportionately targeted at minority communities
corporate lobbying
Colonization disrupted the food systems for many Indigenous peoples, forcibly removing them from their traditional homelands to often unfamiliar and barren reservation lands.
gentrification
Breastfeeding equity
Access to SNAP/EBT
Food deserts
Racism
Medical training
Community gardens
How do you give cost-conscious nutrition advice?
Eat two 12-ounce bags of frozen leafy green per week: Two frozen bags often cost <$5, last much longer than fresh greens and taste better than canned vegetables. Frozen greens require little prep time — not washing is required — and can be added in the final stage of cooking for meals you already regularly prepare, such as a can of soup, to boost nutritional value.
Eat a 16-ounce bag of frozen berries each week: $3 for a 16-ounce bag, (cheaper than fresh berries)
Eat 1/3 cup of nuts or seeds five days a week: Source of protein, omega 3 FA. $8 for 2 week supply. Nut butters when on sale.
Eat one can of beans per week: Each can of beans contains three servings and may cost as little as 70 cents. Start with one can a week and add one serving to meals every other day→ transitioning to two cups a week. Include beans, lentils, split peas.
Introduce intact, whole grains to your diet: quinoa, wild rice, pearled barley, old fashioned oats (<$3 for 1 serving x 1 month).
Don’t forget the prebiotics: whole grains, onions, garlic, artichokes, soy beans.
Fermented foods: yogurt, kefir, sauerkraut, pickles, miso, kimchi, kombucha
American College of Lifestyle Medicine
Tips to provide cost-conscious nutrition Rx
PRE TEST
Please complete the POST-TEST
Change Your Plate! Thank you!
Danielle Medina www.fitnplaymama.com
Krishna Desai, MD, FAAFP NYP/CUMC
SURVEY FOR DANIELLE MEDINA:
https://www.pcrm.org/good-nutrition/plant-based-diets/ffl/classes/136371