John La Puma is a doctor, a chef, and a big believer in "culinary medicine," which holds that the art of cooking can be scientifically applied to fight disease. La Puma, who taught the first cooking and nutrition course for medical students in the country at SUNY Upstate Medical University-Syracuse, explains in a new book written with Rebecca Powell Marx, ChefMD's Big Book of Culinary Medicine: A Food Lover's Road Map to Losing Weight, Preventing Disease, and Getting Really Healthy, how everyone can add "medicine chests" to their kitchen pantries. He spoke with U.S. News about the book, in which he offers foods to eat for 40 conditions, plus 50 easy recipes to try. Edited excerpts:
What will people gain from your book?
We've crunched 3,000 peer-reviewed studies, almost all of which were done in people, and have begun to figure out how food actually works like medicine in the body—what its mechanisms are. Everybody knows that eating fast food isn't good for them; they don't need me to tell them that. They need me to tell them what to eat instead and how to make it taste good.
Can people really control and prevent health conditions with food?
Yes. One example is Tom Burton, a Pulitzer Prize-winning journalist at the Wall Street Journal whose [LDL] cholesterol was over 160 milligrams per deciliter. Some of the best cardiologists in the country told him he ought to try statins. I persuaded him that he ought to first give food a try. He's a single dad with two kids, who thought, "Gee I might not have time for this," but agreed to. Over nine months, he actually dropped his LDL to 114, just with changing what he ate and how he ate it. Instead of chicken and potatoes, he ate grilled salmon with honey-mustard marinade and barley. He added steel-cut oatmeal in the morning and split pea soup at night. I have prescribed statins. I think they can be very good medicine. But I often know of people who don't want to take them or who want to do what they can with food.
What are other examples of health conditions influenced by food?
Diabetes. Probably the most important foods for diabetics are anything containing bran, because bran effectively and almost immediately lowers blood sugar. Same with foods that are high in magnesium like barley, almonds, and buckwheat. And anyone who lives in the Southwest or Latin America will be familiar with "nopal," the prickly pear cactus. It's a green vegetable that's a little crunchy, sometimes found in bottles, and a little slimy. Amazingly, there was a study in the Archives of Internal Medicine in which type 2 diabetics were fed chilaquiles (a Mexican breakfast dish) with nopales, and it had a dramatic and direct effect on lowering blood sugar.
Another is constipation. To a doctor, it barely qualifies as a condition, but to anyone who has fewer than three bowel movements a week, it's definitely a condition. It turns out to be directly related not just to what everybody knows about foods high in fiber but also to fermented dairy products like yogurt and kefir. [They] actually soften stools and make defecation more frequent with just a quarter cup a day. It's probably because of the probiotics—healthy bacteria inside.
How does culinary medicine work?
The three keys are antinutrients, satiety, and bioavailability.
Antinutrients symbolize the bad stuff in food. That's everything from agricultural chemicals and nitrates (which come from fertilizers with nitrogen and are carcinogenic) to trans fats to high fructose corn syrup. Satiety means feeling full and fully satisfied. A little lean protein at each meal, eating carbs rich in resistant starch, and eating mindfully are three of my 12 tips.
And finally, bioavailability, which just means 'body ready'—that you're absorbing more of food's good stuff. If you add avocado to a spinach salad, you absorb seven times more eyesight-saving lutein than if you don't have a little healthy fat. Chopping watercress releases some of its glucosinolates, which are anticancer chemicals. And that's just chopping. You can really do little things like this that make a big difference.
What does your eating plan for optimal health involve?
It's targeted for eight weeks because it takes that amount of time to begin to create a palate change, so that the foods that are good for you actually taste good. There's a quiz at the beginning, and I ask people what their cholesterol is, their triglycerides, their heart rate, their waist-to-hip ratio, their stress and anxiety level, how much knee and hip pain they have. The program is designed to affect each one of these parameters. I want people to know how their food works and whether it's working. The way to test that is by recording where they are now, where they want to be, and where they are after the program.
Do you follow your own eating plan?
Yes. I think modeling is underestimated in medicine. I think doctors increasingly have an important role to play by showing patients that they themselves are invested in eating healthfully, exercising, and becoming fit.
How did you come to culinary medicine?
Two things: my own weight gain and my private medical practice. The trigger was when I appeared on the cover of a magazine, and I found I had three chins. I thought, "That's just too many." Since I had an uncle who died of diabetes at age 48, that too was in the back of my mind. Then, in my medical practice, I was seeing patients like those near the end of life but 50 years younger, who were just beginning to have high cholesterol, high blood pressure, joint pain, or bouts of depression. I said, "I have to learn how to make a healthy diet taste good because it's obvious it's missing for these younger people."
What do you hope people take away from all this?
That people have the power to reverse disease processes with what they eat, along with exercise and medication. And that it should taste good.