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As the general public begins to recognize the medicinal power of food, Â鶹¹ÙÍø & Wales is poised to meet the opportunity — and responsibility — of making the world a healthier place.

When Assistant Professor Jonathan Poyourow '03, RD, LD, CSCS was an officer and a dietitian in the Army in 2006, he was in charge of a dozen soldiers, and one of their monthly exercises was a 12-mile road march around the Fort Campbell, Kentucky, base. “You’re wearing upwards of a hundred pounds of gear — weapon, helmet, all that stuff,” says Poyourow. “And it’s up and down; the course is never flat.” The first time out with the group, they met the standard of a three-hour time. But no one was happy with just meeting the standard. 

So before they went out for their next 12-mile march, Poyourow had some specific orders: “You are going to eat and drink exactly what I tell you to eat.” They filled up their canteens with Gatorade and loaded their packs with energy gels that Poyourow supplied, with a prescription of one gel for every four miles. “Every soldier beat his original time by at least 15 minutes,” says Poyourow. “And everybody was saying that they felt better. They said they didn’t feel as tired. They told me, ‘I don’t feel as useless the rest of the day as I normally do.’” It helped gain the young commanding officer some trust, but was also visceral evidence for Poyourow, now a sports and fitness nutrition expert, of the direct link between diet and human health and physical performance.

The rest of the world is coming around to this idea, too. A 2022 McKinsey study of consumers in the U.S. and Europe found that “healthy eating” was a top priority for half of those surveyed. And a recent report from Deloitte found that most consumers see food as having medicinal effects, with some 78% saying that “the right foods keep me healthy and prevent me from suffering certain health problems” and with large percentages reporting they seek specific therapeutic effects from fresh foods, including weight management (43%), preventing disease and preserving health (39%), and mental and emotional health (34%).

“This has really bled into everyday life,” says Poyourow. “People are seeing the importance of this, and they’re buying into it.” 

And while there is rising personal interest in the subject, it is also relevant to the massive public health concern around rising levels of Type 2 diabetes and heart disease. Poor diets are the leading cause of mortality in the United States according to the Institute for Health Metrics and Evaluation, and a 2019 study in the journal The Lancet found that, globally, about 11 million deaths a year are linked to poor diet. “As we continue to struggle with systemic issues concerning public health, we have to look to expand how that education of nutrition gets to the general public,” says Mike Makuch ’03, ’05 M.A.T., CEC, associate professor of culinary arts.

Addressing a field that has this kind of impact, he notes, requires the kind of multidisciplinary approach that Â鶹¹ÙÍø employs, bringing in expertise from disparate fields to deepen instruction. And the scope of the potential impact makes Â鶹¹ÙÍø’s growing expertise and leadership in culinary medicine not just a relevant educational priority, but also a social responsibility, says College of Food Innovation & Technology (CFIT) Dean Jason Evans, Ph.D. “Because of these resources that we have and the fact that we are one of the largest — if not the largest — populations of food-centric knowledge students in the country, I think that we as food educators have to adopt our own sort of Hippocratic oath,” says Evans. People who are feeding people — product developers, chefs, performance chefs, dietitians — have a real responsibility to the larger public, he says, even if the national policy conversation hasn’t yet fully recognized the value of food to lifelong quality of life. “What and how you feed people and the way you change how people think about food is incredibly important. And you are the only professionals with the skills to fundamentally change the way people eat and see food, so you have a great responsibility,” he says. That’s a heady concept, and he understands that. “But that’s really our messaging to our students: This is a big deal, what you’re able to do.”

On Friday nights in the spring and the fall, medical students from Brown University head to what professor Makuch calls “culinary bootcamp.” Starting at 5pm and ending somewhere between 8 and 9pm — “depending on how long it takes to clean up the kitchen”— Makuch and student volunteers from Â鶹¹ÙÍø’s Nutrition Society offer their Brown counterparts some general culinary grounding and an understanding of how that knowledge can be applied to a clinical setting. Makuch handles the lectures — “the boring stuff,” he says — and the Â鶹¹ÙÍø students handle the kitchen. “They’ve formed some really awesome relationships with the Brown students,” says Makuch. “Sometimes they actually help tutor one another.”

For the Brown students, it helps fill a gap in their medical education. “It also provides them with some resources about food insecurity that they may not be familiar with. It takes kind of a broad view, really looking at the barriers that may prevent somebody from actually cooking at home and eating healthy — and looking at how we overcome those barriers,” says Makuch. “It’s a much more holistic approach to medicine in the sense that you really have to understand where your patient is coming from: their needs and specific challenges, their culture and what foods they like to consume.” 

The course, says Makuch, launched in 2014, after celebrity chef-turned-Brown medical student Dave Lieberman reached out to him to express interest in working together to bring more nutritional knowledge to the curriculum. The resulting course, Food + Health, has become one of Brown’s Medical School’s most popular electives.

“Partially because they get to eat really good food,” Makuch notes with a laugh. 

Nutrition has become increasingly accepted as a critical element of hospital care, says Associate Professor and Registered Dietitian Kara Cucinotta ’06, RD, CNSC, LDN, who teaches in the College of Health & Wellness (CHW). She offers a story from her time working in the intestinal failure clinic at Hasbro Children’s Hospital as an example: Some of the children were born with such severe digestive issues, lacking some or all of their small intestine or their colon, that they were not able to eat any food or even be tube fed. Their only source of nutrition would come via IV. “So part of my job was to work with one of the surgeons to help figure out what should go into that IV bag that provided pretty much all of their nutrients,” says Cucinotta. 

She uses a similar hands-on, practical approach in her Nutrition Assessment course, where the students conduct what she calls a “nutrition-focused physical exam” on patients, looking for things like brittle hair or fingernails that could signal a protein deficiency. 

As students progress to her Medical Nutrition Therapy and Advanced Medical Nutrition Therapy courses, they work to figure out not just what health conditions and diseases patients might have, but also how to modify their diet to help treat or manage those conditions. In the advanced course, Cucinota’s students do mock case rounds in a hospital setting, playing the roles of nurse, pharmacist, occupational therapist and other specialists, with a dietitian overseeing the reports. “It gives them an appreciation for what their job is as a dietitian,” says Cucinotta. “What is my scope of practice? When do I reach out to the speech-language pathologist or the respiratory therapist? Where does my job actually end?”