When Dr. Linda Shiue became Kaiser Permanente’s first-ever director of culinary medicine at the San Francisco Medical Center three years ago, she saw an opportunity to address a gap in care that she recognized over 15 years of practicing medicine.
“I realized that in my career as a primary care doctor I could only do so much because most of how people take care of their health is what they do on their own at home,” she explained. She cited exercise, sleep and stress management as some of what physicians refer to as “lifestyle factors,” but it was diet that particularly interested her.
“Really most of everything I saw in the office over the years – high blood pressure, high cholesterol, heart disease, diabetes – are related to diet and also weight and we didn’t address that with anything more than writing a prescription and perhaps a referral to a dietitian.”
Shiue began handing out recipes to her patients. She started a cooking blog that’d emerged from entering recipe challenges at Salon.com, and published nutrition articles in major publications. She also taught cooking classes in a variety of community settings. Utilizing that experience, at Kaiser she created a class, Thrive Kitchen, where one Wednesday a month she teaches people how to make nourishing dinners at the health provider’s Mission Bay campus.
Each month the class features a different theme. Upcoming courses include Healthy Asian Cooking, Mediterranean Picnic and Spanish Summer. Many of the themes are global, reflecting Shiue’s experiences as an avid traveler. Her parents are from Taiwan, her husband from the Caribbean.
Last month’s theme was Cooking for Your Heart and Soul: African Heritage Diet, with recipes for West African groundnut stew, Texas caviar, grits and Jamaican rice and peas. Groundnut stew is a vegan version of mafe, a peanut-based dish popular in West Africa. Shiue’s formulation features peanut butter, okra, ginger, sweet potatoes and cabbage, among other ingredients. Texas caviar is a combination of black-eyed peas, peppers and tomatoes but, instead of served as a dip with tortilla chips, Shiue opts for collard greens cut into cups.
Held in the unlikely setting of a sixth-floor conference room at 1600 Owens Street, Shiue rolls in tables, burners and utensils for her presentation. Over two hours, the dozen students, along with a handful of volunteers, listen to an introduction before pairing into three groups to prep, cook and eventually eat. The end result is a meal rich in color, by itself an indicator of a full range of nutrients, but equally wealthy in taste. The latter is critical, explained Dr. Dan Santiago, a Kaiser physician who frequently volunteers at the classes. The program is designed around plant-based meals but not advertised as such so as not to dissuade people who have a bad attitude towards vegetarian diets.
“When they taste it, they realize you don’t have to eat fatty foods to get food that tastes good,” he said. “And that makes people a little more open minded to try things.”
He added that Shiue, in her role as culinary director, often teaches other physicians at Kaiser. “A lot of stuff we didn’t learn in medical school,” he noted. “If you cook and eat healthy then you are more comfortable talking to patients about it.”
Dr. Rakesh Jotwani, who also volunteers, recently became a vegetarian, something he was initially hesitant about. “I still wanted to enjoy my food,” he said, adding that every time he has come to the class, the “food has been incredible.” He’s lost weight and gained energy since shifting his diet.
Others gave similar reasons for attending. Tammy Radmer, present with her husband, Dave Oldman, was looking for tips that’d steer her toward healthier eating. “I love to cook but don’t necessarily cook the healthiest,” she said. Others were simply trying to follow through on a New Year’s resolution or wanting to extend their skills beyond “Trader Joe’s defrost.”
For Hannah Schmunk the classes play a more vital role. In 2016, she contracted Lyme disease after being bitten by a tick while working at an orphanage in Nepal. She thought she’d been a healthy eater most of her life, but soon realized she didn’t know as much as she thought. “I now have a new appreciation for food that comes from the earth,” she said. Learning about diets that help with inflammation has been her “silver lining” in having been diagnosed with the disease.
“Plant based diets can help people with diseases as an alternative to processed foods which are really inflammatory in the body,” said Jae Hoyt, a research assistant at Kaiser. She’s been attending the classes as she works toward becoming a physician’s assistant, and wants to be able to dispense nutritional advice to patients. The recipes, she explained, are rich in nutrients, fiber and vitamins that’re often lacking in the American diet.
While Shiue’s ideal plate is one-half vegetables, one-quarter each healthy protein and whole grain carbohydrates, her advice goes beyond recipes. For people living an urban lifestyle she said planning may be the biggest component to successfully having a healthy diet. She advises strategizing for at least four days weekly, and to consider taking advantage of California’s produce by turning trips to farmer’s markets into fun social activities.
She gives each class a list of pantry basics to keep stocked to minimize trips to the grocery. Included are grains such as brown rice and quinoa; nuts and seeds; cooking oils; aromatics like onions and garlic; and acids like lemons, limes or vinegar. It’s important to have access to a wide variety of seasonings so as not to rely on salt, often the default for people but not ideal for a lot of health conditions. “Spices can transform the same dish into many different dishes and bring you to many different parts of the world through those spices,” she said.
She advised keeping it simple. Expect dinner to take between a half hour to an hour to prepare. “Once you have those basics stocked you can actually rotate the same five basic recipe types and alter them from week to week.”
Kaiser members get first dibs on classes, which are limited to 12 participants. The cost is $30 for members, $40 for non-members. Slots cannot be booked beyond the next class. For more information, call the Kaiser’s Health Education Department at 415. 833.3450 or email SFhealthed@kp.org.