For as long as I’ve been studying food as medicine, I’ve grappled with what I perceive as a lack of attention in the field on actual cooking and caring for others. To me, this has always been at the core of what makes food as medicine so appealing; cooking is love, first and foremost. But while food as medicine is many wonderful things, I’ve rarely seen it consider how the ways we cook for ourselves and our community might factor into intervention and program design.
I expect this is due in part to the fact that most food as medicine interventions have been grounded squarely in healthcare and medical spaces so far. But as the field gains more recognition, I wonder if we might need a moment to check in with ourselves around more attention on the “food” part of food as medicine is needed. I’ve also been considering the role of food therapy as an alternative approach within the larger conversations we continue to have around food, health, and wellbeing.
The first exposure I had to the concept of food as medicine was through my food therapy certification at the Institute of Culinary Education. While we spent the morning learning about nutrients and therapeutic applications of food, in the afternoons we were in the kitchen, gaining hands-on culinary training in how to prepare specific ingredients and meals with care.
Throughout my subsequent masters program, I consistently drew upon what I learned at ICE: how to consider the conditions that actually cause someone to feel healthy, how to approach meals with their desired effects in mind, and how to take the entire bodily experience (including mental health) into consideration when supporting dietary needs through cooking. Interestingly, while many of my classes talked about the role of food in policy, systems change, and culture, there still wasn’t a ton of space to talk about what we actually liked to eat, and why it made us feel good when we did.
The intuitive angle to food therapy sits apart from the more empirical food as medicine interventions, but I believe holds just as much weight. Food therapists put “prescriptions to plates,” translating what can be complex or confusing dietary recommendations from doctors or nutritionists into real meals. For example, while I can’t diagnose someone with hypertension as a food therapist, I can work with them to identify culturally relevant meals, cooking techniques, and ingredients to lower their sodium intake once they receive that diagnosis from a medical professional.
On the other hand, programs like medically tailored meals or medical nutrition therapy aim to treat specific conditions with diets designed and overseen by healthcare professionals. These plans are very personalized and carefully monitored, with each meal's nutrients calculated precisely for the individual. While these programs are crucial and have been proven effective, they often miss out on the emotional and social aspects of eating that make meals enjoyable and important for our well-being, such as feeling connected and part of a community.
Food therapy encourages me to think about not only what ingredients might contribute to someone’s overall wellbeing, but the larger social and emotional circumstances around their ability to eat as well. As a public health practitioner first and foremost, considering these social determinants of health is key to the bulk of the work I do. No matter how many free vegetables you give someone, if they don’t have the time, capacity, or infrastructure to prepare them it’s kind of for naught.
The difference I see here is that "food as medicine" is used for specific, urgent needs, while "food therapy" can help anyone who needs some support. For example, special recipes for new mothers, a friend cooking for you when you're injured, or making yourself a comforting bowl of soup on a cold day all use ideas from food therapy. I love that food therapy is flexible and focuses on food, which is often missing from the more structured "food as medicine" programs that are becoming more popular and funded.
This distinctly medical flavor (if you’ll excuse the pun) to food as medicine, has made it feel quite exclusive at times. It has grown increasingly professionalized over the last two years that I’ve studied it, and feels harder and harder to break into discussions if you don’t have certain certifications or specific language and skills. The involvement of tech startups, insurance companies, foundations, and political groups is both encouraging and a bit worrying as the field becomes more guarded about its knowledge and status. I fear this focus on prestige will ignore the most important part of the conversation: how food affects us emotionally, socially, and physically.
This is not to say that food therapy is without its boundaries too. Straddling the role of private chef, coach, nutritionist, and supportive friend, a food therapist’s work requires extensive investment, time, and care, as well as a deep passion for food. This is why I think 1) we don’t see too many food therapists out in the world and 2) why in many cases their work is limited to the select populations who can adequately afford their services. This isn’t thankless work, but it is difficult and often challenging to figure out how to make a living from it. Working with wealthy clients is an easy solution, but not the most equitable by any means.
Food therapy is ultimately what drew me to food as medicine, and it’s where I’m turning to now. Because at the end of the day, while I love the data and science and policy of food as medicine, what really brings me joy is cooking and caring for others. And I firmly believe that food therapy can and should be accessible to everyone, not just those with the budget for it. With that in mind, I’m exploring a new project that will allow me to pursue my interests in this space, and will create accessible and scalable food therapy services for those who need it most. I’ll announce more details soon, and plan to return to Food As/Is as a space to share updates, wins, reports, and more from both food therapy and food as medicine.
Thank you for following this journey with me, and for continuing to engage with my work. It’s been a wonderful season, a year and a half, of sharing my thoughts with you all. I’m excited for what’s to come.