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The Leading Voices in FoodAuthor: Duke World Food Policy Center
The Leading Voices in Food podcast series features real people, scientists, farmers, policy experts and world leaders all working to improve our food system and food policy. You'll learn about issues across the food system spectrum such as food insecurity, obesity, agriculture, access and equity, food safety, food defense, and food policy. Produced by the Duke World Food Policy Center at wfpc.sanford.duke.edu. Language: en Genres: Health & Fitness, Science, Social Sciences Contact email: Get it Feed URL: Get it iTunes ID: Get it Trailer: |
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Culinary Medicine and connecting med students with patients
Thursday, 30 April, 2026
I'm delighted today to be joined by Dr. Joseph Skelton, professor of Pediatrics, founder and director of Brenner Fit, a program at Wake Forest University School of Medicine. FIT stands for Families in Training, which is a family-based pediatric obesity program. He's the author of a new book on children and their weight, a topic we discussed in a separate podcast. But in this podcast, we're talking about something he teaches at Wake Forest, a course in culinary medicine. This is a fascinating, pioneering area of focus, so let's dig in. Interview Transcript There's a lot of language about medicine and nutrition now, so people talk about food as medicine. There's a move afoot to get more training and nutrition and medical education, and here you are doing culinary medicine. Tell me how all these things differ from one another. Our interest in this here at Wake Forest School Medicine started a little organically with our program. A lot of what we do is focus on family meals. There are decades of research showing the benefits of family meals, not only for the nutrition and obesity risk, but the quality of nutrition, time spent together, parent child communication. Kids are less likely to get pregnant or do drugs and alcohol. All these things from just spending that time together over the meal. And I inherited a small teaching kitchen that was at a local organization that someone before me had gotten funding for. And we, sort of, took it over and used this opportunity to teach families how to cook. And a lot of families know how to cook but trying foods in different ways and to get kids involved and things like that. Then a couple years after that, the local YMCA approached us. They had some space and wanted to do this as a partnership. So I became a fundraising machine for a year or two and took a lot of dinners to raise the funds. And we built this gorgeous teaching kitchen, and we were mainly doing it in the efforts of sort childhood obesity treatment or prevention, getting families, teaching them new recipes, which then kind of extended to that whole key thing of getting families just to be comfortable in the kitchen and spending that time together. And we just started seeing these amazing things. We always say we've converted more kids to Brussels sprouts than I think any other effort of just getting them cooking it a different way. You and I were both probably raised with steamed Brussels sprouts, which I think is an abomination. If you really want to highlight the sulfur smell of a food, then you're going to steam it. And so, we really started to do that. And then students started volunteering. Actually, it was a student, Josh Patman, he's an emergency medicine physician now at East Carolina University, and he was a cook in a professional kitchen college. And he said, hey, could I help volunteer with that? And then more student medical students wanted to do it. And then we all found that you, much like I did, I'm a self-taught cook myself, and the more time you spend in that, the more you learn, the more comfortable you are. And the more you start to know, you know, I can teach med students nutrition all day, but that doesn't teach them how to get nutrition on their patients' plates, into their mouth. And so it really grew from there. And then I, kind of, stumbled upon what other people were doing. It started in New York, but the biggest program started was really Tulane School of Medicine that had it as a very focused way about teaching nutrition through cooking. Not just on a blackboard through PowerPoint slides and stuff like that of like hey, let's teach it in a different way. And the old-fashioned analogy, and actually the medical educators hate this, it used to be see one, do one, teach one. That was sort of the old surgical thing. And so, it's really you got to see how to make a recipe and you got to do it yourself. And what we found that when students start then teaching each other, or teaching patients or teaching community members, it really drives home and gives them a much deeper understanding of what nutrition in the real world is. Let's talk about the need for this. If we go back in time and we think about your parents or my parents, you know, the likelihood is that meals were being prepared from the real foods rather than from a package, let's say, or in a micro. How are things different now for the modern parent that has kept people distanced from their food and where it comes from, and that's led families to be distant because they're not having meals together as much? What does that look like now? Yeah, pulling from our own history, you know, Home Ec is not really a thing anymore. We did this study in our own med students. You know, most of their cooking, nutrition, the nutrition education they're getting tends to be the popular media. They're learning it from social media. Very few students have a degree in nutrition or took a nutrition class. And as much as we have to cram into medical student's education, there's not much room for it. They mainly learn to cook from their families. And what we know is families are cooking less and less for multiple reasons. They're much busier. Especially parents, actually parents of kids of all ages with that. And again, the marketing of food, you know, it's much easier to get ready made meals. And I'm not badmouthing those, you know. We're in talks right now of actually writing a cookbook for families, and one of the things that we promise is we're going to have a chapter on assembled meals. You know, having a pre-made salad with a rotisserie chicken, that's still going to be a better thing to do if you bring that home, sit at a table or at a bar or around a coffee table and eat that meal together. It's still going to be better for your family in multiple ways on multiple levels than eating out. And what I see, it really with families right now when it comes to actually raising "healthy eaters" or raising good eaters is when we... and again, I love a good restaurant, I'm not trying to badmouth that... but when you're going out to eat a lot of kids have endless choices and there's two issues. One is a paradox of choice. Whatever they get, they're always going to think that other thing might have been better. And it doesn't allow them to spread their palate and try different foods and get exposed to different things. And we always laugh... whenever in this field we want to play a drinking game where every time you say complex or complexity, you take a drink because, but it is such a complex issue with parents. You know, with kids and getting meals on the table. And hopefully finding some time, whether it's a breakfast or it's a dinner, but finding that time to come together around a meal. You mentioned the paradox of choice. I was reminded at one point I downloaded this cute app called You Choose or something like that. And it would help you make a decision if you were undecided. It would flip a coin, it would roll a dice. It would do, yes, no, it would do rock, paper, scissors, it would do all these things. And I was at a restaurant once. I couldn't decide between two entrees, so I used it. I did rock, paper, scissors, or something, and I then it said, okay you should choose X. So I ordered X and the second I ordered it, I immediately thought I should have ordered Y. Alright, so tell us about culinary medicine. What does this course look like that you teach? Yeah, the best way to think about it is applied nutrition. Because again, you can understand a ton about nutrition, but if that doesn't change into you getting the foods that you want in front of you, to me it's almost theoretical or scientific. It's applied nutrition. It's this idea of teaching some very basic cooking skills, and then including within that very core elements of nutrition. And for us, we tend to do it by the balanced plate. We think that works really well for families. But having it be very real world. You know, so again, we have recipes... in two weeks, I'm doing one... we're doing a rotisserie chicken and you're breaking it apart and making a chicken salad out of it. We were always teaching using microwavable rice and a couple of the students cornered me and said, this is very offensive to my culture. You need to teach people how to make real rice. But what it looks like for us is about a quarter, almost a third of med students will rotate through these classes. So, it's voluntary. Next year we're actually hopefully going to surpass half of the first-year med school class. That's unbelievable. That's very impressive. Well, especially up until last year I was doing this in my free time and paying for it with fundraising money. But yeah, Wake Forest is really behind this now. But about a quarter to a third of med students. They do five classes. And it's set up and again, that sort of theme of that family meal. They come in and we get stuff cooking. We get stuff in the oven; we get stuff on the stove top. We usually take some time out for a very short lecture. Again, tends to be very practical stuff. We include a lot about social determinants of health and food insecurity. Given what I do, we talk about picky eating. Very little do we go into details about Mediterranean diet and Dash diet and some of the really core things with that. We really just try to keep it about getting that balanced plate of a protein, a starch and a fruit or vegetable on the plate in front of you. They come back and usually finish what they're cooking, and then they sit down to eat together. And unlike when I was in med school and you were in grad school, or when you were teaching, a lot of students don't go to class anymore. A lot of students, they record the lectures so they can listen to them at one and a quarter speed and study in the best way for them. I love getting to know my students on a different level of sitting down. And that's what my really own exposure to medical student education anymore is really through this, which to me is just the ultimate. Being able to sit down, teach them some interesting things, eat a meal with them. Given my chemistry background, I love getting into the science of a lot of the stuff. And I think for them being, you know, sort of STEM kids, it makes a lot more sense. One of my favorite things is the science of grilling, you know, the science of garlic, you know, things like that. And it helps them sort of understand and helps them remember that, and also peppering it with the stories. It just tends to stick that much more when they know the science, they know the story, they know the culture behind it. So, it's five classes. It's all set up that way, that there's a short lecture. They're preparing everything they can and they're eating it. Again, we include some very easy stuff. One of the classes we do microwaveable vegetables because that's what a lot of what their patients are doing. The bagged vegetable medleys. And one, the important thing that we teach them is most of these don't have any seasoning. So yeah, you can microwave them, but you have got to teach your patients throw a bit of olive oil on there, throw a pad of butter, do some salt and pepper, add some other spices to it. And they go nuts with one group will do some more Indian spices. One group will do more sort of traditional, one to do more Asian flavorings to it in our teaching kitchen. It's really teaching very practical things like that. The fun part of that, that's really spun onto the other things that I'll tell you about, is about half of those students that do that- we have about 18 per semester- and about half those students end up volunteering with us. They come to the classes that we have that are community focused. Now some of the students are going through lead teacher training. They get Serve Safe Certified. It's awesome for me and my staff because it saves us a lot of time and overtime that they come in, they let themselves in the kitchen, they set up, they run the class, they clean up, and they can't get enough of it. They absolutely love it. Now you do some celebration of different food cultures in your class. Tell, tell us about that. Including, as I understand, some of the food culture that you grew up with. Yeah. Yeah. That, that's about, that was a big understatement right there. We just love that and that's a great thing. Wake Forest, being a private medical school, kids are from all over the country, from all different backgrounds. And so, we absolutely sort of herald that. One of the things I love doing is class three is a plant-based proteins class. The first class is a general cooking class. The second class has a focus on animal proteins, and again, we're always also cooking vegetables and fruits and starches. The third class is plant-based proteins, and I do that as Southern cooking. And I just love that sort of theme with that. So, we do pinto beans, you know, And the slow cooker. We tell them how to use instant pots, pressure cookers. We do black eyed peas. A lot of these kids don't know that you're supposed to eat that on New Year's Day. I do a vegetarian collard green recipe, taught to me by a local chef. And I think this is probably my number one post that I do in social media is cornbread night. And teaching them how to make cast iron skillet cornbread, which is the only way to do cornbread in my book. And letting them know, sort of, the background of a lot of the stuff. My wife is from South Carolina, so I teach them great thing about cornbread if you're a poor student, is you have a slice with your beans and your collard greens, and then for dessert you put honey on. Which is what I picked up in South Carolina. So, you know, really celebrating that stuff. We have a whole Spanish speaking program, and we have an article written, we just haven't found the right journal for it. It says, leave my tortilla out of this. Instead of, you know, saying, oh, you have to eat less tortillas, celebrate it. Why is that such an important part of not even that culture, but this family's food history and stuff like that. Because food is personal, it's cultural, its family, and it's to be celebrated. We do a fourth-year elective, it's the last full elective of their fourth-year class and a very lucky 20 students get to do that class. And we always have one called Family Night where they bring a dish that's important to them and their family. And it could be like me, it was the roasted chicken that one of my classmates in med school cooked. And I just thought that was so exotic. You know, I never had a whole roasted chicken before. You know, we had a student that had spent the first part of her life in Australia, so she did pavlova and told the history about where the pavlova came from. Now that's considered sort of the national dessert of Australia. And I always remember this one student, he was going to emergency medicine, very quiet kid. And he's over there cooking these porridges. That's the only way I could describe it is just these porridges. We said, what are you doing? And he told the most amazing story. I almost tear up when I talk about it. His grandfather fled Saddam Hussein. He was Iraqi Christian and fled Saddam Hussein and his grandfather lived with them. And this was their afterschool snack. Was this Iraqi dish that his grandfather would make. And there was a sweet one and there was a savory one. And so just stuff like that is... it's fantastic. I just, I can't get enough of that. And they remember that. And so, as students leave us, and I just came from Match Day where they found out where they're spending the next three to seven years of their life. And I always say wherever you're going, learn something about that culture and that food. If you're moving to Cincinnati, you have got to learn about Cincinnati Chili and getta. take something from that. I did all my training in Wisconsin and the Wisconsin supper clubs and how you can tell what a fresh cheese curd is, and it's just... food is fantastic. And we can take that with us wherever we go. And it can give you a way to know your patients even better. And when I hear of a family that they're from West Africa, ah, you like Jollof Rice. And their face lights up and like, oh yeah, where'd you have Jollof rice? So, it's a great way to get to know more about people. So, there's way more to it than cooking technique. I mean, there's, you know, you roast a chicken that this temperature for that long, or here's how long you microwave. It's really a lot more than that, isn't it? It's just like medicine. It's science and an art. And you know that one of my most popular lectures I give does not have to do with obesity but has to do with barbecue and all the different styles of barbecue. And what is just amazing, despite what we know about the science of taking spareribs, which are an incredibly tough cut of meat, and you have to cook them low and slow to get that temperature up. I think it's 189 degrees or higher where you start to get the collagen that breaks down and they turn tender. So yeah, spareribs to be good tender and edible, you're talking four to six hours. But then you go to Tuscaloosa, Alabama and you go to Dreamland Barbecue. They do spareribs over live coals for an hour and a half. I sat there talking to the person doing it. I'm like, you must bake them ahead of time. Do you soak them? And he's just like, nope. And so again, I know the science of that. So how do these jokers do that for an hour and a half, and it turns out in what my opinion are the greatest bear ribs in the world. Oh really? Oh, I'll have to try. I'll have to try that place out. Yeah, there's several. Birmingham has two there. There's several in Southeast and they cook them for an hour and a half. Over live coals. Violating every scientific principle of low and slow. Don't get it. It's fascinating. That sounds really good. Yeah. Well, Joey, thanks very much. One final question. Do you see this... is this a movement in medicine now or more and more people doing this? Yeah, you know, it was really big for a while. Tulane had so much. You know, they were sharing their curriculum and they were doing some good research. And that's where a lot of what you see now as the food is medicine food is medicine or as medicine where hey, we need to find ways to get medically tailored meals in the patient's hands. There's really good evidence of that with diabetes and stuff like that. I think what you're seeing now is, I think especially with some of our efforts in the government right now, is sort of demanding more nutrition education in medical school. And I'm going to double down on culinary medicine because you know what? My students, myself, I don't need to know more about the biochemistry of carbohydrates. I need to know the biochemistry of cooking and how to do that quickly and safely to teach my patients. And also, with that, we have to forget, there's an entire field that's already doing this, you know? Dietetics and nutrition and there's professionals that probably are way better than us. But I think having this increased understanding, especially dwelling in that food space, is going to help us relate to them that much more. So even though I do a lot of nutritional counseling and talking, I still use my dieticians way more. I think they're going to be way better at that. So I think there is a lot of steam building towards that, but we don't need to turn doctors into junior dieticians. But I think we can give them deeper understanding of how food and nutrition affects their health and the broader aspects of that. It's not about the biochemistry of insulin secretion, it's about where are they accessing food and how can they make use of the food pantry near them. And let them know, hey, it's okay when you open a can of beans it's gonna smell like cat food initially, but you know what? You wash that off and actually it's not going taste like cat food. And you know, just kind of be able to work with them. Hey, canned beans are perfectly fine. Guess what? Canned beans now are coming in no salt added and low salt preparations. And here's an easy way that you could take these canned great northern beans, chop up some herbs with olive oil and a chunk of garlic and you can make some fantastic bean recipe that is incredibly filling and healthy and cheap as dirt. Oh, that's really nice. Well, this is an exciting advance in the field and you're really at the forefront of it, and your students are lucky that they have this available to them. So, thanks very much for being with us and sharing your experience. Well and what the big secret about this is, Kelly, is this is fantastic. I love doing it. Our med school really values it, but it's a lot of fun. That's the thing. You can tell just by the way you're talking about it. It is so much fun. And again, I just saw all my students that were graduating. And that some of these I hadn't seen in three years and they're like doing Doctors in the Kitchen and then seeing patients, they're cooking and being able to relate to them in those ways. I just have a text from one of my students going to family medicine, and she's like, this changed the trajectory in my career. And I'm not taking credit for that, but just the idea of giving that experience I think especially in my world to medical students, I absolutely love it. In the end it's a hell of a lot of fun. BIO Joseph A. "Joey" Skelton, MD, MS, FAAP, FTOS, DABOM is a Professor of Pediatrics, and of Epidemiology and Prevention, at Wake Forest University School of Medicine. He is the Founder and Director of Brenner FIT® (Families In Training), an interdisciplinary pediatric obesity treatment, prevention, research, and educational program. He serves as the Director of the Center for Prevention Science in Child and Family Health, Vice Chair of Research for the Department of Pediatrics, Associate Leader of Community and Stakeholder Engagement at Wake Forest University School of Medicine. He is the Editor-in-Chief of the journal Childhood Obesity. He is board certified in Pediatrics and Obesity Medicine. His research and clinical work has focused on the treatment of children with obesity. He has secured nearly $10 million in funding over the past 15 years, has given over 50 national and international presentations, and has over 130 peer-reviewed publications. He enjoys teaching cooking classes that are both fun and informative to anyone who will listen.
