Column: Culinary medicine can help in fight against food crisis

For today, Dr. Ira Zunin has turned over his usual monthly column, Wealth of Health, to Dr. Jeanette Qablawi

We have a food crisis in Hawaii, and culinary medicine presents part of the solution. With 1 in 4 children facing food insecurity, Hawaii ranks second in the country. At the same time, youth obesity in Hawaii is over 15%. How can the islands have skyrocketing rates of obesity and food insecurity?

According to a study by the University of Hawaii at Manoa, approximately 76% of families who reported very low food security had lost employment income due to COVID-19. As COVID-19 abates, rising food prices related to inflation are emerging as another key reason for food insecurity. An unfortunate reality facing many families at the grocery store is the fact that the most-affordable foods tend to be nutrient poor but calorie rich. Food insecurity and obesity are intrinsically linked because both are signs of a society struggling to find healthy yet affordable food.

Obesity in the United States was trending upward in the years before the onset of the COVID-19 pandemic, but since the pandemic, multiple studies have shown a drastic increase in weight gain throughout the population. Pandemic isolation, inactivity and an increase in mental illness have all played a role in this trend, but economic food insecurity adds to the problem.

People who are obese are at increased risk for elevated blood pressure and cholesterol, diabetes, breathing problems such as asthma and sleep apnea, joint issues such as osteoarthritis and musculoskeletal pain, gallstones, fatty liver and depression. Obesity also increases the risk of cancer. Fifty-five percent of all cancers diagnosed in women and 24% of those diagnosed in men are associated with obesity. In addition, obesity and its related health problems have a significant economic impact on the U.S. health care system. Annual obesity-­related medical care costs in the United States, in 2019 dollars, were estimated to be nearly $173 billion.

Metabolic syndrome refers to a cluster of health issues characterized by abdominal obesity, high cholesterol, high blood pressure and type 2 diabetes. The link between metabolic syndrome and increased risk of multiple chronic health issues like cardiovascular disease, stroke and early death have been reported for many decades. Providers at Manakai O Malama have begun to see evidence of what we now call advanced metabolic syndrome, which also includes chronic pain, depression and sleep apnea. These additional findings tend to develop when standard metabolic syndrome persists.

Focusing more of health care on lifestyle and nutrition is critical for reducing the burden of chronic disease and related health care costs. Optimizing our budget to eat healthier is far less costly than the medications and invasive procedures needed to manage chronic disease. The bottom line is that a balanced diet, along with a healthy lifestyle, can reverse these risks. It can be arduous to reverse years of unhealthy habits, and medical guidance can ensure sustainable success.

I recently joined Manakai O Malama as an integrative family physician. I was excited to join because of the collaborative, multidisciplinary team the clinic is known for. This approach offered fertile ground to launch our program in culinary medicine. This new service is an evidence-­based field that blends the art of providing nutritious food and cooking with the science of medicine. In culinary medicine, meal recommendations are provided by the health care professional and tailored to individual medical issues, social, cultural and human factors as well as budget constraints.

Highlighting the pleasure of healthy foods, rather than stressing about how to avoid unhealthy foods, is a central approach enabling patients to realize the benefit of culinary medicine. Culinary medicine offers a comprehensive approach, adding to current nutrition interventions by incorporating both the practical hands-on preparation, a person’s relationship to food and the scientific knowledge of how nutrition and dietary patterns affect health. Also essential is an assessment of an individual’s level of physical activity, which allows us to offer tailored programs for movement and exercise that are enjoyable, feasible and safe.

Medications also may be prescribed as an adjunct to lifestyle changes. For example, several medicines called GLP-1s have been used for their management of diabetes and recently have been approved by the Food and Drug Administration for weight loss. Often, these medications can be tapered down or off as patients progress in the culinary medicine program.

Culinary medicine offers a comprehensive approach to provide support leading toward improved food security while also addressing the local obesity epidemic.

For those with available time, food and economic resources, consider donating and volunteering at food pantries on the island to help with Hawaii’s food crisis.

Please join us for a panel on culinary medicine at the Hawaii Book and Music Festival:

>> By Zoom: Today, 6 p.m.

>> To register: hawaiibookandmusicfestival.com

Dr. Jeanette Qablawi is a family medicine physician and integrative medicine specialist at Manakai O Malama Integrative Healthcare Group and Rehabilitation Center (manakaiomalama.com). Submit questions to info@manakaiomalama.com. The Wealth of Health column appears on the first Wednesday each month.