Cooking up a healthy life

Extension’s new Integrative Nutrition certificate teaches the ingredients for a healthy life.

We’ve all heard it before: you are what you eat.

In fact, that oft-repeated phrase is credited to French author Jean Anthelme Brillat-Savarin, who wrote all the way back in 1826, “Tell me what you eat and I will tell you what you are.”

While most accept a basic correlation between nutrition and overall health, the idea that the right food prepared in the right way could treat or reverse certain ailments, even cancer, has often met with resistance, said Dr. Gordon Saxe, director of research and a founding member of the UC San Diego Center for Integrative Medicine.

But when it comes to nutrition as medicine, the times are a-changin’—or have already changed.

“I’ve dealt with doubters for decades,” he said. “Nowadays, there aren’t many skeptics left. They’ve mostly either converted or died off.”

Saxe remains very much focused on the living and how proper nutrition can improve a person’s health and well-being. Along with Lauray MacElhern, who serves as the managing director of the Center for Integrative Medicine, Saxe has designed a combined hands-on cooking course that draws on “nutrition science, epidemiology, and time-tested” principles to offer up self-healing concepts centered around meals that are easy to prepare and enjoyable to eat.

“You can have all the education and information in the world, but if it’s not practical, you are not going to use it,” MacElhern said.

The classes have been popular—especially among students and health professionals who want to incorporate this as part of clinical care. So Saxe and MacElhern have been searching for the right partners to help keep up with demand.

“What we are trying to do is establish a deeply rooted approach to the use of food as medicine—and to offer it on a large and broad scale,” Saxe added. “We want to help transform healthcare from inside-out.”

McElhern agreed, adding, “We need to train more people on how to use and teach this approach so we can reach even more people with this empowering and potentially life-saving knowledge.”

To accomplish that, the Center for Integrative Medicine has teamed up with UC San Diego Extension to offer a certificate in Integrative Nutrition starting this fall.

Grace Miller, director of UC San Diego Extension’s Healthcare and Behavioral Sciences Division, said the new certificate will be online, allowing a wide variety of people—including nurses, physicians, case managers, caretakers, dieticians, and, of course, those who are interested in eating healthy—to access the content.

“Online learning certainly ups the scalability of the program,” Miller said. “It almost becomes a train-the-trainers model.”

MacElhern said providing this type of information is critical as more people are seeking complementary and alternative therapies (now referred to as “integrative medicine”), especially food and natural products. A National Institutes of Health survey from 2007 found that 83 million adults spent $33.9 billion out-of-pocket on complementary and alternative care. Of that total, almost $15 billion was spent on non-vitamin, non-mineral, and natural products.

“People are demanding this as part of their overall health care,” she said.

Recipe for Health

Eating healthy can mean many things to many people, but Saxe said the best diet is one that is whole-food and primarily plant-based.

“It’s what is optimal for most people,” he said.

Saxe stressed that there are a couple of important keys. One is the concept of eating cooked or raw foods in their natural state - whole and unrefined – not processed or chemicalized. A second is that the foundation of our diets should be a diverse array of plant foods. This doesn’t mean that one must be a strict vegan; only that most of what you eat is plant-based. While vegan diets can be among the healthiest if properly balanced and based on whole foods, veganism per se is not necessarily healthy.

“Oreo cookies and even Bacon Bits may technically be vegan,” he said. “But they’re really not part of a whole food, plant-based diet.”

There also are certain foods that are helpful for certain health issues.

One of Saxe’s patients had an acute flare-up of Crohn’s disease, a condition from which she had long suffered. While her other doctors recommended that she have her colon removed, she wanted to avoid this at all costs.

Saxe recommended the patient begin to eat congee, a porridge of slow-cooked whole grains, such as brown rice, that can be traced back to the physicians of ancient China and is used in other cultures under different names. According to Saxe, congee, which is soothing, anti-inflammatory, and easily digested and absorbed, almost immediately began to do the trick, eliminating the severe pain and bowel symptoms of her Crohn’s disease. Today, about two years later, she remains free of the disease.

“We were evolved to eat food,” he said, and because of that, our bodies are less equipped to absorb medicine and vitamins in pill form. “With many problems, we can use food as medicine.”

Of course, a better diet is not the answer for all illnesses or conditions.

“If I’m in a car accident, get me to a trauma center,” Saxe said. “That’s not the time to have a discussion about diet.”

Discovering the Possibilities

Saxe and MacElhern are hardly new to the cause of integrative nutrition and complementary medicine. Still, both made their way to this passion via different paths.

For Saxe, it was his father’s cancer diagnosis that fueled his interest.

“I was just out of college and I stumbled across this,” Saxe said. “My dad was told he had less than a year to live. Together, we worked to improve his diet. Whether it was the diet or just the hope that it gave him, he lived another 10 years, mostly good quality. That time was a gift.”

Saxe, who received his MD from Michigan State University, his PhD in epidemiology from the University of Michigan, and his MPH in nutrition from Tulane University, said he wanted to provide the empirical data behind the link between food choices and the ability to protect against a range of maladies, including diabetes, heart disease, and cancer. Much of Saxe’s research, which has received funding from the National Institutes of Health, the American Cancer Society, and The Cancer Project, has focused on the potential of diet to control the spread and improve survival in such cancers as prostate, breast, and pancreas.

MacElhern, on the other hand, was practically born to her work in integrative medicine.

“My parents had a real passion for nutrition. They took lots of courses in macrobiotics, and I grew up going to naturopaths,” she said. “That was my life: being the weird kid eating seaweed and tofu and being made fun of for being so strange.”

Being different became her strength, eventually leading her to advocate for nutrition at an international level to help promote a healthier society. MacElhern has run a Washington, D.C.-based nonprofit organization whose award-winning cooking classes in cancer centers and hospitals has educated more than 100,000 people in 160 cities and eight countries.

MacElhern and Saxe know their work is no longer looked at as outside the mainstream. They point out that the Center for Integrative Medicine, rooted in primary care in the UC San Diego Health System, is able to refer patients back-and-forth with almost every department in the Medical Center. They also have a long list of medical students who are clamoring to be a part of their efforts. In addition, the center recently received a  considerable research endowment from a “lifelong believer in the healing power of foods and herbs” Saxe said. It’s the largest endowment at any academic institution in the United States to support integrative medicine research, especially with regard to nutrition.

“Even in the early 2000s, there were few people who were interested in this,” Saxe said. “Not anymore. Health care providers see this as central to their mission. The landscape has changed enormously. And the potential to contribute to the transformation of health care is real.”