Culinary Nutrition Workforce Course Offered at Hostos through FamilyCook Productions

by Marissa Sheldon, MPH
Culinary Nutrition

FamilyCook Productions is a nonprofit organization based in New York that develops teaching kitchen curricula for students of all ages and socioeconomic backgrounds across the country. They use a train-the-trainer model to provide nutrition and culinary education in various community settings including schools, farmers’ markets, health departments, hospitals, and early childhood education centers. FamilyCook has been operating since 1995 and now has disseminated curricula to more than 350 sites across 30 states. 

Lynn Fredericks is the founder of FamilyCook Productions. In 2017, she was named Public Health Leader of the Year by the New York State Public Health Association, and in 2020, she and FamilyCook’s Teen Battle Chef program received the Society for Nutrition Education and Behavior (SNEB)’s Program Impact Award. She is also the author of Cooking Time Is Family Time and co-author of Get Your Family Eating Right!.

Mercedes Sanchez, MS, RD, has been FamilyCook’s resident dietitian and Director of Nutrition for more than 25 years. She helps develop FamilyCook curricula and materials with a focus on the social and educational aspects of family meals. She has a Master’s degree in nutrition from New York University and has served as a registered dietitian in pediatrics at NewYork-Presbyterian Brooklyn Methodist Hospital. Ms. Sanchez co-authored Get Your Family Eating Right! along with Ms. Fredericks.

As of January 2024, FamilyCook is partnering with Hostos Community College in the Bronx to pilot a no-cost Food as Medicine: Introduction to Teaching Kitchens continuing education course that will prepare students to assist culinary medicine classes for people of any age. The course was developed by Ms. Fredericks and Ms. Sanchez and is taught by Ms. Fredericks. Funding was provided by the Carroll and Milton Petrie Foundation.

Update April 16, 2024: On April 9, Robin Hood Foundation announced that FamilyCook and the Nibble with Willow preschool culinary nutrition program has been chosen as a grand prize awardee of the Fuel for 50 early childhood initiative.

Food Policy Center: Please tell me more about culinary medicine and teaching kitchens – what are they and why are they important?

Lynn Fredericks: I really can’t do that without referencing the fact that culinary nutrition is a field that we’ve kind of pioneered at Family Cook Productions – I started in the mid ‘90s and Mercedes joined us in the late ‘90s after she got her Masters in Nutrition – so we’ve been pioneering what culinary nutrition looks like in the prevention space for nearly three decades. We’ve been working with all ages, including adults, and we’ve been training and licensing these programs for 20 years. But, around 2016, I could really see that clinical settings were beginning  to take a lot of interest and recognize that there was a role not only in prevention, but also in treatment, using food and nutrition. So that is when we went back and looked at our research and curricula and saw patterns of program components that were key to driving behavior change. We collaborated with Dr. Pamela Koch of Columbia’s Teachers College to confirm those ‘experiential drivers of behavior change,’ and that research was published in 2020. We wanted to share what we already knew was key to achieve success so that new programs would have a better opportunity for efficacy. This would also help new partners to better understand what made our programs effective.

When I think about culinary medicine or culinary nutrition for clinical settings, I think of anything that is offering a practical way to adhere to and act on nutritional guidelines. I don’t even believe the definition of culinary medicine that people generally cite in journal articles. It was established by a physician named John La Puma who published a seminal paper on the topic, but I do not agree with his definition. His definition of culinary medicine is a “field in medicine that blends the art of food and cooking with the science of medicine.” I’m not trying to disparage anyone, I have absolutely nothing against him, but based on my 30 years of experience in this field, I don’t think it’s “the art of” cooking coming together with medicine. Rather, I think it’s nutritional science being combined with the practical application of those recommendations through cooking as a form of complementary medical treatment. I don’t think it’s “the art of” anything. That’s my view anyway, being a practitioner for such a long time. 

Culinary nutrition and culinary medicine are hugely important for two big reasons. 1) Since so many diet-related diseases are affected by what we eat, we want to change people’s habits and not just see how many medicines we can offer them – it’s possible to save money and even reverse situations by changing diet. And 2) is because in this country, unlike some other parts of the world, we do not track how we treat people with comorbidities within diet-related chronic diseases. Talking to colleagues who see patients as physicians or nutritionists, so many patients have comorbidities, but we don’t know exactly how many because we don’t track this. Think about it – we are creating all these medicines and treatments for individual diseases when, in fact, we could treat people who have multiple conditions through diet, and then maybe we wouldn’t need all the medicines and the complications of side effects that too often are a result. 

Mercedes Sanchez: I’m a huge believer in teaching cooking as a tool to help people change their diets. I worked in a hospital in-patient clinic for five years, and I’ve seen my colleagues – other dietitians – teaching and helping people to understand what kind of diet they should follow based on their health. And I’ve been so disappointed throughout the years, because we dietitians have only a small amount of time to teach these patients and we can only get through maybe one or two pages’ worth of information in that time. How can you give patients all of the information they need in just one page? All dietitians tell me that patients may change certain things, but they all go back to their old habits. It’s very difficult to change the diet. 

What I believe in the most, and what I know works, is teaching people to cook from scratch using fresh ingredients. We teach cooking as an important tool and use inspiration to motivate behavior change. No matter what disease you have, the first thing you need to do is to learn the basic skills of cooking and explore the world of food in a broader way. Many people come to my classes and already know how to cook, but they don’t do it because the food industry makes it so convenient not to. Our society makes it so easy to just order food in. People need to become inspired to get back to enjoying cooking and feel confident they can make the right food choices. It can be very demotivating for the cook in the family, if what you’re making is not valued by anyone in the house, like when your kids say “I’d prefer a burger from a restaurant.” We need a whole network of people who are interested in this way of life. This is what Family Cook is trying to do – reaching as many communities as we can. 

FPC: How did you decide to create an Intro to Teaching Kitchens course?

LF: There’s a very unusual pathway to this course. In the summer of 2022, the Caroll and Milton Petrie Foundation provided an opportunity for funding under a project called Bold Solutions, and it was related to providing people in early adulthood with experiences that would make them want to participate in higher education. We have a long history of working with this age group using our program Teen Battle Chef – it’s won several awards. So we came up with this project called CHEF – Culinary Health Education Force. We thought that if we could train young adults in culinary nutrition, put them through the city’s Summer Youth Employment Program – get them a summer job – then a subset of them might want to have their first job be as an assistant in a culinary nutrition or a culinary medicine program. So we needed a course to teach them to become assistants. First we got a planning grant, and then the implementation grant, which paid for the development of this course. That course, which we’re now offering as a Continuing Education course at Hostos, is part of the bigger project called CHEF, a partnership among Family Cook (we’re the leader), Hostos, and two nonprofits – Bronxworks and Brotherhood Sister Sol

The idea for the course and for teaching people to become assistants, came from two things. Too often, in my opinion, there is an overemphasis on people needing very high levels of education in order to learn how to teach others how to use culinary nutrition or medicine in clinical settings. But that isn’t necessary. It’s costing more to deliver this education than it needs to, and currently there’s not a reimbursable code for this work. We’re trying to help contribute to the creation of a workforce of assistants who would support a dietitian who would lead these courses. It could support creation of a much needed and cost effective business model for delivering teaching kitchen education. So as part of this, we want to develop a model for a workforce that will support this. Also, the more relatable the instructing team is, the more likely people are to adhere to what they learn. People feel more confident that they can make dietary changes and that they will like the recipes when fellow community members help provide the classes. It can be intimidating to have physicians, chefs, and dieticians all in the weekly sessions – all highly educated people yet they don’t necessarily share the same experiences as the population they are teaching. 

FPC: When and how did you get involved with Hostos? Did you develop the course with Hostos in mind, or did you partner with them after the course was created?

LF: This course was always planned to be part of this CHEF initiative. Yet we needed to figure out what the scope would entail to make it college-level and eligible for credit, but not too intimidating to our target audience of people wanting to assist in culinary nutrition education. So we met with the Continuing Education department who is our lead partner, and also Hostos’ Food Studies department. Food Studies was really excited about this course, because they have found that a lot of young people want to be in Food Studies, but then when they find out there isn’t any hands-on cooking and it’s more about policy, they get a little disillusioned. So the department thought this would fit really well for people who are coming into Food Studies and want to get more hands-on with food and explore the intersection of health with food. 

FPC: What was the process for developing the course materials? Who was involved? 

LF: Mercedes and I have been working together for 25 years! We know the same things, but we have very different skills and capabilities. I am not trained in anything, but after 30 years I have a lot of experience! Mercedes is very well-trained as a dietitian and has become an amazing chef and culinarian. And she is from Spain, so that gives her a very different background and perspective. But we share the same appreciation for food and the importance of it, not just in the diet, but in people’s lives and in their families and how it’s shared. So, for this course we had to look at our shared vision for where we wanted people to end up, and we took a lot from the cookbook we co-authored in 2013 – Get Your Family Eating Right! – and thought about how to introduce this topic in a way that would first get people really inspired and then provide a lot of preliminary information. If you’re teaching people to be culinary assistants, they really need to have a foundation in cooking, but they also need to understand what this field is trying to achieve in terms of developing a healthier diet and lifestyle. We’re passing on information related to the research we’ve done and building of the evidence base. The students are going to be doing some food preparation every single time and practicing presenting in break-out rooms. This will help them to develop the skill to speak in front of an audience. 

MS: Just to add to what you’ve said, we have been training a lot of coordinators and instructors to teach Family Cook programs, so when we developed this course, we had that in mind. We are training these students to be assistants for these programs, and in our experience, many of these students have to be inspired just as much as they’re going to inspire others. They’re usually not used to eating the foods we present, because we provide a multicultural collection of the foods that New York has to offer. If we’re teaching Hispanic instructors, they may not be used to Asian or Italian food, and vice versa. Oftentimes, we’ll have to really push the instructors to try the foods we’re offering. So, the first thing is to inspire them. If they don’t buy into our philosophy, they cannot inspire others. Then, we give them tools to inspire others and teach them about our ‘Ten Experiential Drivers of Behavior Change,’ which are as important as teaching knife skills. 

FPC: What knowledge and experiences will students gain throughout the duration of the course?

LF: They’re going to be able to help facilitate a course, organize the cooking stations, assemble the mise en place and help demonstrate recipes and cooking techniques. Whether they are working in a preschool class or with adults who have late-stage kidney disease, they are going to understand what people need to experience in a class and how they can facilitate that – peer support, a sense of collaboration, a sense of success, going outside their comfort zone (these are all drivers of behavior change). If we do a good job teaching that, they can bring it to their demonstrations. 

And, they’ll also learn how big this field can become and how broad the opportunities are. For example, the many preschools and other schools we collaborate with teach the kids to help prepare a simple recipe. How amazing would it be if you were to be hired at a preschool that had our program or another similar one, and you were already comfortable handling the food and all the cooking supplies? Because right now we have to train preschool teachers to do that, and some of them find it very intimidating to prepare food instead of having it delivered. 

We want to see an army of young adults (they don’t have to be young, but many of them will be) whose first job may be supporting kids to cook in afterschool programs or seniors who live alone and need help to learn to make quick and easy, healthy breakfasts. There are programs like that proliferating everywhere, but we have to train people to teach them. So wouldn’t it be great if we could develop a workforce that was already trained to supply this specialized support? We want students to see that there are many opportunities to use these skills, including and beyond the clinical settings. 

FPC: Is the course geared towards any specific demographic or profession?

LF: This first time we’re delivering the course, we don’t have any prerequisites, although you definitely have to have a high school diploma or GED. We didn’t put a lot of boundaries around who could participate. We have six or eight registered students who are from this cohort of young people participating in the CHEF program. But we have more than 20 enrollees now, and some of them are coming from outside the area – Phoenix, Chicago – and are already involved in this work in some way. We have a couple of medical students from Albert Einstein College of Medicine who were interns with Family Cook and helped us do the preliminary evaluation of our adult program called Deliciously Healthy. We have kind of a motley crew for this first group. It also includes a physician up at Columbia. The medical students want to see what this course looks like because they may want to license some of this material from us to develop a course for other medical students. I think some other people, like this physician, may be overqualified, but they can decide that for themselves. Because we’ll be teaching some basic cooking, and explaining what teaching kitchens do in different settings, not just in clinical settings. 

The course is geared towards developing assistants, not lead teachers. It is more about being able to demonstrate the food and understand the larger context of what this field is becoming and all the opportunities they will have. 

FPC: Are there any plans to expand the course offering to other CUNY campuses or to pair it with existing nutrition programs in NYC (e.g. Hunter College Nutrition, etc)?

LF: There’s been some interest. I don’t want to cannibalize what we’re going to be offering at Hostos, so that conversation has to start there. But I am very interested in expanding this outside the area. There are communities in Washington, DC, and health organizations like MedStar that I think could benefit. They do a lot of culinary nutrition education, and they’ve been trying to lower their costs, so working with a community college there in DC and having people trained as assistants could really benefit them. So I’m looking at that as a possibility, but I think it’s a little premature to say. 

FPC: As registration is already full for the spring 2024 semester, will the course be offered in the summer or subsequent semesters? 

LF: The plan is yes, and for it to be awarded credit in the future, but the Food Studies department is still exploring. The course was developed through us, outside of CUNY, so they’ll become more familiar with it and see how it aligns with the degree programs they offer, and then make a decision about what might be added to the course and how many credits it would be. That’s a process. I’m hopeful that it’ll be offered again in the summer and ongoing. I don’t know who we’d train to be the professor, but I definitely don’t want it to be a one-off course. We just don’t have any details yet. 

FPC: As this is an Intro course, do you have aspirations to create additional Food as Medicine and/or Teaching Kitchen courses for Hostos in the future? 

LF: I would say yes, we’ve thought about that a lot. But, there’s a lot of people out there trying to do this. It’s premature to train people in a specific role before there’s more of a business model established for this work. From what I’ve seen, all the jobs and programs in this field are primarily dependent on outside funding, so we’re trying to bake things into existing funding streams that aren’t going away. We work with the CHEF program that works with Summer Youth Employment, which helps people get their first job. We work with people all over the country who are SNAP-Ed funded, because they’re probably going to continue getting that money and the program can stick around. When it comes to clinical settings, though, that’s a tough one. If they’re using Shared Medical Appointments (when a group of patients sees the healthcare team for a longer amount of time than a one-on-one medical appointment), there are scaling challenges because you have to have a physician present. I don’t really want to develop a course until I can really isolate what the ideal roles should be and what the reimbursable services are. I think this field needs to settle in, and once there’s reimbursement we can move forward. I’m always looking at things from a systems perspective, and that’s why I’ve developed this course to make teaching culinary nutrition more affordable, and then you can demonstrate a cost that is feasible to attract reimbursement from insurance companies. 

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