Practicing MNT in the Kitchen
Today’s Dietitian
By Victoria Shanta-Retelny, RD, LD
Vol. 6 No. 6 p. 30

Imagine an office where your desk is a chopping block, your pen is an 8-inch chef’s knife, and your nutrition assessment plan includes an ingredient list of heart-healthy recipes. This is a real-life scenario for many dietitians practicing medical nutrition therapy (MNT) in the kitchen. From educating clients and students on the DASH (Dietary Approaches to Stop Hypertension) eating plan to comparing restaurant portions to the USDA’s recommended serving sizes, dietetics professionals are combining clinical practice with culinary arts.

Whether MNT is for obesity, diabetes management, hyperlipidemia, or hypertension, healthful eating is the first line of defense. The challenge is to make it simple and fun. With obesity and type 2 diabetes reaching pandemic proportions and the United States alone having an estimated 129 million obese and overweight adults1 and 18 million individuals with diabetes—a number that may double by 20302 —dietetics practitioners are forced to get creative in their efforts to facilitate nutrition change. What better way to ignite passion and excitement for healthful food than to demonstrate how easy it is to prepare nourishing meals?

Celebrate Food with Healthful Cooking
Dietitians are rising to the culinary occasion. In New York City, Jackie Newgent, RD, CDN, a culinary and nutrition communications consultant, teaches nutrition-based cooking classes, such as Cooking for Fitness and Superfoods: Fresh and Fabulous, at The Institute of Culinary Education. Newgent describes her career path as “a natural progression.” With a love of food, its parts, and traditional roots, she knew she wanted to pursue nutrition in the culinary world. Newgent received a Certificate of Professional Cookery from Kendall College’s School of Culinary Arts. Becoming a chef “was a key adjunct to an RD as it added credibility when working with clients,” says Newgent.

While still in culinary school, Newjent taught nutrition to the students, which “blended it all together” for her. She recalls discovering her passion for teaching people about healthful food preparation skills while working the American Dietetic Association’s (ADA) “Ask the Dietitian” hotline. Her nutrition communications training was really honed as ADA national media spokesperson from 1998 to 2001. These days, she owns a culinary communications business, which she describes in three tiers: “teaching nutrition at a culinary school, publishing and writing about culinary nutrition, and consulting to the food industry.”

Along the same lines, chef Renee Zonka, RD, CEC, MBA, CHE, a chef instructor at The Illinois Institute of Art Culinary School, Chicago, has an extensive dietetics, culinary, and business background. Zonka immersed herself in the culinary world early in her career. After eight years in clinical dietetics, she gradually became more involved with foodservice and received much of her culinary training on the job. After years as a self-taught chef, Zonka became a certified executive chef through the American Culinary Federation (ACF) and keeps up with continuing education through a variety of culinary and dietetics-related associations.

“It is so rewarding to share the knowledge of everyday eating without faddism,” she explains. Her passion for culinary education led her to teaching nutrition theory as it applies to cooking. She stresses the importance of teaching aspiring chefs “sound, basic nutrition information so that they give the public credible answers without making fraudulent menu claims.”

With the popularity of the culinary profession and the masses of chefs vs. dietitians, Zonka’s classes focus on “the normalcy of nutrition.” She arms her cooking students with nutrition information, such as gluten-free foods for celiac disease and tasty soy-based dishes for cancer prevention. From beginner to advanced classes, the curriculum aims to “expand knowledge and appreciation for wholesome food, proper cooking techniques, and acquiring a taste for healthier cuisines,” states Zonka.

A Sense of Community
Every day, consumers are bombarded by national newsmagazines featuring articles on fad diets and the Food Network airing a perpetual stream of cooking shows—some healthier than others. Dietitians must be competitive contenders for public health awareness and are managing to make names for themselves in their communities.

Naomi Kakiuchi, RD, CD, the founder and president of NuCulinary in Seattle, is “committed to inspiring community and culture through cooking.” In 1998, Kakiuchi founded a full-service culinary business on the principle of fusing cuisine and life. With more than 20 years of experience in nutrition, foodservice management, catering, sales, and marketing, Kakiuchi refers to herself as a “culinary educator.” Although Kakiuchi has no formal culinary training, her exposure to chefs over the years and sheer enjoyment in working with food made her a master of the craft. As a strong proponent of community outreach, she coordinates chef demonstrations for five farmers’ markets in the Seattle area through the Seattle Neighborhood Farmers Market Alliance.

NuCulinary’s programming focus is on keeping the recipes simple, the mood light, and offering a general orientation to nutrition. Kakiuchi warns, “We keep it simple so that clients do not lose concentration.” The basic nutrition principles she employs in her classes are to focus on the whole plate, balance what is on the plate, and add a variety of colors. “People find pleasure in nourishing themselves, and our philosophy is that all foods can fit,” explains Kakiuchi. The cooking classes range from ethnic cuisine (eg, Sushi, Dim Sum, Japanese, Chinese, Korean, Philippine, Vietnamese, Italian, French) to cooking with herbs, bread baking, cooking with chocolate, and wellness-centered cooking.

The Hands-On Culinary Experience
Is hands-on culinary education really a more effective form of MNT than traditional office visits? Yes, according to student feedback from the Calphalon Culinary Center (CCC) in Chicago. CCC started offering healthful culinary curriculum last year with classes like Vegetarian 101, Total Body Wellness, and Spa Brunch. The emphasis is on simple, healthful recipes that fall within the National Heart, Lung, and Blood Institute’s Step I Diet (=30% total fat, 8% to 10% saturated fat, =15% monounsaturated fat, and =10% polyunsaturated fat; =300 milligrams cholesterol; 20 to 30 grams per day dietary fiber).3 On close analysis of CCC’s postclass comment cards, students continually rate the healthful cooking classes as “excellent” and “very good.” Perhaps the most telling indicators are exclamations such as, “Great information! I learned a lot!” and “I can’t wait to try the recipes at home!”

Just as in traditional MNT, where the provider must build a partnership with the patient, in the culinary education world, the RD-chef instructor must build a partnership with the student. The instructor must be a source of general information, perspective, support, and some measure of guidance3 but cannot make the student cook healthful recipes at home if the student is not ready or willing. Because empowering people in the kitchen is the premise of culinary education, it is important to note that solutions (eg, healthful recipes, cooking tips, techniques) offered by the RD-chef instructor do not necessarily lead to the commitment needed for behavior change. The best solution depends on the person with the problem reaching a self-reliant landmark4 (eg, buying a healthful cookbook, new cookware, healthful meal planning). Therefore, the class evaluation becomes an effective way to monitor behavior change and outcomes.

Getting Creative with Healthful Food
The act of cooking is a creative outlet many dietitians explore. Allison Condon, RD, is currently studying to obtain a degree in culinary arts. For Condon, the creativity that cooking affords her is the most rewarding aspect of the process. “Every audience, client, or person will desire something different, and it takes creativity to make simple foods visually inviting and taste good at the same time.” Six years after becoming an RD, Condon’s rationale for continuing her education in culinary arts was to “expand her hobby of cooking into the art and craft of cuisine.” By combining her background in nutrition with culinary arts, she hopes to increase knowledge of different cooking methods, skills, and presentation of food to eventually be able to teach cooking classes and become a personal chef.

Culinary RDs seem to have a creativity gene; chef Stephanie Green, RD, is the perfect testament to this. As founder and president of Nutrition Studio in Phoenix, Green is a nutrition educator who “teaches people that achieving good nutrition can taste good, too.” Green has gone from working in clinical dietetics as the chief research nutritionist at the Hospital of the University of Pennsylvania General Clinical Research Center to collaborating on cookbooks, media work with local television stations, and writing various articles in local newspapers and magazines. Her varied experience lends itself well to Nutrition Studio, which offers a wide variety of nutritionally focused lectures, cooking workshops, nutritional research, recipe and menu consulting, health and dietary analysis, and recipe development and testing.

With classes that rotate monthly, Nutrition Studio offers programming designed to “blend good food with good health.” The following nutrition topics are covered: Women’s Health, General Health & Wellness, Heart Disease, Cancer, Diabetes, High Blood Pressure, Weight Management, Vegetarian Cooking, Cooking with Soy, and Exploring Ancient Grains. According to the studio, the unique aspect of the educational environment allows clients to learn by doing in a hands-on approach in a real kitchen environment. Clients learn according to their individual nutritional needs and with the appropriate culinary skills. Nutrition Studio offers individual nutrition counseling and education programs. In addition, there is a Registered Dietitian Referral Program in place to help clients find a dietitian who will best meet their needs.

Professional Culinary Associations
Entwined in many of the culinary RDs’ professional lives is a strong link to professional associations, such as Food & Culinary Professionals (FCP), a dietetic practice group of the ADA. “Not only is it great networking,” states Kakiuchi, “it’s a lot of fun to learn what other people are doing in the field.” FCP is a resource for members of the American Dietetic Association interested in the culinary arena. Its mission is to increase food and culinary skills among ADA members, impact the public’s nutritional status and health, and expand members’ career opportunities. FCP offers continuing professional education credits through participation in bimonthly teleforums, culinary symposiums in exotic places, and international culinary adventures (Ireland was the most recent stop in May).

The International Association of Culinary Professionals (IACP) is another organization that caters to the advancement of culinary education and communication. The IACP is a not-for-profit group with global membership of nearly 4,000; it is the culinary stomping ground of the elite in the professional food community. Food writers, cookbook authors, chefs, and food stylists make up the strong infrastructure of this association. The IACP is a resource vehicle and support system for its members with the main purpose of facilitating career success for culinary professionals. Annual programming includes educational teleforums and regional and international conferences for members.

The ACF has been long esteemed as “the voice of the chef.” Founded in 1929, the ACF is the largest nonprofit professional culinary organization in the United States. The federation’s Web site states that it is revered in culinary circles as the first organization to elevate chefs from service to professional status. With a host of educational and networking opportunities for culinary professionals, the ACF sets culinary standards and offers certification programs and continuing education with videos, cookbooks, and technique manuals. From exposure to world cuisines to industry trends, the ACF also sponsors frequent presentations on a variety of subjects, such as food labeling, nutrition, sanitation, and management.

If culinary education is where your heart is, explore the possibilities. Enroll in cooking classes, partner with a chef, gather information on local community food networks, and volunteer your time. Empower yourself to take MNT to a level where food is a dynamic source of creativity, not just a static model on your desk. Bon appetit!

— Victoria Shanta-Retelny, RD, LD, is a practicing dietitian at Northwestern Memorial Wellness Institute in Chicago, a freelance food and nutrition writer, and a culinary spokesperson.

References for this article are available upon request by e-mailing TDeditor@gvpub.com.

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