Food as Medicine

On the menu for the cooking class were sweet potato casserole and smoked turkey collard greens. A chef from MLKCH addressed the assembled group from behind a table laden with fresh vegetables—butternut squash, onions, Swiss chard—and passed out bowls of samples. Murmurs of appreciation filtered through the group as they dug in.

Though it may have appeared to be an ordinary cooking class, this one was part of something much more powerful happening in South LA—a movement for food as medicine. Held in the light-filled cafeteria on the first floor of the hospital, the class is one element of the health system’s innovative Recipe for Health program. Says Lauren Espy, MLKCH’s Director of Equity and Community Programs, “We see patients that tell our doctors that they’re only able to get fast food or unhealthy food options. And we thought, how can we create something that shows food as medicine?”

Lauren looked around the country for the type of healthcare program that would address food insecurity and food access challenges, but found few examples—despite the growing body of research that finds that addressing the root causes of health issues could be just as important as treating those issues with medication. “A lot of our disease truly comes from what we eat and how we live our lives. When you eat well, you feel better,” says Dr. Edward Cardenas, a family medicine doctor at MLKCH. 

Recipe for Health was launched as an MLKCH pilot program in March 2019. Doctors from the medical group identify patients struggling with diabetes, heart disease and obesity—both adults and children they believe would benefit from the program. Care coordinators screen the patients for food security and nutritional access. Once patients are accepted into the program, they’re given food vouchers that allow them to arrange for weekly pick-ups of fresh produce. Nutritional coaching and cooking classes enhance the program’s offerings. To date, more than 1,400 patients have participated in Recipe for Health, including the addition of children in 2023.  

Dr. Cardenas has prescribed many of his patients into the program. “The evidence is growing—if you eat the same amount of calories but they’re processed foods, you’ll gain more weight, you’ll feel worse [with] depression. All these things are linked to poor nutrition.” His ambition for Recipe for Health is to give patients the knowledge and tools to empower them to make changes to their lifestyles that will translate into improved health—for themselves and for their families. The data is showing success: Patients enrolled in the program were able to maintain their blood pressure numbers and HbA1c levels (which measures average blood glucose levels over two to three months) at a rate 11% higher than those not enrolled in the program. 

Patients have appreciated that MLKCH doctors are providing solutions beyond prescribing medications—solutions that acknowledge the realities of their environments on well-being and health. Lillian*, one of Dr. Cardenas’ patients who participates in Recipe for Health, was excited to join the program. “Dr. Cardenas cautioned me, if you go up two points [in your HbA1c numbers] you’ll be diabetic. You have to eat healthy,” she says, in Spanish. Her high blood pressure numbers were also concerning to her doctor. With her prescription, Lillian began picking up weekly bags of fresh produce and participating in the cooking classes.

“The education component is very important to us,” says Lauren. The classes, which also began in 2023, support patients in finding new ways to use the produce they’re given. MLKCH chefs aim to show their students how easy it can be to cook healthy meals. The classes are held in the cafeteria and have become increasingly popular, even with members of the community not enrolled in the program. 

At the sweet potato casserole and smoked turkey collard greens class, Lillian watches the chef walk the assembled group through each step of preparing the dish—from chopping to seasoning to baking. Back home, she recreates the recipe, getting a positive review from her family. She’s excited to master a dish she otherwise wouldn’t have tried.  

“At my appointment two weeks ago, Dr. Cardenas told me, ‘You’re stable,’” says Lillian, beaming with pride. When he asked her if she was making her meals, she proudly said yes. 

*pseudonym used