Episode 264: Dr. Robert Graham
Jun 28, 2023
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In the realm of modern culinary arts, Chef Robert Graham stands out as a true trailblazer. With a passion for combining the healing power of food with the artistry of cooking, he has revolutionized the way we perceive and approach nourishment. Through his groundbreaking work in the field of fresh medicine and food as medicine, Chef Graham has become a respected figure in the realm of culinary wellness. Tune in as we share the story of this remarkable chef and explore the transformative impact he has made in the world of Food as Medicine.
Lori Taylor (00:00.95)
Hey everybody, welcome back. This is the Produce Moms podcast. I’m Lorie Taylor. It is so great to be back continuing our celebration of food as medicine. As always, thank you to our sponsors of this mini series, Crunch Pack. Yes, I’ve got Tony Frytag from Crunch Pack with me again here today. And oh my goodness, do Tony and I have the most amazing guest. Truly, he is just world renowned. As it relates to medicine and this intercession of food and medicine, we are welcoming Chef Robert Graham, MD, Dr. Robert Graham, also known as Dr. Rob the Chef. He’s the co-founder of Fresh Medicine. He’s board certified in internal and integrative medicine. He is absolutely changing the world as a national leader in the field of complimentary and alternative integrative medicine, nutrition, urban farming, culinary medicine, food policy, health disparities, and cultural competency. All of these things fall under the umbrella of food as medicine, and it is such a joy and such an honor to welcome Dr. Robert Graham today to the Produce Moms podcast. Thank you so much for joining us.
Hi Tony, Hi Lori. Thank you so much for offering me the opportunity to share my thoughts.
Thanks for being here.
Lori Taylor (01:21.862)
Yes, we’re so glad you’re here. So let’s kick the show off. Please tell us more about your work. How did your journey lead you to being both a doctor and a chef? How do you find these fields being very connected?
Well, you know, the great adage, the father of medicine, Hippocrates, reminds us that, let food be thy medicine, medicine be thy food. I think that was roughly 2,500 years ago, and I think it’s about time that we start putting it into action.
Lori Taylor (01:51.751)
I love that. And so let’s clear this up for folks. So you went to medical school. Where did you go?
So I went to medical school here in New York. I’m speaking to you from New York City. So if you see horns and sirens and fire trucks, it’s just part of the deal here. I went to medical school here in New York at Stony Brook Medical School.
Lori Taylor (02:04.235)
Wonderful. And then are you classically trained as a chef? Is this something that came about as you became passionate about? Tell us a little bit more about the culinary art side of what you do.
Yeah, so it kind of tie into the medicine part too. And I know Tony and I will talk about a little bit about the lack of nutritional knowledge in medical training. So I was born in New York City in a town called Jackson Heights, which is called the Global Village. And so the world came to me. These very early formative experiences within a home where my mom is a folk healer and my
the irony of my daily life, right? And then as soon as I walk out of my house, I’m seeing friends from all over the world. And what I realized is that when it comes to health and healing, most healers, and what I mean by healers is mostly the parents, grandparents, right? That’s who you first go to. You don’t go to run to your doctor. You go to your village elder. And they always start the conversation off by what are you eating? And then I enter medical school.
Lori Taylor (02:56.992)
Lori Taylor (03:20.046)
And there’s very little to no education in medical school about nutrition. In medical school, I realized that there was very little mention about the five ingredients that we’ll talk about, but also very little information about acupuncture, aromatherapy, meditation, exercise, happiness, anything that we consider the recipe to health. And so we started an elective in medical school called complementary and alternative medicine.
Lori Taylor (03:43.843)
Fast forward, I realized that I needed more education. And so I became an internist. I did my residency in New York City at Lenoxville Hospital. And then went up to Boston, Harvard Medical School, to study this evolving field back in 2003 called integrative medicine, trying to understand the evidence, the science, and research behind the movement beyond conventional medicine. And then I fell into an MPH where I learned about clinical nutrition from one of the greats called Walter Willett.
Lori Taylor (04:11.31)
and helped start and launch a lot of the early beginnings of the culinary medicine movement. So published a paper in it as well. But then I realized that going back to New York after my training that education again and nutrition was missing. So we started a bunch of initiatives that I’ll talk to you guys about later, including a rooftop garden, teaching doctors how to cook. And then I realized in about 10 years later that Why am I teaching these guys how to cook as a physician? Why don’t I join the team, the ranks of a chef? And so just trying to think about it. In 2018, I looked at here in my one of my diplomas, in 2018, I decided to trade my white lab coat, which I still wear today for Chef White and get formally trained as a chef. But more importantly, really I think in a progressive culinary school where the French techniques were taught, but were not.
Lori Taylor (04:58.638)
I’m going to go ahead and close the video.
introduced into our training because we wanted to focus on more plant-based nutritious whole foods with an attention to sustainability and the planet period. Thank you.
Lori Taylor (05:25.026)
I love that. Oh my gosh. Thank you. What a, yes, what an amazing background. Tony, I’m gonna let you get things kicked off and we’re gonna dive into one of Dr. Rob the Chef’s famous lines, “‘If food is the problem, food is the solution.'” I’ve heard him say that several times in different interviews and on stage.
Yeah, very, very strong.
Well, and I totally, I think the more we’ve learned about this and whether it’s in the last year or the last five years, and it’s so true that if food is the problem, and as a food manufacturer, I’ve gone very cognizant of that, then how do we make food the solution? I mean, is there data? Is there, you know, what can we feed off of what you’ve learned?
Yeah, so first of all, it’s the missing ingredient in healthcare, right? So let’s go back a little bit because I think research is important. We all kind of feel that, we all feel and have an opinion that bad food equals bad health, right? We kind of all agree on that. But yet we have to prove the opposite in science, right? We have to prove that good food equals good health. And a lot of that research isn’t done, right?
Which again, reminds me of a classic research study that has never been done. That if you take two people and you push them out of an airplane, one with a parachute and one without a parachute, who will live? So sometimes we don’t have to prove everything to be true. And so the fact that if bad food equals bad health, good food should equal good health. But yet in medical school, going back to how we do it, not what we learned, but how we do it, we are taught that for every…for almost every single medical condition out there, there is a food approach to it. Let’s start with one of the most common things, hypertension. Do you know that there’s a diet called the DASH diet that was developed and studied to stop hypertension? Most people don’t even know. And I would argue the fact that most physicians don’t instruct their patients about a very simple dietary modification called the DASH diet. And so I think the science is there, has been there.
But when we’re talking about the burden of disease, one in five deaths globally are attributed to poor nutritional quality. Here in the US, it’s the number one cause of death and disability. And so now we’re taught that we have to introduce food as medicine into our clinical algorithm, but yet we’re not taught about it. And we also know that the explosion of particularly ultra processed foods has led to such bad healthcare outcomes. I just feel that why don’t we experiment with a food first approach. And that’s what we do here in my practice. So every single person that comes into my office from an IBS to hypertension to cancer to diabetes, let’s focus on food first, and which will again, compliment and hopefully reverse and manage your disease better.
Well, you talk about, I was listening to one of your earlier videos from Healthy Futures, it says all diseases start in the gut. Again, we are what we eat. And you talk about the role of the microbiome. And I was wondering if you could put that into layman’s terms.
Yeah. So we have this beautiful garden of living creatures called bacteria, viruses, mycology, fungi, all within our gut. And in fact, Tony, you know, we are what we eat, but in true, we are what the bacteria and viruses and fungi eat. Right? And understanding this intersection between our food and our health has to happen in our gut. Right? Besides our gut, the only other exposing organ that we have to the external environment is our skin, right? And again, going back to the, I’m quoting Hippocrates again. Hippocrates said, at the same time, 2,500 years ago, all diseases start in the gut. And so in my very early training, I had the opportunity to work at an integrative holistic center in Massachusetts called the Merino Center. And it was right at the beginning of evaluating the microbiome. And fortunately, many of those great scientists and pioneers of the field, the scientists finally caught up to them by looking at the impact on gut health, on immune health, mental health, metabolism, almost just about everything. And I think we, again, I believe that in the next five years, just like you go to a doctor, get your vital signs and your blood work done, I believe evaluating the microbiome will be one of the key interventions and therapeutics that we will be using in healthcare.
That said, what is the current state? I happen to go, I have a clinic here just locally that I stopped in the other day to get my blood pressure checked. We don’t wanna talk about hypertension. But I was talking to him about this whole concept. He’s a friend of mine, the doc is. But what is the current state of food as a medicine approach or the holistic approach, which is what you’re taking?
But where are we with that? I mean, when we talk about the rest of the medical world.
Yeah, so I just want to say that what I practice is what we call integrative medicine. It is the evidence-based field of things that have been proven to be useful and clinically relevant. So this is not voodoo, hocus pocus. It’s informed and driven by evidence, which is very important in this movement. Because a lot in the holistic movement is opinion-based. And I’m just going to put it out there. And again, we need a scientific basis for it. I just wanna clarify a couple things. So I described to you earlier regarding Hippocrates, food is medicine has been the movement that’s been around for 2,500 years. Food as medicine, using it clinically as medicine is an evolving term, right? And those are food-based interventions, including medically tailored meals, produce prescriptions and produce groceries, I would argue culinary education, culinary medicine, that will help prevent treat and manage chronic diseases that burden our society today. So how do we test it as medicine? We treat it as medicine. So we prescribe it as medicine. So this is where I’m really passionate about it, is that we have to first put food into our algorithm. Food first. If you don’t know what to eat, this is where I think the field and the movement of medically tailored meals is a good crutch.
But then what’s equally important is that we have to educate the parents, the patient about sustained behavior change. Because when it comes to cooking, despite the fact that I love to cook and I prescribe it all the time, people don’t have the money, skill or time to cook, right? And so this is where I think we have to get this movement, this intervention at food as medicine, we have to get it right. Because it’s not gonna be just like with big medicine, throwing another prescription for a medically tailored meal. to the problem, won’t solve it, unless we get to the root causes of it. And that’s really important when it comes to food manufacturers, grocery stores, communities, healthcare, farmers, chefs, everyone has to be involved and brought to the table to really change how healthcare will be delivered as medicine.
That’s fascinating. I mean.
We’ve seen this and for me, we’ve all been studying it, but we’ve also seen it all of a sudden. It’s to me, the layman or somebody who’s just in the business, it seems like in the last year or the last 18 months, there’s been quite the movement. Maybe this is a repercussion of COVID, I don’t know, but are you seeing that or is it just my perception?
Well, I think there’s been a greater intelligence awareness to this movement during COVID, because one of the facts about COVID, right, despite excluding your age, the greatest predictor of severe COVID was your BMI. Right, and that, and of course, tying into the whole social determinants of health, food insecurity came into play during COVID. As someone who’s been at this field from a…clinician, researcher, educator, chef point of view. This is nothing new. It’s just shed a spotlight on the bigger societal problem that we’ve had for probably the last 50 years, ever since the industrialization of our food systems. So I think it’s been a slow burn as they say. It’s been a slow burn, but finally, I think leading up to the White House Conference on food, hunger, and nutrition, and then the subsequent ripple effect of it has been a big movement.
But some of us in the field, we’ve been doing and shouting from the hilltops for about 20 years.
Lori Taylor (14:55.71)
Yeah, so I have to come in and ask you, I mean, so you’ve pretty much already defined this. One question we’ve asked all our guests, Dr. Rob, is how do you define food as medicine? And you did a pretty good job elaborating on food as medicine versus food is medicine, but do you have a quick punchy one-liner that you want people to remember as they look back on this episode?
I can say food as medicine will be the medical intervention that will change health care.
Lori Taylor (15:26.11)
Yeah, absolutely. So what’s the role of fruits and vegetables in this? On a scale of one to 10, how important are fruits and vegetables in food as medicine?
Nine and ten.
Lori Taylor (15:37.046)
Nine, 10. Yes, good. All right, what other categories on the plate or other categories of nutrition you wanna call out?
Eat more plants, really. You know what, this is, you know, oftentimes people ask me, you know, how do you eat a healthy diet? So, you know, I would love to take credit for Michael Pollan’s seven most important words in the good food movement. Eat real food, mostly plants, not too much, right? That’s it, that’s basically what it comes down to. What I prescribe in our fresh prescription is simple. When it comes to food, eat more plants.
Lori Taylor (15:59.874)
Mm-hmm. Yeah, definitely.
That’s it. So we’re not talking about anything else. We just want you to incorporate more fruits and vegetables, grains, whole foods, nuts and seeds into your diet. If you are going to eat meat, eat less meat. And if you’re gonna eat meat, make sure it’s good quality meat. And something I just like to talk about is that the movement has been going on. And one of the things that really pivoted my perception of this was the role of organics.
Lori Taylor (16:28.331)
Now we can have a whole other podcast on organics. Yes. Yeah. You know, the whole G.
Lori Taylor (16:43.583)
We have some in our archives.
And we’re a large, our partner is a large organic grower, so we’ll go with that.
Lori Taylor (16:50.639)
Yeah. But you know, you know, you asked someone 15 years ago, who was the largest purchaser or procurement of organic foods? And it would probably be Whole Foods. But in fact, as you probably all know, Walmart is right. And so that’s where people vote with their feet and their forks. People who shop at Walmart wanted organic foods and fruits and vegetables. And guess what? Again. Grocery stores and restaurants will supply
Lori Taylor (17:01.442)
the consumer what they want. And so when the demand is there, they will follow. And I think it’s time that we start voting with our feet in our forks.
Lori Taylor (17:22.77)
Always. Yeah. Absolutely. Yeah, great advice. So one of the things that I love about your bio and your work history, Dr. Rob, is all the work that you’ve done to bring your private sector brilliance and…be a catalyst for the public sector. You’ve done some great work in New York City. You were actively involved at the recent White House conferences. Share a little bit more about how this movement, food as medicine, is really a convergence or of the public and private sector. It’s a true example of a P3 partnership in America.
Yeah, I think, you know, particularly when you’re looking at food as mentioned, you have to tip your hat off to the amazing work of the The the nonprofits that have really catalyzed this movement, you know here in new york god’s love we deliver project angel common Common threads and commonwealth. There’s so many right that we stand under shoulders, right? But again, you know, we have to If we’re going to go far, we got to go together And I think there is a huge opportunity
Lori Taylor (18:12.031)
for public and private partnerships to further foster their relationships. Unfortunately, in today’s society, we have enough sick people for everyone to help. Right, and oftentimes in the nonprofit world, I see it all the time and I’ve consulted with them and I’ve been friends with them, as the people I mentioned before, is that they’re all fighting for that same sort of funding stream. And I think it’s time that we have to kind of expand
Lori Taylor (18:37.186)
our offerings to incorporate more, um, more intervention so that will help many more people. And that’s part of the reason why I went from a public face to working with Performance Kitchen, you know, a private company trying to, and I know you had Mark on the podcast as well, and I think we’re trying to do the right thing at the right time for the right people.
Lori Taylor (19:08.907)
Lori Taylor (19:24.39)
I agree. And I also think it’s worth a call out. Something that we said in another episode within this mini series is, yes, the public sector is heavily involved. It has to be. Food is a highly political industry, agriculture, lots of regulations, as there should be. Um. But as it comes to this movement in particular, and really most of the food policy, it’s not even bipartisan, it’s nonpartisan. And I think that’s very important to call out. It can be a very divisive political climate, and it’s important that we call that out. We are talking about something that’s much grander than do you lean right or left? Are you centrist with your political views? This is really something that is for the common good.
Diabetes doesn’t pick political sides, right? And so I think it’s so important that we all, and we saw it during the healthcare debates too. I think you can’t take away, you can’t separate the healthcare debate and the food debate because they’re intertwined, right? Big food equals big problems equals big pharma. That’s, I’m just gonna say it, right? And I think in a lot of…
Lori Taylor (20:15.694)
Correct, yeah. Right.
Lori Taylor (20:29.4)
Lori Taylor (20:36.215)
You know, in my world, a lot of the distrust amongst not only black and brown communities, but all communities to the healthcare establishment, right, comes from that, right? It comes from that intersection. And I hope what will happen is that we will start peeling the layers of the onion and understanding that food is at the center of this big problem we have in healthcare.
Lori Taylor (20:51.99)
Yeah, I agree. And I love that you just brought in a produce pun there, peeling the layers of the onion. Good job. All right, so before I give the mic back to…
Yeah, yeah, go.
And we like to say that, and we like to say apples are the core of our business, but that’s another one.
Lori Taylor (21:21.168)
And before I give the mic back to Tony, I want to get your description of your five ingredients in your recipe to health. It’s an acronym, FRESH. Walk us through these five ingredients.
Yeah. Yes, correct. Okay, so again, based upon the work that my wife and I have done, and I’ve even mentioned my wife here, my wife does positive psychology, she’s an integrative nutrition, she’s a yoga teacher, meditation teacher, she’s what I call the art of it all, right? And Julie Graham, yes.
Lori Taylor (21:44.716)
Yeah, and that’s Julie Graham, folks. Julie Graham is an amazing superstar, just like Dr. Rob the Chef, and together they co-founded their practice in New York City.
Yeah. fresh medicine. Yeah. And so we have found through over 50 years of combined education and clinical application that we need five things to be addressed before we even enter the clinical encounter. We have to ask about our food, relaxation, exercise, sleep, and happiness. We have found that together, if once you start addressing those five important ingredients or pillars in your wellbeing, medicine will be of less or no need.
But again, the way we do medicine, right, it doesn’t allow the time to explore these very important things when it comes to true health and wellbeing.
Lori Taylor (22:40.802)
And I’ve already, I was reading the fresh definition, and I’ve sent that already, so I hope that was okay, to a number of friends who need to be reminded about all of those, some very close to my heart. But when we talk about medicine, and in your video, you had some pictures of you writing out scripts for food. So…
Lori Taylor (22:53.398)
Ha ha ha! I know.
But when we also talk about medicine, we talk about the medicine, whether it’s big pharma or whatever you want to call it. But is it medicine versus food or medicine with food? We’re not going to pit one against the other, I presume.
No, I think, as I say all the time, food first. It’s always, if you ever took any sort of dance class or anything, you go back to the fundamentals. If you lose your track of your steps, you go back to the fundamentals. And I think what we’ve forgotten is that the fundamentals of true healthcare, not medicine, the true healthcare starts with food. And just tying back my acronym.
Our motto is when it comes to our health, it starts with food. But at the end of the day, what everybody wants in life is to be happy. Right? And I think it’s never about, it’s complimenting medicine. And hopefully, better managing your disease, right? Hopefully treating it, but more importantly than anything, preventing it from ever happening. I think that’s probably the most important thing that we can often recommend to our patients is that.
The best medicine is prevention.
In doing that, we talk about that more plant-based. But you put that into one big umbrella, but you have nutrition and then you have healthy, but bottom line is it eat more food-based, period. Because it’s not all equal, is it?
I’m not sure I understand the question. I think when we eat too much of something and we don’t eat enough of another thing, right? And the standard American diet, right? The last research I’ve seen is that 69% of our calories come from processed foods. Fat, butter, and oil. And guess what? That’s what we learned in culinary school. You wanna optimize flavor, throw the fat, throw the salt, and throw the sugar in there.
Lori Taylor (25:30.619)
right? But we don’t eat enough of, like I said, fruits and vegetables, right? And I think of iron fiber and seeds. So I think I don’t, I never, I rarely tell people not to eat. I really try to encourage people to eat more of something because you need to crowd it. You need to crowd in, not crowd out.
That’s a very good way to put it. Where are we with nutritional training in the medical field? Yeah, are you? But are you getting it? That’s the question, are you getting it?
We’re hungry for it, man. We’re hungry for it. Yeah, you know, I struggle a lot with that question, you know, because the reason why it’s not in medical training is that there’s simply no quote unquote room for it.
Lori Taylor (26:18.702)
Right? And so you got to get the pathophysiology. You have to understand, and there is the problem again, right? So if we study the origins of disease through the lens of pathophysiology, shouldn’t there be an equal and opposite educational track studying the origins of health called salutogenesis? And unfortunately, we just don’t do that. We focus on a disease-focused mindset in order to treat, manage a disease that can be treated and reversed and or prevented, particularly with food. I Tony, honestly, I go back and forth because for 15 years I taught doctors how to cook, I taught culinary medicine. But I wonder if the doctor is the right person to offer that advice. I would argue maybe not, you know, and I think we do have experts, we have registered dieticians that understand nutrition. I do believe that the movement of culinary nutrition is a growing one as well, because similar to our physicians who want to start to understand the impact of food, so do our dieticians. Our dieticians and our physicians are taught a very antiquated model of nutritional education. And I think it’s time that we have started incorporating more of a food centered approach into our training of nutrition. And I’m old enough to remember home economics. I don’t know if any of the audiences, but home economics,
Right? I’m a kid from New York City. It was called the rotten apple breakdown. Right? It was poor. It was bankrupt. But yet our schools had home ec. And so when I hear today that we don’t have the money for kitchens or culinary training, I think that’s BS too, because there was no poorer city in the 1970s and 80s in New York City, but yet we still had culinary training in our schools. This is the third generation of kids that don’t understand where our food comes from. This is the third generation of kids.
Lori Taylor (27:49.728)
that have diseases that should be left to adults to handle. But we’re seeing heart disease, diabetes, hypertension in kids who are 10 years of age, you know? And that’s directly related to our poor nutritional system that we have, or food system we have in our.
Lori Taylor (28:31.69)
Yeah, we have an entire mini series on family and consumer sciences, which is essentially the rebranded home economics. It definitely is still very much alive in all 50 states and part of the middle school and high school curriculum. But you’re absolutely right, there’s new unique challenges as it relates to infrastructure in schools and even just the safety protocol around cooking in schools. So.
Lori Taylor (28:57.438)
But for folks that are interested, you can scroll back in our archives and we did that in partnership with the FCCLA, which is a student organization for promoting culinary arts, nutrition, and many of the other concepts or educational tracks that fell under the formerly known as Home Economics, currently known as Family and Consumer Sciences. So yeah, with that, you guys, this has been an amazing, amazing show. I am so thankful for your time, Dr. Robert Graham.
I love that.
Lori Taylor (29:27.014)
Chef Dr. Robert Graham, you are a true mover and shaker. You are making the world a better place with your work. I wanna thank you and of course thank your wife, Julie as well for your commitment to the Food is Medicine movement and really being modern day pioneers in this space. You are on stage and well known for a reason and it’s because you’ve been committed to this for a very long time.
So I want to give both Dr. Rob as well as Tony opportunities for closing remarks. I want to remind everyone, you know, you can rate, review, subscribe, share this show with your friends. It helps us keep it going. And at FreshMedNYC is where you can follow along with all the great work that Dr. Robert Graham is doing as the co-founder of Fresh Medicine. So thank you so much for being here today.
Dr. Rob will pass the mic to you for your closing remarks. And then Tony, you can sign us off from today’s show.
Yeah, so thanks again. Thank you so much for the opportunity. I think in medicine, we often think that solution is a throwing a prescription at it. And I think it’s larger than that. And I think the context of this food as medicine movement, as I described, will take a village to change, right? To change how we do things today, both in healthcare and in our food systems. And to you, Tony, for your friends who need to become fresh or stay fresh, You know, we do offer a free online school called Fresh Med U that you guys can go. It’s a 25 minute course that of course you can buy up. But again, I think everyone needs to learn these very five simple ingredients in your recipe to help. And trust me, I’m a doctor.
Lori Taylor (31:13.758)
and a chef.
I, NSF, and we can’t thank you enough. Thank you for being here today, for taking the time today. As you said, you’re being a doctor today, so you have patients, so we don’t wanna keep them waiting if there’s somebody out in the lobby. But thank you for all you’re doing for the movement. I say that because it makes sense. It’s gonna continue to make sense and it’s gonna make us all better. So for myself, for my family, for my friends, for Lori, for everybody out there, we thank you. And we so appreciate you being here today.