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The Trickle Down Effect

Over the last several years as I have listened to patients talk about the foods that they remember growing up, they tell of the cabbage and noodles, and the ethnic cuisine of kibbe, grape leaves, and home made pasta sauce that their grandmas cooked. When I ask if they have continued those traditions, they tell me that they never really learned how to make those things, and that they don’t really cook. Somewhere along the line the traditions were lost.

The art of cooking from scratch to feed a family on a daily basis, both healthy and economic meals, is dying… maybe dead. This began with the baby boomer generation as women entered the work force in unprecedented numbers in order to raise the standard of living for the family,and because of gradually increasing numbers of divorced and single parent households. Recipes and cooking skills that had been passed down from generation to generation in families did not take precedence as time became a precious commodity for the working woman. Home Economics Class, once a requisite for high school graduation and which taught cooking and household skills on a bare bones budget, was no longer thought to be important. The skills that were once taught by watching and listening to our grandmothers and mothers as they prepared the family’s meals in the kitchen were no longer passed along.

This is what I call the Trickle Down Effect. Don’t confuse this with Regan economics. No. What I mean by this is the loss of a societal norm that produced devastating effects. The impact of the loss of cooking skills for American society was huge. And despite the fact that at any time, there are 20 cooking shows on cable television, and that any recipe imaginable is available in seconds on the internet, we still don’t cook. There are many reasons for this, but regardless of the “whys”, the effect has been the gradual decline in the health of our country, and more specifically West Virginians. Chronic disease, especially Type II Diabetes, Obesity, and Heart Disease are directly related to dietary intake. Obviously genetics plays a big part, but what we eat does also.

As our cooking skills declined, the food industry filled the void with the development of a plethora of prepared foods high in processed carbohydrates, fats, salt, and calories, taking the place of the fresh ingredients once the mainstay of American culture. Microwave ovens, boxed mac and cheese, and Lunchables replaced the home cooked goodness of our past. The ultimate negative result of the Trickle Down Effect is an unhealthy population.

The solution to this problem lies in education and a compromise between ease of food preparation and healthy nutritional meals. As a physician caring for patients with chronic disease for many years, I have learned that patients are more compliant and are able to manage their illness more effectively if they have been educated about their illness. This education needs to come in part from their physician, but because of time constraints, the bulk of the education can come from resources available in the community. The education needs to be a combination of both nutrition and basic cooking skills, with the additional curriculum of preparation of fresh healthy produce as a mainstay of diet. This education should and MUST be mandatory for all patients with chronic disease, especially Type II Diabetes and Obesity.

There are existing programs which meet this criteria. The WVU Extension Service has programs that provide this basic education within the Family Nutrition series, and there are WVU Extension representatives in most WV counties that provide this education at no cost to the patient. The Wellness Bridge program developed by Judie Hladek in Wheeling, WV also meets criteria for an all encompassing nutritional and wellness program suited for the chronically ill. This past summer Health Right clinic partnered with WV Northern Community College culinary program run by Chef Gene Evans to present a combined nutritional, wellness, and cooking program to both HR patients and community patients. There are available resources in every community, and these can be developed to provide the needed education and skills to patients.

The FARMacy program has been in part developed to resurrect the tradition of home cooking. Cooking doesn’t have to be complicated, expensive, and time consuming. There are ways to prepare nutritious meals on budget. Let’s rally around the home cooking revolution. Our lives depend on it.