There are well-documented health benefits of nutritionally diverse cultural foods and flavors within cultural heritage eating patterns. Spices, which play a strong role in cultural heritage, have been associated with a plethora of health benefits (20). The bioactive components, polyphenols, and microbiota within traditional foods offer novel mechanistic insight for metabolism and health promotion (21, 22, 121). Advancing cultural diversity education of nutrition educators (23) can harness the benefits of ethnic “superfoods” to optimize healing. Clients can be free to enjoy choosing cost-effective local seasonal produce from ethnic markets rather than work extra shifts to afford the latest marketed “superfood” supplements. Shop with the Doc (24, 25) culinary grocery tours can bring awareness and joy to choosing nutritious, seasonal, culturally revered produce. Diverse traditional cultural diets rely on locally available, minimally processed, nutritious foods rather than processed and packaged foods, which more frequently contain GMO components (26).

Health benefits of spices from various cultural traditions (e.g., TCM, Ayurvedic, Mediterranean, African, and Latin American) have been associated with star anise (27, 28), ajwain, clove (28), cinnamon (28–31), allspice (28, 29), oregano (28, 29), cumin (29) black cumin (30), coriander (29), garlic (29, 32), ginger (29, 30), turmeric (29), caraway (33), parsley (29), black pepper (29), allium (29, 34–36), paprika (29), chili powder (29), rosemary (29), cilantro (29), thyme (29), bayleaf (29), cardamom (29), sage (29), and dillweed (37).

Benefits include blood pressure (29), glucose metabolism (30, 31), reduction in advanced glycation end products (28), cancer risk reduction (34), gut microbiome modulation (38), and immune health (27). Spices confer selective inhibiting effects on pathogenic organisms (Candida, Clostridium, and Bacteroides) while having no effect on beneficial organisms (Lactobacillus and Bifidobacterium) (33). Culinary amounts (2 tsp. cinnamon daily × 4 weeks had effects on 24-h glucose measured by continuous glucose monitoring) (31).

Enjoying culturally familiar and revered foods can promote a healthy relationship with food (39). The benefits of introducing culturally diverse foods and spices include less picky eating (40), increased acceptance throughout the lifespan (41), intake of vegetables (42–44), positive emotional context, family bonding, connection, flexibility, and enjoyment. Conversely, the risks of restriction include allergy risk (45, 46) and exacerbation of food anxiety in avoidant restrictive food intake disorder (ARFID) (47). Expanding food variety, increasing pleasure around food, and creating positive emotional context surrounding food are particularly beneficial in situations of food anxiety, ARFID, and disordered eating (which has increased with post-COVID-19 mental stress).

Elevating and embracing the cultural food wisdom of our patients within the medical visit preserves cultural heritage and supports the idea that there are many “best diets” (48), not just the well-studied Mediterranean Diet. For example, oldways (49) and Blue Zones (50–52) have also been associated with vitality and longevity.

Some foods common in traditional heritage healthy dietary patterns are often less commonly consumed in Western diets. These traditions deserve recognition and support wherever possible. For example, studies suggest that Saccharomyces boulardii may play a role in the prevention and treatment of certain gastrointestinal diseases (53–56). This tropical yeast was first isolated from lychee and mangosteen fruit peel (57) by the French scientist Henry Boulard, who was searching for a yeast strain that could withstand heat for wine production. He discovered this “modern probiotic” during his travels to Southeast Asia in the 1920s, after noticing that the natives who drank tea made from Mangosteen skins and other tropical fruits experienced fewer diarrhea symptoms from cholera.

One practical way to recognize and support traditional dietary patterns during medical visits is to ask patients to share their stories about food. Consider inquiring (58) about familiar tastes and foods while growing up, details around taste, smell, feelings, sensations, mood around the table, and memories of preparers. This may open the way for discussion about special cooking (or fermentation) methods, recipes, ingredients, or cultural food events. Not only do cultural and religious food community events preserve heritage, but some also involve philanthropy, commensality, hospitality, and sharing (59–61), thus contributing to equity.

Many cultural food preparation methods and techniques, such as sprouting (25) or fermentation (25, 62) have known health benefits (63). Examples of fermented foods with health benefits include fermented rice (jiu niang) (64, 65), injera (66), dosa (67), natto (68), tempeh (69, 70), sauerkraut (122), yogurt (71), kefir (72), and kombucha (73).

Caregivers within food-insecure household settings face tremendous stress, often working multiple jobs, seeking to avoid wasting food, and may even seek to maximize calories by choosing fast food items with the highest number of calories for the price. Taking into account Satter’s Hierarchy of Food Needs (76), families must first be provided with the resources to meet their immediate needs (77) and then connected to additional resources (78, 79) that allow them to explore a variety of novel foods without the fear of cost burden or waste (74).

These caregivers also include students, many of whom are first-generation parents or caregivers, non-traditional in age, and/or identify as being part of minority groups (80, 81). Sadly, food insecurity among students, including those in postsecondary education, has been on the rise (82–85), with minority and first-generation students facing the highest risk of food insecurity (86, 87). Providing culturally diverse food choices is one way to create a culture at higher institutions supporting food security and health equity.

Providing inclusive dietary options for special food needs, including medical restrictions, religious dietary restrictions, and food allergies (vegetarian, vegan, halal, kosher, gluten-free, lactose-free, and allergen-friendly) in schools, hospitals, and communities is a baseline requirement, and a variety in cuisine offerings (88) (Japanese, Italian, and Australian) can increase nutritional quality.

Institutions and communities can consider offering alternative ingredients that are cost-effective or more readily available. Within global cuisine, there are diverse options to build basic flavors. For example, salty taste can be imparted through salt, soy sauce, fish sauce, celery, seaweed, and miso, and sourness can be conveyed through apple cider vinegar, rice wine vinegar, citrus, and tamarind.

Perhaps “food swamps” should be reframed as “food havens” (75), focusing on the role of local ethnic markets (including dollar bins), bodegas, and farms as underestimated treasure troves of food (89). Patients need to be encouraged to enjoy their “ethnic superfoods” (often found locally and in abundance at ethnic grocery stores) rather than focusing time, money, and resources on acquiring costly “trendy superfoods” (90). Such superfoods are often heavily marketed and processed, stripping them of their nutritional and price value (91).

Providing families with resources for access to healthy foods in low-resource environments, such as week on WIC (78) and “Cooking healthily on a penny” (92–94), can have effects on purchasing behavior and consumption of fresh fruits and vegetables.

The role of rising food costs and inflation have also led to an interest in home-cooked meals. In the Seattle Obesity Study (95), home-cooked dinners were associated with higher Healthy Eating Index scores and reduced per capita food expenditures. In contrast, frequent eating out was associated with higher expenditures and lower dietary quality. Food away from home (FAFH) frequency is associated with adverse weight and cardiovascular outcomes (96) and lower overall Healthy Eating Index scores [fewer servings of greens and beans, total and whole fruits; and a higher intake of saturated fats (97) and added sugars (98)]. A greater amount of time spent on home food preparation was associated with a significantly more frequent intake of vegetables, salads, fruits, and fruit juices. Spending <1 h/day on food preparation was associated with significantly more money spent on FAFH and more frequent use of fast-food restaurants than those who spent more time on food preparation (99). Away food contained less dietary fiber, calcium, and iron on a per-calorie basis (97). One study showed variations in socioeconomic and race/ethnicity differences in home dinner preparation habits, indicating that households with foreign-born reference persons and households with dependents tend to cook more dinners at home (100). Regardless of income level, more frequent cooking at home was associated with better diet quality (101). Providing resources for quick, easy, culturally familiar meals at home can have far-reaching public health benefits.

Family meals are powerful tools for nurturing physical and emotional health. The frequency of family meals has been associated with improved dietary quality (102), rates of chronic disease, mental (103) and emotional wellbeing (104), and overall positive outcomes (105). Connections to families and cultural values have been shown to be powerful buffers in promoting mental health among minority college students facing stressors (106). Family meals centered around cultural favorites can be especially nourishing.

The use of plant-forward dishes has been associated with lower greenhouse gas emissions in healthcare systems (109) and campuses (110, 111). Emphasizing the procurement of food for local ecosystem also supports sustainable food practices. The export of quinoa is one tale of caution (112, 113).

Many cultures have a tradition of “upcycling” foods by using products that would otherwise go to waste in the food supply chain, yet contain valuable bioactive compounds that confer health benefits (114). Examples might include fruit rinds, vegetable pulps, extracted fibers from plants, or corn silk.

In recent years, medical schools have started to include justice and advocacy in their curriculum. For example, in one Justice and Advocacy in Medicine course for first-year medical students, culturally relevant cases using traditional Chinese medicine principles to teach nutrition to older Asian adults from the local area highlight cultural competency and health equity applied to patient care (115). A literature review of DEIB in nutrition education provided a recommended checklist for culturally competent nutrition education (7). All healthcare trainees and providers need to be aware of and responsive to the dietary habits and needs of diverse patient populations, diversifying the foods recommended to their clients. Furthermore, increased diversity among professionals with representation of all backgrounds will allow patients to see their cultures embraced (116).

Integrating ethnographic food questions into patient history (58) is a helpful tool within patient encounters. Past case studies highlighting successful integration of cultural culinary practices in healthcare settings include using cultural foods to support an oncology patient’s nutrition, making healthy pizza together with an adolescent of Mediterranean origin suffering from a metabolic condition, recommending asafetida to a patient struggling with IBS symptoms, incorporating the five flavors of TCM and 6 flavors of Ayurvedic medicine in expectant mothers’ diet (prenatal palate), and making Hungarian sauerkraut with an older Eastern European patient dealing with chronic pain and lack of purpose.

Adding detailed ethnographic food life questions to standard patient history and clinical encounters provides a broader cultural approach beyond standard food intake questions. It delves into the patient’s emotional, cultural, and familial relationship with food and food choices, for example: asking “what food and flavors take you right back home?,” “what are your food rules?” “how are you learning to care more about food in your life?” (58). These questions often lead to rich discussion that ultimately has lasting effects on patient’s sense of self-efficacy and motivation for behavioral change.

Culturally sensitive culinary medicine can be applied to group visits, community outreach, and employee health initiatives. Insurance billable shared medical appointments/group visits (117) extend access to quality care. Group topics may focus on metabolic health, lifestyle change (118, 119), intuitive eating, positive relationships with food, seasonal eating, TCM/ayurvedic dietary patterns (120) healthy detoxification, prenatal health, and oncology (119, 120).

Programs such as Shop with a Doc, farm-to-table events, or cooking demonstrations (121) for employees/staff are other ways to incorporate culturally diverse foods into community outreach education.