Children’s Hospital of Philadelphia has a chef who doesn’t work in any of the kitchens that prepare food for patients, families or staff.

Instead, Paige Vondran, MS, SLP, is CHOP’s medical chef educator — one of only a few such positions at hospitals across the United States — and her role is to develop recipes with ingredients that ease physical symptoms some children experience because of their specific medical condition or treatment. Under the umbrella of Culinary Medicine, a collaboration among Clinical Nutrition, Integrative Health and other clinical divisions, Vondran creates and teaches tailored recipes to families so they can use nutrition to improve their children’s health. She has created recipes for children in specialties across the hospital, such as nephrology, endocrinology, gastroenterology, allergy and others.

“When a child is sick, we want to use nutrition to help improve symptoms and disease control,” says gastroenterologist Maria R. Mascarenhas, MBBS, Director of the Integrative Health Program. “For example, in inflammatory bowel disease, eosinophilic esophagitis, celiac disease, heart disease, hypertension, kidney disease and a lot of other conditions, we know that changing your diet can make a significant impact on the underlying condition and decrease the need to use medications. That's the power of nutrition.”

Children with some chronic conditions or allergies must stay away from certain foods, which means their entire families may be impacted by dietary restrictions. Vondran’s recipes use suitable replacement ingredients while mimicking the original taste and texture.

All recipes keep kids in mind. They aim to be great tasting, inexpensive, easy to make and support overall nutrition, in addition to addressing specific symptoms or medical restrictions. Including or excluding specific ingredients doesn’t replace medical care but can be an important part of a child’s overall treatment plan.

“The key to all these recipes is that they have to taste good,” Vondran says. “It doesn’t matter how ‘healthy’ the dishes are, kids won’t eat them if they’re not delicious.”

Different diseases, different recipes

One Culinary Medicine program where food makes a dramatic difference is CHOP’s Keto Kitchen, created for children whose epileptic seizures cannot be controlled with medication. They often can find relief by following a very strict, high-fat, near-zero-carbohydrate diet. Because recipes must be precise to a 10th of a gram, families need to learn how to make them — more than 250 have been developed — in the Keto Kitchen. About two-thirds of children who use the keto diet have 50% fewer seizures and up to 25% can be seizure-free.

Diet can also play a role in helping children with cancer. They face many challenges from treatment, which can not only change the way food tastes, but can also cause nausea, constipation and an inflamed mouth, leading to weight loss and dehydration. As part of the Integrative Oncology Program, Vondran has created recipes that specifically address these symptoms, and she can bring them to families directly thanks to support from the Fight On Makenna Foundation. The foundation funded a mobile food demonstration cart, which Vondran uses to show families how to make snacks and meals that can ease symptoms. There is even a series of videos that demonstrate how to make the dishes.

Along with its current work, Culinary Medicine has plans to promote food as medicine to a wider audience. Last year, the CHOP Women’s Committee chose the Integrative Health Program and the Integrative Oncology Program as beneficiaries of their support. Their grant will allow Culinary Medicine to expand the mobile food demonstration cart and to create a special searchable recipe database on CHOP’s website. That way, anyone can access recipes with ingredients tailored to their child’s medical condition and dietary needs.