American College of Physicians: Internal Medicine — Doctors for Adults ®

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Internist-chef advises patients how—and what—to eat

From the September ACP Observer, copyright © 2006 by the American College of Physicians.

By Gina Shaw

About two years ago, Timothy S. Harlan, ACP Member, a solo practitioner and cookbook author in Front Royal, Va., had a revelation while working with a 26-year-old patient who had a BMI of 37.

"This patient looked at the handouts with simple information about healthy eating and exercise, and said, 'No, tell me what to eat.' I started talking about the handouts again and she said, 'No, you know about this stuff. Tell me what to eat.'"

Dr. Harlan, a former restaurant owner, got the message and decided to meet the challenge. He custom-crafted a six-week set of menus for his patient, largely based on Mediterranean diet principles. "She cycled through the plan four times for 24 weeks, and lost a pound a week every single week," he said.

He dubbed the program, "eatTHISdiet" and it wasn't long before word spread and Dr. Harlan had started half a dozen more patients on eatTHISdiet.

One variation of the diet is geared toward people who take warfarin, with menu items low in vitamin K. Another "comfort food" variation includes such dishes as macaroni and cheese and pan-grilled asparagus as a middle ground "for people whose eyes glaze over at the words, 'Thai coconut shrimp,'" he said.

All three are available for free on the drgourmet.com Web site, which, he said, gets about 30,000 visitors per week. The site's "Resources for Physicians and Health Professionals" section includes details on such topics as gout and GERD, plus a BMI calculator and links to different diet plans. Each recipe has notes indicating what to do if the patient is lactose-intolerant, watching sodium intake or has reflux.

"Soon we will move to a database format where the menus are fully customizable," Dr. Harlan said. A patient will be able to enter that she is diabetic and on warfarin, for example, has GERD and doesn't like zucchini or tofu, and get a six-week customized meal plan with recipes and shopping lists.

Dr. Harlan, now 47, insisted his diet plan isn't another fad. "It's the happy medium between McDonald's and wheat grass juice," he said. "There's no gimmick here. It's just eating great, healthy food."

From menus to medicine

Dr. Harlan traces his history in the food business back to his first restaurant job, at age 11, as a dishwasher in his hometown of Atlanta. By age 22, he had launched a French bistro, Le Petit Café, in Athens, Ga. Three years later, he closed the restaurant to return to college at Georgia State University in Atlanta, fully intending to get a degree in hotel and restaurant management.

But while attending classes, Dr. Harlan found himself plunged into the medical world when a family member with diabetes required a kidney transplant. "I was walking across the hospital parking lot one day and I thought, 'I can do a better job than these guys.' So I literally went across town to Emory and said, 'I want to go to medical school.' They said, 'We think you'll need an undergraduate degree for that.'"

In the fall of 1983, Dr. Harlan enrolled in pre-med classes at Emory, while at the same time keeping up-to-date on the latest in healthy eating and adapting his recipes based on what he learned. In his second year of medical school, Dr. Harlan's first book, It's Heartly Fare—now in its fourth edition—was published.

As he continued through residency and set up practice in rural northern Virginia, Dr. Harlan and his brother, an Atlanta television producer, created the "Dr. Gourmet Show," which won an 2002 Emmy and still airs in syndication in some parts of the south. Most recently he wrote Hand on Heart, a book of recipes that includes nutrition and cooking tips with each entry.

Maintaining balance

Even though he now spends 20-30 hours per week as Dr. Gourmet—creating two to three new recipes each week, sending out regular e-newsletters, and traveling for book tours and media interviews—Dr. Harlan said it's not difficult to maintain his practice.

The key, he said, is having employees who are dedicated to the cause of healthy eating, including an office manger who keeps him posted on emerging crises or patient needs while he is on the road. For the past dozen years, he's also shared call with five other internists.

Yet his patients worry that he will stop practicing and become a full-time Dr. Gourmet, especially if more television opportunities come his way. Dr. Harlan insisted that will never be the case even if it might change the way he practices. "I might stop taking new patients and have less extensive office hours, but I'd never quit practicing," he said.

"I'm wary of being considered 'the diet guy.' I'm Dr. Gourmet. Being a practicing doctor is an integral part of who I am. I learn so much from my patients every day."

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