Takeaway
Start nutrition conversations with patients’ food preferences, then build healthy changes around the foods they enjoy. Familiar favorites can make a plan more appealing and easier to maintain.
Lifelong learning in clinical excellence | November 10, 2026 | 2 min read
By Boyoung Ahn, MD, Johns Hopkins Medicine
When I handed the patient the cookbook, her eyes lit up. For several minutes, she flipped through the pages. Then she paused and exclaimed, “Blueberry oatmeal muffins! That looks delicious! I’ve never baked with nonfat milk, but I’m willing to give it a try.”
At the resident clinic at Johns Hopkins Bayview Medical Center, we’re encouraged to share copies of “The Complete DASH Diet for Beginners” with patients who need dietary guidance. The Dietary Approaches to Stop Hypertension (DASH) diet emphasizes fruits, vegetables, whole grains, low-fat dairy and lean proteins. Research has shown that it lowers blood pressure and modestly improves lipid profiles, making it an effective strategy for reducing cardiovascular risk.
When advice falls short
Early in my residency, I followed a familiar script with patients: Watch your carbs, cut back on sweets, and … that was often where the conversation stalled. My advice was usually met with a shrug and, “Yeah, I can do better.” These interactions felt impersonal. I’m a foodie who loves pasta and burgers—even if my physician self discourages them. And there’s always room for dessert. For me, eating isn’t just a necessity; it’s also a favorite pastime.
From restriction to intentionality
The DASH cookbook we give patients features everything from shrimp and vegetable pasta topped with Parmesan to cheeseburgers layered with avocado and portobello mushrooms. It even includes desserts, such as chocolate cake made with whole-wheat flour. These recipes remind us that even foods often viewed as indulgences can have a place in a balanced diet. Healthy eating starts with small choices, whether adapting familiar recipes at home or selecting more nutritious options when dining out.
Instead of asking, “How’s your diet?” I now ask patients, “What foods have you been enjoying lately?” Together, we explore how their preferences can align with their health goals. This approach grounds the conversation in realistic, sustainable changes.
Food for thought
The patient’s excitement about the blueberry oatmeal muffins is a reminder that eating well doesn’t mean giving up the flavors patients love. There’s room for both at the table.
Practical tips for discussing diet with patients:
1. Ask about foods the patient already enjoys before recommending dietary changes.
2. Explore food access, budget, cultural traditions, and cooking skills.
3. Frame healthy eating as making substitutions rather than eliminating foods, such as using nonfat milk instead of whole milk in a muffin recipe.
4. Keep a collection of recipes on hand to share with patients rather than simply giving directives.
5. At the next visit, follow up on one small change the patient has made.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.