Fifteen years ago, Preston Maring, MD, had an idea. He was strolling through his hospital lobby and noticed vendors selling jewelry and other trinkets. “Why not offer something here that is closely tied to people’s health?” he thought. Not long after that epiphany, a farmers market was born at Kaiser Permanente’s Oakland Medical Center, the first such organic farmers market at a hospital in the U.S.
Since then, that idea of offering healthy food in a health care setting has taken off. There are now more than 50 farmers markets at Kaiser Permanente hospitals and clinics across the country, and many other health care organizations have opened them as well.
Over the years, the markets have provided healthy, fresh produce to staff, patients and others who visit the hospitals. They have also served as gathering spots for farmers, vendors and the surrounding community. In this podcast, Dr. Maring describes the first one as “a block party,” that brought people together in celebration, as good food often does.
Dr. Maring started sharing seasonal recipes soon after the first market opened in 2003. Originally, he wanted to inspire his patients and colleagues to cook with the fresh ingredients available at the markets. Today, more than 500 of his recipes are available on the Food for Health blog, as are those from more than 20 Kaiser Permanente physicians, nurses and employees, including his son, Ben Maring, MD, now a primary care physician at Oakland Medical Center.
OPEN WITH PRESTON MARING: I remember the first day of our farmers market on May 16, 2003. I remember it well. It was a beautiful spring day. The trees were in flower. There were eight farmers with their fruits and vegetables and flowers outside of our medical center. And it was like a block party. The staff came out. Patients were there. People from the surrounding neighborhoods showed up. The strawberry vendor did $2,000 worth of business. It was a miracle and, for many Fridays thereafter, when I came to my medical center in the morning and saw the tents being set up, I just pinched myself to say, "Gee, it's really real. It's happening again."
SUSANNAH PATTON (intro): I’m Susannah Patton with Kaiser Permanente.
I recently had the chance to sit down with Dr. Preston Maring. He’s famous for bringing farmers markets and healthy food to Kaiser Permanente.
So, fifteen years ago, Dr. Maring had an idea. Why not host a farmers market at his hospital? He’d been an OB GYN for 32 years and he had observed that diet was fundamental to the health of his patients.
The first market opened at Oakland Medical Center in May of 2003. And since then, these farmers markets have really taken off across the country and the idea of marrying health care with healthy food has spread far beyond Kaiser Permanente.
Dr. Maring is also known for sharing recipes, first by email and then on his farmers market recipe blog, which is now known as Food for Health. He retired in 2013, but he continues to work to improve access to healthier food options in Oakland and in surrounding communities.
Our conversation begins with how it all got started.
PRESTON MARING: I came up with the idea for the farmers market, actually just walking through our hospital lobby. Often, there were vendors of various kinds in the lobbies of our hospitals around Northern California and they're usually, you know, selling jewelry or trinkets of various kinds. And one day it just struck me that, what if we could actually sell something at the hospital that had something to do with people's health?
I think the reason that farmers markets were embraced by health care, not only with Kaiser Permanente, but also around the country, was that it was just an obvious connection between food and health. And secondly, that there were no downsides. The farmers had another market that they could attend to sell their product. Farmers market associations had another place to offer their farmers. The staff at hospitals could benefit from having a market up front. The patients that were coming to the hospital or the visitors of patients in the hospital. And then the surrounding neighborhoods, of course, depending on the setup of the hospital, could also benefit from the market. So there was, the reason it spread so easily around Kaiser Permanente, but also around the country, was that it just benefited everybody. It was not about competition, it was about collaboration. There are more than 60 markets at VA hospitals. Early on, one of the first markets that Kaiser Permanente offered was in Honolulu and I had the opportunity to visit that market and you could literally walk down the sidewalk in front of the hospital and create a mango salsa. It was just, really, just spectacular.
SUSANNAH (transition): Looking back, Dr. Maring remembers the people: patients, colleagues and also the vendors and farmers at the markets. From his perspective, the markets brought people together and they all benefited.
PRESTON MARING: I remember a few specific examples of people, of Kaiser Permanente staff members who said that the farmers markets really changed their lives. I was at the Santa Clara market, beautiful market, big market, many vendors, picnic tables, grass and nice, big area that they have at their hospital. One of the nurses there had serious diabetes. She was on insulin and she was overweight. She wasn't feeling well. She shared with me that, after the farmers market came to Santa Clara, she changed how she ate, dramatically. And that started it off and that, over a period of time, she was able to go off of her medication and it really did change her life.
Of course there are a few detractors, when we would talk to various medical centers to see whether or not they were interested in a farmers market, we actually got responses like, "What? A farmers market outside of a hospital, what's that have to do with health care?" That actually happened. But, you know, overall, the markets won out, and that's why we have more than 50.
I loved many of the vendors. I'd say Dale Simmons from the Lone Oak Ranch was the most outrageous because I would sometimes be standing off to the side and hear him interacting with the customers and a customer picked up a certain kinds of stone fruit and say, "Well, what does this taste like?" And Dale would say with a very straight face, "Well, this one tastes like spotted owl" and sometimes I would just break in and say, "Dale, you are so bad." Uh, he's, he's pretty wonderful.
Another farmer that's been coming to the medical center in Oakland for years now is Mr. Roberto Rodriguez. He grows strawberries in Watsonville. When he first started coming to the market, he had a daughter. She was five years old at the time and he had told me the story that he used to grow his strawberries conventionally, meaning with the usual sprays and pesticides and fertilizers. But he said when he and his wife, when she was pregnant, he realized that he did not want his daughter growing up around those kinds of chemicals. So he started growing organically. And she's now a teenager, but he's been doing very, very well selling his organic strawberries at, not only our market, strawberries, raspberries at our market, but also many other markets with the Pacific Coast Farmers’ Market Association.
SUSANNAH (transition): Dr. Maring’s philosophy about food and nutrition? Keep it simple. Focus on fresh, whole foods. And don’t worry if you’re not always perfect – spoiler alert: neither was he!
PRESTON MARING: The connection between food and health was obvious to a physician, but in reality, good food was good for all of my patients, not just for people with specific diseases. It’s just a fundamental part of taking care of yourself. I've never been a micro-nutritionist, I've never gotten particularly excited about how much of this, and how much of that, and this fruit has certain vitamins and that vegetable has certain micronutrients. That's all important, but it's of much more interest to others than it is to me. I'd always approached food with my patients and food and health is just, let's keep it simple, you know, use fresh, whole foods that you prepare yourself when you can. And if you can, buy them, grown organically, better for the farmers, better for the earth, better for you, better for your kids.
My diet in my earlier years was not particularly healthy. I'd eat as many burgers and fries as the next guy. Uh, in 1971, when I first started working at the Kaiser Permanente Medical Center in Oakland, um, I would have a stop at the donut shop on Telegraph Avenue, and would go in with two or three really big, really gross donuts. When I look back now, I can't believe I did that, but you know, cinnamon rolls and various, uh, I don't know. I don't really remember exactly, but boy, it was bad. And times have changed.
SUSANNAH (transition): Soon after the market opened, Dr. Maring started sharing recipes with friends and colleagues on paper, then email. The recipes got so popular, they were overloading the servers. Soon after, he started posting to his farmers market recipe blog. After his retirement, that blog became the Food for Health blog.
PRESTON MARING: When we first got the farmers market started, a few of us discussed, how best could we, how best could we advertise the market, you know, how, how are we going to do our marketing for the market? And maybe a fun way to market the market would be to put on some recipes that used what's fresh. It was a great place to, if I put out an email or some other notification to people, I could tell a little story about the vendors, who is coming to the market next month, and just feature some of the farmers. And I remember the first recipe I put out was just pasta Puttanesca. What could be easier than, you know, garlic, crushed chilis, tomatoes, some anchovies, little pasta, that was just an easy way to connect. So I started first by just sending out an email to a few interested people and the word got around, and I got more and more requests for this email.
So I created a distribution list and then the distribution list had a max number of people on that list. And I remember getting in trouble with IT because they told me when I sent the recipe out, that it actually crashed one of the servers. So that was not a very good plan.
Watching my son Ben, who's a primary care internist at Oakland Medical Center, get involved in food and health, is satisfying. One of our favorite things to do together as father and son is to hang out in the kitchen. We just did, actually, recently. It was his birthday. He wanted to cook for his birthday. So that's what we did for the afternoon, is put out a lot of good food together. So it's great watching him get involved with that. We've cooked together off and on since he was a teenager
PRESTON MARING: When I think about the, the core, what, what's the, what's the real foundation for a farmers market or for a focus on food and health? And I would say it's pretty simple. It's trying to make the right thing easy to do. The right thing is to cook yourself when you can, using fresh whole food, organically grown if possible and having a farmers market right in front of you, where you work or where you come for care, is a great way to make the right thing easy to do.
Preston Maring’s earliest farmers market recipes and recipes from new contributors can be found at kp.org/foodforhealth. To locate a Kaiser Permanente farmers market near you, go to kp.org/farmersmarkets.