A group from the University of Kentucky recently returned from several days in San Diego at a global symposium where they educated attendees from 48 different countries about the field of neurogastronomy. Neurogastronomy is a somewhat new study that unites the science and culinary worlds by examining the human brain and behaviors that influence how we experience eating and drinking.

Timothy McClintock, PhD, university research professor and the Louis Boyarsky Professor of Physiology in the UK College of Medicine, currently serves as president of the International Society of Neurogastronomy (ISN). ISN is a professional society founded by chefs, neuroscientists, agricultural scientists and health care professionals. The group is devoted to the study of how flavor sensations are created in the brain, what the brain does with flavor information, and the behavioral and physiological consequences that result. ISN works to translate this knowledge into uses that promote healthy diets.

Sponsored by the National Institutes of Health/National Institute on Deafness and Other Communication Disorders, UK plays a big role within ISN with four other UK representatives serving as officers for the group. Neuropsychologist Dan Han, PsyD, is the past president; UK chef-in-residence Bob Perry serves as program chair; clinical administrator Kelsey Rahenkamp is ISN’s secretary; and neurologist Siddharth Kapoor, MD, serves as treasurer for the group. 

Each year since their creation, with the exception of 2020 and 2021 due to the pandemic, the group holds a symposium which includes the always entertaining cooking challenge called the Gina Mullin Challenge. The tradition of the event is to feature the culinary skills of a few chefs as they prepare dishes with a set of certain dietary restrictions and then serve those dishes to a panel of judges impacted by the challenge at hand. 

This year ISN decided to take their annual meeting and cooking challenge to the eighth Global Symposium on Ketogenic Therapies. The conference was formed through a partnership between the International Neurological Ketogenic Society’s (INKS), The Charlie Foundation for Ketogenic Therapies, United Kingdom’s Matthew’s Friends, and the Glucose Transporter Type 1 (GLUT1) Deficiency Syndrome Foundation (Glut1DSF), and ISN.

“It just seems like a good fit,” said McClintock. “Our groups are teaching each other and also have some overlapping interests in terms of diet. The work at this symposium focuses primarily on the use of food as medicine. Part of that is having a diet that is flavorful and will help patients be compliant while keeping on with their lives.”

Flavor is a big focus of what ISN does and it is a bit different than taste when it comes to neurogastronomy. Certainly, these terms are used interchangeably by the average person and often within dictionaries their definitions refer to each other as synonyms. Flavor, which is defined as a noun, is the overall sensation of a food or drink. In everyday speech this sensation is also referred to as taste. 

To avoid ambiguity a scientist or clinician will reserve “taste” to mean the five things — sweet, salt, sour, bitter and umami — that are detected by the taste buds. They use the term “flavor” as how someone experiences a food or drink based on a combination of senses like smell, taste and, sometimes, touch. The science of flavor is highlighted by Chef Bob Perry through the now internationally renowned flavor stations.

This year’s Gina Mullin Challenge

In the past, the cooking challenge has focused on creating dishes for cancer patients who have experienced changes in taste, smell and appetite due to their therapies, and on creating appetizing desserts that were appropriate for people with diabetes. To match the theme of the symposium, this year’s challenge focused on dishes that would be appropriate for a ketogenic diet.

The classic ketogenic diet is a special high-fat, low-carbohydrate diet that helps to control seizures in some people. It is prescribed by a physician and carefully monitored by a dietitian. It is more commonly used in children with seizures that do not respond to medications. The science behind it is that a keto diet causes an increase in adenosine signaling in the brain and thus suppresses seizures.

With the task of cooking delicious dishes that are compliant with a classic keto diet, Chef Fred Morin and Chef Trevor Morones, were hard at work inside the kitchen at the Loews Coronado Bay Resort, the host site for the INKS symposium. One chef has extensive experience cooking within the guidelines of keto, the other chef is internationally renowned but pretty new to the diet.

Morin, who is the owner of a few different restaurants including Joe Beef in Montreal, says learning more about keto in recent months became a hobby for him as he prepared for this challenge. 

“It is a trendy diet,” said Morin. “But I think it is important for me to understand this all not from a podcast perspective but from having conversations with both people who suffer from conditions that are helped by keto and from the people who are cooking for them.” 

The internationally known chef has been involved with ISN for several years now and serves as their membership chair. 

“Each time we meet and do this I find answers to the questions I encounter throughout the year. It is a privilege to have access to this plethora of minds and it is easy for me to make a link for myself within it all,” said Morin. 

Morin faced off in the kitchen against someone who is not only a skilled chef, but who has been eating a keto diet himself as an epilepsy patient. 

“I’ve known Bob Perry for a few years and have stayed in touch. Bob knew I was practicing keto to mitigate seizure activity because pharmaceuticals don’t typically work too well with me,” said Morones. Morones, who is a trained craft butcher, is the founder of Control Point, a food safety training firm. 

As a native of Bowling Green, Kentucky, Morones felt right at home with UK’s ISN group. He centered his main dish around a flat iron steak. 

“The flat iron is the second most tender cut in the steer to a filet, and it is only a third of the cost,” said Morones. “We came into this with the idea that we are presenting the children or other people preparing for children. So, things that they realistically do at home or in their hospital.” 

Morones coated his steaks with a homemade bourbon butter and then topped them with a salsa seca, a “dry” salsa made of toasted flax seeds, sesame seeds, sunflower seeds, pepitas and pistachios. The steak was served with a mushroom-infused dashi soup, and instead of noodles, Morones utilized zucchini. 

To finish off the keto-friendly meal, Morones served a take on overnight oats. Instead of using oats, cauliflower rice was mixed with warm spices, coconut oil, chia seeds, cardamom and a scoop of protein powder. 

Morin’s keto spread played off a Montreal classic known as poutine. Poutine is traditionally a dish of french fries and cheese curds topped with a gravy made from a smoked meat. 

“It is one of those magical combinations like key lime pie and whipped cream, where all the ingredients as a whole are far greater than the sum of its parts,” said Morin. “I also think it can be seen for someone on a very regimented diet as a bit of a ‘splurge,’ although it is not really breaking away from the guidelines of the diet.” 

Morin used almond flour to create his french fries and rolled them in a pork panko before frying them. His poutine was followed by a take on one of his childhood favorites — tri-color Jell-O. Morin utilized Jell-O, hibiscus tea, and cream to create the layered desert served in mason jars. 

Both chefs presented their dishes to a panel of judges with varying backgrounds including hospital dietitians, hospital chefs and parents of children with epilepsy. The group was torn on who to declare their winner, but ultimately went with Chef Morones. One of the big deciding factors was the ease of recreating the dishes for families or nutrition teams in health care settings. 

All those involved not only enjoyed the delicious dishes by two accomplished chefs, but everyone also felt they came away better equipped to prepare meals within the keto diet with a focus on ensuring the food is flavorful. 

“I am really grateful to be here and I’m fortunate to live with something called epilepsy and get to be a representative not only for other adults as well as children,” said Morones. 

ISN’s sensory flavor stations

A second way ISN illustrates what all goes into flavor, is through sensory flavor stations. The group hosted five of these throughout an opening reception for the global symposium. One of the stations utilized salt as a sweetener, another station blindfolded participants and asked them to try to identify what kind of puree they were tasting, the next station asked participants to identify a flavor based off smell alone, then participants tried out a smell and taste interaction by tasting an apple alone and then taking a second bite while smelling some vanilla extract. A fifth sensory station illustrated the role color can play into flavor. For example, at the station the orange Jell-O was actually cherry and the red Jell-O was vegetable stock.

“Some of the reactions are pretty funny,” said McClintock. “I think we have really helped show people here who work with these diets how critical everything is and how to pay attention to all the senses when it comes to flavor.” 

McClintock and the rest of the group hope by getting these hands-on illustrations and examples to better educate others on how to approach improving the flavor of certain diets and increase the acceptance and diversity of the diet in terms of flavor. “That is going to improve the reach to some patients and their compliance. If someone has some more choices or more flavorful options, they might follow the guidelines better.” 

Other highlights from the symposium

As part of their time at the symposium, the UK group, two competing chefs, and Rachel Herz, PhD, a neuroscientist at Brown University, presented a full plenary session. Coordinated by Kelsey Rahenkamp, the session covered the topic of how the brain creates flavor and why it matters. 

Speakers throughout the conference came from all around the globe, speaking on a range of topics pertaining to keto diets. While at the meeting, ISN members had a chance to listen to a fellow UK colleague who was there to present on the impact a keto diet could have on the treatment of traumatic brain and spinal cord injuries. 

Patrick Sullivan, PhD, professor of neuroscience with the UK College of Medicine, attends the symposium on ketogenic therapies whenever he is able as his studies focus on ketone effects. During his presentation, Sullivan presented data from work done at UK through mouse models does show that delayed administration of ketone bodies can improve cognitive outcomes when dealing with TBI. 

On the clinical end, Siddharth Kapoor, MD, and Qutub Khan, MD, represented the UK Kentucky Neuroscience Institute’s epilepsy program, to absorb the latest to bring back to benefit UK’s epilepsy patients.

To round out their time in California in partnership with INKS, ISN members helped put on a special Family Day conference, which was a more intimate setting geared toward patients and their families. The family day included talks by clinicians and organizations who work with ketogenic diets as well as a few cooking demonstrations. McClintock also spoke to the group about the science of flavor.

“Our partnership between scientists, chefs and clinicians allows use of our shared knowledge and talents in ways that have a positive impact on the lives of people,” said McClintock. 

ISN plans to hold their next symposium in May in Lexington, where they will focus on low salt diets for hypertension patients.