When Preston Maring graduated from medical school almost 35 years ago, he wouldn't have predicted that an 8-inch chef's knife would be his most powerful weapon in the fight against chronic disease.

But that's exactly what happened. "It's the best public health tool I have," he says.

That's because Maring is convinced that fresh, nutritious foods improve people's health, and that cooking is a crucial way to include them in our diets. But so is selecting healthful ingredients -- the kind often sold at farmers markets. To that end, in 2003 Maring spearheaded the Friday Fresh Farmers Market at the Kaiser Permanente Oakland Medical Center in Northern California, and since then has become widely known as a national advocate of a movement to establish farmers markets at other hospitals.

Trained as an obstetrician and gynecologist, Maring, a tall man with an easy manner and comfortable good looks, joined the staff of the Oakland hospital in 1971 and rose to become its physician in chief. In recent years, because of his commitment to fostering healthful cooking and eating, he's been able to cut back his administrative responsibilities. He now spends about 40 percent of his time working on food issues -- showing people how to select and cook food, explaining the health consequences of food choices, creating recipes for his blog.

Junk food out of place in a hospital

His professional path hasn't exactly been the path most doctors would take. But Maring is not most doctors.

Although he graduated at a time when young doctors could look forward to healthy incomes and prestigious positions in the community, Maring signed on with Kaiser, a total care hospital system that provided him with a competitive salary, but not the potentially much larger income he could have earned in a fee-for-service hospital.

"I liked the way Kaiser was structured," he says now, emphasizing the time- and money-saving aspects of the partnership between the medical staff and the owners of the hospitals. "Your only incentive is to do the right thing."

He was also attracted to Kaiser's emphasis on community health and its focus on preventive care. And that, he says, "ultimately helps the bottom line."

Maring wasn't a food system activist when he began thinking about setting up a farmers market at the hospital in 2002. But he'd always liked to cook, and he'd shopped at farmers markets long before words like "locavore" and "sustainability" became common.

Then one day, while walking through the hospital lobby, he was struck by the "assortment of junk" for sale there, and questioned what that had to do with health care.

"I thought we ought to be selling something that makes sense," he says. "Like fresh fruits and vegetables."

The fact that a farmers market wasn't first on the hospital's list of desirable add-ons, or that the only outdoor space available at the hospital was not ideal -- irregular, about 120 feet long and 15 to 20 feet wide -- didn't deter him. "It seemed so obvious to me," he recalls.

Allies and impact

A practical man, Maring started by seeking support from his colleagues at the hospital. That was the easy part. More challenging was figuring out how to set up a viable market and anticipating issues such as the impact on groundskeepers and cleanup, and the potential effect on local grocery stores. "We wanted to create something good without any downside," he says.

Looking for models, he visited as many area markets as he could and particularly liked the ones he saw in Oakland -- the diversity of people shopping there reminded him of the staff of the hospital. One July day, a vendor at local market told him if he wanted to learn how to set up a market at the hospital, he should speak with John Silveira, the head of the Pacific Coast Farmers Market Association, who was standing 10 feet away and then managed 22 markets. Silveira was not only able to guide him, but shared Maring's vision of creating good health in the community.

That impact is what continues to drive Maring, particularly on an individual basis. Although he's educated himself on things like the intricacies of the U.S. Farm Bill, on SNAP (the supplemental nutrition assistance program that used to be known as food stamps), and on school food, he sees his contribution as educating people one at a time. That's what he hopes results from activities like his public appearances, his website, and his outreach to the constituents of local farmers markets.

The feedback he gets from people who write to say how he helped them change their diets, their health and their lives is encouraging. But some encounters are particularly meaningful. At a market in the Watts section of Los Angeles a while back, he encouraged a local kid named Charles to help him in a cooking demonstration by cutting up vegetables, and showed him how to do it. "If I can do it, anybody can," he told the boy.

A year later, Maring got an email from Charles, telling him he was still at it. "I love making stir-fries," he wrote. Says Maring, "It was the biggest gift I've ever gotten."

Judith Weinraub has won two James Beard Foundation journalism awards. She worked for 25 years as a reporter and editor at the Washington Post, where she wrote about food and politics as well as arts and culture. Weinraub has also been a W.K. Kellogg Foundation Food and Society Policy Fellow. Last year she conducted an oral history project for New York University's Fales Library, recording the memories of people who have changed the way Americans think about food.

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