Hold The Garlic: A Manhattan Startup Delivers Gut-Friendly Meals To The Digestively Challenged
On a recent evening in Manhattan's Soho neighborhood, stylish guests mingled in a spacious loft office/test kitchen, sipping "mocktails" and sangria and nibbling on Manchego cheese, baby squid and paella. In many respects, this soirée could have been an event for any one of the dozens of trendy meal delivery companies that have sprung up in recent years to cater to busy professionals.
But that's where the similarities ended: All the fare served that evening by Manhattan startup Epicured was gluten-free, and, surprisingly for a Spanish-themed meal, it was notably devoid of garlic and onions. (The trick: using garlic- and onion-infused oils instead.) That's because Epicured specializes in delivering chef-prepared dishes that adhere to the low-FODMAP diet.
FODMAP is an acronym for the five classes of fermentable, short-chain carbohydrates that can particularly cause digestive upset for people with Irritable Bowel Syndrome, or IBS, and other digestive disorders. Patients with Inflammatory Bowel Disease (IBD) may also benefit from low-FODMAP diets with some modifications. A recently installed "extra-sensitive" filter lets patients request dishes with softer textures, less fiber and fewer spices.) Epicured also attracts many customers with celiac disease, who must eschew all gluten. Besides garlic and onions, high-FODMAP foods include apples, honey, watermelon, cauliflower, wheat and many legumes.
The low-FODMAP diet was developed by researchers at Monash University in Australia. It is widely prescribed to patients with IBS, which afflicts about 15% of the population worldwide, according to Monash, and to those with a related disorder, Small Intestine Bacterial Overgrowth, or SIBO. Up to 86% of IBS patients experience symptom relief on the diet.
Typically, a patient's physician or nutritionist, will give them dietary guidelines and recipes for an elimination phase that usually lasts from two to four weeks. That period of avoiding all high-FODMAP foods is followed by a gradual reintroduction of FODMAPs, one category at a time, to identify which ones are problematic and which ones can be eaten without discomfort. But it can be daunting to follow the regimen, particularly if you don't feel particularly handy in the kitchen. And, even if you do love to cook, measuring out your Brussels sprouts portion to no more than 34 grams might just seem like more trouble than it's worth.
That's where Epicured comes in. Many of its customers are Millennials, who are used to ordering in from Seamless or eating out in restaurants, but they may find it challenging to find low-FODMAP options. Cofounders Richard Richard Bennett, CEO–whose previous career included starting a pharmacy chain, Vivo Health, for what is now Northwell Health and working as an investment banker–and Renee Cherkezian, a registered nurse- turned-chef who guides the menu development, consider Epicured a health care company that's deploying "food as medicine."
"I never woke up and said, 'I really want to start a food company,'" Bennett said. "If we are truly going to improve health outcome and population health we need to think of a way to engage in nutrition that’s sincere, honest practical, and can really help people."
About a third of Epicured's clients don't even need to eat low-FODMAP or gluten-free. "They love the taste and convenience of Epicured," said Bennett. On average, nonclinical patients order eight meals a week while clinical patients order an average of 14 to 15 meals a week, spending about $130-150. The average entree costs $11.80. The company's executive chef, Chris Cortez, formerly worked at Bouley and La Vara. All meals are delivered fresh, not frozen, and keep in the fridge up to five days. The company delivers over 3,000 meals a week to customers.
"We want to get around that whole idea of restriction," Cherkezian told me during a visit to the test kitchen, as she used a fork to tease out long pasta-like strands from a roasted spaghetti squash. "We want to make it like they have no restrictions, so they feel liberated in terms of eating and flavor."
One of Epicured's largest investors is Mount Sinai Ventures, the investment arm of the big Manhattan-based health system. Brent Stackhouse, managing director and vice president, said he got interested in Epicured after hearing about the company from Laura Manning, clinical nutrition coordinator at the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center, "I generally invest in things that the experts at Mount Sinai are using or are going to use."
"Because of our distinguished gastroenterology program and our massive IBD center, Epicured fit at a good moment," Stackhouse added. "We're looking at Epicured in the long run to understand how we might expand into other menus where diet and clinical nutrition are proven to improve outcomes." In 2016, Mount Sinai ran a pilot with doctors and nutritionists, who used Epicured with their patients and met with the company. They are now also offering Epicured to employees through its wellness program.
"When it came to evaluating Epicured and the revenue model, we definitely saw a lot of enthusiasm from the patient population," Stackhouse said. But he said he has gotten mixed feedback from the Mount Sinai medical community as to whether people should eat a low FODMAP diet indefinitely.
Alexandra Rosenstock, a clinical dietician for the Center for Advanced Digestive Care at New York Presbyterian Hospital, told me that many of her patients do benefit from following the low FODMAP elimination diet, but her goal is to eventually expand their eating options.
"A lot of high-FODMAP foods are healthy sources of fiber. We don’t want people avoiding them for too long," she said. Still, she said she could see Epicured being useful for about 10 to 12 weeks for patients who don't want to cook for themselves while they are completing the elimination and challenge phases of the diet.
But the truth is some people do stay on the low-FODMAP diet for a long time. "We certainly hope with all of our patients is that they’re able to find relief and some sort of balance," Stackhouse said. "We also didn’t want our patients to be buying boxes of food in perpetuity order to meet their nutritional needs."
To that end, Epicured, with Mount Sinai's help, is educating patients about the low-FODMAP diet so they can be more self-reliant. It plans to install a television studio at its headquarters where they'll offer cooking demos and other programming. And because buying prepared meals can be a financial barrier to some patients, the company is also looking at various solutions to improve access, including philanthropic support, lowering the average cost of meals, offering discounts and working with insurers to get coverage for patients, Bennett said.
Epicured, which has brought in about $6 million to date from investors, is currently raising a $10 million Series A round. The funds will go toward expanding its delivery service, which now ranges from Washington, D.C. to Boston, with the addition of another factory in the South that will enable them to reach from Florida to Maine to Chicago. Bennett said they plan to build a West Coast facility as well. In 2020, Epicured hopes to offer at least one other therapeutic menu for another medical condition.
One newish Epicured customer is Becky Davies, a, certified yoga teacher, health coach and student who is finishing the prerequisites for in a Masters program to become a registered dietician. The Manhattan resident has been diagnosed with celiac disease, pelvic floor dysfunction and SIBO. She said that with her busy schedule it's hard to prepare her own meals all the time. She sees Epicured as a useful tool, rather than a permanent solution.When we spoke she had ordered three times, requesting three meals a week.
"My food is pretty expensive anyway," she said. "It's actually a great option when I have a super-busy week."
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March 30, 2019 at 11:50PM