So Much Nutrition Taught In Medical Education…REALLY?

Which doctor said that?

Nutrition is fundamental to enjoying good health. Though we all come to the table with varying ideas about what good nutrition looks like, the reality is that the common denominator is whether it can sustain healthy life.

This article is about recognizing the need for doctors to be better skilled in helping their patients to turn their health around by improving their eating habits.

Although more and more people are waking up to the idea of nourishing food being the key to good health, for many doctors their knowledge of nutrition seems rudimentary to say the least.

A relative of mine was some time ago diagnosed with type2 diabetes. So he and his wife met with his GP to map a way forward. Now let me say upfront this was a businessman, an academic who spent lots of time away from home, and (I’m making an ‘academic’ guess here), probably didn’t eat well.

His wife asked the doctor if there was another way of addressing his condition, rather than taking the multiple medications advised.

He looked at her askance and said, ‘That’s like asking if you can be just a wee bit pregnant. No, once you are diabetic that’s it. It’s a chronic condition. You’re on medication for life.”

Cold comfort!

The fact is, he did take the medication for a few months, and following the dietician’s advice, and his wife’s cooking, his blood sugars continued to rise, especially after a carbohydrate-laden meal. He neither felt well, nor did his sugar readings convince him that he was on the right track.

And so he and his wife began their research. And on their journey they found this quote on Diabetes Victoria,

‘The key to managing type 2 diabetes is achieving and maintaining a healthy body weight, making healthier food choices and being as active as you can be, every day.

Healthy eating for people with diabetes is no different to what is recommended for everyone — there is no such thing as a diabetes diet! ‘

My relative is tall and slim, and also energetic, so this certainly didn’t stack up. Nor did it give him confidence in the nutritional advice he was receiving.

There had to be a better way.

Some six months later, after a check up, and when he had read assiduously, and implemented a different dietary protocol, where not only did he get the results he wanted, but felt so much better as well, he was subsequently asked to make yet another appointment with his GP. Anxiously he arrived in his office to be told, “I don’t know what you’re doing, but whatever it is, keep doing it,” after which he read out an extensive list of perfect results, (and then wrote out further prescriptions), and billed him for his happy news!.

Prescriptions when his test results were over-the-top excellent?

Now, if I were doctor I’d instead be asking a few questions, things like:

• What exactly have you done to make these improvements?
• Are you still taking your medication?
• Are you exercising more?
• What do you eat?

He asked none of those things, no questions at all.

I would not suggest that he is a careless doctor, but a busy one who just follows the creed he knows best.

But that can be improved on

In Britain in particular, medical students assert that they learn very little about diet and lifestyle in their university study.

They also feel that their training lags behind the reality of what they see when involved in practicum work.

It’s no fairy tale that a very large percentage of illness is directly attributable to lifestyle and diet. There’s talk about processed food being the culprit. But the counter argument to that is that humans have been processing food for a very long time.

Roasting and drying, and fermenting are ways of preserving, and cheese-making has been around for many years in different forms. None of these is a problem.

But beware the ultra-processed

It’s the ultra-processed, the scientifically-produced food that we need to tread carefully with. Historically speaking, this kind of food is the modern-day new kid on the block. Laced with chemicals, with additives that bear no resemblance to food, cheap to produce and very, very addictive, it is also affordable.

Even more important it has a long lifespan. With little to no nutrition, it can survive in your pantry forever.

‘To make these foods, cheap ingredients such as starches, vegetable oils and sugars, are combined with cosmetic additives like colours, flavours and emulsifiers. Think sugary drinks, confectionery, mass-produced breads, snack foods, sweetened dairy products and frozen desserts.’

Selling points

All you need to make products take off in a mad scramble are things like, affordability, addictive flavors, satisfying crunchiness, coupled with super-clever marketing, and we’re off at the races.

Processed food will have you eating more. It’s designed that way. It’s a science. Sadly it impacts our health and the more we eat of it, the more sick we become.

Yet it’s a booming industry, harmful to us, and harmful to our planet, and the proponents of the industries, the big players such as Coca Cola, and McDonald’s do not have your health front and center of their concerns.

‘Their policy to be part of Rising consumption also reflects Big Food’s political power to undermine public health policies. This includes lobbying policymakers, making political donations, funding favorable research, and partnerships with community organizations.’

Such power! How can we possibly fight them? Yet we must not stand on the sideline and accept this as something we can have no control over.

‘Whether you think you can, or you think you can’t — you’re right.” Henry Ford

We must first change our attitude. That is what will determine our success or failure. It’s a bit like eating an elephant, just one determined bite at a time, and over time the transition is made.

One of the things that medicos can do is to skill themselves in the nutrition debate and passionately care about really turning the health crisis around. They could, for instance:

Re-frame nutrition as the health issue that it is

If ever there was a need for the medical profession to be both informed and proactive, this is it.

When someone walks into their GP’s office and asks the question, Why am I fat? The doctor should have his own arsenal of ideas for solving the problem, and helping the patient.

Writing more and more prescriptions, is often little more than tinkering around the edges of the issue.

Thinking of ways to improve their practice could be advantageous. Setting up small educational agencies such as the following could help.

• in-class nutritional education
• cooking classes
• helping patients to read and understand food labels
• teaching patients how to plan healthy, yet affordable meals

When affordability is an issue…

Setting up community partnerships aimed at providing greater patient access to more condition-specific, healthy foods by:

• Working with government agencies to provide assistance
• Engaging local farmers markets and other low-cost produce sources to sell to them through a voucher system
• Launching ‘food pharmacies’…and providing in turn, ‘food prescriptions’ for those with chronic health issues

Why not guide our children when they are young?

In schools we can simply disallow processed foods. I recall as a teacher, our making the canteen a not-for-profit agency for a time,where the children could only buy fresh produce, or sandwiches. I know, sandwiches can be an issue, but Rome wasn’t built in a day!

The children bought the food because they knew there was no alternative. Sadly, we only tinkered around the edges with that one, and gradually things slackened, and horrifically-bad food was sold once again.

These days, however, we are fighting an ever-increasingly steep climb in terms of protecting our children, and this is our chance to do what is right, to convince young people why it is better to stop buying ultra-processed products.

We can lobby for school canteens NOT to buy ultra-processed products. For that to be effective, training for management must be put in place.

We can set up initiatives to teach children how to cook.

With the evidence that ultra-processed foods are harming our health and the planet, we must now ramp up ways and strategies to say no to large corporations.

Simply telling people to “be more responsible” is unlikely to work, when Big Food companies spend billions every year marketing their increasingly unhealthy products, and when those same companies boldly fund public health organizations, a serious conflict of interest exists.

And for us as individuals the advice is simple. Shop the periphery of supermarkets if you choose to shop there. But if you really want great food, shop at your local farmers’ markets. We need them and they need us.