You might love the medical doctors that are a part of your health team. Even I, a chiropractor, has medical doctors or doctors of osteopathy who I love and trust with my health, my families health, and my patients health. Despite this your MD might no be your best source for nutrition education. I was first introduced to this idea a few years ago when, during a discussion on Vitamin D, my primary care physician who was very pro taking Vitamin D gave me a pamphlet to inform me of the benefits. Now I don’t exactly blame him for this because due to the current state of healthcare primary care doctors are in a time crunch to see enough patients to afford to keep seeing patients. They don’t have the time to spend an extra 10 minutes with you to give you at least a partial proper education on nutrition. They also, though, are limited due to a lack of nutrition education while they were in medical school.
What is wild is that there is a complete consensus that nutrition and poor diet is the leading preventable risk factor for disability and early death in the United States. Despite that only around 1 in 4 medical schools have a required nutrition course. According to an expert committee of the Nutrition Academic Award Program of the National Institutes of Health it takes at least 25-30 hours of medical school instruction to achieve basic nutrition competencies. According to research collected from 2000 to 20012 medical students only received a median of 16 hours of nutritional education. Meanwhile, the percentage of US medical schools that do no require any instruction on nutrition increased from 5% in 2000 to 10% in 2012. A follow-up study published in 2016 found theses numbers have not meaningfully improved. In colleges of osteopathy the numbers are worse. Analysis of data collected from 30 US colleges with a DO program revealed that most osteopathic colleges did not provide 25 hours of nutrition education and close to 1/3 only provided one half the recommended minimum of nutrition education. Only 25% provided clinical training in nutrition and those were only about 4.1 hours.
When your experience as a patient is to be handed a pamphlet in response to a request about nutrition how serious are you going to handle that advice? For many of us our physicians yield a great amount of influence over our health, if they new what to say and how to say it more patients would make positive changes in their nutrition. Instead, many physicians decry what they call fringe nutritional advice despite a complete lack of even the minimum in nutritional education. Right now the big push from the medical field is diets associated with this acronym DASH. DASH stands for Dietary Approaches to Stop Hypertension. It emphasizes eating whole grains, fruits, and vegetables, and limiting salt. The National Heart, Lung, and Blood Institute came up with it to help people lower their high blood pressure. The Mediterranean diet also emphasizes fruits, vegetables, and whole grains, with moderate alcohol intake. Both include lean proteins such as chicken or fish. If you ask your medical provider about nutrition be prepared for a response that likely includes handing you a pamphlet.
There are resources for medical doctors and hospital systems to help improve nutrition education through post grad programs. There are a number of online resources that doctors can elect to take. Hospital systems are starting to build healthy kitchens to teach the community healthy nutrition. I have heard such a thing is coming to our Delnor-Community Hospital in the near future. In general the practice of medicine in the U.S. is adverse to change which has everything to do with the complexities of the business of medicine.
If your medical doctor is not a reliable source of nutrition education where should you turn when you are instructed to eat healthy. One place is the internet which is full of information which is difficult to discern what is credible. Another is from people like us, chiropractors who tend to endorse nutritional advise which is outside of what is typical. I cannot speak for every chiropractor but many who I know, including myself, base my recommendations off of what is in the literature. I don’t think every diet is right for everyone. In other words, one diet that works for patient A may not work or patient B and vice versa.
The general diets I believe have the best health benefits include the paleo diet, gluten free diet, ketogenic diet. The paleo diet is easiest to follow as a lifestyle and ketogenic diet has great potential but is much more difficult to follow as a lifestyle. Likely it is best to alternate between the two with periods of intermittent fasting in between. Intermittent fasting is another topic of discussion perhaps. In the past we had a class at the office which taught low glycemic index/load lifestyle of eating but I found that almost too complex for many patients to follow. Starting in February 2018 we are going to have periodic workshops in the office on the paleo diet based on the book The Paleo Cardiologist written by a cardiologist. It is a great resource to understand the paleo diet and to get you into it if you want to learn more. Contact us to learn about our next class or book us to present this topic with your company or group.