Yves here. While the push for all doctors to get some training in nutrition is all well and good, maybe lawyers should look at what works in nutrition science and get back to me. There is painfully little in the way of good support due to the lack of solid studies. It takes a lot of long-term efforts with regular and accurate reporting. The strongest ones have nurses as a sample group. Many people lie about what they eat and how much they eat.
A related issue is that what I have seen in my limited interactions with nutritionists is enough to make one bored. Check out the meals offered by many hospitals. Those menus are created by nutritionists. My mom was served things I wouldn’t say no to, like turkey on white bread, pasta with red sauce, canned fruit with sugar and breakfast cereal (and I don’t mean oatmeal).
One of my sisters at home got a Masters degree in nutrition science. Maybe things have changed since then, but he said there are two types of programs, one is for people who intend to work for one of the big food companies and learn how to make fast food and junk food, and the other is more focused. health effects. The problem is the latter I don’t know what you read. For example, she got pregnant after graduating. Her doctor told her that she needs to eat more protein. He told me that he started eating cheese every day to do that.
Cheese is a very inefficient way to get protein. A pound of hard cheese (and he ate hard cheese) 54 calories fat v. 32 from proteins. And she was already chubby when she got pregnant, so it wasn’t like she needed to increase her body fat level.
Another fad is dietary advice, which is the result of basic difficulties in doing good studies. Limited wine is ready for you! Any alcohol is bad for you! Coffee isn’t good for you before it’s good for you. At least tea seems to always be good for you….unless you drink it the British way, with milk.
Now I faced one case, but he was found by what I called the sports mafia, a group of highly skilled doctors and trainers who worked mainly with professional athletes, who competed in the Olympics, and a few ordinary people who received rehabilitation help. . Remember that bodybuilders and athletes eat their game. There are real stakes here, hence some practical attention. Nutritionists may remember The Zone fad, which was developed for distance athletes such as runners and long-distance swimmers (The Zone works but you have to control your health and most quit. Similarly, pizza is very suitable. for football players before competition, it turns out, because of the time to take the -caloric after eating.
The professor in question taught nutrition at Ohio State and also practiced medicine about half the time, and conducted nutritional trials on cooperative patients. He had issues like finding a patient with a total cholesterol of 400, but he wasn’t worried about it because his HDL was 300.
When I was in his speech (about 20 people, I was the only one who wasn’t a coach), he called out, “Does anyone have any cookies here?” A woman raised her hand limply. He was carrying a small packet of supposedly healthy cookies.
He said, “I guarantee the second or third ingredient will be hydrogenated oil.” It was number three.
He continued, “It’s a deterrent.” It keeps cookies from going bad. Those things are removed from the diet so that if you put a pound on your counter, in a year it will not change. Even cockroaches won’t touch it. “
Admittedly this is anecdata, but I’ve never seen anything written by nutritionists to make me change my generally bleak outlook.
By Nathaniel Johnson, Assistant Professor of Nutrition and Dietetics, University of North Dakota and Madeline Comeau, Student of Medicine, University of North Dakota. Originally published on The Conversation
In television shows like “Grey’s Anatomy,” “The Resident” and “Chicago Med,” doctors always seem to have the right answer.
But when it comes to food and diet advice, that may not be the case.
One of us is an assistant professor of nutrition and dietetics; the other is a medical student with a master’s degree in nutrition.
We both understand the powerful effects that food has on your health and longevity. A poor diet can lead to cardiovascular disease, diabetes, obesity and even mental conditions such as depression and anxiety. Diet-related diseases are the leading cause of death in the US, and unhealthy diets cause more deaths than smoking.
These health problems are not only common and debilitating, but they are expensive. Treating high blood pressure, diabetes and high cholesterol costs about $400 billion a year. Within 25 years, that cost is expected to triple, to $1.3 trillion.
These facts support the need for physicians to provide accurate dietary advice to help prevent these diseases. But how much does the average doctor know about nutrition?
Lack of nutrition education occurs at all levels of medical training.
What Doctors Don’t Know
In a 2023 survey of more than 1,000 US medical students, nearly 58% of respondents said they received no formal nutrition education while in medical school for four years. Those who did an average of three hours of nutrition education per year.
That’s woefully short of the goals set by the American Nutrition Committee on Medical Education back in 1985: that med students should get a total of 25 hours of nutrition education while in school — more than six hours a year.
But a 2015 study showed that only 29% of medical schools met this goal, and a 2023 study shows that the problem has gotten worse — only 7.8% of med students reported 20 or more hours of nutrition education in total. four years of med school. If this is representative of medical schools across the country, it has happened despite efforts to strengthen nutrition education through many government programs.
It is not surprising that the lack of education has had a direct impact on the nutritional knowledge of doctors. In a survey of first- and second-year osteopathic medical students who answered a nutrition knowledge questionnaire, more than half passed the test. Before the test, more than half of the students – 55% – felt comfortable advising patients on healthy eating.
Unfortunately, this problem is not limited to US medical schools. A 2018 international study concluded that regardless of country, nutrition education for med students is universally inadequate.
Restoring Nutrition Education
Although evidence suggests that nutrition education can be effective, there are many reasons why it falls short. Medical students and doctors are some of the busiest people in society. The amount of knowledge taught in the medical curriculum is often described as overwhelming – like drinking from a fire hose.
First- and second-year medical students focus on intensive topics, including biochemistry, molecular biology and genetics, while learning clinical skills such as interviewing patients and understanding heart and lung sounds. Third and fourth year students practice in clinics and hospitals as they learn from doctors and patients.
As a result, their schedules are already crowded. There is no place to feed. And when they become doctors, it doesn’t get any better. Providing preventive care including nutritional counseling to patients will take more than seven hours a week – and that’s not counting the time they must spend on continuing education to keep up with new findings in nutritional science.
In addition, the lack of nutrition education in medical schools is due to the lack of qualified nutrition teachers, as many doctors do not understand nutrition well enough to teach it.
Ironically, many medical schools are affiliated with universities that have nutrition departments with Ph.D.-trained professors; those education students can fill this gap by teaching medical students about nutrition. But those classes are often taught by doctors who may not have enough training in nutrition — meaning that truly trained instructors, where most medical schools reach, are left out of the process.
Finding the Right Advice
The best source of nutrition information, whether for medical students or the general public, is a registered dietitian, certified dietitian or other type of nutrition professional with multiple degrees and certifications. They study for years and write many hours of practice to provide dietary advice.
Although anyone can make an appointment with a nutritionist for dietary counseling, a referral from a health care provider such as a physician is usually required for the appointment to be covered by insurance. So seeing a doctor or other primary care provider is often the first step before seeing a nutritionist.
This extra step may be another reason many people look elsewhere, such as to their phones, for dietary advice. However, the worst place to look for accurate nutrition information is social media. There, nearly 94% of posts about nutrition and food are undervalued – either incorrect or lacking sufficient data to support the claim.
Remember that anyone can post nutrition advice on social media, regardless of their qualifications. Good dietary advice is individualized and takes into account a person’s age, gender, goals, body weight, goals and preferences. This complexity is difficult to capture in a short social media post.
The good news is that nutrition education, when it happens, works, and many medical students and doctors recognize the important role nutrition plays in health. In fact, nearly 90% of med students say nutrition education should be part of medical school.
We hope that the teaching of nutrition, after being undervalued or neglected for decades, will soon become an integral part of the medical school curriculum. But given its history and current state, this seems unlikely to happen anytime soon.
In the meantime, those who want to learn more about healthy eating should meet with a nutritionist, or at least read the Dietary Guidelines for Americans 2020-2025 or the World Health Organization’s healthy eating recommendations.
Source link