Science of nutrition has long been ignored in medicine

GUEST COLUMN: Dr N Prabhudev

Bengaluru, July 1: When I was in medical school, I learned very little about nutrition. Sadly, this is the case for most doctors. If food is medicine, why isn’t it taught at medical schools? Students in medical schools across the country spend less than 1 percent of lecture time learning about diet.

Just 10 to 14 percent of doctors feel qualified to offer that nutrition advice. How did the gap get this wide?
The best way to lead a healthy life is through proper nutrition. Today nutrition is rarely discussed during patient visits because doctors seldom broach this subject with their patients. Until nutrition becomes a consistent part of patient-doctor conversations, we will continue missing a major opportunity to help people live longer, healthier lives. Online nutrition courses designed as continuing medical education can be a quick and highly effective way to provide physicians with practical information for engaging patients about nutrition.

Nutrition, when done right, can create more health than all the pills and procedures combined. I know this is a big startling idea but I really mean that. If we do it right, if we eat the right food, we get away from drugs and its side effects and we can be healthy.
There’s not a medical school that properly teaches nutrition.

Among the 130 or so medical specialties and sub specialities – that we now have, not one is called nutrition. So, here’s a problem. The professionals who are supposed to be offering us their services in the area of health care, and not been taught the one subject – Nutrition, that is the most important, in my view, of all.
Nutrition education in medical schools has historically been inadequate. In India Despite the critical link between diet and health, most medical students receive fewer than 20 hours of nutrition training during their four or five years of school. Only about one-fifth of American medical schools require students to take a dedicated nutrition course. It’s essential to address this gap and prioritize nutrition education for future physicians.

Doctors with solid nutrition knowledge can empower patients to make informed choices, improve health outcomes, and prevent disease.
Although food and nutrition have been studied for centuries, modern nutritional science is surprisingly recent. The first vitamin was isolated and chemically defined in 1926, less than 100 years ago, ushering in a half century of discovery focused on single nutrient deficiency diseases. Research on the role of nutrition in complex non-communicable chronic diseases, such as cardiovascular disease, diabetes, obesity, and cancers, is even more recent, accelerating over the past two or three decades and especially after 2000.
A global epidemic of diet related chronic disease has prompted experimentation using food as a formal part of patient care and treatment. One of every five deaths across the globe is attributable to suboptimal diet!
Nutrition Renaissance is needed to deal with most diseases!

An ounce of prevention is worth a pound of cure.
We should eat whole foods. Whole foods, not the individual nutrients and food fragments within them. Nutrient supplements- is a huge industry- multi-billion dollars a year. Fifty percent of the population uses nutrient supplements as a means to nutrition. Nutrients taken out of the food and out of the context, do not do exactly the same thing that they do when they are in food. When you take it out and use it separately, we get a different response than the whole food.
Chronic disease is defined by the World Health Organization as being of long duration – three months to one year, generally slow in progression and not passed from person to person. Most chronic illnesses do not fix themselves and are generally not cured completely. Lack of good nutrition is “the basis of most of the chronic diseases that people worldwide suffer from. Lack of proactive action on nutrition reflects the “sick care” system, in which we clinicians wait until a patient has an obesity-level body mass index -BMI or out-of-control A1C in diabetics before making a referral for a diet or lifestyle intervention.
Nutrition Gets Short Shrift in Battle Against Chronic Disease. Good nutrition is foundational to preventing chronic disease and helping people live a healthier life, and yet physicians in a survey believe that only about half of their patients would benefit from counselling on diet.
The Number of patients who could benefit from some nutritional guidance from a health professional is 100%. Patients with other conditions or co morbidities — including hypertension, dyslipidaemia, digestive disorders, and food allergies — could also benefit from discussions on nutrition.

Our food choices have an unparalleled impact on our health, and we can make better choices when physicians become more effective advocates for proper diet and nutrition.

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