Food as medicine

Physician, heal thyself, learn nutrition!

It is both puzzling and shocking that doctors aren’t taught nutrition in medical school. That they don’t routinely ask patients what they are eating that is keeping them fat and sick. It’s as if the medical powers that be (who are wedded to the pharmaceutical model) don’t want doctors to know food can be the most powerful, safest medicine or slowest poison.

This is another great blog, a shortened version, by Jerome Burne, an award-winning health journalist and editor of HealthInsightUK

Here’s a really bad idea.

Send a dozen nutritionists to work alongside regular doctors in a Medecins Sans Frontières team providing emergency treatment to the wounded in a war zone: It’s a bad idea because they would lack any relevant skills. They might help speed up recovery but in the operating theatre they’d be worse than useless as the wounded come in.

It’s obviously a ludicrous idea but how is it different to GPs trying to deal with a daily stream of people with chronic disease? With (usually) the most cursory knowledge of nutrition and ways to change lifestyle, aren’t they doing something very similar?

Everyone agrees we have an increasingly unhealthy population with rates of obesity, diabetes, cancer and Alzheimer’s soaring. Many estimates put the proportion of cases that could be avoided by eating well and following a healthier lifestyle at around 50%.

Yet 40,000 skilled and expensively trained GPs sit on the front line to deal with patients needing help with nutrition and lifestyle with no real knowledge of how best to do it. The only difference between them and the theoretical nutritionists in an operating theatre is that their patients die over years rather than hours.

Why this mismatch between medical skills and what patients need has to change was the focus of a conference held last week. Food: the Forgotten Medicine was organised by the College of Medicine and held at the Royal Society of Medicine in London. [See Programme – PDF] The speakers were nearly all doctors or clinicians who had already incorporated nutrition into their practice.

They talked with passion and authority on how this approach can offer GP’s a far more sophisticated set of options to deal with the myriad problems that come with chronic disease. By the end it was all too clear that the existing tool box GPs and other medics currently rely on to deal with chronic metabolic diseases – eat a healthy balanced diet and try to get a bit of exercise – is desperately in need of a massive upgrade.

The grand old man of nutritional medicine, American Dr Andrew Weil, took us on a whistle-stop tour of some of the possibilities.

“A patient is more than just a physical body,” he began, immediately introducing a much broader perspective than the one usually available in a time-poor GPs surgery, emphasising the importance of such lifestyle issues as sleep, ways of handling stress and social connections as factors that can help or hinder health.

All of which can directly impact on such an obviously physiological problem as raised inflammation, often found in people with chronic disease.

One of the attractions of sophisticated nutrition is the number of options – nearly all low risk when used carefully – that may work for different conditions. So another route to bringing down inflammation is to reduce intake of polyunsaturated vegetable oils, used for cooking and found in processed foods.

This is now controversial since vegetable oils have long been sold as the healthy option, in contrast to those dangerous saturated fats, but the evidence increasingly suggests that the two should swap approval ratings.

Jerome BurnHere again, a good grip on nutrition is needed to help patients to understand the evidence and to make this switch not just with fats but also to make sense of the confusion currently swirling around the debate over the benefits of a low carbohydrate diet.

Click here for a full version of Jerome Burne‘s (left) blog, Doctors can only tackle chronic disease with the right tools. Teach them nutrition


Related reading:

UK ‘Fat Wars’: Martin Luther moment for medicine?