Nutrition first – a doctors’ duty

Research has increasingly pointed to a link between nutrition and chronic disease. Between the growing list of diet-related diseases and a burgeoning obesity epidemic, the most important public health measure for us to take may well be watching what we eat and teaching our children about the role that food plays on their health and well being. I believe it’s time to focus on health and not disease and to educate patients on preventative medicine. Our role as health and medical practitioners is no longer only about writing scripts and medicating. Our role is to prevent disease and make people well using a variety of treatments and approaches -- one of them being food.  Food as medicine is an old term used by many still today. It is powerful and something very much essential to our lives.
"Let your food be your medicine and your medicine be your food" Hippocrates 460 - 359 BC

Medical practitioners often get asked the following questions:
“I just read that removing milk is good for asthma, is this true?”
“Are allergies related to the foods we eat?”
“My child has ADHD, does sugar affect the condition?”
“I read a scientific study that says that I can reverse my diabetes through diet; I don’t need medication, is this true?”
“Are vitamins good?”
“Should I give my child Omega 3”?
“What do you think of this diet?”

Many of these questions are unrelated to medication or operations, but are food related.  People are hungry to know what they should be consuming so there’s no choice but to get savvy about nutrition.

In the mid-1980s, the National Academy of Sciences in the US published a landmark report highlighting the lack of adequate nutrition education in medical schools; the writers recommended a minimum of 25 hours of nutrition instruction.

According to the New York Times, researchers from the University of North Carolina at Chapel Hill asked nutrition educators from more than 100 medical schools to describe the nutrition instruction offered to their students. While the researchers learned that almost all schools require exposure to nutrition, only about a quarter offered the recommended 25 hours of instruction, a decrease from six years earlier, when almost 40 percent of schools met the minimum recommendations. In addition, four schools offered nutrition optionally, and one school offered nothing at all. And, while a majority of medical schools tended to intersperse lectures on nutrition in standard, required courses, like biochemistry or physiology, only a quarter of the schools managed to have a single course dedicated to the topic.
Nutrition is really a core component of modern medical practice.

It is now common knowledge that diet is the building block to good health.
A classic example of the role nutrition plays on health is contained in a study last year by Newcastle University which found that a two-month extreme diet can cure type 2 diabetes and overturn assumptions that it’s a “lifelong” condition.

The results of the Newcastle investigation -- even though the study was small -- demonstrated that full recovery from diabetes type 2 was possible, not through drugs but through diet.
Eleven people with diabetes took part in the study, funded by Diabetes UK. They had to slash their food intake to just 600 calories a day for two months. Three months later seven of the 11 were free of diabetes.
There are scores of other examples of the impact of diet and nutrition on health – all well documented. See the references below should you wish to explore further.
So, rather than only writing out script after script, diet is just as important as drugs or any other treatment a patient may be using.  

Taking a drug to lower blood sugar without making lifestyle changes is a classic example of trying to deal with a problem without going to its root. Another is taking a pill to suppress stomach acid so that you can eat foods that cause heartburn.

While it’s extremely difficult to get people to change their diets, if this is communicated by a doctor – particularly the trusted family doctor -- patients are more likely to listen.
Paediatricians, especially, have a responsibility to assist parents in educating their children on how to eat, particularly since obesity is on the rise globally.

Medical practitioners have the power to influence the diets of their patients and even future generations. Providing early guidance, referring patients to nutrition experts and making nutrition information easily accessible to their patients, can help elevate the role of nutrition in childhood and influence overall health and well-being.

From my experience with clients, many parents know very little about nutrition. Why would they? Schools don’t teach us. Only now, due to an overload of information, are we asking more as we learn more!  Parents want credible information and will often seek this from their doctor – and this is where medical practitioners can make a huge difference in helping prevent childhood nutrition challenges and even diseases later in life.

Imagine being in a position of being able to help prevent chronic illnesses, obesity and mental disorders simply by providing guidance in terms of food and diet.
We can effectively help prevent obesity by educating families on nutrition and healthy lifestyle behaviours and intervening with tailored treatment modes when necessary.

Paediatricians and GPs could also make credible print information available at their practices and refer patients to credible health websites. But GPs and paediatricians can’t do it alone – they could partner with registered dieticians and nutritionists for the overall benefit of their patients’ health.

The goal going forward should be integrating nutrition into clinical practice, medical education & community health. It makes sense as a duty and service to our patients that we focus on their health and not their disease.

Vanessa is a nutritional consultant and holds a Master’s of Science in Nutrition.