Think Doctors Know Nothing About Nutrition?

How could doctors not know much about nutrition? Here's an example:

"The average training in nutrition for a physician in a 4 year medical school program is 2 1/2 hours." - Sherry A. Rogers, MD, in her book, "The Cure is in the Kitchen"

As a number of you have essentially suggested, you have to follow the money. For example, medical school curriculum development is largely financially supported by the pharmaceutical industries. So its not a surprise that "the machine always wins", be that machine a piece of technology, a pill, or what have you.

Up to the first few years of the 20th century in the U.S., physicians in general and medical school professors in particular looked down on pharmaceuticals, warning people to stay away from "those dangerous patent medicines". After the advent of penicillin, however, the pendulum swung the other way, where it's been stuck even since.

On the subject of what oils are safest for human consumption, here is a link to the best book I have seen on that subject. While the author's background is unconventional, he does know his science:


www.willmountain.com...


He only sells this book online, at his website. I'm going through my 2nd copy so far, which I have heavily annotated. Plus I bought about 6 other copies so far to give to families and friends, 2 of whom are health professionals.

Examples of his recommendations include buying only unrefined oils. Hint: The product packaging, according to current FDA law, does not have to say the product is refined (at high heat) oil, but it can only use the word unrefined on the packaging if it is unrefined (produced at only low temperatures which preserve all the oil's nutrition and avoids creation of free radicals). One maker of unrefined coconut oil (and their website) is named in his book. BTW, I recently say unrefined coconut oil from another manufacturer at The Coopportunity market in Santa Monica, California. If that is not your neck of the woods, here is the website of that manufacturer:


www.deliciousorganics.com...




[edit on 9/16/2008 by Uphill]

Starred! Great post and Great Info!!

"The average training in nutrition for a physician in a 4 year medical school program is 2 1/2 hours."

This was my point exactly. The nutrition that is taught to doctors is rudimentary and short lived, at best, and yet the general population follow the advice of their doctors ignorantly.

-Dev

This is just me personally but I think doctors have to know enough as it is. They should just stick to the needles and diagnostic work, and leave diet and nutrition to those who specialize it. Nutrition and dieting is so complicated that I think that is one thing that doesn't also need to be dumped on a doctor. But a doctor should also have the capability to easily refer to someone to a nutrionist, and that person should also be covered by insurance.

reply to post by nixie_nox


Someone else mentioned this earlier in the thread. My response was something like this:

If they're not going to learn it, then they don't need to prescribe it. People will blindly listen to whatever a guy in a white lab coat says. Unfortunately, this can be detremental to one's health.

Referring is problematic, in my opinion. Problem is, nutritionists still only need to have a 4 year degree. I've run into my fair share of RD's who couldn't tell the difference between glucogon and glycogen. I suggest figuring it out yourself. You can start by listening to a dietetic , but don't stop there. Get as many opinions as you can. Sniff out the myths and misinformation and you might do yourself some good.

Originally posted by Scramjet76
reply to post by Badge01

 

Yeah I'm sure doctors have a lot on their mind and if you were in a healthy weight range... then guess he didn't think anything of it.

[edit on 17/9/2008 by Badge01]

As someone who's powerlifted and trained others for nearly 10 years I think I know as well as you that the problem isn't lack of education. It's lack of giving a crap by nearly everyone.

If I never got paid by the hour doing personal training and nutritional advising, I'd end up cutting myself. Doctors get paid by the visit and they don't have all day to listen to people pretend to be interested in dieting and then have them go home and eat an entire cake.

You know how stupid and lazy people are. Even if they shell out a couple grand over a long period of time, ultimately, unless fitness is a serious hobby, they'll quit in short order.

Maybe doctors don't spend a lot of time directly on nutrition but I'm sure during their education they end up coming across more than enough to be qualified to give advice. Even if there was such a thing as a PhD in nutritional science and all doctors had one, I would wager any money it wouldn't matter.

The majority of America isn't obese because of anything to do with doctors or lack of trying on their part.

[edit on 17-9-2008 by ANoNyMiKE]

reply to post by Badge01


Haha, oops. Typo!

Thanks for the correction Badge01!

reply to post by ANoNyMiKE


Did you happen to see the interview by Suzanne Somers last night.

Though she's undoubtedly had plastic surgery, she attributes her youthful appearance to proper diet and exercise and avoiding foods with additives.

It's amazing. She's 62 years old and looks 30. Seriously. Plastic surgery could -not- account for the youthful look of her skin.

Now, maybe she's a freak like Vicky Lamotta who looked 30 when she was 65. But my point is, Doctors SHOULD be very interested in and concerned about diet. (I'd be surprised if she's not also on a life extension regime, and she does talk about taking 'hormone replacements' so no doubt that includes hGH and other things)

To me the stuff you put in your mouth has a direct bearing to your health and your aging. From various disease to simply aging, I think it can have a more important effect than any drug (over time).

Doctors in the Far East (China) focus on 'health' and not on 'illness'. Indeed the patients don't pay if they become sick, only if they stay healthy (IIRC).

I know my doctor cares about me - we're friends in addition to the doctor patient relationship. As I said, I don't know why he failed to react. Maybe he was just confused or too concerned about my lab results.

Good point though. The system has changed Doctors and made them refocus on staying in business. It's hard to find that family doctor who really cares about his patients theses days.

reply to post by ANoNyMiKE


I have dealt with a lot of people on the diet issue too. As a former and successful member of weight watchers, many people end up there because their doctors tell them to lose weight and leave it at that.

Or the dumbest advise I hear doctors give. Cut calories. Its like telling an alcoholic to stop drinking. Gee.


So lets say you have someone completely undeducated about nutrtion and diet and they need to lose weight. They have gained weight because they eat 200 extra calories a day. So they say "alright, giving up my evening cookies." Cookies are 200 calories, after a few weeks they don't lose a pound and can't figure out why and get discouraged.

Losing weight, just like quitting addiction is 90% mental and 10% physical.
Yes the physical makes all the differnce, but if the mind isn't behind it, it isn't going to work.

I have had doctor friends complain that they tell their patients to lose weight and watch them grab a candy bar on the way out the door.

HELLO, it is called emotional eating. By having a professional confirm your worst fear, they go to sooth some feelings of low self esteem with food.
It is not laziness or apathy. It is people with psychological and food related issues. Get to the root of those issues, and you can start solving the eating problem.
People eat for positive psychological reasons too. Say that every week grandpa took you to the park and then got you an ice cream cone. Created warm and fuzzy feelings. You want to re-create those feelings, so you get an ice cream cone.

Yes, exercise can help a lot with everything: with depression, with stress, etc.
The thing that people always fail to inform new dieters is that if exercise is gonna work, it has to be fun.

No one is going to stick to a program where you gallop along a treadmill for 30 minutes. Those were usually the longest 30 minutes ever.
Exercise doesn't have to be the treadmill, eliptical machine, or bike. While you savagely watch the clock waiting for your boredome to be over.

There is dancing, rollar blades, hiking,karate, yoga. Even the dance revolution pad at home.
If you like your exercise, you are gonna go.
When it actually produces a hobby like dancing, where you are developing a skill at the same time, you are even more likely to go. And a lot of times you can't wait.

The fact is that there is a lot of mis-information, lack of information, and bad information going around.And I have watched so many people struggle who just can't get good information to help them along.
And so much information conflicts it is not even funny.People feel lost, abaondoned, and ignored.
And negative feelings create negative consequences.

A study came out recently that reported people lose weight just by writing everything down. When they can actually see how much they are eating, they tend to cut back.

No one wants to be oveweight or obese. No one really likes feeling that way. So to sit there and assume they are just lazy or just don't care is callous un-empathetic.
What people need is to get to the root of the problem and figure out why they use food as a crutch. What sets them off. What are their triggers?
And how do you go about fixing that? Then the rest will follow. The better the person feels about things, the more capable they are of taking care of themselves.
You basically have to treat overeating like depression. And a lot of it is a result of depression.

reply to post by nixie_nox


reply to post by ANoNyMiKE


Both of you made very good points. Stars for both of you!

Mike, you're right on. Too many people just don't care. I see it everyday. I would say there are two types of personalities on this end of the spectrum. There are those who are apathetic and those who are just flat out ignorant.

Even if they shell out a couple grand over a long period of time, ultimately, unless fitness is a serious hobby, they'll quit in short order.

I agree with this statement in the sense that most trainers and nutritionists just have their clients go through the motions. Do this, do that and you get this. I, on the other hand, strive to educate my clients because I know that if I can teach them not only the hows, but the whys also, they're more likely to continue once I've finished my job.

Nixie, at the same time, I agree with your point that not everyone is just lazy. Not only are there those who eat emotionally, there are also those who have tried multiple times to lose weight, but thanks to a lack of discipline, motivation, a good program, or whatever the reason may be, they fail.

Losing weight, just like quitting addiction is 90% mental and 10% physical.

Agreed. Although a great program is needed, if you can't stick to a program, you're destined to fail.

The thing that people always fail to inform new dieters is that if exercise is gonna work, it has to be fun.

They also fail to inform people that exercise alone does not work. Losing weight is 80% diet and 20% exercise.

the dumbest advise I hear doctors give. Cut calories. Its like telling an alcoholic to stop drinking. Gee.

At least telling an alcoholic that if he stops drinking he'll be healthier is true. Telling someone to simply cut 200 calories to lose fat is ridiculous. Simply restricting calories without regard to calorie type will, 9 times out of 10, result in nothing.

Good discussion guys.

-Dev



[edit on 17-9-2008 by DevolutionEvolvd]

reply to post by Badge01


I would add that Ketosis, as achieved upon consuming a Ketogenic Diet, is not dangerous and is a natural process that occurs when the body doesn't receive enough glucose from it's diet. Many doctor's, including Dr. Michael Eads, argue that those suggesting that ketosis is dangerous are confusing ketosis with Ketoacidosis, a related but different process.

reply to post by DevolutionEvolvd






[edit on 17/9/2008 by Badge01]

Double Post


[edit on 25-9-2008 by DevolutionEvolvd]

I was on Dr. Eade's website this morning, reading one of his latest blog entries that read the following:

I can guarantee you that if you have been reading this blog for any length of time....you are much more nutritionally savvy than the vast majority of doctors out there. The old saw is absolutely true: doctors get very, very little nutritional training in medical school and even less in their post-graduate training. In my own case, I got exactly one lecture on nutrition in medical school, and that was from a registered dietitian, which should tell you all you need to know. And it wasn’t even a lecture on nutrition; it was a lecture on how to write orders for various diets for hospitalized patients.

This is a great entry that discusses how to talk to your doctor about diet and nutrition. It really goes well with what's been discussed in this thread.

Originally posted by DevolutionEvolvd
So here we have a doctor who DID know about the benefit of nutrition as a medicine but chose not to inform his patient of such treatments.

So my questions to you, fellow ATS members, are:

1) Why aren't medical doctors given more nutritional training?

2) If some doctors are well educated on the topic, why do they dismiss it and resort to drugging their patients instead?

3) Is there a conspiracy here?

It is unfortunate that most people will believe what a man(or woman) in a lab coat tells them simply because of a few letters after their name.

I think a lot of the answers to these questions have been given already, but I'd like to add my take on it. I'm in an undergraduate pre-health professions program; I'm interested in going on for a Ph.D in biochem or molecular bio, but must of my fellow students are planning on being doctors. Also, since the program is designed for post-baccs (people with B.A.s in other fields who are missing the science requirements) we tend to be older than most undergraduates.

I would say that, for one thing, my fellow students are very health-conscious personally. They are as well-educated in nutrition and exercise as any group of people I've ever met. And by and large they focus on health maintenance, not medication. In their personal lives, at least, they are very interested in organic foods, herbal supplements, vitamins, etcetera.

The second thing is that, although doctors may get very little specific nutrition training in med school, we are taught in biology and in anatomy&physiology an awful lot about how the body uses what we put into it. It's not very useful information in terms of recommending a diet to someone, because we don't learn that much about what foods have which nutrients, and even less about how to combine them into a diet that will be satisfying to eat. But it does count as nutritional training. As it happens, I just read last night the chapter in my anatomy&physiology text that discusses ketosis and ketoacidosis, so I was prepared for this thread to pop back up today

I think people who write off the medical profession as a bunch of pill-pushers are missing a change that's going on within the medical profession. More people now are aware of alternative medicines and of the dangers of pharmaceutics; particularly educated people with an interest in health. If that is true in the general population, don't you think it would be even more true among those who have decided to spend their lives studying health?

Instead, people assume that all M.D.s are tools of the giant pharmaceutics companies and are uninterested in anything but making money. The truth is that medicine (aside from a few areas, like elective cosmetic surgery) is not a very good way to make money, especially considering how much training is required. And doctors are, for the most part, genuinely interested in helping people feel better, and stay better.

One thing that has been brought up several times in this thread, and that I think remains a problem, is that doctors do not have enough time to spend with patients. They certainly don't have enough time to determine whether the person they're working with is going to be able to stick with a strict diet. We lie to our doctors all the time, so they assume that we're going to lie to them.

Also, we as consumers have been taught by the pharmaceutic companies and the media, to believe that anything less than perfect physical and mental health is a sign that something's wrong with us, and that the way to fix it is a pill. Heck, we even take our vitamins and supplements in pill form! People don't actually go to the doctor's office to hear "yeah, you're sick. Drink a lot of water, take some Vitamin C, and you'll be better in a couple days." If they hear that, they say "well, I could have figured that out myself" without stopping to realize that the doctor has done his/her job by assessing the patient and deciding there's nothing to worry about. But a patient would rather walk out with pills in hand, because then they feel like they "got something" for their time.

Sorry for the rant. But I do think that there is an image of the medical profession that was probably accurate in the sixties and seventies when alternative therapies started to spring up, that is becoming less accurate with every new class out of med school. Doctors may still have huge egos, but they're much more likely to know something about nutrition (and other health-maintenance strategies) than they were twenty years ago.

reply to post by americandingbat


I believe you. In my opinion, it's often not the doctors themselves who are at fault. It's the insurance companies, the FDA, and the lawyers, and sometimes the patients themselves.

You may find that doctors have very strict rules to follow and lots of guidelines about what they can and can't do.

About 8 years ago I suffered an episode of Bell's Palsy. First I had to go to my PCP who referred me to a specialist, but then they had to schedule the MRI and then get me the appointment and yada yada. By the time I actually got to SEE the neurologist, it was nearly 3 weeks later and I had not the faintest remaining symptom of the palsy.

In trying to figure out why I had recovered so completely in such a short period of time, he asked me to tell him every single thing I did and and every single thing I took, even OTC meds and supplements.

"Well," I began, "when it first started the side of my face and my ear hurt. I thought I was getting an ear infection so I started taking my echinacea and garlic but"

"Stop right there," he interrupted me. "You took echinacea? How much?"

I told him, and he said that explained it. He told me that the cause of Bell's Palsy is usually an inflammation of the facial nerve that runs through a narrow "tunnel" of bone. When the nerve becomes sufficiently inflamed, it swells up. However, it doesn't have room to swell up and the constriction of it trying to do so within the bone causes damage to the nerve. The inflammation is most often caused by a viral infection, and the echinacea I took is an antiviral. I had taken enough echinacea soon enough to stop the viral infection before the nerve was sufficiently inflamed to be damaged. He was then satisfied that he'd figured out what happened and was ready to let me go, but I had one more question.

"If I had come to you when I still had the inflammation, would you have told me to take echinacea?"

Not only did he regretfully answer "No" but he went on to explain that he can not legally prescribe a "dietary supplement," and even if he ignored that he could lose his job for suggesting that I take echinacea.

So here's a doctor - a neurologist - who KNOWS that this common herb which can be bought at Walmart or any drugstore is an effective antiviral, but he can't advise his patients to take it. How many other restrictions are doctors under that prevent them from telling us what we need to know? Perhaps some or many of the doctors are just as frustrated as we are by the requirements to follow all the rules, prescribe the "approved" drugs, and withhold information from patients.

I absolutely agree about the bureaucracy and the rules also.

He very likely could not recommend echinacea because it is not FDA approved. But one of the reasons that it is not FDA approved is that the companies that sell it don't want to jump through the hoops needed to thoroughly test it, and also don't want the restrictions on marketing that would apply if it was approved as a medicine.

So, why can't he recommend it even though it's not FDA approved, the same way he could recommend something like drinking more water? Because if something went wrong (and I know it doesn't happen as often with herbs as with lab drugs, but it does happen), he would not be covered by insurance when the patient (not that you, specifically would; but many do) sues him.

Not that we should do away with malpractice laws, either: I read the thread started by nineeyedeel in this forum today Doctors that cut off parts of people's bodies without obtaining consent should be sued for all they have, banned from ever practicing in any health-related field, and probably have the same part cut off.

But it is absurd when a doctor can't tell a patient that echinacea might work for them because on the one hand the big Pharma companies are guarding their turf and on the other the natural supplements companies are guarding theirs and avoiding regulation, and meanwhile the insurance companies and lawyers are checking every move he makes to make sure there is no potential liability. Not to mention having to spend at least as much time trying to deal with insurance company/HMO paperwork as he can allot to the patient.

I know that doctors are not blameless in this, but I really believe that the attitude of "doctors are tools of the Pharma companies" is counterproductive to any real change in how our health care choices are made. There are doctors calling for FDA reform, and criticizing the AMA for cowtowing to Big Pharma. But when they look to potential allies in that struggle, and basically have their faces spat in, as many as 10 years of really intensive training completely belittled, and an average (as of a couple years ago) of $100,000 in school debt forgotten totally by people who are convinced that they're just in it for the profit, it's not surprising if they react by closing their minds.

I don't know what the solution is, and I really do believe that we're on the right path -- that mainstream medicine is moving away from the idea that a pill is always the right way to go. Twelve years ago I worked as a secretary on the oncology floor of a major teaching hospital. While I was there, one of the ongoing studies was a cooperative venture between one of the oncologists and a nurse who was also a Reiki practitioner. The other nurses would cover her patients while she treated patients.

That kind of thing makes me really hopeful.

I'm also a personal trainer. One of my former clients was a doctor and he had VERY poor nutritional habits. I had him fill out a diet log that we went over each week so that I could teach him the basics of good nutriton. He came to me one day claiming that he was getting plenty of good lean protein from eating chicken wings from BW3's and he was getting his servings of veggies by eating potatoe salad! I was simply stunned by this and had no idea what to say!

He couldn't figure out why he simply couldn't lose any weight. I eventually had to give up because he couldn't get the idea that just because you eat chicken in one form doesn't mean it's good for you.