The lifesaving skill top medical schools aren't teaching

Dear Reader, Last week, I told you about Michelle Obama's campaign to teach kids how to cook. And I also explained why, despite its good intentions, it's not likely to change anything. The fact is, our country's poor eating habits are a systemic problem at this point. Dealing with the crooked subsidies couched in the Farm Bill is one way we can work to fix that. But there's another sad reality fueling the U.S. obesity epidemic. And that's the fact that most doctors--the first place that most people look for important nutrition advice--know absolutely nothing about the role nutrition plays in causing and preventing disease. Nearly 70 percent of adults in this country are obese or overweight. And issues related to nutrition account for more than a quarter of visits to primary care physicians. Primary care physicians who haven't got the first clue how to counsel their patients back to good health. And the reason they don't know is the same reason most Americans don't know:because no one is teaching them. So I can't just sit back and say nothing. Not when poor nutrition is a leading cause of death and disability in this country. And when sugar stands neck and neck with notorious threats like tobacco in the risk department. It's funny, because many of my patients simply assume that all doctors must learnsomething about nutritional medicine. (And I know they're not the only ones who mistakenly believe that.) As I've explained before, though, this simply isn't the case. And the Journal of the American Medical Association recently published an illuminating editorial on this very subject. It was written by a second year Harvard medical student. Among other disheartening observations, he noted that the nutrition course lasted all of nine hours. There were no exams or patient interactions involved. (And trust me, if there are no exams or clinical practice, medical students just aren't going to learn it. There's too much information to take in already.) But it gets worse. The lecture on obesity--our nation's most dangerous epidemic at the moment and a leading cause of diabetes and heart disease--lasted a mere 45 minutes. Compare this with the curriculum for cardiology--which included 60 hours of study in the second year alone. It just goes to show you. Our medical system is expert at teaching its doctors how to "fix" patients once they're already sick. But it's terrifyingly negligent when it comes to teaching doctors how to keep them healthy. And don't forget, this data comes from one of the top medical schools in the country. It's a disturbing message to be sending. "If Harvard doesn't teach nutrition, well... then it must not be too important." This status quo also leaves a dangerous knowledge vacuum that other sources are all too happy to fill. Since most physicians get their continuing medical education from pharmaceutical representatives, where do you think their nutritional education is coming from? I'll tell you where. The same place everyone else in this country gets it--from food manufacturers. Not to mention all the backward-thinking government agencies that they've got operating out of their very deep pockets. It's a classic case of the blind leading the blind. And that's exactly why you and I are living in the diabesity capital of the world. After all, why should patients think there's anything wrong with sucking back soda when the American Heart Association says a few cans a week is just fine? Why should they ditch bread for fresh vegetables, when the USDA says that whole grains are healthy? Luckily, you're smarter than the average patient. And especially if you've been a reader of mine for a while, you know a thing or two about nutrition and disease prevention. And you'll enjoy the benefit of a longer, healthier life because of it. But what about the rest of the country? Needless to say, America needs a change. We need the baby boomers to get their groove back and speak out for this cause like they did in decades past. (After all, they're the ones who really started the nutrition industry in the first place. They're also the aging population that's affected by this issue the most right now.) We also need to inspire current and future generations to care about the quality of the food on their plates. But just as importantly, someone needs to lead a revolution to overhaul the standard medical school curriculum in this country. So that physicians are instilled with the vital education they need to teach their patients--young and old--the right way to eat. What do you think about that Mrs. Obama? Until next time, Dr. Fred Source: "The neglect of nutrition in medical education: a firsthand look." JAMA Intern Med. 2014 Jun;174(6):841-2.