You are tired of diet contradictions in the media. You have had enough of celebrities who are “half their size! Learn how they did it!”. You have done your own research and now you are going to your family doctor, because you want answers. So, Doctor, is 1.5 g of protein per kilo enough for me if I am doing intervals and strength training 3 times a week? What do you think of Omega-3 composition of grass-fed meat vs grain-fed? How do I reduce my body fat while maintaining muscle mass and strength? You are getting a blank look. The eyes are glazing over. A hesitant hand reaches for a referral pad to a dietician…
Hey, they are doctors! They wear white coats and have stethoscopes around their necks! Don’t they learn this stuff? Let me tell you how much education on nutrition we ACTUALLY get in medical school.
Year 1. The age of innocence
- a lecture on triglycerides in diet. It details the cholesterol transport in all its chemical formulaic glory and exciting medications like statins which we can use to disrupt this process.
- one of the cardiology lectures briefly mentions that saturated fat and cholesterol cause coronary heart disease. A graph from Framingham heart study is flashed on screen. We are assured that it shows a relationship between blood cholesterol levels and heart attacks.
Year 2. Depth of lecture boredom
- endocrinology block introduces hormonal regulation of metabolism. A very dry and boring biochemistry lecture describes the relationship between insulin and glucagon.
- a couple of lectures by an obesity specialist. She talks about different strategies used for obese populations: high vs low carb diets, very low calorie diets, lap band surgery, behavioural strategies, more drugs. At the end she pessimistically concludes that none of the above work in the long term
- a very exciting lecture by Jennie Brand-Miller. She concedes that obesity is probably related to metabolic syndrome, mentions the role of carbs in developing insulin resistance. Then she enthusiastically talks about her research in glycemic index. We are told that to reduce the incidence and severity of diabetes we should recommend low GI diets. The lecture concludes with the slide of her book.
- a few lectures on diabetes management with a focus on medical (=drug) treatment.
Years 3-4 Unleashed onto unsuspecting public
Oh, I got presented with a free patient and doctor information booklet on diabetes during my general practice rotation. It is written in a very clear, easy to understand language, colourful pictures, graphs and all. It is written by Pfizer, the pharmaceutical developer of Lipitor, the cholesterol-reducing medication which brought its happy executives $12.2bn in 2005.
Does anybody else think that this is a bit like a car mechanic who blindly swears that he found a mechanical fault with your car and now you have to pay him $x to fix it? (I normally pay just in case because I don’t understand half of what he is saying and I am a little scared of all this stuff under the bonnet).
Other than these delightful handouts from pharmaceutical companies, we are encouraged to visit websites like the Heart Foundation, the organisation which has just given its tick of approval to Milo cereal. ‘Nuff said.
Yes, there are others, who study nutrition in order to help their increasing (in size) patient population. But their knowledge is the result of a conscious effort, not an automatic consequence of a medical degree. They are worth their weight in gold when you find them. Because apart from being diet-savvy, they clearly possess humility to acknowledge what they don’t know.
So what does your doctor know about nutrition?
Disclaimer: other medical schools might provide more teaching on lifestyle modification. Also, I might have had a microsleep in one of these lectures and missed some pearls of nutritional wisdom. This is not intended as a personal attack on any individual physicians. This is merely an illustration that unless doctors are interested enough to search for truth themselves, you are getting second-hand information.