From a nutritionally oriented physician, this is a sad tale.
In four years of medical school we had only one class on nutrition and that came in the first semester of our first year. It was by far the lowest on the totem pole of our education. Conspicuously this class was after lunch on Wednesdays when there were no more classes for the rest of the day. So for even the most committed of students making it back for nutrition after lunch and a morning marathon gross anatomy lab was unlikely.
Attendance for the nutrition class (I did go a few times) was less than 25% of what it was for the “important” classes of pharmacology, anatomy and physiology. And to tell you the truth, if you missed the class you really didn’t miss much. The professor was by far the most uninspiring of lecturers and the information was solely a didactic on each vitamin and its effects on the body when deficient. Other than a short lecture on how dietary fat caused heart disease (yes it was the low-fat days) not once did we talk about how what we eat effects how we feel, age and the likelihood of getting diseased.
And since there wasn’t an attendance requirement and all the information for the all-important multiple-choice examinations could easily be found in our text book, there really was no need to attend the class.
This class was so unimportant in the curriculum that in order to entice students to come to a special lecture by a visiting Registered Dietician, lunch was provided prior to the talk. And, I I kid you not, the buffet was pizza, rolls and butter, coca cola and donuts! The message we were provided for all those in a glucose coma was that it doesn’t matter what you eat as long as it is in moderation and that it is OK for diabetics to eat sugar, white bread and all the carbohydrates they want as long as they don’t eat too much.
Well 30 years later, while I am not sure if medical education has changed, at least the popular knowledge and awareness about the power of food is changing! Medical education can take years to adapt. Information is institutional and unfortunately, tied to grants and industry interference. From McDonald’s still sponsoring conferences for dieticians going back to the time when doctors promoted cigarettes as a way to calm nerves. Check out these old advertisements..
Ok so what lead me to this post.
This past week a recent study published in Lancet, the prestigious British Medical Journal. The sensationalized headline being “Bad Diet Causes More Deaths than Smoking” Here are two links from the Insider and Runners World which also link out to the full Lancet article.
Here is the upshot.
Diets lacking in “healthy food” are responsible for more deaths across the globe than smoking. The researchers claimed that around 11 million deaths per year – or one in five – are a result of a poor diet.
The diets cutting lives short were found to be particularly high in salt and too low in whole grains and fruit. The analysis, part of The Global Burden of Disease Study, saw researchers assess the diets of people in 195 countries using data from surveys, sales, and household expenditure from 1990 to 2017. Of the 11 million deaths linked to diet in 2017, 10 million were a result of cardiovascular disease. Cancer (913,000 deaths) and Type 2 diabetes (339,000) were the next biggest diet-related killers.
Perhaps unsurprisingly, countries where people follow a Mediterranean-style diet were found to have the fewest diet-related deaths: Israel, Spain, and France emerged top and at the other end of the spectrum, Uzbekistan, Papua New Guinea, and Afghanistan were found to have the most diet-related deaths. For context, Israel had 89 diet-related deaths per 100,000 people, compared to 892 in Uzbekistan. The US and UK were in the middle of the pack.
The recommendations were we should be eating more whole grains, fruit, nuts, seeds, vegetables and fish. We should avoid salt, sugary drinks and processed meats. And the study cost millions!
Ok while this is important information to share with people. Will they or can we believe it is correct. And will another study come out next year saying they were wrong. Large population studies have been notorious for leading us a stray due to weak data based on subjective surveys. The most recent case was the study that came out that said eggs are now bad for us again. If you spend just a few minutes actually looking at the study you will see that the whole premise is based one single food questionnaire to estimate diet going back 17 years with no consideration how it changed over the years!
So while it is great to make people aware of the importance of food on health and longevity. But the news can be confusing and to make things worse the recommendations many times are not meaningful and certainly not individualized. Clearly, almost everyone knows these days that pizza, coke and donuts are not good for our health. But what should we be eating? What is a “healthy” diet anyway? It is too confusing so we may as well just do what we want. Check out this all too funny video on a time traveling dietician.
Next week, I will make it easier for you.
Based on my many years of nutritional supporting people, fine-tuning my own personal health and the latest cutting science, I want to provide you a more meaningful strategy with the six steps to take to determine what diet and foods are best for you!