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Your Doctor Probably Knows Nothing about Nutrition

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In my first year of med school, we learned about macromolecules in biochemistry: carbohydrates, proteins, lipids, and how they behaved on a cellular level. We understood that they are ingested by eating food and were told about a few foods which exemplified each substance. Since then, nutrition is mentioned only occasionally in the context of excess equaling risk: too much sugar and you could end up with diabetes, too much fatty food and you could get a gallstone. A gastroenterologist friend and I have discussed the correlation between meat consumption and colon cancer, but he’s not a professor; it’s not even anything he discusses with patients since he feels most people are unwilling to change their lifestyles, and that people wouldn’t know what to eat if they weren’t eating meat. A few doctors have acknowledged data that I’ve mentioned during rounds about the detrimental effects of meat ingestion on most organ systems, but they don’t really elaborate, and it’s certainly not part of the curriculum. And that’s it. That’s been the extent of my education on nutrition in med school.

Patients seek my advice all the time regarding nutrition, and I’m only able to give it because of the research I’ve done on my own over the last 25 years. Most of the information I’ve sought was in an effort to defend my choice to be vegetarian and, later, vegan. Thankfully, this information has benefited my family, friends, and now patients, but that’s not the case for most doctors. Despite the publication of several academic papers pushing for an improvement in this arena, the conclusions are still the same, “The amount of nutrition education that medical students receive continues to be inadequate.” In fact, the amount of hours has dropped off in the last few years according to an excellent article in the New York Times by Dr. Pauline Chen. Continuing education programs exist for those interested, but that’s not everyone’s cup of tea.

Like any professional, doctors are human. They are not all knowing. They’re people with opinions and traditions and interests. If their interests do not lie in preventive health and diet, they won’t be able to do much but discourage you from your healthy lifestyle. If you want a doctor who you will feel comfortable discussing your nutrition with, you may want to ask for references from members of your local vegetarian community. If you don’t have one of those, ask folks at your local health food store. Don’t have one of those? Try VegDocs. It’s a work in progress that counts on patient participation, so send them info on a good doctor when you find one. Finally, make sure you do your homework before talking to your doctor. Let her or him know that years ago the American Dietetic Association declared that “Well-planned vegetarian diets are appropriate for individuals during all stages of the lifecycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.” Mention Dr. Dean Ornish’s acclaimed work on reversing heart disease or the work of Doctors Esselstyn and Campbell featured in the documentary Forks Over Knives. And let them know these are choices made for the health of your family, rather than in spite of it. If he or she is still not convinced, offer to get some bloodwork done: B12 and other vitamins and minerals, hemoglobin (iron), and whatever else they see fit. Let the numbers do the talking and then you’ll be speaking to your doctor in the language they were trained to understand.

Posted in Family Life

Cassandra Cusack Curbelo is a long-time animal advocate from Florida. She is currently attending medical school in Cuba where she and her husband live with their young son.