Sunday, January 30, 2011

Who should teach patients about nutrition?

A recent national survey published in the journal Academic Medicine found that on average, U.S. medical students receive less than 20 hours of education about nutrition in all four years of medical school, a figure that has decreased since 2004. Since improving patients' dietary habits plays a crucial role in the management of many common conditions, AFP is committed to providing our readers with practical nutritional information in articles such as "Diet and Exercise in the Treatment of Hyperlipidemia," in the May 1, 2010 issue.

In a Letter to the Editor in the January 15th issue, however, Dr. Sean Lucan points out that translating advice about food constituents into guidance that patients can easily understand is easier said than done:

[The article] mentions a food constituent, saturated fats, as a prime target for dietary reduction in patients with dyslipidemia. The problem is that people do not eat saturated fat; they eat foods. So what foods should patients avoid to limit their intake of saturated fat? Dr. Kelly describes one option, the Mediterranean Diet, as recommending “low consumption of saturated fats” and “limited consumption of red meat and dairy products.” In fact, with regard to lipids, red meat, dairy, and saturated fats are one and the same; the former two being the principal dietary sources of the latter. Unfortunately, few people know this because medical science tends to reduce foods to their constituent parts, and because the beef and dairy industries work hard to ensure that consumers do not make connections between undesired abstract nutritional constituents and food.

One might question whether family physicians are really the most qualified professionals to educate patients about basic and specialized nutrition issues, given the limited education that we receive. Wouldn't it be nice to have a nutritionist routinely available to counsel patients about what to eat? Unfortunately, most insurers will not pay practices for dietary education given by anyone except a physician, if they pay anything at all.

1 comment:

  1. The US Departments of Health and Human Services and Agriculture officially released the final version of the 2010 "Dietary Guidelines for Americans" today (http://www.cnpp.usda.gov/DGAs2010-DGACReport.htm). Previous guidelines have had some impact on food industry standards but very little on Americans' dietary behavior. Do you think that the effect of this version will be any different?

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