Eat This, Not That – Why Medical Schools Need to Emphasize Nutrition | Opinion

I am a 58 year old doctor and have been overweight most of my life. My average Body Mass Index (BMI) is around 27, which means I am overweight. Despite being a doctor for over thirty years, I didn’t know the difference between healthy and unhealthy food until a few years ago. Although I acted diligently, I chose to be ignorant of the risks and harms of the typical American diet, one rich in processed carbohydrates and meat and full of fresh fruits and vegetables.

This summer many Americans turn to grilling steaks, burgers and hot dogs. In addition to red and processed meat, many BBQ consumers enjoy their meat with sugary sauces and marinades in partnership with high-calorie foods. It is estimated that three out of four Americans do not eat a single piece of fruit in a single day, and nearly nine out of 10 do not reach the minimum recommended daily amount of vegetables. This is despite the World Health Organization’s recommendation to eat at least five servings of fruit and vegetables a day.

Being overweight or obese is a serious, common and costly disease. More than two in five US adults are obese. By 2030, nearly one in two US adults is expected to be obese.

More than 108 million US adults live with obesity and more than 1 billion people are obese worldwide. Obesity accounted for nearly $173 billion in medical spending in 2019.

Recent news that weight loss medications, including GLP-1 receptor agonists such as Ozempic and others, are revolutionizing the treatment of obesity. Some patients lose up to 20 percent of their initial body weight in a year or two on these drugs. However a recent lawsuit against the top brand raises concerns about this relatively new class of drug.

To maintain a healthy weight, a healthy diet is the cornerstone of good health. Obesity now kills more people than smoking. Obesity is a risk factor for many diseases, including heart disease, cancer, and severe COVID-19, which was the top three causes of death in the US in 2021.

The effects of obesity can take years or even decades to manifest, but will eventually contribute to and promote other diseases. It is a common cause of obstructive sleep apnea, strokes, heart attacks, liver disease, back pain, degenerative joint disease and joint replacement, and diabetes mellitus.

As a doctor, I am ashamed to say that I believed I had a healthy lifestyle. I was overweight, but I didn’t smoke, drink too much alcohol, or eat fast food regularly. I was also exercising. Still, the family pantry was stocked with bread and other dry carbohydrates, and my fridge was filled with red meat and ice cream.

A year ago, my blood pressure jumped to pre-hypertensive levels and my blood sugar increased to pre-diabetic levels. I decided to learn more about nutrition – even though I graduated and taught at a top medical school.

Although the American Heart Association offers grants to teach nutrition in schools for pre-K through school, medical schools need to do a better job of teaching nutrition.

Earlier this year, President Joe Biden announced new ways to tighten school nutrition rules and increase children’s nutritional values. These programs were not available when I was growing up. As a child, I ate mostly Korean food but in high school my diet consisted of fast food and pizza.

In medical school, I didn’t focus on the few nutrition classes that were offered, because I considered the subject much less important than other classes that focused on different organ systems like the heart or the brain.

More than half of graduate medical students report insufficient time devoted to clinical nutrition instruction. In a striking study of 115 medical doctors, the majority of participants (65.2 percent) indicated insufficient nutrition knowledge, and 30.4 percent of those who scored low on their nutrition knowledge had a high self-perception.

The important role of medical doctors in addressing nutrition in clinical practice has been recognized by numerous authoritative professional bodies. Ironically, most doctors often lack the knowledge to help patients eat healthily and to understand the importance of food for well-being.

In a contested space full of commercial interests and influencers, it is critical for your doctor to be a trusted source of evidence-based nutrition. There are so many diets and opinions about what constitutes a healthy diet. I switched to a plant-based diet; My blood pressure and blood sugar are now normal.

Medical school administrators, policy makers, and faculty must challenge the current medical curriculum and place greater emphasis on nutrition education. Physicians must evaluate their current knowledge and take further continuing education courses as needed. Patients need to ask questions about and if possible, seek nutritional advice from their doctor.

These steps can save millions of lives and reduce the obesity epidemic in this country.

Prescott Lee, MD, is a staff physician at Massachusetts General Hospital-North End Waterfront Health, a medical instructor at Harvard Medical School, and a Public Voices Project OpEd Fellow.

The views expressed in this article are those of the writer.