Paleo Diet: Why Doctors Know Nothing About Nutrition

Back in September of 2010, published an interesting article entitled “Teaching Doctors About Nutrition and Diet”. The gist of the article (I won’t go into detail, because you can read it yourself, I’m sure), is that doctors know diddlysquat about nutrition (including the Paleo diet, of course). Recent history shows that the recommended 25 hours of Nutritional education is not being provided to medical school students, and the trend is actually getting worse.

“In the mid-1980s, the National Academy of Sciences published a landmark report highlighting the lack of adequate nutrition education in ; the writers recommended a minimum of 25 hours of nutrition instruction. Now, , it appears that even two and a half decades later a vast majority of medical schools still fail to meet the minimum recommended 25 hours of instruction.

Researchers from the University of North Carolina at Chapel Hill asked nutrition educators from more than 100 medical schools to describe the nutrition instruction offered to their students. While the researchers learned that almost all schools require exposure to nutrition, only about a quarter offered the recommended 25 hours of instruction, a decrease from six years earlier, when almost 40 percent of schools met the minimum recommendations. In addition, four schools offered nutrition optionally, and one school offered nothing at all. And while a majority of medical schools tended to intersperse lectures on nutrition in standard, required courses, like biochemistry or physiology, only a quarter of the schools managed to have a single course dedicated to the topic.”

Almost as a follow-up….but actually not…..a new article was published in the Academic Medicine Journal on the 11th November 2011, entitled “”. The article was written by medical student and registered dietician Caleb Kelly, who obviously has first hand experience with the lacking nutritional training in medical school.

“Medical nutrition therapy was once prominent in the armamentarium of physicians. In 1920, the Presbyterian Hospital in New York City could provide 54 unique therapeutic diets, a number typical of any major hospital at that time. The selection included 4 typhoid diets, 5 nephritic diets, and 10 gastric diets. Such diversity is no longer necessary. For example, peptic ulcers, then treated by selecting from among 5 therapeutic diets, are today treated with pharmacotherapy.”

That’s right, the standard medical doctor’s answer to practically everything these days, is a pill with a generally unpronounceable name. Why is there such a disconnect between nutrition and health these days? Why have people forgotten that what we put in our mouths DOES have a great deal to do with disease and chronic conditions? It’s like this important link has been completely dismissed.

“Patients expect and trust nutrition advice from their physicians, yet few patients receive such advice. Physicians face distinct barriers. These include limited time, reimbursement, and training, but not lack of interest. To preserve their time, physicians often delegate nutrition to allied health professionals. Doing this is prudent, but it does not absolve physicians from responsibility for nutrition, particularly when diet contributes to the cause and treatment of common conditions. The lack of time may be a result of inadequate reimbursement and training as much as congestion of the calendar. Reimbursement will improve somewhat under the Patient Protection and Affordable Care Act of 2010, which supports healthful diet counseling for adult patients with risk factors for diet-related chronic disease. Thus, inadequate nutrition training may become the only limiting barrier to physician engagement in this aspect of patient care.”

So delegation of the responsibility is another reason why doctors know nothing about nutrition.  And “diet-related chronic disease”? It’s basically ALL diet-related in my opinion, but of course the mainstream doesn’t yet see it that way.

“Unfortunately, a dwindling number of physicians receive adequate training to teach the art and science of nutrition. For example, in 1990, 1,752 physicians were members in the American Society of Parenteral and Enteral Nutrition. By 2009, the number dwindled to 634. A similar decline in physician membership has occurred across all nutrition societies and in the number of physicians taking nutrition board exams (only 29 physicians in the United States passed any nutrition board exam in 2009). The public should be concerned that physicians-in-training do not consistently receive effective nutrition education.”

Wow! That is an impressive decline in the number of Physicians who maintain memberships in Nutritional Societies. This is why doctors know nothing about Nutrition.

I actually think that this kind of information shows that the door is opening wider, and wider for well-educated Nutrition “experts” to really steal the show from the classically trained medical Doctors. Maybe this presents a great opportunity for people like Robb Wolf, and Mark Sisson to step in and help the masses in ways that regular doctors and even standard Dieticians will continue to fail to do. Hell, maybe even the little people like myself can hope to grab a little piece of the pie, and actually begin to make a living by helping people to regain their health through real-world, scientific, cutting edge nutritional information. The proof is in the pudding, after all.

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Barry Cripps is a Paleo-based Nutrition and Wellness Consultant, who operates out of Bowling Green, Kentucky.

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5 Responses to Paleo Diet: Why Doctors Know Nothing About Nutrition

  1. Jim Purdy December 16, 2011 at 8:11 am

    “So delegation of the responsibility is another reason why doctors know nothing about nutrition. And “diet-related chronic disease”? It’s basically ALL diet-related in my opinion, but of course the mainstream doesn’t yet see it that way.”

    Are you familiar with the expression that someone “can’t see the forest for the trees?”

    Focusing on why doctors and dietitians don’t (or cant) intelligently discuss proper nutrition is like missing the forest for the trees, because nutrition is just a small part of a much larger problem.

    The real problem is that, more than 150 years after Charles Darwin published his first book about evolution, “Origin of Species,” most doctors, dietitians and patients have only the feeblest understanding of how evolution has worked to shape our bodies and our behavior.

    If doctors, dietitians and patients truly understood evolutionary health, they would realize that the standard American diet bears little resemblance to the diet our bodies evolved to eat. And the health problems will not go away until the diet is changed.

    And vastly compounding that problem is the fact that the same ignorance about evolution lets doctors, dietitians and drug companies convince patients that the problems caused by lifestyle can be fixed with bizarre new chemicals from pharmaceutical labs, instead of by correcting the lifestyle.

    Forget the doctors, forget the drugs.

    Just fix the dang lifestyle.

    • Barry Cripps December 16, 2011 at 8:37 am

      Yes Jim, I agree completely.

      YOU SAID:
      “problems caused by lifestyle can be fixed with bizarre new chemicals from pharmaceutical labs, instead of by correcting the lifestyle”

      What a great statement, and how very true it is!! We live in the McDonald’s Drive-Through Health generation……”would you like a pill for that?”. :-)

  2. hazmat December 16, 2011 at 8:54 am

    The problem is the information that the doctors are taught in med school. If you are taught in med school that nutrition has zero effect on health what do you expect a doctor to do?

    The flexnor report (Rockefellers) basically turned the med school education into a standardized pharma drug school. They drug companies view med school as training grounds for their drug dealers. Think about paying hundreds of thousands of dollars to learn how to prescribe pills so that a huge drug company can become wealthier and more powerful.

    • Lila Solnick December 16, 2011 at 9:30 am

      Hazmat (interesting alias!), this is something that I recently learned about, that Rockerfeller, in 1913, “donated” funds to 14 of the 16 medical schools in the US, to move medical training away from, what WAS traditional medicine, at that time (what we call alternative) toward pharmaceutical use. Quite extreme and shocking, I know. but if true explains a great deal about what has happened to us and the blind eye and reluctance od allopathic medicine to embrace proven alternatives. All the more reason we have to educate people that food is our medicine. Part of my goal in setting up Paleo Diet News is to inform people about the role diet plays in our health and that, as Barry wrote, chronic disease IS diet related and health can be restored with a proper diet.
      There is a lot more to the discussion on the formation of the FDA, Rockerfeller and the drug companies, but I’ll leave that for another discussion.
      Thank you for your comment!

  3. Glen January 6, 2012 at 8:42 pm

    I think one of the problems isn’t just the lack of training, it’s the fact that much of the information is now outdated, AND that students will retain only that which is important to them and their field of study.

    Studies suggest medical doctors retain under 10% of the information they study during university and medical school. Slightly more for specialists. With that in mind, how much emphasis will they place on nutrition?

    The other issue is with he medical model itself - the medical model is more designed around patient history, symptoms/complaints, diagnosis and then treatment (often with medication) instead of in PREVENTION.

    The problem with dieticians and nutritionists is they often are required by their professional agencies to recommend diets based on USDA guidelines, or Canada Food Guide (up here) or whatever, wherever you are. For those with diabetes or heart disease they base their dietary advice on recommendations from the diabetes or Heart associations in their countries.

    The big problem with that is that the USDA (or other government agencies) are lobbied quite heavily by the agriculture sector and base their guidelines around that. We all know their out of date and unhealthy, yet they persist for economic reasons.

    As for the diabetes/heart associations - these agencies are primarily funded by pharmaceutical and agri-business/food companies. Their guidelines again keep one on medication instead of really helping cure their ills.

    With all that in mind, only people that really search the truth AND know how to read a research study - rather than take what the media or a propaganda website reports about said study - will learn the truth.