The Nutrition Gap: Are Doctors Ready to Think Outside the Pillbox?
newrepublic.com
newrepublic.com
OK, so the article is being provocative. The author knows that eating lettuce won't cure cancer, but is dismayed by the lack of focus doctors have on diet.
I think that's partly wrong. Any doctor will tell a patient to eat more veggies and get more exercise, and if you've got some specific issue they might get more specific (or refer you to an expert).
Most patients don't need to even go to a doctor to know they are eating shit foods.
The larger problem is FDA standards, vs the usual standard of proof. The FDA has its weaknesses, but it's rigorous. Anything not regulated (including surgery!) is a barely-scientific mess.
There's no regulator demanding companies prove that spinach is healthy, and side effect free. They pretty much only regulate pills and devices, not surgery, and certainly not foods. Obviously, the lack of a patent holder is an issue here - no-one owns the patent for spinach, so the FDA can't find a target to force to pay for the studies.
The problem the FDA has with regulating unhealthy food is similar to one the EPA has with regulating CO2, because the goal isn't complete avoidance, it is maintaining a safe equilibrium. But with the EPA, they have all the tools at their disposal to monitor the environment (and we are so far gone at this point that there is little risk to treating all CO2 like a bad thing). The FDA still has to rely heavily on doctors and other health professionals to make recommendations on top of their recommendations, because they don't have the tools to monitor health.
Maybe devices are what we actually need. A device that could monitor someone's actual health and diet and provide daily recommendations would be an amazing thing for the FDA to work towards.
Sounds like a good argument for personalized medicine, either in the form of a device as you suggest, or better processes used by physicians, or both.
We have superintendents responsible for arbitrary school districts, post offices for zip codes, etc. If we had a public health official or body in charge of a region, they would be responsible for the health of their constituency. They could administer the right combination of food & drugs to ensure that wellness was being achieved.
At the end of the day, we know CO2 is something that affects everyone so it needs to be regulated. We are at the point where public health & preventive epidemics such as childhood obesity do affect everyone and society at some level, even just due to the interconnected nature of the cost of insurance, drugs, and various externalities.
Optimisation can be a literal genie, even when it's humans doing the optimising.
Yep. But they won't be very forceful about it, because they know all about the research showing that people don't really give a rat about their doctor's urgings to eat a healthy diet. And they also know about all the more recent research showing just how poor the effectiveness of dietary intervention really is, largely because the percentage of people who stick with them is statistically comparable to zero.
That said, pulling back a bit, I find it fascinating that doctors can spend decades publishing guidelines about the importance of diet and exercise without anyone paying attention, but as soon as someone with a "NOT A DOCTOR" shingle hanging outside their office suggests maybe lightening up on the Whoppers it's suddenly this revolutionary idea that somehow threatens to upset the medical industry.
This is changing with efforts like "make every contact count".
http://www.makingeverycontactcount.co.uk/
> Making Every Contact Count (MECC) encourages conversations based on behaviour change methodologies (ranging from brief advice, to more advanced behaviour change techniques), empowering healthier lifestyle choices and exploring the wider social determinants that influence all of our health.
The best bet for a healthy life is to listen to your body and take an active role in getting proper nutrition and exercise. If you're not doing that, very few doctors will be able to help you.
I've had many doctors, but only one of them was really great. She was unabashed in providing non pharmaceutical guidance in addition to traditional doctor fare. This included nutrition. Unfortunately she's retired, and I've yet to find a doctor that can do much besides being a traffic cop or pill pusher. I'm no longer surprised at the number of overweight, out-of-shape doctors and nurses.
If you can find a doctor that takes a wholistic approach, realize that they are worth their weight in gold.
You're right, in the sense that it's the best way to maintain health generally. But 'proper nutrition and exercise' is unlikely to cure your aggressive cancer.
Nobody's fool enough to deny that diet has an impact on health; it's obvious, and well-researched. It's almost certainly the case that nutritional interventions can reduce the severity or course of some diseases.
And I don't agree with the thesis – that doctors don't pay any attention to diet. Generally speaking, they do – doctors will frequently offer advice advice regarding foods which should or should not be consumed based on an individual's medical conditions. "High levels of dairy consumption are a " was the advice given to a relative who had cancer, for example.
What they won't do is advocate the use of nutritional therapies in place of conventional medicine. That's because, as far as I'm aware, there is no convincing scientific research that demonstrates a case where nutritional changes are more effective than conventional treatment options.
It's trite, but we have a name for 'alternative medicine' that works – it's just 'medicine'. The benefits of particular diets are ultimately due to compounds that they do or do not contain, and that's something that can be studied. Until there is research done, such cures will remain firmly in the domain of pseudoscience.
The apparent contradiction was confusing. After all, even I know nutrition isn't found in steaks, fish tacos, grilled cheese sandwiches, bacon omelets and glasses of milk. I went home to learn more and found nutrition is regarded as more of 'soft science' in medical education today. Suffice to say, doctors don't have all the answers, or even most of them. Many are presumably ignorant altogether.
And if the inane imprisonment, torture, rape, mutilation, and murder of tens of billions of helpless animals every year doesn't make you want to cut out meat from your diet, I recommend looking at the overwhelming evidence pointing out a plant based diet is ideal for human health and the environment. Here is a good starting point: https://www.youtube.com/watch?v=e-F8whzJfJY
Ummm, maybe I've seen different feedlot videos than you have?
Generally meat eaters just do it without considering ethics, mmm tasty.
Is this bad or good? Dunno. Such philosophy.
Of course, it's probably important to admit that 95% of Western civilization (and maybe all civilization; and maybe all of humanity) agrees with your perspective on this topic, to my dismay.
Edit: although when you consider all relevant issues about the morality of how humans use animals, the ethics of forcefully inseminating them come pretty low on the list, imo.
If anyone is committing rape on my farm it's the roosters, not me.
This statement has no factual basis. Please cite a source for this claim.
> there is no shortage of protein in a proper plant based diet.
This is probably true, but I would question whether most vegans get enough protein. Have you tracked your nutritional macros? What do your numbers look like?
> Many are presumably ignorant alltogether.
You extrapolated your take away from a single encounter during which you did not engage the doctor about her opinions to cover the entire medical profession?
The typical American consumes 50-100% more protein than the recommended intake, so most of us are working from an incorrect baseline when trying to come up with an intuitive idea of how much protein is needed. And the animal products that vegans don't eat aren't just a big gap in the grocery budget; they need to be replaced with other foodstuffs. Despite common stereotypes that's typically not going to mean mountains of rabbit food because that's a horrendously expensive way to get your calories and it's not very filling either. More likely you'll see staple products like legumes, and those also tend to be relatively high in protein.
edit: Curious why the downvote. If someone feels I'm giving really bad nutritional advice here, then it would be MUCH better to provide a response that explains where I'm wrong. A downvote and no reply is pretty useless in this situation; it lets me know someone disagrees but otherwise does everyone else a huge disservice by allowing the bad information to remain unchallenged.
Show me the data. Most people I see are eating carb heavy diets and not much protein. Until you track your macros over tme, you have no idea if you're eating enough protein each day
That said, if you'd like some data how about the CDC? http://nchstats.com/2010/03/03/adults’-daily-protein-intake-...
|Resist commenting about being downvoted. It never does any good, and it makes boring reading.
The downvote's a feature that really needs to be removed from sites like HN. Keep the upvote; that does something constructive. But the downvote has an almost strictly adverse impact on the quality of discourse, and for that reason alone I'm more than happy to use opportunities to encourage people to use their talking words.
That one right there is such a tell about how well-educated many doctors are in nutrition. There are more than enough nutrients that pose a genuine problem for vegetarians, but still the one that's mentioned is one of the ones that generally isn't a problem.
That said, a MD or DO speaking about nutrition is technically operating outside their specialty. So maybe one shouldn't expect them to be too sure of what they're talking about. Though I don't know if most folks really understand that, and it's also true that dietitians often get overlooked.
Meat and dairy is filled with junk [2]. Animal protein contributes to the acceleration of osteoporosis [3]. Cutting it out will lower your chance of disease [4]. Humans are herbivores [5].
Modern industrial animal agriculture is a major cause of global warming [6]. Cattle consume 16 times more grain than they produce as meat [7]. The U.S. could feed 800 million people with grain that livestock eat [9].
So, there is plenty wrong with eating the carcass of an animal mutilated in horrific ways. For me, it simply has to do with non-violence.
1. https://www.youtube.com/watch?v=kK_KEQb_YVA
2. http://news.harvard.edu/gazette/2006/12.07/11-dairy.html
3. http://pcrm.org/search/?cid=1010
4. http://www.ornishspectrum.com/wp-content/uploads/A-Very-Low-...
5. http://www.peta.org/living/food/natural-human-diet/
6. http://ecowatch.com/2013/01/21/factory-farming-global-warmin...
7. https://books.google.com/books?id=ishlcmQuatoC&pg=PA293&lpg=...
8. http://modernfarmer.com/2014/03/pigheaded-smart-swine/
9. http://www.news.cornell.edu/stories/1997/08/us-could-feed-80...
And that peta page is stupid.
Unrelated: how do you define will to live?
"It's absolutely insipid to think that plants are different to animals in any way. Plants are alive, and contain cells and circulatory systems. They grow, consume food, respire and reproduce."
It's obvious from the above that selecting a set of characteristics and asserting that they render a comparison 'insipid' doesn't really supply any information or make a coherent point.
Then you would be making just as an asinine and ignorant statement which is factually correct, but grossly misrepresents the truth - that there is a distinct difference between plants and animals, but not so much between human and non-human animals.
http://fcmconference.org/img/CambridgeDeclarationOnConscious...
Yes, I would be – exactly the same as the one you made previously.
Animals and humans are alike. Animals and plants are also alike. Your argument therefore appears to be one of scale – plants are sufficiently different, in your opinion, that eating them is not mutilation. I'm of the opinion that animals are sufficiently different from humans that eating them is not mutilation. You see the problem?
You didn't really answer either of my questions. What is 'horrific' about chopping up a dead animal, and what is a will to live?
That's an assertion of your personal view, and not at all objective.
Meat and dairy is filled with junk
The US has a problem with food quality – this issue is orthogonal to the health benefits of various foods. You are always free to eat organic.
Animal protein contributes to the acceleration of osteoporosis
That's a controversial conclusion at best, and it's supported by a paper backed by a vegan lobbying organisation – not a problem in itself, but sufficient to require skepticism.
Cutting it out will lower your chance of disease
That statement is not supported by the research you supplied.
Humans are herbivores
We'll set aside the obvious problems with linking to PETA as reference. The description of humans as 'herbivores' is objectively untrue, given that at least 95% of humans worldwide are omnivorous.
Modern industrial animal agriculture is a major cause of global warming [6]. Cattle consume 16 times more grain than they produce as meat [7]. The U.S. could feed 800 million people with grain that livestock eat [9].
No argument there. Eating meat is pretty clearly bad for the environment. That's arguably a separate issue.
You're not really succeeded in supplying much in the way of convincing arguments, and you've managed to be rude in the process.
That even sounds like a pretty conservative figure to me. Lacto-ovo vegetarians are a class of omnivore, too, and I have a really hard time believing anything within an order of magnitude of 5% of humans are strict vegetarians.
Why is it always the responsibility, throughout history, of a vocal minority to convince others that violence against a group is wrong? No, empathy isn't my personal view, it is shared by any rational and sane person, who will agree animals have an inherent right to be free of pain and suffering. Or do you dare assert humans have an exclusive monopoly on freedom?
> You are always free to eat organic.
Good grief. Organic poison is still poison. Please see this page for many cited examples of health benefits from a vegan diet, and risks of a non-vegan one: http://nutritionfacts.org/topics/vegans/
> it's supported by a paper backed by a vegan lobbying organisation
Just as claims that milk, cheese, egg and meat products are necessary are lobbied by animal agriculture organizations.
http://www.foodpolitics.com/2010/11/lets-ask-marion-nestle-c...
If that is the case, then such a view can obviously not require vegetarianism or veganism. Unless you are claiming that 'any rational and sane person' is a vegetarian or vegan – a dubious claim.
I'm a big fan of ethical treatment of animals used for food production. It's just that my ethical standards apparently differ from yours. That doesn't make them invalid.
Organic poison is still poison.
Your point was specifically about produce being 'filled with junk' – in this case, hormones. That's the point I was disputing.
I don't disagree that vegan diets have the potential to be healthy. Your argument commits the typical fallacy of drawing unwarranted conclusions, however; vegan diets tend to be healthier compared to average omnivorous diets, but this is typically due to reduced consumption of saturated fats, increased consumption of dietary fibre and so on. Veganism is not a prerequisite for improving one's diet.
Just as claims that milk, cheese, egg and meat products are necessary are lobbied by animal agriculture organizations.
Yes, and I don't agree with those either. It's obvious that it's possible to be vegan. The difference is that I didn't use those studies in defence of my point; you did.
This is an utter logical fallacy. There is no such thing as ethical treatment of animals used for food production, just as there is no such thing as ethical slaughter, ethical rape, or happy and humane slavery. No commodification of another body is ethical, nor should be tolerated.
You may be interested to learn that Heinrich Himmler, the Gestapo commander responsible for deaths of many people, ordered as a "more humane means" of execution the use of poison gas in specially constructed chambers disguised as shower rooms.
Why?
It's not a fallacy - we just don't agree on ethical boundaries. I'm completely comfortable, from an ethical standpoint, with animals being used for food production. Clearly that's a popular view globally.
You may be interested to learn that Heinrich Himmler, the Gestapo commander responsible for deaths of many people, ordered as a "more humane means" of execution the use of poison gas in specially constructed chambers disguised as shower rooms.
That's a cliché reductio ad Hitlerum. I'm not sure what your point is, aside from "bad people can do bad things*.