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ENRICH Physician Education to Improve Patient Health

This is a guest post from Angela Eakin, M.D.

As a doctor in my final year of family medicine residency, the issue of nutrition education for medical school students is particularly significant to me. The influx of chronic disease in America is linked to what we’re eating. This is why the ENRICH Act, which will expand the nutrition curriculum offered at medical schools, is so important.

ENRICH

During my daily rounds, I see nutrition-related diseases in my patients. I’m not just talking about diabetes, high blood pressure, heart attacks, or strokes. Acne, migraines, chronic pain, inflammatory conditions, and many other ailments may all be amendable with dietary changes. Many of the chronic disease states in America stem from or contribute to systemic inflammation throughout the body. Inflammation is multifactorial, but what we put in our mouths or choose to keep out of our mouths can have a significant impact on the level of inflammation in the body.

The great part about this is that individuals can take control of their health through their dietary choices. The hard part about this is that there is so much conflicting information about nutrition and what is considered a “healthy” diet.

Although practicing medicine had always been my goal, I took a different path to medical school than most premed students. Instead of obtaining the common biology or chemistry degree, I completed a Bachelor of Science in nutrition and dietetics, followed by a Master of Science in nutrition science. I was excited to apply and expand my strong base of nutrition knowledge in medical school. However, I quickly learned that nutrition is not emphasized in the core curriculum—despite the fact that many of our country’s health problems stem from dietary choices.

My peers and I wanted to promote health in our future patients, but received very little education about how lifestyle choices, including diet, can directly impact disease risk and outcome.

Throughout my years of training one large realization has really stuck with me: Even the health care industry is nutritionally under-served. 

Misleading headlines and conflicting data can confuse providers just as much as the general public. However, through this confusion, physicians still aim to provide patients with optimal dietary advice. But how does a provider know what is the optimal advice? Even if a provider feels they know the optimal advice, do they feel confident enough to counsel patients?

These are questions that require attention if we want to help the millions of Americans who suffer from dietary related chronic diseases. Although there has been some support in the past, a renewed effort to help medical students learn and apply basic nutrition knowledge is desperately needed. The ENRICH act will educate future health care leaders about the importance of nutrition, arming them with tools to help reverse the rising chronic disease epidemics.

If we can help someone delay starting a medication, come off a medication, or reverse a chronic disease, then we’ve succeeded.

For more information about the ENRICH Act and to ask your members of Congress to co-sponsor this bill, go to www.ENRICHYourHealth.org.

Taking the “Angelina Jolie Effect” a Step Further to Prevent Cancer

Last week, Angelina Jolie wrote movingly of her decision to reduce her risk of cancer by opting for preventive surgery. While few of us will ever have to stare an 87 percent risk of cancer in the face, as Jolie did, the unfortunate truth is that at some point in our lives, many of us—nearly one in two men and one in three women—will develop cancer. Whether we carry the BRCA1 gene mutation or not, we can all learn from Jolie’s thoughtful, proactive approach.

As a doctor, I want people to know that they already wield some of the most powerful tools to help take control over the risk of cancer:  the fork and knife. According to the World Cancer Research Fund, diet and lifestyle changes could prevent up to one-third of U.S. cancer cases.

In 2014, the Journal of the American College of Nutrition published research my colleagues and I conducted showing that with so much evidence pointing toward a link between dietary choices and certain types of cancer, we ought to apply the precautionary principle to the foods we eat and avoid the products likely to cause the most harm.

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For the most part, that means animal products. Consuming just one serving of processed meat per day can up the risk of colorectal cancer by 21 percent, while drinking two glasses of milk per day can increase the risk of prostate cancer by a staggering 60 percent.

In fact, regularly consuming animal protein can quadruple the risk of dying from cancer – making dietary choices just as deadly as smoking.

Fortunately, it’s not all bad news. By favoring plant-based foods—fruits, vegetables, whole grains, and legumes—we can dramatically minimize the risk for various types of cancer. For example, one recent study found that vegetarians can reduce their risk of developing colorectal cancer by 22 percent. Another study shows that women who consume the most carotenoid-rich fruits and vegetables—including carrots and sweet potatoes—reduce the risk for breast cancer by about 19 percent. And compared with those who consume meat and dairy products, women who follow plant-based diets have a 34 percent decreased risk for specific cancers including breast, ovarian, and uterine cancers.                                                                                  

Like Jolie said, we can never fully eradicate the risk of developing cancer. But that doesn’t mean we should sit around and wait. Learning about our risk factors and options is a good place to start in taking a proactive, precautionary step forward.

Updating the 2015 Dietary Guidelines for Americans

A Chance for Physicians to Comment in Favor of Sustainable, Science-Backed Solutions

As a nation, we’ve never been more confused about which food choices lead to optimal health. With the recent controversy surrounding cholesterol, it’s easy to see why. This is one reason I presented today at the Public Meeting for Oral Testimony on the Scientific Report of the 2015 Dietary Guidelines Committee at the National Institutes of Health.

The final 2015 Dietary Guidelines for Americans will come out later this year, but the public now has an opportunity to weigh in on the Dietary Guidelines Committee’s recommendations. The Dietary Guidelines have an extraordinary impact on food choices consumers will make and dietary habits our next generation will form. The guidelines manifest into meals purchased for our nation’s schools, senior centers, and hospitals, not to mention choices you’ll see readily available at the local corner market and grocery store.

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We should be supporting sustainable, healthful foods that fall into these four food groups.

Unfortunately, these menus often fall short on painting the picture of perfect health. Instead, they still serve a surplus of fat, sodium, and cholesterol, which, despite recent headlines, is still a nutrient of concern. If we want to combat metabolic syndrome—the perfect storm of high blood pressure, high blood sugar, excess weight, and elevated cholesterol—we have to act now. Nearly 70 percent of Americans struggle with weight, a risk factor for many forms of chronic disease, including heart disease, type 2 diabetes, and certain forms of cancer. And half of Americans who maintain a healthy weight are still at risk for at least one metabolic risk factor.

While the expert report for the 2015 Dietary Guidelines for Americans is heading in the right direction with a focus on plant-based dietary patterns, it still needs some work. Especially when it comes to educating the public about the dangers of dietary cholesterol, the “necessity” of dairy products, and explaining the leading sources of saturated fat, in plain language: high-fat cheeses, meats, oils, and dairy products.

Click here to read my testimony, and make your voice heard by submitting a public comment. The deadline is extended until May 8, 2015.

Dr. Barnard presenting his testimony on the Dietary Guidelines.

Dr. Barnard presenting his testimony on the 2015 Dietary Guidelines.

Follow the conversation on Twitter by searching for #DGAC2015 and #PlantBasedRx.

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