It is only right that doctors understand the causes of their patients’ illnesses and have the knowledge to help them get well.
Doctors want to help their patients get healthy by discussing nutrition with them, but many feel unprepared to do so, according to a new poll of D.C. doctors. The poll found that 73 percent of doctors feel that patient visits should include nutrition guidance, but only 15 percent feel “totally prepared” to offer it.
That’s why earlier this year, Councilmember Mary Cheh introduced the Continuing Nutrition Education Amendment Act of 2019, calling for continuing education on nutrition for health care providers. The bill’s goal is to “provide information and skills to enable health professionals to incorporate nutrition counseling into clinical practice.”
Yesterday, I testified about the importance of the bill at a D.C. Council hearing. Read my full testimony below.
Statement of Neal D. Barnard, MD:
Thank you, Chairman Gray, for all you have done for the District of Columbia, and thank you for the opportunity to speak with you today. I am Neal Barnard, MD, a graduate of the George Washington University School of Medicine, and head of the Barnard Medical Center and the Physicians Committee, both located here in the District.
I don’t need to tell anyone here that we are facing major health disparities. In Wards 4, 5, 7, and 8, diabetes mortality is several times higher than in Wards 2 and 3.
In 2002, the Diabetes Prevention Program showed that a combination of diet changes and exercise could reduce diabetes rates by 58 percent.1 In 2003, our research team, funded by NIH, proved that diet changes can greatly improve diabetes control and help many patients reduce their medications or, in some cases, get off them altogether.2
The question is, are doctors making these advances available for patients and their families?
Earlier this year, researchers at the Johns Hopkins University surveyed doctors, finding that only 36 percent referred prediabetes patients to diet and lifestyle programs. Many did not know the risk factors for prediabetes, and most were not referring patients for appropriate treatment.3
We have a similar disparity in colorectal cancer. In this city map, “R” refers to the rate of colorectal cancer incidence. In Ward 3, it is 22 per 100,000 people per year. In Ward 8, it is three times higher, at 73.2 per 100,000 people per year.
In 2015, the World Health Organization reported that many cases of colorectal cancer could be prevented with better food choices. But most doctors are not sufficiently aware of food choices that can reduce the risk that cancer will start.
Medical schools, by and large, neglect nutrition in their curricula. Our poll of DC doctors found that only 18 percent felt that their nutrition education in medical school was adequate. And while 73 percent reported that nutrition guidance should be included in patient visits, the majority of doctors polled were not taking any nutrition CME. The good news is that 65 percent agreed with the proposed requirement that some of their CME hours be related to nutrition.
Free, noncommercial, AMA-accredited CME is widely available, including free programs that can be accessed online anytime, anywhere. It is only right that doctors understand the causes of their patients’ illnesses and have the knowledge to help them get well. Thank you.
- Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
- Barnard ND, Cohen J, Jenkins DJ, Turner-McGrievy G, Gloede L, Jaster B, Seidl K, Green AA, Talpers S. A low-fat, vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006;29:1777-1783.
- Tseng E, Greer RC, O'Rourke P, Yeh HC, McGuire MM, Albright AL, Marsteller JA, Clark JM, Maruthur NM. National survey of primary care physicians' knowledge, practices, and perceptions of prediabetes. J Gen Intern Med. 2019 Sep 9. doi: 10.1007/s11606-019-05245-7. [Epub ahead of print]