Nutrition-- Educating Doctors

I spent almost two years wandering around the Indian subcontinent between 1969 and 1971-- Afghanistan, Pakistan, Ceylon (now Sri Lanka), Nepal and, of course, every region of India. I lived in my van and was broke most of the time and had no choice but to eat whatever the locals were eating. When I got back to Europe I came down with a debilitating illness. No need to go into the gruesome details but I wound up under the care of an elderly physician in Innsbruck who decided he would have to operate on me and that I would have to stay in Innsbruck for six months. Innsbruck is lovely, but 6 days is a stretch and I was disinclined to buy into his plan, particularly when I was sitting in his office one day as a nurse opened a cabinet and exposed bags and bags of white sugar. Even at the time I knew that white sugar was unhealthy and a major contributor to some of the worst diseases plaguing modern man. I opted to get out of Dodge and I escaped to Amsterdam, where I was able to cure the problem with a holistic approach that included healthy eating.

Not long ago, I spoke with a doctor friend of mine. He told me that in all his years at medical school, there was only one lecture that involved nutrition. Today, even in western medicine, nutrition is increasingly accepted as having a large role in preventing and treating chronic disease, but current medical education curriculum still doesn't reflect this growing emphasis. The direct medical costs associated with obesity in 2008 totaled $147 billion. In 2010, heart disease cost $189.4 billion, hypertension cost $54.9 billion, and cancer cost $102.8 billion. Diabetes cost $116 billion in 2007. Combined, the total costs of these diseases are more than twice the cost of the entire Apollo Space Program. Further, these figures all represent direct medical costs. Indirect and intangible costs, such as lost productivity, pain, and a decreased quality of life, add considerably more.

This week Raúl Grijalva (D-AZ) and Tim Ryan (D-OH) introduced HR 4378, the Education and Training (EAT) for Health Act to encourage a stronger focus on nutrition and disease prevention in medical education. The bill requires new Department of Health and Human Services (HHS) guidelines that ensure federally employed physicians and nurses learn more about about the role of nutrition in preventing cancer, diabetes, obesity and cardiovascular disease in their continuing education programs. Physicians are already required to get a certain number of continuing medical education credit hours each year. The bill makes sure some of those hours are spent learning about nutrition without adding any new hour requirements to existing standards.

“This isn’t just about keeping medical costs down, although that’s an important goal,” Rep. Grijalva said. “More than anything, it’s about making sure Americans get the best advice about healthy living as well as medication and surgery. We can prevent diseases and injuries and live longer, healthier lives by making good lifestyle choices, and our medical professionals can help make that happen. That’s what this bill is about, and that’s why I’m proud to introduce it.”

Grijalva's fact sheet emphasizes the national security crisis inherent in poor nutritional education.

Weight problems were the number one cause of military discharge in 2012. In the first 10 months of 2012 alone, the U.S. military discharged 1,625 active-duty personnel due to obesity, about 15 times the number discharged for obesity in 2007. According to Mission: Readiness, an organization comprised of 300 retired military generals and admirals, the Department of Defense annually spends $1 billion on medical care associated with weight-related health problems. Further, the cost of replacing and train- ing each one of those discharged soldiers is $50,000 for each man or woman, adding up to approximately $60 million per year.

Further, in recent conflicts more soldiers were 79 percent more likely to be evacuated from battle due to bone fractures or sprains than combat injuries. Although fit soldiers also suffer these types of injuries, they are far more likely to occur in overweight or obese individuals.

The EAT for Health Act of 2013 will improve our military readiness and increase our national security by ensuring a fit, effective Armed Forces. It will continue to help those soldiers that have been discharged by requiring health care professionals employed by the Veterans Administration to receive nutrition education.

What the EAT for Health Act DOES and DOES NOT Do:

IT DOES:

• Ensure that physicians be kept up-to-date on the latest nutritional science by requiring annual credits in nutrition CME.

• Stipulate that six of those annual credits be in nutrition.

• Place a higher federal priority on holistic care by ensuring that nutrition education courses taken by federal health care professionals focus on the prevention, management, and reversal of diet-related disease.


IT DOES NOT:

• Require that any particular diet be taught.

• Advocate for adoption of the Mediterranean, Paleo, Atkins, vegan, or vegetarian 
diets.

• Add an extra burden to our physicians’ already busy schedules. Physicians are already required to get a certain number of hours of CME credits every year, according to their state licensing requirements.