Don't ask your doctor for advice on nutrition, unless...
The problem is that physicians not being taught the latest concepts in medical school. A study published in the journal Academic Medicine found that in the 2008-2009 academic year, just 27 per cent of 105 medical schools met the minimum requirement of 25 hours of teaching on nutrition. A more recent study found the number of med schools keeping up with obesity and nutrition education has gone down. Medical schools aren't teaching enough about nutrition, and the people who make up licensing exams aren't testing that knowledge. A panel of experts on obesity looked at the content of medical licensing exams; it found that the most important topics on obesity aren't well tested on the exams.
The knowledge and testing gap is important because rates of obesity have risen over the past generation. Obesity is a risk factor for diabetes, heart attacks and strokes, depression, osteoarthritis, and even cancer. We're seeing these diseases at younger and younger ages. As physicians, we act as if we're overburdened treating patients with all these kinds of diseases. We're supposed to be in the business of preventing disease or minimizing its impact. By not addressing these issues, I think we're missing in action on one of our most important tasks.
Some medical schools are improving education of medical students and residents. As welcome as that is, I don't think it provides better access to the latest information quickly enough to the patients who need it.
Registered dietitians are the ones I'd ask. They have the requisite knowledge and experience to do the job. I also favour using health coaches to teach patients what they need to know about nutrition and about obesity – provided they're trained by RDs. Health coaches partner with patients to teach them and to set specific and achievable goals for health.
Health coaches are available in some family practices under pilot programs. New Brunswick provides them free of charge to people with diabetes. That program has helped people in that province to lose weight, eat better, with lower blood pressure and better diabetes control. Elsewhere in Canada, health coaches may be covered by extended or employee benefits, and you can pay for them out of pocket.
I think RDs and health coaches make enough of a difference that the system should pay for them. The investment would be well worth it.