An Effort to Educate Physicians About Nutrition

The American Academy of Family Physician should be lauded in their recently announced efforts to begin an education process to bring their members up to speed concerning nutrition. In January 2002, the AAFP along with the American Dietetic Association introduced a set of clinical guidelines called the Nutritional Screening Initiative to help physicians understand what effect diet can have in managing certain common diseases. Although this is a rudimentary effort, it is a great start.

It seems that more awareness is finally being given to the fact that the number one way that people, especially the older population, manage their health is through drugs. Currently, 81% of North American seniors over 60 use prescription medications to deal with their infirmities. I’m sure that statistics adding the use of over-the-counter medications would lift this figure to closer to 95%. The economic and quality of life costs involved in this degree of drugs overuse is staggering. Recognizing these facts, responsible organizations in medicine are attempting to address the problem of over-dependence on medications whereas following simple dietary measures would suffice.

How do they know that the public will be receptive? In a telephone survey of 600 seniors, it was shown that 80% felt that nutrition had a very important role in managing chronic diseases. Only 33% said that they got any form of nutritional information from their doctor. (My experience would lead me to believe that this “nutritional information” would likely be in the form of whether to take a certain drug with or without food.) A huge majority of those polled responded by saying that they would likely use nutritional strategies if they received them from their doctors.

As a result, a national effort is being undertaken, the goal of which is to get simple and easy-to-use information into the hands of doctors and consumers alike to help them apply nutrition in the management of chronic conditions. The Nutrition Screening Initiative, which was partly funded by the pharmaceutical company Abbott Labs, will distribute nationwide a document known as “A Physician's Guide to Nutrition in Chronic Disease Management in Older Adults”. You can download a copy of this paper by going to: http://www.aafp.org/nsi.

I have reviewed this document and was impressed less by its content than by its presentation. The nutritional information given is cautious and basic, but desperately needed and long overdue. It is well laid out and, I imagine, colourful and glossy in its original format. It is certainly needed: The United States has nearly 35 million people over the age of 65, more than 12 percent of the population. This number will more than double by the year 2030. Eight of ten older Americans have at least one chronic disease, and the vast majority would benefit from nutrition intervention. Please let us not mislead everyone into thinking that you only begin to apply nutritional strategies after you get diagnosed with a chronic disease! Why close the gate AFTER the horse got away! Could we not get these and other health guidelines out to the entire population via all physicians, including pediatrians? Should not doctor of all stripes be first and foremost concerned with prevention?