Things they didn’t teach in medical school: Part 25 Giving dietary advice

One of the commonest questions my patients have is “What should I be eating?”

Interestingly, I don’t think I was taught very much about basic nutrition at medical school. We did learn about the deficiencies such as scurvy (vitamin C) and beri beri (thiamine) but I don’t think we were taught much about normal nutrition. We definitely weren’t taught anything about nutrition in sickness or aberrant nutritional status. This is somewhat unfortunate as most of my patients are either malnourished as a consequence of their cancer or the treatments for their cancer. Living in modern society, most of the remaining people I see are overweight.

Now, you could argue, as the Nutrition Science Initiative does, that we don’t actually know what the ‘correct’ diet is and that most of what has been taught or is understood is wrong, or flawed, but I guess you have to start somewhere. Currently the debate is raging around whether the culprit for obesity is fat, carbohydrates or sugars, or lack of exercise. Various diets – vegan, paleo, Atkins, Mediterranean, etc – argue over the proportions of fat, sugar, carbohydrates, sugars and proteins allowed in the diet. Regardless of the best proportions the fact is that if doctors asked their patients they would soon discover that many wouldn’t know which foods contained what.

Future (and current) doctors need to be taught the best available information about dietary composition and also the behavioural techniques that have been demonstrated to assist in weight loss (or gain). Doctors also need to know how to manage the malnourished patient. Now we can turn to dietitians and nutritionists for advice this is knowledge is so intrinsic to healthcare that it should be considered essential learning. And besides….we might improve the hospital food.

Nutrition Science Initiative NuSI

Prescribing a diet

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