“Looking at food to improve and maintain our health, and to prevent disease, is especially relevant to neurology,” says neurologist Vanessa Baute, MD, associate director of education at the Center for Integrative Medicine at Wake Forest Baptist Hospital in North Carolina. “I’m passionate about education. I think that training people in nutrition is really the key, and it’s done very rarely.”
Indeed, the cry for increased nutrition education among physicians is getting louder. In an article out this month (March 2019) in JAMA Cardiology, Devries et. al. say, “Requirements for meaningful nutrition education in all phases of medical training are long overdue.” The authors put an emphasis on cardiac issues like [type 2] diabetes and cardiovascular disease, which have particularly well-established links to diet. If you read the word diabetes and think peripheral neuropathy or the words cardiovascular disease and think stroke, you realize, of course, that the authors are talking about neurological issues as well.
“I see physicians all the time walking around with sodas, snack packs, and quick processed foods from all the demands of the profession,” says Baute. But she sees a change in the new generation coming up. “The students now are noticing that there is a disconnect between physicians, patients, and nutritional habits.”
According to Devries et. al, in the recent JAMA article, an average of just 19 hours is currently devoted to nutrition during the four years of medical school. Further deficits in training span the three or more years of graduate medical education. One reason nutrition education deserves special attention now, say the authors, is because of “increasing attention on the wellness and self-care of residents and fellows.” Not to mention, the high rates of burnout among physicians themselves.
The more students demand change, the more likely it will happen, however slowly. In service of speeding up that process, Devries et, al. suggest that nutrition education be integrated into existing curricula. For example, “a lecture on the clinical management of hypertension could include detailed information about the Dietary Approaches to Stop Hypertension (DASH) study.”
In the meantime, what about all those physicians well past their educational years? It’s definitely not too late.
It wasn’t until Baute had completed her training and entered practice that she realized she needed more nutrition education and then did a fellowship at the University of Arizona Center for Integrative Medicine in Tucson. “I was blown away in our nutrition classes that it was all new to me, and for many of the other 100 classmates of mine who were also physicians.”
Baute realizes a fellowship like this isn’t an option for everyone but says nutrition education is still highly accessible, especially in this digital age. Baute, who presented on the science of nutrition and neurology at last year’s annual meeting of the American Academy of Neurology (AAN), recommends checking out their section on Neurohealth & Integrative Neurology. The AAN meeting is coming up again soon and already looks to have several talks on nutrition scheduled.
Even easier, Baute recommends starting at your local farmers market. “Just try one fruit or vegetable that is in season per week, and see which one you actually like.That is making a huge step toward improving your own nutrition.” Tell your patients you just tried a rutabaga and you liked it. Then, when you give them nutrition advice, they’ll know you are not asking them to do anything you wouldn’t do.
“Physician visits are ideal opportunities to reinforce the message that attention to nutrition and lifestyle are critically necessary for optimal health…,“ say Devries et, al. in their JAMA article.
Besides, as payment for medical services becomes increasingly value-based, “An emphasis on nutrition is not only good medicine, but is also becoming sound economics.”
If you do end up attending the annual meeting of the American Academy of Neurology, come by and see us at the Ambu booth in the Exhibit Hall. We’ll be offering quick tutorials on how to make the most of our free unbranded patient newsletters.