We probably have all heard these claims:
- Conventional doctors under-rate the importance of nutrition for our health.
- They know nothing about the subject.
- Medical schools completely ignore the importance of nutrition.
- Only practitioners of so-called alternative medicine (SCAM) know enough about nutrition.
I have to admit that such cliches have gone on my nerves for a very long time. So, let me try to address them and put the record straight:
- This claim is an unwarranted generalization. Some doctors may indeed under-rate the importance of nutrition for our health. Many doctors under-rate many important issues in many situations. Some doctors are negligent or unmotivated or poorly traained. Some doctors are just bad! If your doctor falls in this category, please change doctor!
- Another unwarranted generalization. Most doctors know a lot about nutrition and are competent to advise you what is best for your needs.
- I have taught at 5 medical schools in 3 countries and can assure you that medical schools do not ignore the importance of nutrition. It is true that there may not be dedicated courses for students on this subject. Arguably, that would not be productive. Nutrition is usually taught in the context of the disease with which it can effectively help. For instance, the treatment and prevention of diabetes needs a specific diet, so do several liver, kidney, heart, skin conditions, obesity, various forms of malnutrition, etc. In our experience, this approach to medical education is more productive than a dedicated course on nutrition.
- It is true that many SCAM practitioners pride themselves to be competent in advising their patients about nutrition. It is also true that most give such advice. And it is allso true that, according to my experience, much of this advice is nonsense, not based on good evidence or even counter-productive. I am not aware of reliable data on this specific point and therefore added the caveat “in my experience”. If anyone knows about solid evidence on this point, please let me know.
The ex-influencer and recent nominee for US Surgeon General, Casey Means, is one of those who endlessly bemoans that medical schools are negligent about nutrition. She wrote, for instance: “I took zero nutrition courses in medical school.” To this, I cannot resist replying that
- firstly, she should have paid more attention when nutrition was dealt with in the context of all the other courses that she hopefully did attend,
- secondly she could (and should) have booked herself on one of the many postgraduate courses, particularly if she was aware that she had missed important sections of her learning schedule.
Let me conclude my rant with stating:
- Nutrition is an essental part of evidence-based medicine.
- Almost all the evidence on the subject originates from mainstream research.
- Nutritional advice from SCAM practitioners, influencers, etc. is often not evidence-based.
5 Responses to “Conventional doctors know nothing about nutrition” – true or false?
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In the US there are registered dietitians that study nutrition science and go threw an internship of a 1000hrs, so the physicians that worry about the patient’s diet should refer them to a RD and definitely not to SCAM practitioners that did not study nutrition science and usually give advice based on pseudoscience.
It’s not like med school should teach doctors every little thing about medicine, there are specializations to go deeper on each subject and there is no need for doctors to specialize in nutrition if there are RDs that the barrier of entry to this field is lower and its much more focused on the matter at hand.
Nutrition consultation is lengthy so its not economical to use doctors for it, same with psychotherapy or PT.
Ad. 4: “Only practitioners of so-called alternative medicine (SCAM) know enough about nutrition.”
Well, let’s see:
https://www.nutritioned.org/how-long-does-it-take-nutritionist/
“Q: How long does it take to become a nutritionist?
A: Conservative estimates, therefore, say that an entry-level nutritionist can enter the job market after four years of study”
I am VERY certain that 99% of SCAM practitioners who dispense nutritional advice to their customers did not put in even one tenth of this time of study in the field. I wouldn’t be surprised if most only took maybe a couple of weekends of ‘Google Academy’ (i.e. no meaningful training at all).
Even the most extensive SCAM courses such as Bastyr University’s naturopathy course only list about 150 hours of study on the subject of nutrition. Britt Hermes compiled a handy list documenting the hours on the curriculum:
https://www.naturopathicdiaries.com/wp-content/uploads/2015/03/Chart-my-ND-education-hours.pdf
So even these ‘highly trained’ SCAM practitioners received at best one month’s worth of study on nutrition.
Let’s just say that at least they have a pretty good grasp of the end point of the nutritional process.
A couple of years ago I went undercover as a patient, seeking advice from a naturopath. It’s covered in my presentation last year at the ECSO congress:
https://www.youtube.com/watch?v=CO_5mjXtRxc&t=864s
Go to 13:58.
very good!
thanks
Thank you Prof Ernst.
I would like to add that Registered Dietitians and Accredited Nutritionists are also sources of nutritional advice. The term ‘dietitian’ is protected by law, so only appropriately qualified people can practice as Dietitians. According to the British Dietetic Association (BDA), ‘Dietitians are the only nutrition professionals to be regulated by law, and are governed by an ethical code to ensure that they always work to the highest standard.’
However, anyone can call themselves a Nutritionist, which is where it can be confusing. ‘Anyone can call themselves a Nutritionist, a Nutritional Therapist, a Clinical Nutritionist or a Diet Expert’ (BDA).
See the BDA website for more information: https://www.bda.uk.com/about-dietetics/what-is-dietitian/dietitian-or-nutritionist.html