A systematic study by a group of 125 leading researchers who call themselves the U.S. Burden of Disease Collaborators shows that diet is the leading cause of both death and disability in the United States (U.S.). Meanwhile, only 12 percent of visits to doctors’ offices include counseling about diet, according to research by the U.S. Office of Disease Prevention and Health Promotion.
Even in young populations, nutrition-related health conditions are highly prevalent, according to the U.S. National Center for Health Statistics (NCHS). Cardiovascular disease, diabetes, obesity, hypertension, and many cancers are linked to diet and are together called non-communicable diseases (NCDs). NCDs are the highest cause of adult mortality in the U.S. and account for 70 percent of premature deaths globally, according to the World Health Organization (WHO). Because NCDs are in large part caused by food or lifestyle choices, the WHO argues that “most premature NCD deaths are preventable.”
While more than 70 percent of both men and women in the U.S. are overweight or obese, according to the U.S. NCHS, a national survey by the University of Chicago reports that 60 percent are trying to lose weight. In total, MarketData Enterprises reports that Americans spend US$ 66 billion annually on diets and diet aids.
Unfortunately, while 94 percent of physicians feel that nutrition is important, only 14 percent feel comfortable talking about it, according to the U.S. Office of Disease Prevention and Health Promotion. Even among high-risk patients with CVD, diabetes, or hyperlipidemia, only 1 in 5 receive nutrition counseling.
The root of the problem lies in the way doctors are educated in American medical schools, according to Dr. David Eisenberg of the T.H. Chan School of Public Health at Harvard University. “The fact that less than 20 percent of medical schools have a single required course in nutrition is a scandal,” he says. “It’s outrageous.” According to a study in the Journal of Biomedical Education, less than one-third of medical schools in the U.S. teach the recommended 25 hours of nutrition content over a student’s four years of classroom education.
Dr. Eisenberg’s solution is to train other doctors himself. Through a partnership he founded with the chefs of the Culinary Institute of America called Healthy Kitchens, Healthy Lives, he has taught thousands of American doctors in teaching kitchens around the country. This new class of doctors is learning to turn their backs on the reductionist ‘a pill for an ill’ approach and instead live what they preach.
Some medical schools are starting to retool, like the Tulane University School of Medicine, home to the Goldring Center for Culinary Medicine, and the Keck School of Medicine at the University of Southern California, in partnership with the L.A. Kitchen.
Dr. Erica Frank, the Research Chair of Preventative Medicine and Population Health at the University of British Columbia, has been working to build a body of literature that describes the connection between doctor lifestyle and patient outcomes. A decade ago, Dr. Frank surveyed more than 2000 medical students and found that the best predictor of whether they counseled their patients on healthier practices was whether they themselves incorporated those practices into their lives. She also showed that patients actually had better food habits when their doctors also did.
Increasingly, doctors are turning to culinary training to flesh out their toolkits as healthcare professionals. Food Tank interviewed Dr. Robert Graham of New York City as he was in the process of enrolling in culinary school at the Natural Gourmet Institute. “My decision to become a chef comes after years of watching patients battle ailments that could be remedied with a change of a diet,” he said. I’ve spent the past 15 years of practicing medicine witnessing the impact of poor diets on the health of people I was trying to take care of.
Collectively, efforts to combat obesity in the U.S. seem to be making progress. A report in August 2017 by the Robert Wood Johnson Foundation and the Trust for America’s Health suggested that U.S. obesity trends began to level off in 2015 and 2016, after decades of constant increase.