Print To PDF
Kevin Taylor1 and Pera Gorson2
1 Health Care Industry Consultant, Portland, OR, U.S.A.
2 ND, Food as Medicine Institute (FAMI), National University of Natural Medicine (NUNM), Portland, OR, U.S.A.
© 2020 Cereals & Grains Association
Around the world primary care practitioners (PCPs) are on the front lines of delivering health care and are the first point of contact most patients have with their respective heath care systems. PCPs, especially physicians, are viewed by the public as highly credible experts in nutrition. However, most physicians are unable or unwilling to provide meaningful nutrition advice due to a lack of adequate nutritional training or time spent with their patients or lack of comfort in offering counseling about health-promoting dietary patterns. At the same time, patients expect their PCPs to answer questions and provide specific directions on healthy eating and dietary choices to prevent or reverse disease progression. The disconnect between patient expectations and PCP engagement on nutrition often leads patients to search elsewhere for information. This often results in patients relying on questionable scientific data that often reinforces existing food myths and nonmedically necessary exclusion of macronutrients from their diets.
“Let food be thy medicine and medicine be thy food.”
—Attributed to Hippocrates
Trying to reach content?
View Full Article
if you don't have access, become a member
- AANP. 2018 AANP National Nurse Practitioner Sample Survey. American Association of Nurse Practitioners, Austin, TX, 2018.
- Adams, K. M., Kohlmeier, M., and Zeisel, S. H. Nutrition education in U.S. medical schools: Latest update of a national survey. Acad. Med. 85:1537, 2010.
- Aggarwal, M., Devries, S., Freeman, A. M., Ostfeld, R., Gaggin, H., Taub, P., Rzeszut, A. K., Allen, K., and Conti, R. C. The deficit of nutrition education of physicians. Am. J. Med. 131:339, 2018.
- Bechthold, A., Boeing, H., Schwedhelm, C., Hoffmann, G., Knüppel, S., et al. Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies. Crit. Rev. Food Sci. Nutr. 59:1071, 2019.
- Burgoon, J. K., Pfau, M., Parrott, R., Birk, T., Coker, R., and Burgoon, M. Relational communication, satisfaction, compliance gaining strategies and compliance in communication between physicians and patients. Commun. Monogr. 54:307, 1987.
- Cleveland Clinic. Diet, nutrition, & healthy lifestyle help reduce cancer risk. Published online at https://my.clevelandclinic.org/health/articles/4516-diet--nutrition--healthy-lifestyle-help-reduce-cancer-risk. Cleveland Clinic, 2010.
- Dagenais, G. R., Leong, D. P., Rangarajan, S., Lanas, F., Lopez-Jarmillo, P., et al. Variations in common diseases, hospital admissions, and deaths in middle-aged adults in 21 countries from five continents (PURE): A prospective cohort study. Lancet. DOI: https://doi.org/10.1016/S0140-6736(19)32007-0. 2019.
- Food Insight. IFIC 2019 Food and Health Survey. Available online at https://foodinsight.org/2019-food-and-health-survey. International Food Information Council Foundation, foodinsight.org, 2019.
- Ha, J. F., and Longnecker, N. Doctor-patient communication: A review. Ochsner J. 10(1):38, 2010.
- Harris, M. The abominable pig. In Food and Culture: A Reader. C. Counihan and P. van Esterik, eds. Routledge, London, U.K., 1997.
- Harvard School of Public Health. Disease Prevention. Published online at www.hsph.harvard.edu/nutritionsource/disease-prevention. The Nutrition Source, 2020.
- Irving, G., Neves, A. L., Dambha-Miller, H., Oishi, A., Tagashira, H., Verho, A., and Holden, J. International variations in primary care physician consultation time: A systematic review of 67 countries. BMJ Open. DOI: http://dx.doi.org/10.1136/bmjopen-2017-017902. 2017.
- KKF State Health Facts. Data source: Special data request on state licensing information from Redi-Data, Inc., March 2019, “Professionally active primary care physicians by field.” Kaiser Family Foundation, www.kff.org/statedata. 2019
- Kushner, R. Barriers to providing nutrition counseling by physicians: A survey of primary care practitioners. Prev. Med. 24:546, 1995.
- Levinovitz, A. The Gluten Lie: And Other Myths About What You Eat. Regan Arts, 2015.
- Ley, S. H., Hamdy, O., Mohan, V., and Hu, F. B. Prevention and management of type 2 diabetes: Dietary components and nutritional strategies. Lancet 383:1999, 2014.
- Mozaffarian, D. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: A comprehensive review. Circulation 133:187, 2016.
- Pollak, K. I., Krause, K. M., Yarnall, K. S., Gradison, M., Michener, J. L., and Østbye, T. Estimated time spent on preventive services by primary care physicians. BMC Health Serv. Res. 8:245, 2008.
- Spencer, E. H., Frank, E., Elon, L. K., Hertzberg, V. S., Serdula, M. K., and Galuska, D. A. Predictors of nutrition counseling behaviors and attitudes in US medical students. Am. J. Clin. Nutr. 84:655, 2006.
- U.S. Food and Drug Administration. Authorized health claims that meet the significant scientific agreement (SSA) standard. Published online at www.fda.gov/food/food-labeling-nutrition/authorized-health-claims-meet-significant-scientific-agreement-ssa-standard. FDA, Silver Spring, MD, 2018.
- U.S. Institute of Medicine. Committee on Dietary Guidelines Implementation. Health-care professionals: Strategies and actions for implementation. Page 169 in: Improving America’s Diet and Health: From Recommendations to Action. P. R. Thomas, ed. National Academies Press, Washington, DC, 1991.
- Vetter, M. L., Herring, S. J., Sood, M., Shah, N. R., and Kalet, A. L. What do resident physicians know about nutrition? An evaluation of attitudes, self-perceived proficiency and knowledge. J. Am. Coll. Nutr. 27:287, 2008.
- World Cancer Research Fund and American Institute for Cancer Research. Diet, nutrition, physical activity and cancer: A global perspective. Continuous Update Project, Third Expert Report. Published online at www.wcrf.org/dietandcancer. WCRF International, London, U.K., 2018.
- Yarnall, K. S., Pollak, K. I., Østbye, T., Krause, K. M., and Michener, J. L. Primary care: Is there enough time for prevention? Am. J. Public Health 93:635, 2003.
- Young, R. A., Burge, S. K., Kumar, K. A., Wilson, J. M., and Ortiz, D. F. A time-motion study of primary care physicians’ work in the electronic health record era. Fam. Med. 50:91, 2018.