by The University of Arizona College of Medicine's Program in Integrative Medicine and The Rosenthal Center for Complementary and Alternative Medicine of Columbia University College of Physicians and Surgeons
We believe that the population of North America is in great nutritional peril. People are consuming increasing amounts of low-quality foods. There is an epidemic of obesity and in its wake rising incidence of type 2 diabetes in younger and younger children. More people than ever are following extreme and fad diets that may pose long-term risks to health. The food served in schools, hospitals, and senior facilities promotes obesity, chronic inflammation, and accelerated development of age-related diseases. We are also concerned about food safety, given the practices of factory farming, conventional agriculture, and the genetic modification of foods. And we are dismayed to watch the successful exportation of our unhealthy foods and eating habits all over the world.
The current state of nutrition education of health professionals is nonexistent to substandard. This is particularly true in the training of medical doctors. The scientific literature is exploding with information about optimum diets and the effects on health, both good and bad, of particular foods, components of foods, and dietary supplements, but this information does not find its way into the training of clinicians.
- Some consequences of the nutritional illiteracy of physicians are:
- Physicians are unable to counsel patients about an optimum diet or make use of dietary change as a primary therapeutic intervention or help patients be informed consumers of dietary supplements.
- The medical profession is unable to act as a social and political force to counteract the commercial pressures that have led to the ubiquity of fast food restaurants and soft drink and low-quality-snack-food vending machines in public schools and hospitals.
- The food served in hospitals and medical centers in North America—both that served to patients and that served to staff—is full of high-glycemic-load carbohydrates, unhealthy fats, and less desirable proteins. It includes processed and refined foods that are contraindicated for the prevention of heart disease, cancer, and many other chronic diseases. It must be a highest priority that our medical centers serve healthy food.
- More than 20 % of US hospitals now have fast food restaurants on their premises. This is unacceptable. How can the medical profession encourage people to make better dietary choices if it cannot itself exemplify healthy eating habits?
The nation is in the grip of low-carb mania, the latest dietary craze. It is important for people to understand that an optimum diet includes a balance of carbohydrates, fats, and proteins. Carbohydrates are not bad foods any more than fats are. It is important for people to understand, however, that there are good and bad carbohydrate foods, good and bad fats, and better and worse protein choices.
If there is any category of foods that are bad, it is highly refined and processed foods. Modern food technology tends to reduce the nutritional benefits of natural food sources and increase their health risks, as exemplified by the refining and processing of vegetable oils and the processing of whole grains into unhealthy snack foods.
We recommend that people decrease consumption of the following foods: foods of animal origin (other than fish), refined and processed foods, fast food, high-glycemic-load carbohydrates, and polyunsaturated vegetable oils. We recommend that they eliminate margarine, vegetable shortening, and products made with partially hydrogenated oils.
We recommend that people increase consumption of the following foods: fruits and vegetables, vegetable protein sources, low-glycemic-load carbohydrates (eg, beans, whole grains, sweet potatoes, winter squashes), monounsaturated vegetable oils, nuts and seeds, and omega-3- fatty acid sources (eg, oily fish or fish oils, walnuts, flax seeds, hemp seeds).
We recommend counseling consumers that dietary supplements are not substitutes for the whole foods that contain them. They may be useful as insurance against gaps in the diet and as natural therapeutic agents to help prevent or treat specific diseases. Pharmacists, physicians and other health professionals must be educated about their appropriate uses, benefits, and dangers.
We strongly support organic agriculture and better production, distribution, and marketing of organic produce to make it available and affordable to more people.
We call on industry to demonstrate leadership in improving the eating habits of North Americans instead of defending their current practices as “giving people what they want.” We want to see a new generation of fast food restaurants with healthy offerings, modification of snack and convenience foods to conform to current nutritional guidelines, and downsizing of portions. (Typical portions served in restaurants or packaged for individual sale are two to three times the standard serving size. Giant-sized soft drinks sold in convenience stores cost much less per ounce than small ones.) We applaud companies that have begun to do this, for example by removing sources of trans fats from processed foods. We encourage the public to patronize food companies that follow the principles set forth here.
We believe that the obesity epidemic in North America must be addressed by attention to physical activity as well as to eating patterns. Physical activity has gone down in our population, with many people exercising less than 30 minutes per week.
We must work to develop strong programs in nutrition education for physicians and other professionals, including pharmacists, who should be reliable experts on the benefits and dangers of dietary supplements. We must also work to educate consumers about nutrition and healthy eating and get this information into K-12 curriculums for our children.
We emphatically state our belief that healthy food can be delicious, convenient, and affordable.
Reprinted with permission from the University of Arizona College of Medicine's Program in Integrative Medicine. Available from: http://integrativemedicine.arizona.edu/nutrition/callaction.html