The Idiot Doctor

Filed under: General Health, Nutrition

My title for this blog may be a little dramatic, but it is well deserved, and you will see that I don’t pull any punches on this one. It is a little long, but bear with me, it is one of the most important discussions I have ever had on this blog, and I feel it is necessary reading for everyone.

At CP we have a ton of high school athletes, most of whom are struggling mightily to pack on size. We encourage some of these clients to have a protein shake either during or after their training, or both, then the rest of the time I highly encourage them to eat real food. Now some parents get a little bent out of shape about the protein shakes, and we don’t make kids take them, it is just a suggestion usually given to kids older than 15 to help them reach their protein and calorie needs. I do explain to the parent, if they are willing to listen, that there is no danger from these shakes. Protein in a powdered form was once protein in a solid food form. Whey protein is merely a dairy protein that has been extracted, dried and powdered. It isn’t some dangerous synthetic concoction made from petroleum and bull testicles. I understand that these parents are just concerned for their kids welfare, and that is all well and good, if they really dont want their child to take it, we don’t force the issue. The problem really arises when the parents claim they heard these shakes are dangerous, from no less authority than their child’s physician. (If their is a pre-existing health condition, obviously that is an entirely different animal). It truly pisses me off like few things can.

We recently had some athletes who have been with us for well over a year see their physician. Well Mr. Doctor who clearly knows nothing about nutrition, and most definitely has no formal education in nutrition, speaks his mind about these “dangerous protein shakes”. This is akin to me telling someone what is wrong with their car just because I can change my own oil. I may know a thing or two about cars, but I sure as shit am not a mechanic. According to the athletes’ mother, “Dr. X was very clear to eat food, not protein drinks.  He explained about the toll it takes on the liver and kidneys which manifests years after the person has ingested the substance.”

Right. Physiologically this makes complete sense. Since we have researchers showing evidence that the body metabolizes high fructose corn syrup (a man made substance) exactly as it does sucrose(since they are off almost identical sugar composition), clearly a dairy based protein like whey would damage the liver and kidneys years after I have a shake in ways that complete dairy protein(whey and casein) does not. Yes sure, that follows. And where might I ask did this doctor find such inscrutable information? What research studies was he referring too? Absolutely none. There is absolutely ZERO research on healthy subjects showing ill effects from a high protein diet, whether from food sources or from protein shakes. If protein shakes actually lead to serious health complications there wouldn’t be hundreds of studies using them to test their efficacy, it would be considered unethical. We don’t do studies on human subjects using known harmful substances. We do know, from real research on human subjects that whey has actual health benefits such as: promoting weight gain (our goal), elevating glutathione levels (which in turn increase superoxide dismutase levels, a powerful antioxidant), and some types of whey, containing lactoferrin, can possess bacteriostatic and bactericidal activity against microorganisms that can cause gastroenteric infections and food poisoning. Not only has whey protein been shown to be safe, they are using specific kinds to prevent infection by food borne pathogens: http://www.ncbi.nlm.nih.gov/pubmed/17293018?log$=activity.

Quotes like this are more ridiculous bullshit that come from nowhere. I remember in my Nutrition 101 class my ancient professor (I believe she was 88 at the time, no joke) mentioned in a slide that high protein diets can be dangerous. She went on to mention that there actually isn’t any proof for it, but that she kept it in her slide because it had always been there and that’s what she believed (and taught). It’s the same with the general statements about saturated fat and dietary cholesterol causing heart disease, a 70% carbohydrate diet being good for us, and that all vegetable oils are healthy(even the highly refined kind). We wouldn’t want to upset the status quo now would we. The American Dietetic Association is no better at giving information, since they are sponsored by big food industry and they wouldn’t want facts to get in the way of the needs and wants of their sponsors, but I digress.

And there we come to the crux of the problem. People, including doctors, regurgitating false information merely because it is what they had heard or what they had always said, regardless of the actual facts. It has been clearly shown in research and in surveys that physicians do not receive nearly enough training in nutrition to earn their degree, yet people continue to seek their advice, and physicians continue to give it, whether accurate or not. Physicians, by their own admission, are not nearly educated enough in the world of nutrition to give counsel to people, so why do they continue to do it? Who knows, but here are some interesting stats to prove my point:

  • When surveyed 85% of physicians were dissatisfied with the quantity and 60% with the quality of their medical-nutrition education.
  • In 1991 the Association of American Medical Colleges (AAMC) reported that of 128 US medical schools, only 23% (29 schools) had a required nutrition course, with an average of <6 h of class time; 25% of schools failed to offer any formal nutrition education.
  • The AAMC raw data for the 1997–1998 academic year reported that 26% of schools had a required nutrition course whereas 25% of schools still did not require or could not quantify nutrition education in their programs.
  • This is sad.

A little more food for thought, the results and discussion from one of the studies given below:

In its 1985 survey, the National Academy of Sciences (NAS) found that, overall, an average of 21 h of nutrition instruction was required in medical schools, but only 34 of the surveyed US medical schools (27%) had a separate, required nutrition course (3). The NAS report concluded that “Nutrition education programs in US medical schools are largely inadequate to meet the present and future demands of the medical profession.” This report has been called groundbreaking because it was the first comprehensive and systematic assessment of the status of nutrition education at medical schools that helped to identify the deficiencies. Publication of the report prompted the inclusion of medical education in the National Nutrition Monitoring and Related Research Act of 1990 and emphasized the need for physicians to be educated on nutrition topics. Patients routinely seek physicians’ guidance about diet, and the relation of nutrition to the prevention and treatment of disease is well known. However, practicing physicians continually rate their nutrition knowledge and skills as inadequate (5). It also is no surprise that more than one-half of graduating medical students report that the time dedicated to nutrition instruction is inadequate

According to the 106 respondents of a 2004 survey, the curricula of 99 schools (93%) provided required nutrition instruction. Five schools (5%) offered optional instruction only, and another 2 (2%) reported that they did not offer any nutrition instruction. The schools requiring nutrition instruction provided an average of 23.9 (range: 2–70) contact hours. Remarkably, less than one-half (41%) of the responding schools provided the minimum 25 h or more recommended by the NAS in 1985 (3). Also surprising was the finding that 17 schools (18%) required only ≤10 h of nutrition instruction.

An overwhelming majority (93/106, or 88%) of instructors indicated that students at their medical schools need more nutrition instruction, whereas only 8/106 (8%) said that they did not. Six of these 8 were at schools offering much more than the national average number of nutrition hours. The remaining 4% of schools responded that they did not know whether their students needed more nutrition instruction.

Is the national average of 23.9 h found in our survey adequate to properly train future physicians about nutrition? We realize that the definition of adequate is open to interpretation, but we used 2 major recommendations reported in the literature as a benchmark. The current 23.9 h fall just short of the NAS 1985 minimum recommendation and far short of the American Society for Clinical Nutrition (ASCN) 1989 recommendations. The ASCN recommendations were based on a survey of curriculum administrators and nutrition educators; the former group suggested 37 h (median: 32), whereas the latter suggested 44 h (median: 40) be devoted to nutrition instruction (9).

By either criterion, less than one-half of the surveyed medical schools (41%) provided the minimum of 25 h of medical nutrition education; compared with the later recommendations of 37–44 h, the percentage of schools meeting the recommendation falls below 20%. This means that roughly 60–80% of schools are teaching far less nutrition than is recommended. In addition, nutrition education typically occurs during the first 2 y of medical school when the basic sciences are being emphasized; nutrition does not appear to get much emphasis during the clinical years when nutrition concepts and skills could be applied more directly to clinical problem-solving. Because the number of schools requiring a nutrition course (32 versus 34) and the overall number of hours of nutrition teaching (23.9 versus 21) has changed little over the past 2 decades, it is not surprising that most medical students continue to assess the time devoted to nutrition as inadequate. From our surveys, it seems that instructors are even more dissatisfied with the hours of nutrition in the curriculum than medical students are. Thus, it appears that we are producing a pool of physicians who feel largely unprepared to counsel their patients about nutrition (6, 1012) and to make appropriate clinical decisions on nutrition-related issues. Surveys in the literature show that practicing physicians feel inappropriately prepared to address the growing problem of obesity, particularly in children (13, 14). With the rising epidemic of obesity in the US population and the knowledge that prevention is more likely to be successful than treatment, it is clearly imperative to ensure that medical students are adequately prepared.

There are many famed medical doctors, Dr. Michael Eades comes to mind, who clearly state that classically trained physicians are completely unprepared to offer nutrition advice unless they are willing to seek out nutrition information, attend seminars, and participate in continuing education. So I urge everyone to stop asking their unqualified physician nutrition information, and actually ask someone who may know what they are talking about.

For more info, here are some links to some serious research on the topic.

http://www.ajcn.org/cgi/content/full/83/4/941S

http://www.ncbi.nlm.nih.gov/pubmed/3717071?ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ajcn.org/cgi/content/full/72/3/868S

http://www.ncbi.nlm.nih.gov/pubmed/15165973?dopt=Abstract

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Posted on March 18th, 2009 by Brian St. Pierre

8 Comments

  1. Dave Says:

    On a similar topic, I was recently interrogated at a recent family event by an aunt who works in the medical field. The object of her annoyance was the fact that I refused the vast array of dessert on offer and had passed up on the “party food” buffet that had preceeded it. I politely answered her on each question, backing up each point with the science as best I could.
    Her daughter, a teenager, struggling with obesity ironically had overheard this discussion and had begun to attempt to follow my example.

    She has since been diagnosed with suspected diabetes.
    According to her mother, I am responsible for this due to my extreme diet. Apparently attempting to control the insulin response through her diet (quoting her daughter) has led to the pancreas being overworked to the point of failure (her mothers reasoning).

    Brilliant eh?

  2. Lindsay Says:

    Great post Brian. It really makes me upset that we can’t even trust our own physicians to have our best interests in mind. When they are being influenced by pharmacutical companies, there seems to be a lack of authentic motivation to encourage healthy eating habits for patients. I have also always found it ironic and disturbing when nurses and even some physicians are overweight and look unhealthy. That’s just wrong.

  3. Topics about Animals » Archive » The Idiot Doctor Says:

    [...] Gday Blog added an interesting post on The Idiot DoctorHere’s a small excerpt…health condition, obviously that is an entirely different animal). … And where might I ask did this doctor find such inscrutable information? [...]

  4. Bob Parr Says:

    Unfortunately, the sort of misinformation you cite seems to be everywhere.

    I’ve heard uninformed people say that creatine is an anabolic steroid! I wouldn’t be surprised if many of these same people believe protein shakes are steroids, especially since some of them include creatine.

    No wonder this idiot doctor was worried. He was probably convinced that his patient would soon swell to Mr. Olympia size, have his genitals shrink down to nothing, and feel compelled to murder his family members and then hang himself!

  5. Danny Says:

    great post. f-cking idiot doctors are everywhere. we need to be our own advocates, do our own research, and question everything. seek out better doctors — the ones that demonstrate an open mind and a willingness to discuss and consider the work we do as “patients”. it’s like evolution….the more we refuse to accept lackluster medical care and lazy MDs spouting outdated bullsh-t dogma, the quicker they will die off as a species. F-cking worthless oxygen thiefs.

  6. V Says:

    I kind of agree (though I did not read your article carefully). And I am in med school… haha

  7. V Says:

    Disclaimer, first semester of med school

  8. Jon Says:

    http://health.msn.com/blogs/get-back-in-shape-post.aspx?post=1752218&gt1=31036&ucid=37955321#uc2Lst37955321

    I need some of your guy’s help on the comment section at the end of this article.

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