The China Study (cont.)

The book is the summation of the lead author's lifetime journey through academia, which was and is focused on scientific studies related to nutrition. OK, it sounds boring. However, the authors have cleverly woven a life story about change, personal conflict, academic pressures, business interests, government regulations, and personality clashes, all linked to nutrition. To do that and present data to support many of the turning points involved in his life is a remarkable accomplishment to me because it held my interest.

More important perhaps than holding a reader's interest, the book made me rethink what I know about nutrition and its potential impact upon my family members, friends, and my patients' health. I decided to first go back to the basics, which to me helps clarify subjects; that basic point is to define terms that often have several meanings. There is a lot of confusion and much advice about what to eat and what not to eat in order to have a healthy diet. But first, what is a diet, anyway? The term diet as defined by several dictionaries is supposed to mean the usual or customary intake of food and drink by people or animals. A secondary meaning is a regulated or prescribed intake of food and drink for medical or cosmetic (for example, weight loss) purposes. The first definition does not imply that someone's food and drink intake is healthy; it simply means a person's diet is what they normally eat and drink. However, the second definition clearly implies that a diet is regulated or prescribed for specific reasons that are often health related. Consequently, it is fair to state that everyone has or "is on" a diet, but clearly not everyone's diet fits the second meaning. In my view, the second "diet" definition suggests that sometimes a person's customary intake needs to be regulated or prescribed for specific purposes, the first of which is medical. Many doctors (and patients) don't or won't like the sound of that. Why? It implies that someone (the doctor) knows what is medically best for someone else (the patient) to eat and drink.

My experience has led me to believe that diet (food and drink intake) is to most people a very sensitive, complex, and personal decision. Much of our experience with foods and drink are based on family experience, but individual decisions about taste, consistency, and even socialization and emotion can play a significant role in our diet (the first meaning of the word). Most people do not want anyone to "intrude" on basic aspects of their life and lifestyle. If doctors do not see gross lifestyle "errors" like the diabetic who has consistently high blood sugar levels because the patient is still eating foods high in sugar or patients with high blood cholesterol levels who still eat a steak and egg meal frequently, doctors seldom prescribe a diet to lower these levels. The doctors usually prescribe medications and simply suggest that the patients alter their diet. Some may refer the individuals to a "dietary consultant" and simply avoid the potential "intrusion." What data do I have to back up these statements? None of my own; the statements are simply drawn from my experiences and observations, so at best they are anecdotal. Others may not agree if they have had different experiences.