The China Study (cont.)

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How should doctors give dietary advice?

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.

What's the problem with the typical U.S. diet?

Is there a problem with our so-called normal diet, and if so, what should we as both doctors and patients do about it? By "our diet," I mean the usual diet for most people in the U.S. First, is there a problem with our diet? If the incidence of cardiac problems, obesity, diabetes, and other diseases are related to our U.S. diet, then it is likely there is a problem. In the book, The China Study, data is presented that suggests strong relations exist between what we normally eat in the U.S. and the occurrence of these diseases. Even without stating the same thing about the U.S. diet, some physicians suggest that patients with these problems cut back on the volume of food intake, get more exercise, avoid high cholesterol-containing foods, reduce salt intake, and eat more fiber. The book authors go much further and suggest several approaches to not only improve the U.S. diet, but to establish a routine U.S. diet that will help prevent, and in some cases, reverse damage caused by several of these diseases. In contrast to many nutrition publications, claims are backed up by references in the medical and nutritional literature, not by opinion or belief, but actual data. Although different investigators may interpret or criticize the collected data, they, too need to provide some basis for their interpretation and critique. So as doctors and patients, what should we do if we accept the premise that our normal U.S. diet has problems? The answer seems simple; address or fix the problems.

What are the problems? Upon opening almost any magazine or watch a TV talk show, usually an article or individual has a presentation about what and what not to eat. Many will say to increase protein and reduce carbohydrates, while others will say the opposite; some say coffee is great, others warn about the dangers of caffeine in coffee. The lists of items can go on and on. Most articles present little or no data to back up their conclusions. In contrast, the book's authors present data to define problems with the U.S. diet (for example, too much animal-based protein and fat), then present how to address the problem and finally present evidence (yes, data again) how this stated problem can be effected by changes in the U.S. diet.

Medically Reviewed by a Doctor on 2/16/2017

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