Physicians can stop writing prescriptions and actually help reduce chronic disease, comorbidities and pharmacology by educating their patients about what to eat.
The burden of chronic disease plagues our nation. Every day, we treat patients with diabetes, heart disease, cancer, stroke, and the list goes on. As a family physician, this is what we anticipate - and even expect - to treat every single day.
But what if we didn’t have to treat patients with as many chronic conditions or comorbidities?
Physicians around the country are learning the truth to what our mothers know about feeding us chicken soup when we’re sick: Food is medicine. We need to start viewing food as a way to treat disease. After all, the majority of the top killers of Americans are lifestyle related.
A recent Time Magazine piece highlighted programs like Geisinger’s Fresh Food Farmacy, where patients can pick up fresh produce and recipes along with their prescriptions. Other healthcare organizations and insurers are following suit, including OhioHealth Riverside Family Practice Center in Columbus, Ohio.
This information is not new, nor is the advice we give to our patients to exercise and eat more fruits and vegetables. Typically, my patients respond in one of three ways:
When they ask what to do, my response is to consume a diet full of plants such as green, leafy, and starchy vegetables; beans; legumes; nuts or seeds, such as flaxseeds and chia seeds; and whole, unrefined grains. I advise my patients to strive for at least 30 minutes of a daily physical activity they enjoy that is brisk enough so they cannot maintain a conversation. I also recommend they try to avoid alcohol and smoking as well as practice mindfulness and gratitude daily.
Unfortunately, my recommendations are often met with blank stares. But, to be honest, I don’t blame my patients. There is a severe lack of education about nutrition and food in general, for our patients as well as for us physicians.
According to a recent survey in the American Journal of Clinical Nutrition, only 27 percent of medical schools actually required a nutrition course. Additionally, the American Journal of Lifestyle Medicine also recently indicated that with “recent data on the rising cost and loss of quality of life secondary to preventable causes, there is an absolute need for a drastic reform of the US medical education system.”
I remember my nutritional education in medical school equated to around 10 credit hours. All of it was biochemistry. I did not learn about the elements of food preparation, how to read a nutrition label, or the environmental awareness of where our food comes from.
However, something I observed early on in medical school was that most of the chronic diseases we were studying were caused by a diet, exercise, and lifestyle imbalance. That made me wonder why there was a heavier emphasis on pharmacology than the eating patterns of diabetic or obese patients. There was no instruction on how plant-based dietary patterns reversed heart disease, as Dean Ornish, MD, proved almost 30 years ago through Ornish Lifestyle Medicine.
I wasn’t satisfied with advising my patients to, “Eat better or move more.” After medical school, I pursued a certification in health coaching at the Institute for Integrative Nutrition and a diploma in health-supportive and plant-based culinary arts from the Natural Gourmet Institute. Now, when I talk to my patients about diet and exercise, I can break down the importance of meal prepping, grocery shopping, and concepts of nutritional density versus caloric density of foods.
I’m dedicated to sharing these principles with my patients, regardless of why they came in for an appointment, because treating patients’ lifestyle is the best possible medicine.
Some of my less motivated patients roll their eyes at me when I talk about their diet. It’s the same look I get when I tell patients who smoke that smoking is bad for them. They know it, but they aren’t motivated enough to change - yet.
Finding that motivation to change your habits is difficult. I have found that patients who want to change usually get stuck at meal planning. I encourage them by reminding them the prep work is 90 percent of the battle. Or my patients hesitate because they incorrectly assume that eating more plants means sacrificing flavor. Those patients usually salivate when I describe how to create an Indian eggplant curry or a spicy vegan gumbo, proving that healthier foods can also be tasty.
In the end, what usually motivates my patients isn’t their health but a connection to personal goals. It’s helping them to see that making these changes will lengthen their lives and ensure they will see their children get married or grandchildren graduate college. In addition to the personal health benefits of changing to more of a plant-based lifestyle, we need to eat better for our planet’s health.
“Unhealthy diets pose a greater risk to morbidity and mortality than does unsafe sex and alcohol, drug, and tobacco use combined. Because much of the world's population is inadequately nourished and many environmental systems and processes are pushed beyond safe boundaries by food production, a global transformation of the food system is urgently needed.”
We are headed for change whether we like it or not thanks to climate change, pollution, less agricultural land in favor of raising livestock, and an estimated population of 10 billion by 2050. But we can reverse, or even avoid, this grim future if we change what we eat and how we think about food.
If you became a physician to make a lasting impact on the world, now’s your chance. There’s never been a better time for all of us to come together.
Colin Zhu, DO, is a traveling physician who is board certified in family practice and lifestyle medicine. He has practiced as a CompHealth locum tenens physician for the past four years. Zhu is the author of "Thrive Medicine: How To Cultivate Your Desires and Elevate Your Life” and is a podcast host of Thrive Bites.