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#1: A Call to Action to Prevent Diet Related Chronic Disease

How I got started on this nutrition track and why other doctors should consider incorporating nutrition advice into their practice
How I got started on this nutrition track and why other doctors should consider incorporating nutrition advice into their practice
Rashmi Schramm, MD

Rashmi Schramm, MD

Dr. Schramm is a board certified family physician and integrative health coach with 20 years of practice experience.

I remember standing there,

staring blankly at my patient. I was a third year internal medicine resident rounding on the wards.

My patient had just asked me, “Dr. Patel, what should I eat at home for my heart attack?”

I was caught off guard because this was not a question I anticipated.

I recall thinking, “Why was he asking me this question?”

I quickly told him “you should eat more fruits and vegetables, I will order a nutrition consult”, proceeding then to talk about his medication regimen.

I look back on the moment, and realized how generic that advice sounded.

 

 

 

As a resident,

I was in “survival mode,” and most of my meals were consumed from fast food restaurants.

I did not eat fruits and vegetables as often as I should have, and thus felt ill equipped about giving advice to my patients that I didn’t follow.

We know that the food we eat plays a role in our health, so why aren’t doctors trained in practical nutrition education?

We spend countless hours studying disease processes and treatment. We know that diet related chronic disease such as obesity, cardiovascular disease, cancer, and diabetes is on the rise in the United States. Americans are not meeting the recommended daily consumption of foods such as fruits, vegetables, nuts legumes, or whole grains. On top of this, there has been a drastic rise in the consumption of nutrient poor, calorie dense ultra-processed foods.

Now more than ever, physicians and medical trainees need practical nutrition education to better the lives of ourselves and our patients.

 

 

It wasn’t until after my medical training

that I realized that importance of healthy eating.

As a South Asian, I have a strong family history of cardiovascular disease and diabetes with multiple relatives passing away from related complications in their 50s and 60s.

During routine blood work, I saw changes in my blood glucose and lipid panel that were concerning.

I knew I had to make changes to my lifestyle, especially to what I ate on a day to day basis.

In the past, I had tried various diets to “be healthier” but none of it was sustainable for me.

Sure, I would adhere to a diet for a little while, eventually giving up and feeling guilty. This was a vicious cycle, and it never worked for me.

 

 

Now more than ever, physicians and medical trainees need practical nutrition education to better the lives of ourselves and our patients.

 

 

I mistakenly turned to the internet for guidance.

My “Dr. Google” searches were full of innumerable websites with headlines of “try this diet” or “eat these foods to lose weight fast” or “this super food is the next best thing” and my least favorite “take this supplement for x, y, z results.”

Much of the advice was centered on “quick fixes” and the misinformation was rampant.

It was overwhelming and I knew this wasn’t the answer I was searching for.

Around the same time, I became interested in the field of obesity medicine.

During a nutrition lecture at an obesity medicine conference, I learned about the field of Culinary Medicine. Culinary Medicine attempts to fill the need for practical nutrition education for health care professionals such as physicians.

 

 

 

It is not enough

to tell a person to eat healthier if they don’t know how.

You can’t assume that healthy eating is intuitive.

Culinary medicine combines the knowledge of food selection, preparation, planning, cooking skills with evidenced based nutrition and medical science.

For example, if you want to help your patients eat more plant based proteins, you must understand what options are available and explain how they can go about incorporating them into their diet.

We can’t expect someone who eats the majority of their meals out of the home to all of the sudden pick up a chefs knife and start making all of their meals at home. You have to teach one how to prepare healthful foods in a tasty way.

We need to move away from the notion that healthier foods are something that need to be endured at the expense of our taste buds.

 

We also have to take into account

every day life constraints and limitations in what foods are available to a person and learn to work within these confines.

The key is to make sustainable, healthier eating a lifestyle, and this looks different for everyone. There is no one size that fits all.

You can’t assume everyone has access to the same equipment in their kitchens to even do so.

You have to get creative here and that’s why Culinary Medicine exists.

 

Nutrition science is far from perfect

but there is increasing evidence supporting healthful eating patterns such as the DASH and Mediterranean diets.

The word diet comes from the Greek word “diaita” which means “way of life”. Culinary Medicine is the opposite of diet culture. It doesn’t demand perfection. We should encourage a healthy relationship with food and stop viewing food in simplistic terms of “good” and “bad.”

We need to understand why certain foods are healthier and how this translates to health outcomes and chronic disease risk reduction.

 

 

At the end of the day,

I truly believe that we all want to lead healthier lives but taking the first step can be daunting when you don’t know where to start.

I can’t tell you how many times a patient has said to me “Wow! You are the first doctor that has talked to me about nutrition.” I hope that one day this becomes the norm.

An increasing number of medical schools are incorporating formal culinary medicine training into their curriculum, but that doesn’t fill the knowledge gap for practicing physicians. Thankfully, there are programs out there for practicing physicians, but many lack awareness of such programs. I hope to continue raising awareness of Culinary Medicine and inspire other to make sustainable healthier eating habits by sharing my own experiences.

 

 

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