
If Doctors Learned to Cook, They Might Give Better Advice - sethbannon
http://www.npr.org/sections/health-shots/2015/12/26/460803440/if-doctors-learned-to-cook-they-might-give-better-advice
======
jdietrich
Teaching people how to eat better is a laudable idea. Using doctors to provide
that information is absolute insanity. The division of labour is not a new or
controversial idea; you don't need seven years of medical training to teach
basic nutrition.

The British NHS lifestyle education programme is called Change4Life. The
programme uses advertising, social media and partnerships with schools, local
government, food retailers and community groups. The idea is to provide
information in small but frequent doses and in ways that are immediately
actionable.

Convenience stores are encouraged to sell more fresh fruit and vegetables with
free Point of Sale promotional material. Employers are encouraged to run
healthy lifestyle challenges to help their employees eat better, get more
exercise and reduce their alcohol intake. Free smartphone apps provide
nutrition information and exercise ideas.

[http://www.nhs.uk/change4life/pages/overview-policy-
backgrou...](http://www.nhs.uk/change4life/pages/overview-policy-
background.aspx?filter=OverviewAndPolicyBackground)

~~~
kefka
At least in the US, unless the nutritionist is a doctor, they can't legally
diagnose or prescribe medicines or treatments. That also don't usually have
binding orders for blood tests either, to find nutritional deficiencies.

And there's __always __a 'reduce alcohol' message. Even if things like
distilled alcohol have no negative and a slightly positive effect on someone
with diabetes. But alcohol is "sinful" and those teetotalers will shame it
whenever they can.

~~~
dragonwriter
> At least in the US, unless the nutritionist is a doctor, they can't legally
> diagnose or prescribe medicines or treatments

That's not true; all (or nearly all) US jurisdictions give general prescribing
authority to more than just physicians (including MDs and DOs in that label)
-- e.g., PAs and NPs.

------
zappo2938
They used to teach this exact same class to every 8th grade student -- it was
called home economics. There is a very close relationship between home
economics education and health. It is now called family and consumer science
but political correctness put aside home economics describes it quite nicely.

The first woman to enter MIT, Ellen Swallow Richards [1], invented the field
of home economics. After reading about her, I realized much of home economics
is about health. Because we got rid of well defined gender roles doesn't mean
we should get rid of home economics.

[1]
[https://en.wikipedia.org/wiki/Ellen_Swallow_Richards](https://en.wikipedia.org/wiki/Ellen_Swallow_Richards)

~~~
Symbiote
It's still on the curriculum in England [1], though the class is called
something like "Food Technology". I don't know how well it is taught though —
do most children still actually cook themselves for this lesson? It seems the
curriculum requires that.

[1] [https://www.gov.uk/government/publications/national-
curricul...](https://www.gov.uk/government/publications/national-curriculum-
in-england-design-and-technology-programmes-of-study/national-curriculum-in-
england-design-and-technology-programmes-of-study#cooking-and-nutrition)

~~~
jon-wood
Back when I did it (fifteen years ago admittedly) we would cook once a week
when doing food technology, which was part of the technology rotation where
we'd study a particular subject for six weeks or so. In practice that probably
meant twelve weeks or so a year. At about 15 you had to choose a single
technology subject to study, so those who weren't taking it further wouldn't
do any more.

I seem to remember it being quite focused on commercial cooking - lots of
theory on portion calculations and pricing everything accordingly, but we
would end up cooking something relatively simple and worthwhile. The
commercial side apparently became much more pronounced for those who opted to
continue, one friend of mine must have spent several months cooking endless
variations on cannelloni trying to optimise it.

~~~
Symbiote
I remember something similar to that, we spent a chunk of time designing a box
for the food to go in. But that doesn't seem to be on the curriculum any more,
so that's progress.

(Studying boxes could be useful though, for example noticing the different
ways companies emphasize nutritional information.)

------
suneilp
It's not that people don't realize that proper nutrition is important. They
don't want to give up their lifestyle of eating out at every trending
restaurant or indulging in something not so good for you.

Stuff you shouldn't eat too much tends stimulate the release of mood altering
hormones leading to an addiction.

After one or two decades of processed foods, people no longer know what to
eat.

My doctor prescribes foods and it works really well. I'm really glad to see
the industry is beginning to change.

~~~
kelukelugames
A doctor friend says patients never listen when he tells them to lose weight.

~~~
kefka
"Eggs are good."

"eggs are bad."

"Coffee is good."

"Coffee is bad."

"Alcohol is bad."

"Red wine is good."

"Fats are bad."

"Fats are good."

Ad absurdum. What else do you expect when the nutritionists, doctors, and
universities have horrifically conflicting data? The answer, to me, seems to
be a tailored diet to the person... but with 10 minute doctor visits that's
not going to happen. The best you can expect is "take a pill and move on".

~~~
jrowley
Everything in moderation. That's a decent rule of thumb.

~~~
noondip
Everything? Even cigarettes? Of course not, so a better rule of thumb would be
to avoid things which are known to cause health problems altogether, at least
to an extent which is practical.

~~~
ams6110
Sure, an occasional cigarette probably won't hurt much, all things considered.

Exercise (beyond a point) can cause health problems. I know of a guy who is a
quadriplegic because he liked to bike on trails.

~~~
SilasX
But health authorities won't say that; once it gets to the level of advice to
laymen, it's been heavily filtered. A quick search returns this page, which
claims that "there is no safe level" of cigarette smoke:

[http://www.cancer.org.au/preventing-cancer/smoking-and-
tobac...](http://www.cancer.org.au/preventing-cancer/smoking-and-
tobacco/myths-about-smoking.html)

Really? One cigarette per year (per lifetime?) will show up? Of course, what
they mean is that, if you're in the population susceptible to nicotine
addiction and you're trying to quit, some smoking will make it harder than not
at all. But the claim is still false as taken literally.

------
TurboHaskal
But doctors can be helpful.

I was once in poor health. Feeling tired, suffering from high cholesterol and
gaining weight despite not eating much.

He told me to drop saturated fats, simple sugars and animal protein. And
instead choke on complex carbs, vegetables and vegetable oils.

The doctor was fat himself, so the contrarian in me did the natural thing and
went 180 on his advice: dropped complex carbs, vegetables and oils and instead
choked on saturated fats, simple carbs (even sugar and candy) and animal
protein.

I was once in poor health.

~~~
mod
> gaining weight despite not eating much.

It doesn't work like that.

It really discounts the rest of your story.

~~~
jrowley
Yeah outside of tapeworms, eating at a calorie deficit should always result in
weight loss (although not healthy, sustainable weight loss).

------
scholia
The BBC has just run an interesting TV series where a doctor visits families
in their homes and improves their health by changing their diets, and adding
exercise. The results are both visible and -- importantly -- measurable.

[http://www.bbc.co.uk/mediacentre/proginfo/2015/46/doctor-
in-...](http://www.bbc.co.uk/mediacentre/proginfo/2015/46/doctor-in-the-house)

The series is going to be repeated in January so UK residents will be able to
watch them.

[http://www.bbc.co.uk/programmes/b06q6y95](http://www.bbc.co.uk/programmes/b06q6y95)

Of course, medical advice on diet hasn't always been entirely correct, but I
think there's a pretty broad consensus on Dr Chatterjee's approach -- cut out
the fast food and processed foods, avoid added sugars, cut carbs, eat more
veggies and fibre, eat a wider variety of foods etc. You don't really med
school training to figure this out.

------
kefka
About 3 weeks ago, I was diagnosed with T2 diabetes. I was given the "take
this pill and leave me alone" treatment most doctors do these days. The pill
was Metformin.

I asked about food, since that is the only way I am getting nutrients in my
body. His answer was, "If it tastes good, don't eat it."

I cook a great deal, as does my wife. If I can change my diet so that my
blood-sugar level stays within healthy parameters, I'll gladly do it. And,
I've done it.

There is a technique called "Eating to the meter", which tailors a diabetes
diet to your body. I can see what foods do what. Those sugar-alcohols
sometimes do and don't cause an effect. Malitol causes no spike, but xylitol
does. Don't know why, but I know it does in me. And all of this is internet
derived advice. But it's better; far better than what the doctor said...

'Take this pill and go away'

~~~
beachstartup
do some research into ketogenic diets. "if it tastes good don't eat it" mainly
refers to processed sugar and carbs, not real food. for example, roasted
chicken and cauliflower tastes delicious and i would certainly choose it over
a donut any time of day. is chicken and cauliflower somehow off limits for
diabetics? i'm no doctor, but probably not.

~~~
kefka
Unfortunately, that's the pablum my doctor said. I have not been following my
doctor's advice, as it is generally scientifically bad. I haven't went all in
what was said.

All meats are safe, as long as they are relatively unprocessed. When
processing adds corn starch, sugar, or other carbohydrates is when the meats
are not good for me.

Cauliflower is perfect for me. It's also how I make "mashed potatoes". Find a
frozen bag of cauliflower and cook it. Let it dry out a bit, and add butter
and heavy whipping cream, and blend. 0g carb mashed potatoes.

Also, How I have been testing food is "test -> eat -> blood glucose test every
half hour for 3 times". Now that I have data on about 70% of what I normally
eat, I don't have to test those foods.

I'm much healthier now that I'm following a low carb diet of my own design.
I'm eating about 0-15 g carbs a day. Surprisingly, it's similar to Atkins, but
with the blood-glucose meter component. I can scientifically say that I'm
doing better with regards to that dimension.

~~~
noondip
> All meats are safe

Meat, processed or not, is a large risk factor in diabetes. See:

Meat consumption, diabetes, and its complications.

[http://www.ncbi.nlm.nih.gov/pubmed/23354681](http://www.ncbi.nlm.nih.gov/pubmed/23354681)

Association between dietary meat consumption and incident type 2 diabetes: the
EPIC-InterAct study.

[http://www.ncbi.nlm.nih.gov/pubmed/22983636](http://www.ncbi.nlm.nih.gov/pubmed/22983636)

Oxygen-carrying proteins in meat and risk of diabetes mellitus.

[http://www.ncbi.nlm.nih.gov/pubmed/23778318](http://www.ncbi.nlm.nih.gov/pubmed/23778318)

Relationship of dietary saturated fatty acids and body habitus to serum
insulin concentrations: the Normative Aging Study.

[http://www.ncbi.nlm.nih.gov/pubmed/8338037](http://www.ncbi.nlm.nih.gov/pubmed/8338037)

Also, fruit and vegetables are all "carbs", so a diet with 0 carbs is utter
insanity, and a recipe for poor health and disease.

~~~
beachstartup
this guy always chimes in with this kind of thing - he's pushing a vegan
agenda.

~~~
noondip
You have been warned by moderators before to tone down your rhetoric regarding
my posts; I'm simply presenting some worthwhile research, which you should
reply to on its merit, not your preconceived notion that any evidence you
disagree with must be part of some agenda. That you keep painting me with a
"vegan" paintbrush in order to downplay or even dismiss me gives credence to
the fact you haven't actually got a scientifically tenable argument to retort
with.

~~~
kefka
Frankly, I don't care about what percentage of the population gets X. Or Y. Or
might get Z.

In the end, those studies are nigh worthless, because they are about some
statistic. When you're a doctor, a statistic is nice because they can be
partially right. I want custom medicine tailored to me!

Instead of meat-hating studies, show me tests I can conduct that can validate
your assertions about my own body. What tests can I run reasonably? I can
obtain the appropriate equipment.

(I replied here because reply was off. Deleted for a proper response)

~~~
noondip
I absolutely understand where you're coming from. What about measuring LDL
cholesterol (should be <75), BMI (<25), triglycerides (<150), fasting glucose
(<100), and blood pressure? I think those are great biometrics for general
health. Note, my posts do not constitute medical advice - I am simply sharing
my experience and findings which I'm happy to have challenged.

~~~
kefka
> I absolutely understand where you're coming from. What about measuring LDL
> cholesterol (should be <75), triglycerides (<150)

It's within the ideal range, as is HDL. My triglycerides were 290mg/dL, so
High. The more studying I'm doing in this area points more towards Metabolic
Syndrome as well, with T2 diabetes as a result of that syndrome. No proof as
of yet, just uncorroborated hypothesis.

> BMI (<25)

38, but I don't look it. I'm 6'5", and I've always been off the growth charts.
Now, with my current diet, I've lost 18 lbs down to 298 in 3 weeks. I am
working on this. Ideally, I want 220lbs. I've been there before and I look
great, lest the BMI be damned.

>fasting glucose (<100)

That's what I have it down to now. 3 weeks ago, it was fasting=161mg/dL .
After switching to a highly restrictive carbohydrate diet, it took 6 days for
my fasting to drop to 110-120mg/dL. I got sick, which is easily viewable from
my data. It also corroborates from fellow Type 2's and 1's I know. Sickness
causes blood glucose to get "screwy". Now, my fasting is 100mg/dL

> and blood pressure?

I haven't the money for an automated unit, but it is on my agenda. I do test
moderately high (140/80, prior to T2 diagnosis).

> I think those are great biometrics for general health. Note, my posts do not
> constitute medical advice - I am simply sharing my experience and findings
> which I'm happy to have challenged.

I agree. I'm looking for even more, as well as writing software to analyze my
results. Effectively, I want a system I can tell what food I'm eating, and how
much. I want to do these analyses personally for me. Right now, outside of
food, food quantity, speed of eating, temp, BP, heart rate, weight, and blood
sugar, there isn't many ways I can get that great of data. Lab data is so
sparse to be nearly pointless.

I hear allegations about all sorts of foods and supplements. I want proof. I'm
willing to work with others, as well as being a guinea pig (to a point). But I
want to see real results.

My data:
[https://mega.nz/#!JwcSEAwC!zPqA1zVhA3zcLwLLZRJucc6AtT9zlHfNY...](https://mega.nz/#!JwcSEAwC!zPqA1zVhA3zcLwLLZRJucc6AtT9zlHfNYOM1jWXqfX4)

~~~
noondip
I had a peek at your data and must say I'm surprised and impressed you manage
LDL cholesterol under 75 with the amount of animal products you consume. (I
noticed you said it's "within the ideal range", but did not concede it was
actually under 75). For context, a single egg already puts you close to the
daily recommended cholesterol limit of 200-300 mg.

Anyway, I share your ambition to get "real results" and see how foods affect
my biology as quickly as possible. Sadly, we just don't have the technology to
enable us yet (I predict dietary biometrics will be a big trend soon). Until
then, I can only reference my own independent research into and experience
with whole food, plant-based diets void of animal products (strict) and
processed foods (not as strict). I'm well over a year in and feel better than
before, my blood work is great and I regret nothing. The only supplement I
take is a B-12 vitamin once per week. A good jumping off point for me were the
websites, [http://nutritionfacts.org](http://nutritionfacts.org) and
[https://cronometer.com](https://cronometer.com).

------
landonshoop
I think this is an excellent idea. I am a bit surprised at the reactions
against this concept. The key statement to zero in on is that doctors feel
they do not have sufficient training to provide advice. The operative words
being "sufficient training" and "advice."

Providing a few classes in basic nutrition/cooking to doctors can go a long
way in their ability to treat and prevent diseases. Tulane is not suggesting
that doctors spend 4 years in France working their way up from a garde manger.

Food can and should be viewed by doctors as a form of medicine. This
perspective aligns with the basic definition of medicine and the role of a
doctor.

------
jrapdx3
Nutrition has always been high on my list of important topics, and yes, they
do teach the subject in medical school. It used to be that it was an elective
set of courses, so true, not all medical students became well-versed in it.
Not sure how much it's changed, though I suspect nutrition is still not widely
enough taught.

Interestingly, when I was a kid in the 8th grade it was standard practice to
have the boys and girls switch shop/home ec classes a few times during the
school year. It was certainly educational for me. Actually the students rather
liked doing this, and no doubt quite an enlightened policy for the time.

As for behavior modification, no reason a doctor wouldn't be able to be
skilled and assist patients needing help with dietary management, etc. Doctors
have to do a lot of that sort of thing anyway since many conditions and
treatments require "lifestyle" changes. Of course, some doctors will be better
at it, and others not so adept. But that's pretty much the case re: certain
skill sets among those in any given occupation.

~~~
semi-extrinsic
> when I was a kid in the 8th grade it was standard practice to have the boys
> and girls switch shop/home ec classes a few times during the school year

Growing up in Norway, "home ec" was a mandatory subject, 2 hrs/week, for
everyone in 6th grade and again in 9th grade. Shop class was also mandatory
for everyone: I remember in 10th grade everyone made their own outdoor knife
(well, we made the sheaths from leather, the handles from wood, and then we
got the blades and joined them in; no blacksmithing).

In 9th grade we also had outdoor cooking (on a fire) for a rotating 1/4 of the
class every week, summer and winter. Fun times, smelling so badly of campfire
that the 1/4 of class was shunned by others for the rest of the day.

------
amelius
There is an upcoming field called "nutrigenomics", where genetic information
is combined with foods and dietary supplements to address a wide range of
topics, from (chronic) diseases, to aging. See [2] for a practical example.

[1]
[https://en.wikipedia.org/wiki/Nutrigenomics](https://en.wikipedia.org/wiki/Nutrigenomics)

[2] [https://www.bulletproofexec.com/the-mthfr-gene-mutation-
and-...](https://www.bulletproofexec.com/the-mthfr-gene-mutation-and-how-to-
rewire-your-genetics/)

------
pvaldes
Most doctors can cook yet, and most doctors give a good advice yet, so the
title is bad. A fake starting point to arrive to an obvious statement.

And the claimed benefits are not so clear. Doctors that give better advice
probably just spend more time studying and practicing and less time doing
maccaroni. If this people would need to pay money to be teached how to cook as
a part of their really long way to being doctors, they will probably advertise
food brands in the end to compensate the loses.

------
collyw
A great deal of medicine seems to be curative rather than preventative. We ll
know exercise is good for us, but you wouldn't expect your doctor to design
your training schedule. Then again both nutrition and exercise seem to have a
large "common sense" element to them in my opinion.

~~~
spacehome
I would expect my doctor to tell me to hit the gym and eat better.

------
facepalm
So doctors will teach patients how to cook in 5 minutes?

------
stefanix
Without reading the article I already have so many questions. Why all this
speculation!? How many doctors who have learned how to cook does it need to
test this hypothesis and aren't those easy to come about.

~~~
usrusr
I had similar concerns, what new breed of superdocs are they hoping to create,
considering that doctors before them certainly did have some level of meal
preparation ability? But fortunately the article is more nuanced, i read it as
"when general household skills are in decline, young doctors may be
bottlenecked by that when talking about nutrition, some cooking classes might
help".

I see that as a refreshing break from the usual pattern of naive "if there are
numbers (no matter which) it must be true"-empirism that holds the medical
profession in a stranglehold. (even the antiscientific alternative medicine
people do most of their arguing by blowing numbers out of proportion, people
rarely become doctors because they were particularly good at maths)

------
saguin
Preposterous!! they should also be trained to give behavior modification
advice too? This too could save lives. People need to use common sense, learn
what's good for yourself and practice that. At this rate the author will soon
want them to learn to code too!

~~~
jfoutz
I can't tell if you're being sarcastic or not.

Wouldn't a doctor be a good person to ask what's good for you? amazon has
about 50,000 different diet books, it's really not obvious what's "right".
Even the glorious USDA has a lot of industry influence in what it
recommends/accepts. The food plate is better than the water, kale, and
doughnut diet, but it has its own issues.

so, yeah, for a general practice they should probably talk about quitting
smoking, getting exercise, avoiding being overweight, guns, etc. pretty much
anything on the top 10[1] seems like a good idea.

[1] [http://www.cdc.gov/nchs/fastats/leading-causes-of-
death.htm](http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm)

~~~
MikeNomad
I didn't see guns on the list you linked to. I did see that Heart Disease and
Cancer account for nearly twice the number of deaths as the remaining eight
items on the list.

What am I missing?

~~~
nanofortnight
Actual causes of death, table 2:
[http://www.csdp.org/research/1238.pdf#page=3](http://www.csdp.org/research/1238.pdf#page=3)

