Do you think all of us should start smoking, drinking and living on junk food? After all, are'nt these the ones who get all the attention by the medical profession?
I graduated from medical school in January 2020. Long before starting to study to be a doctor, I had become interested in how diet and health are related, with a particular interest in the paleolithic diet. I think this was borne primarily out of my strong interest in evolution and biology – it just made sense that the diet humans were evolutionarily adapted to over the course of millions of years would also be the diet that is healthiest for us.
During my five and a half years of medical training, a few things became clear to me. First, while doctors receive a lot of training in how to deal with medical emergencies, they are taught extremely little about how to avoid chronic disease and maximize long term health, and much of what they are taught is wrong. Over those years, I think I received a total of three lectures about nutrition. In other words, three hours during five and a half years were spent learning about how to avoid chronic disease in the first place.
One of those lectures, during the last few months before graduating, struck a very strong chord. The lecturer showed a powerpoint slide, and said, “this is your bible. This is what you are going to tell people.”
Here’s what was on that list:
Since I have a strong personal interest in nutrition, and have spent a lot of time going through the science, I knew that at least half of the advice on that list was complete nonsense, not supported by the scientific evidence. And yet we were being told that this was our “bible”. Just the word chosen showed clearly that this was not science we were being taught, it was religion.
- Eat more fruit and vegetables.
- Eat more fish.
- Eat more whole grain cereals.
- Eat less sugar.
- Eat less saturated fat.
- Eat less salt.
- Eat low fat dairy.
- Eat less meat.
Another problem with medical school is that we were taught what to do in different situations, but we were rarely given any nuance in terms of the probability of success, or size of benefit, of a treatment. For example, we were taught that, after someone has a heart attack or a stroke, they should be prescribed a statin. But we were never told what that would really mean for the patient. How much longer could they expect to live?
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