Nutrition in medical school

[267028]

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[Fivo]

IIFYM all day

 

[arresteddev]

I'm also very interested in nutrition, and I'd like to hear what people have to say. I've read a fair share of (not so scientific) articles and watched a lot of documentaries. Most, if not all, point to insulin as well. There are seriously thousands of slightly different takes on how it works. I think it's a combination of the two. If you eat too much of anything, you'll gain weight. You can lose weight eating only ice cream for a day, as long as you keep your caloric intake low. The issue arrises in how we perceive hunger/fullness. When our insulin spikes because of a lot of sugar, we try to use it all up/store it as glycogen asap. Then our blood sugar drops, so not long after we become hungry again. Don't quote me though...what I'm saying is probably just broscience.

 

[235788]

I'll be starting medical school in the fall and I've always been interested in nutrition and exercise and just wanted to get a few thoughts about how its taught in medical school. I know that the media and nutrition scientists generally adhere to the principals of "calories in- calories out" which I think is an utterly bogus "theory" of weight gain. I think a more plausible explaination lies with the excessive sugar consumption that leads to insulin production which drives fat stoarge. I'm not an expert but I've done my fair share of reading and it seems that science points to the excessive sugar theory, and I'm just wondering why its taking doctors and others in the health care field so long to promote this theory.

Sorry if it sounds like I'm ranting but I'm just wondering whether science will eventually prevail in this area or if corporations that promote sugary products will keep saying "you can continue to eat this crap as long as its just a little of it and youll still be healthy because the only thing that matters is the number of calories". I hear this same story everyday in the media and yet our obesity rates are sky high, its just frustrating. And I'm not a troll by the way lol.

I can imagine my "nutrition" going to hell. Freshman 15 all over again.

 

[LisaFrank]

The material taught varies from school to school. Nutrition is on Step 1, but it's limited to vitamin deficiencies, so most schools really have no reason to go into further detail than that. If you are passionate about nutrition and policy, consider getting an MPH, too

 

[267028]

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[syoung]

Doesn't it seem ironic that physicians aren't trained more in nutrition, when it seems to play such a huge role in our metabolism, diabetes, hypertension/artherosclerosis and in the fields of internal medicine, pediatrics, OB, cardio, etc. Yes we gotta focus on procedures that generate income, but at what expense? Continue just play catch up with patients on their diseases?

 

[Ost3oclast]

I'll be starting medical school in the fall and I've always been interested in nutrition and exercise and just wanted to get a few thoughts about how its taught in medical school. I know that the media and nutrition scientists generally adhere to the principals of "calories in- calories out" which I think is an utterly bogus "theory" of weight gain. I think a more plausible explaination lies with the excessive sugar consumption that leads to insulin production which drives fat stoarge. I'm not an expert but I've done my fair share of reading and it seems that science points to the excessive sugar theory, and I'm just wondering why its taking doctors and others in the health care field so long to promote this theory.

Sorry if it sounds like I'm ranting but I'm just wondering whether science will eventually prevail in this area or if corporations that promote sugary products will keep saying "you can continue to eat this crap as long as its just a little of it and youll still be healthy because the only thing that matters is the number of calories". I hear this same story everyday in the media and yet our obesity rates are sky high, its just frustrating. And I'm not a troll by the way lol.

I took a couple nutrition classes at my U (for a time wanted to do nutrition for a living)

From what I studied.....both theories need consideration together. You already know about sugar and insulins role in fat storage so no need to dive into that. About the calorie intake, in order to lose/maintain/gain weight, you need specific calorie needs. What this theory assumes, however, is that you are eating balanced and healthy meals.

If somebody were to simply say "hey I need about 2500 calories a day to lose 1 pound a week, so I'll eat about 1500 calories worth of sugar" might initially lose weight. However very soon that person will probably begin to exhibit signs of malnutrition, possible hypertension etc etc.

With that in mind, if a person understands the amount of calories they need to meet their weight goals, as well as implement a HEALTHY meal program....BAM....weight loss.

When I was early on in messing around with calories, I tried to strictly use the "calorie theory" and ate like trash, although maintained a specific calorie intake......after a week my cycling performance suffered greatly simply because I wasnt taking in nearly enough complex carbs.

So to answer your question, you need both theories you mentioned. Hopefully that is how they teach it in med school!!

 

[syoung]

But I think in that case (What's OMS? dental surgeon?) the ortho is primarily doing aesthetic work compared to the dentist... they don't have a dietician. The dentist already tells the patient to eat less sweets, brush teeth, floss, etc. Same as the Ortho.

The physician, though he may recommend some other things, cannot do it in a comprehensive context like a dietician/nutritionist. Most times he has to refer out... right?

 

[267028]

If sound nutrition advice was given to people via their doctors or the mass media healthcare costs would go down, people generally want to do everything they can to lose weight and stay healthy. The fundamental problem is that people in our society are way too overworked and rely on the government and the media to get health advice when they should be reading and researching it on their own since its a vital part of life and being healthy. But when the government tells people to drink milk (sugar), eat whole grains (sugar), and eat less calories (even if its nothing but sugar), its a recipe for disaster.

Doesn't it seem ironic that physicians aren't trained more in nutrition, when it seems to play such a huge role in our metabolism, diabetes, hypertension/artherosclerosis and in the fields of internal medicine, pediatrics, OB, cardio, etc. Yes we gotta focus on procedures that generate income, but at what expense? Continue just play catch up with patients on their diseases?

 

[267028]

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I took a couple nutrition classes at my U (for a time wanted to do nutrition for a living)

From what I studied.....both theories need consideration together. You already know about sugar and insulins role in fat storage so no need to dive into that. About the calorie intake, in order to lose/maintain/gain weight, you need specific calorie needs. What this theory assumes, however, is that you are eating balanced and healthy meals.

If somebody were to simply say "hey I need about 2500 calories a day to lose 1 pound a week, so I'll eat about 1500 calories worth of sugar" might initially lose weight. However very soon that person will probably begin to exhibit signs of malnutrition, possible hypertension etc etc.

With that in mind, if a person understands the amount of calories they need to meet their weight goals, as well as implement a HEALTHY meal program....BAM....weight loss.

When I was early on in messing around with calories, I tried to strictly use the "calorie theory" and ate like trash, although maintained a specific calorie intake......after a week my cycling performance suffered greatly simply because I wasnt taking in nearly enough complex carbs.

So to answer your question, you need both theories you mentioned. Hopefully that is how they teach it in med school!!

 

[Ost3oclast]

I would tend to agree with you on that, I guess my beef (pardon the pun) with nutrional guidelines is that meat and saturated fat are demonized when they shouldn't be. Our ancestors and current hunter-gatherer tribes ate tons of meat and a good amount of fruits and vegetables. The whole notion that saturated fat causes hypertension and what not was based on a couple bogus studies perpetuated by a well known doctor back in the day and the medical community agreed with him because he was very influential. The excessive amount of sugar sends a signal to the body that causes LDL particles to get converted to smaller ones, and these are the ones that get caught in the artery walls and cause plaque buildup.

Exactly. I was always taught....if its made in a factory, dont eat it. Meat is an essential part of a diet not only because of protein but also small amounts of creatine and vitamins. But things like chips, candy bars, sodas are not killed or grown naturally and cooked. They are odd human inventions. Granted I do splurge on candy or a soda every now an then, its normal. However, alot of people take it over board. You seem to have a good grasp on this nutrition stuff.

 

[zeppelinpage4]

Good topic! I was wondering the same thing as the OP. Our biochemistry professor is really interested in nutrition and does a lot of research on the topic. So she often times taught our class in terms of nutrition. It was amazing, and I definitely learned a lot of things that are clearly portrayed incorrectly in the media.

However, she said that doctors aren't as up to date as the scientists, but they're slowly catching up (I have no clue if this statement is accurate, but I would certainly like to know from the med students and physicians posting). Hopefully, medical schools are teaching to the most up to date and accurate scientific findings, and not falling back on old hypotheses.

 

[267028]

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[267028]

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[Ost3oclast]

Haha thanks, and yes exactly, people should be eating natural foods, although I hate the term natural because its so overused and misunderstood. And yea I'm not going to lie I sometimes have a chocolate bar after I lift weights lol, but the sugar goes to the the muscle cells so its all good

Hahaha yea the word "natural" is hilariously misused by the media. ALWAYS read the back of what you are buying. Anyway back on track, The physicians I know are all pretty well versed on nutrition. Not sure if that was self learned or taught in med school.

People always like to talk about how terrible physicians are at getting patients to lose weight. Especially the herbalifers around my town. People forget that all the physician can do for the patient is properly educate or motivate. People have to get up and do the work themselves....this is something that this country has seemed to have forgotten.

 

[267028]

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[Ost3oclast]

Don't get me wrong I don't think it is the physicians job to monitor everything the patient eats, at best they can give a quick 1 minute lecture on what to eat or stay away from. I'm talking about guidlines set out by the american heart association or american medical association or the WHO. There is only so much 1 hurried physician can do but the medical society needs to update their nutrional guidelines so people aren't confused and mislead by outdated science.

Couldnt have said it better.

 

[syoung]

I agree, but a distinction must be made between the meat eaten by our ancestors and the meat widely available now. Our ancestors ate wild deer, elk, antelope, rabbit, bison, etc. that freely roamed the prairie. What's widely commercially available today is just not the same.

I was slowly phasing out red meat when Harvard's study was released, and now it's totally gone from my diet. I stick with sauteed/grilled fish and chicken, lean dairy (I drink a lot of milk), nuts, and legumes. I splurge every once in a while and make turkey burgers or spaghetti and sauce using browned ground turkey.

So the harvard study only really looked at processed red meat (is that ground meat or meats like salami?) What about just steaks? What about free range/standard immobile beef? Lots of potential research.

 

[Ost3oclast]

This is true. Processed meats can actually be harmful. Even meat we wouldnt expect to be processed may be (hamburger for example). Its all about doing your homework and looking things up (companies etc). Im lucky...I come from a farming community and farmers here locally raise alot of the beef I eat. No nasty chemicals or anything used...

 

[267028]

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[Ost3oclast]

You guys ever watch supersize me? More people need to see that. Perfect example of processed meats and too many simple carbs.

 

[267028]

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[267028]

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[sliceofbread136]

Humans do not violate thermodynamics, sorry. If you use less calories than you take in you WILL gain weight (notice I didn't say fat)

 

[267028]

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[267028]

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[235788]

I'm going to go out on a limb here and say the latter?

Which would you rather eat?



or

Elk sucks....


It's all about razorback

 

[sliceofbread136]

If the human body was a closed system I would agree with you, but the human body is an open sytem, we exchange energy and matter with our envirnment. I'm pretty sure that was covered in 1st semester general chemistry lol

If you take in more energy than your body loses to the environment (mostly basal metabolism and work) than your body stores the energy as fat. What you said has no bearing on what I said...

 

[syoung]

Elk sucks....


It's all about razorback

Hell yeah. Although I do like my deer. I'd like to try bison... Mmmm. But does this mean I have to give up my hamburgers??

 

[startswithb]

Our school took note of the lack of nutrition education in medical school and therefore tried to add some to the curriculum. They brought in a nutrition PhD who wrote a series of lectures on...TPN, enteral nutrition, and which diseases require diet modifications. Such as, COPD patients need meals with a smaller CO2 production so eat less carbs- they also need more calories for breathing energy so eat a banana chocolate milkshake. Step 1 has some nutrition from what I can see in First Aid but like someone said, it is mostly vitamin deficiencies. So, as you can see, physicians are still being taught based on and focused on DISEASE. Is that a problem? Maybe, maybe not. As brought up in this thread and many others, there is still a lot of controversy from the scientific community on how our body processes certain nutrients over others. This makes it very hard to develop set guidelines for patients and a set curriculum from which to teach. Not only that, but dieticians are employed by hospitals and should be able to study this more in depth and help patients themselves. (Many people expect physicians to know absolutely everything about the body- including the healthy body- like exercise science and nutrition. There are other professions for that and we can't do it all. In my opinion).

 

[startswithb]

Great points. It's all about time and $. You're not going to get teh $ by telling an obese person to not eat fast food. That's the RD's job.

I wasn't necessarily thinking about money, but training and expertise. Give me a well-researched nutritional plan for my patients and I will recommend it.