#1. Eating the liver of arctic-dwelling animals causes hypervitaminosis A, not D.
Good call, got my wires crossed
#2. Your posts seem fairly biased against MD's for whatever reason, not to mention chock-full of overt sarcasm.
I'm just a few months away from getting my MD, so I'm not
that biased against them. What I am biased against is people who don't confront their own ignorance, poor critical thinking skills, and hubris. I am biased against people acting like experts in a field they have no expertise in.
I think anyone would have to be pretty silly to think that MDs actually get taught effectively about the basics of nutrition, kinesiology, and exercise science. I don't, which is why I make point of reading up on this stuff on my own.
I think that clinical proficiency comes from a solid working knowledge of the basic sciences. My particular concerns are nutrition and fitness, which as almost everyone in this thread agrees, are the most important variables for health. I don't think we can be effective clinicians unless we understand the basic sciences behind these things. And I dont think we can study them, or develop solid methods of scientific study or clinical intervention unless we do that.
I also think it takes a certain amount of ignorance as to the history/philosophy and structure of science to NOT see the dangerously low quality of much of medical research. There are serious systematic, philosophical, and methodological errors in a lot of medical literature that the MD curriculum simply does not teach us. 'Evidence-Based Medicine' emphasis notwithstanding, what little critical scientific analysis ability we're taught relates more to statistics than it does study design.
Pretty sure no med student or MD in this thread said that one certain type of exercise is a cure-all for all people, or that all vegetables are created equally.
You're right, but the problem is most don't even know the basics of nutrition and exercise. How can you counsel a patient to eat right and exercise if you don't even know what that means?
How can we claim to know to understand the spine and musculoskeletal
dysfunction when we don't know anything about proper
function in the first place.
We as MD students aren't even taught about the physiology of
health. WE all understand the difference between diabetic and 'normal', but we don't understand the physiological differences between 'healthy' sedentary and 'healthy and physically active'.
As any exercise scientist knows, there are a host of differences between these two 'healthy' populations, which is why in their studies they differentiate between experiments with 'training naive' and 'trained' individuals. Muscles, physiologies, and metabolisms that have been subjected to strenuous exercise are very different and respond differently to stimuli than those that have not.
The sedentary lifestyle is a very new thing. It used to be a natural part of our lifestyle to get exercise. 40,000 years ago we walked all day, with occasional bouts of sprinting after game, sprinting away from predators, and occasionally carrying large carcasses back to the campfire. Aerobic, anaerobic, and resistance activity all taken care of. I'm pretty happy to sit on my computer, play with mathematical modelling for my research, reading up on the latest scientific knowledge from all over the world, and farting around arguing with med students and otherwise wasting my time, but I'd still like to stay fit. I just don't want to spend my entire day engaged in a physical lifestyle. Exercise science is pretty helpful there, helping me understand how the various modes of exercise strengthen and toughen my body and informing the process of determining how to manage to get the benefits of living a physical lifestyle in only an hour or two at the gym every day.
Do you disagree that the normal human body can obtain all its nutritional requirements from a natural balanced diet? How else have we managed to survive this long?
It can. And as a bioanthropologist, one of the things we study is exactly that: what in fact a natural balanced diet is and how we evolved to eat it.
Provided we obtain
high quality food in the form of nutritionally dense fruits, vegetables, and nuts, eat enough free range meat/eggs/dairy fed on
high quality food and eat
wild fish, don't cook with traditional vegetable oils, and, well you get the picture.
All these things used to happen automatically in the past as there was no such thing as assembly-line chicken, farmed salmon, poorly fed beef and dairy cattle, and overdepleted soil made to produce using artificial and incomplete fertilizer. Nor were vegetables and fruits so carefully and systematically bred and engineered for yield by weight.
The nutrient quaity of food is not the same as it was 50 or 100 years ago. The same meats, the same vegetables, and the same fruits are no longer as nutritious as they used to be, due to the way we grow them now and the conditions they're grown under. Garbage in, garbage out. The activity budget of the modern person is such that the production, procurement, and preparation of food simply is not allotted as much time as it once was. 40,000 years ago the ONLY things we did were feed, fight, f***, and sleep. It's a bit different now.
And in past times, you weren't expected to live beyond 50 or so. Nutrient quality becomes a lot less important when you can't expect to live to 80.
The loss of diet quality in recent history is a well-studied phenomenon and is especially striking when you look at asian peoples' descent into a 'modern western' diet with consequent increase in things like cancer, dementia, diabetes, and heart disease.
All these factors taken together mean that in the modern environment it
is in fact tougher to eat healthy than it was in the past. If people 'can't find the time' to spend 30 minutes in the gym 5 days a week (I somehow found time to put in 10 hrs a week even on inpatient months averaging close to or over 80 hrs/week, so meh), can we really expect them to put in the effort that it takes to eat healthy now? Especially when you have to put extra effort in just to
find the food that's as good as it was a 100 years ago?
There are plenty of studies out there on 'the average diet' and how deficient it can be in important nutrients. There are even a growing number of studies of people who 'eat healthy' and how deficient they can be thanks to all of the above issues.
To draw a parallel, animals in the wild typically eat naturally balanced diets that are very healthy for them. And yet one of the big challenges in captive animals and pets is developing a healthy diet for them. Dog food now is tons better for our pets than dog food was 30 years ago. But as any canid enthusiast will tell you (some of my bioanthropology work draws a parallel between wild social canids and early hominids), they greatly benefit from supplementation with veggies and fruits. Why? the wild canid diet is up to 40% fruit and vegetable by weight. We're still learning more and more about proper pet nutrition today.
We are in the exact same situation as our pets. Today we live in vastly different circumstances and our food is vastly different from the way it once was from the ground to our plate. The challenge of nutrition in the modern world is figuring out exactly what it was about the way we used to eat that was so much better.
If you can't tell, I'm kind of a health fanatic (although I admittedly eat more than my fair share of junk food). I still find it hard to find and afford high quality food and find the time to prepare it in an ideal way.
So I choose to supplement. And I choose to recommend supplementation to those who ask. There are people out there who don't have to. I hope someday I get my butt in gear and become one of them. But until that day comes I'll advocate any and everyone to make up for the glaring deficiencies in their diet with supplementation.
I, for one, subscribe to the idea that our bodies are so well-made that, if taken care of and free from genetic disorder, we can put ourselves through a whole ton of crazy $hit and come out healthier than ever.
Being a longtime athlete and crazy person, I happen to agree with you.
You make it sound like if we don't get the perfect blend of supplements we'll suffer drastic consequences, but that's just not the case in my experience.
Hardly, what I'm saying is that the modern diet and lifestyle means that we are sorely lacking in things that were once automatically ingrained parts of our lives. Otherwise we woudln't be as sick and as messed up as we are. But medicine remains largely ignorant of the science of nutrition and exercise, which leaves it powerless to truly understand the role they play in health. And ineffective in advocating meaningful change in patients' lives that will lead to greater health.
