I used to ask all my patients about their sleep. It was an area I felt comfortable with, having worked for a year in the OHSU sleep lab and treating folks with sleep apnea, narcolepsy, and REM behavior disorder. Now, I ask them all about diet. My quick and dirty is, “How’s your diet–what did you eat last night?” I can get a pretty good sense of their nutritional status with this one question. In the context of known diseases like hypertension, heart disease, diabetes, obesity, and cancer, I can start to narrow down specific dietary tendencies that my patients are having trouble with. The next step is motivating them to change.
I just finished reading The China Study, written a few years ago by T. Colin Campbell, which details an exhaustive 6500 person epidemiological study done in China correlating nutrition intake and disease outcome. Dr Campbell (a biochemist at Cornell) was raised on a farm and ate eggs, bacon, and milk every morning. His father died from a heart attack in his forties. He now advocates for a whole-food, plant-based diet. I am starting to see the point.
My wife and I have been buying less meat since our daughter just won’t eat it. That trend has crossed over from an irrational three-year old’s preferences into the rational science of health and environmental impact. Watching documentaries Food, Inc and Forks Over Knives (both streamable on Netflix) have helped us make the transition over from “flexitarians” to preferring a non-animal diet.
Outside the exam room, I’ve been fighting the battle against fast food marketing to children. New data from Yale’s Rudd Center for Obesity shows that 15% of preschoolers ask to go to McDonald’s everyday. In fact, in our current recession, fast food has become extremely lucrative. People have less time to cook, and their health is paying for it. The food industry is incredible powerful in its lobbying, policymaking, and advertising. Remember how catchy the ad campaigns for “Beef–It’s what’s for dinner,” “The incredible, edible egg,” and the wunderkind, “Got milk?” were? I don’t eat any of those anymore.
I think we need a re-prioritization of healthy food. People need to see how convenience leads to compromise. I have told some patients, “Don’t let your tongue wreck the rest of your body.” You can make a kale salad for less cost and in less time than it takes to drive-thru fast food. A foodie town like Portland is easy to eat healthy in, so it’s up to us (the health professional students who can spend a little more time with patients in clinic) to encourage trying new, healthier foods, promote the benefits, and know the data on how diet and nutrition can prevent and treat disease.