Trying to stay healthy. Can seem like up full-time job. Sometimes especially during a pandemic, but I'm here to make that goal a little easier. Welcome to the nutrition facts podcast. I'm your host. Dr. Michael Greger. Here's a question. How much do doctors actually know about nutrition. I've done a lot of research on the subject and concluded that more doctors should take the Hippocratic Oaths a little more seriously.
Here's our first story,
a poor diet. Now, outranks smoking as the leading cause of death on the planet, as well as specifically in the United States. In the US. The number one, killer of Americans is the American diet. So if diet is Humanity's number one killer then obviously, it's the number one thing taught in medical school, right? Sadly medical students around the world are poorly trained in nutrition. It's not that medical.
Aren't interested in learning about it. Medical schools just aren't teaching it without a solid foundation of clinical nutrition Knowledge and Skills. Physicians worldwide are generally not equipped to even begin to have an informed conversation about nutrition with their patients. How bad is it one study assessing the clinical nutrition knowledge of medical doctors. Found the majority got 70% of the questions wrong, and there were multiple choice.
Ask questions. So they should have gotten about a fifth right? Just by chance, and the wrong answers were not limited to difficult or demanding questions. For example, less than half, could guess how many calories are in fat carbs and protein only one in 10 new, the recommended protein intake and only about one in three knew what a healthy BMI was. I mean, this is like super basic nutrition knowledge. And what's worse? Not only did the majority of medical doctors get a failing grade, but
Thirty percent of those who failed had a high self perception of the clinical nutrition. Expertise meaning, not only were they clueless about nutrition. They're all so clueless that they were clueless about Nutrition, a particularly bad combination, given that doctors are trusted and influential sources of healthy, eating advice for those majority of consumers, who get information from their personal health care, professional, 78% indicate making a change in their eating habits as a result.
Of those conversations. So if everything the doctor knows they read in some checkout, aisle magazine. That's what the patients are going to be following. Only a quarter of doctors surveyed correctly, identified. The American Heart association's, recommended number of fruit and vegetable servings per day and fewer. Still were aware of the recommended, daily, added sugar limits. So, how are they going to counsel patients on it yet again of the doctors who perceive themselves as having high nutrition knowledge.
93% couldn't answer those two basic, multiple choice questions.
A physician's with no genuine expertise in say, brain surgery are neither likely to broadcast detail opinions on that topic nor have their quote unquote expert opinion, solicited by media, and most topical domains in medicine. Enjoy such respect. We defer expert opinion, and commentary to actual experts not. So with nutrition where the common knowledge that Physicians are generally ill trained in this area is conjoined to
Teen invitations to Physicians for their expert, opinions on the matter. All too many are willing to provide their opinions absent. Any basis for actual expertise or Worse. Made on the basis of bias and personal preference. Sometimes directly Tethered to personal gain such as diet, book sales. That's one of the reasons. All the proceeds I received from my books are donated directly to charity. I don't even want the appearance of any conflicts of interest.
In a culture that routinely fails to distinguish expertise, from Mere opinion or personal anecdote. We physician should be doing, all we can to establish relevant barriers to entry for expert opinion on diet and nutrition as in all other matters of genuine medical significance. I mean, we're not talking celebrity gossip lives are at stake and there are entire Industries devoted to marketing messages that make inspired directly against well in for medical advice in this area.
Education must be brought up to date for Physicians to be ill trained in the very area. Most impactful on the rate of premature death at the population. Level is an absurd anachronism. The mission of medicine is to protect defend and Advance The Human Condition. That mission cannot be fulfilled. If diet is neglected. Maybe one place to start is for Physicians and Healthcare organizations to collectively. Begin to emphasize their seriousness about
nutrition and health care by practicing what they at least should be preaching. Is it appropriate to serve pizza and soft drinks at a resident conference? While bemoaning the high prevalence of obesity, encouraging patients to eat healthier a simile, poor example exist in medical conferences, including National meetings were some morning sessions are accompanied by foods such as donuts and sausage.
In our next story, we look at how more of us might be open to changing our diet and lifestyle. If we knew how little modern medicine has to offer.
Yes, an ounce of prevention is worth a pound of cure, but pound. Isn't that heavy?
Why change our diet and lifestyle? We can just wait and let modern medicine fix us up. Previously. I noted that patients tend to wildly overestimate, the ability of cancer, screening drugs or cholesterol lowering medications to prevent disease. So much so that the patients were told the truth, how little they'd actually benefit 90% said they wouldn't bother taking them. The reason we should eat healthier rather than just counting on a medical technical fixes that the same.
Overconfidence may exist for treatment to and a massive study more than 200,000 trials. They discovered that yes, pills and procedures can certainly help, but genuine very large effects, with extensive support, from substantial evidence appear to be rare, in medicine, and large benefits. For mortality making people live significantly longer almost entirely non-existent, right? We're great for broken bones, and curing infections. But for chronic disease are leading cause of death and disability. Modern medicine doesn't have much to offer.
/ and in fact can sometimes do more harm than good side effects from prescription drugs. Kill an estimated 100,000 Americans every year in effect, making Medical Care the sixth leading cause of death in the United States, but that's just for the deaths from taking medications as prescribed. Another 7,000 deaths occur from getting the wrong medication by mistake 20,000 deaths, from other errors in hospitals, hospitals are dangerous places and
National 80,000 of us die from hospital acquired infections more recently, estimated ninety nine thousand deaths, but can you really blame doctors for these deaths? You can, when they don't wash their hands. We've known since the 1840s that the best way to prevent hospital-acquired infections is through hand-washing yet compliance rates among healthcare workers, rarely exceeds 50% and doctors are the worst even in a
Uncle Intensive Care Unit even if you slap up a contact precaution sign signaling, particularly high risk less than a quarter of doctors wash their hands.
Many Physicians greeted. The horrendous mortality data due to Medical error with disbelief and concerned that the information would undermine public trust but if doctors still won't even wash their hands, how much trust do we deserve?
So, you could go into for a simple operation and come out with a life-threatening infection or not. Come out at all.
And 12,000 died from surgeries that were unnecessary in the first place. For those keeping score. That's 225 thousand people dead. From iatrogenic causes, meaning death, by dr. Death, by medical care. And that's mostly just for patients in a hospital. In an outpatient setting adverse effects can send Millions to the hospital and resultant, perhaps 199,000, additional deaths and this is not including all those
Just non fatally injured. Like oops. We accidentally amputated. The tip of your penis.
And these estimates are on the low end, The Institute of medicine, estimated the death from medical errors, May kill up to 98,000 Americans. That would bump us up to two hundred eighty four thousand dead. But even if we stick to the lower estimate, the medical profession, constitutes the third leading cause of death in the United States, it goes heart disease, cancer than me.
One respondent pointed out that it was misleading to call medicine, the third leading cause of death. Since many of those we kill. Also had heart disease or cancer. Doctors aren't out there, you know, gunning down, healthy people. Only people on medications are killed by medication errors or side effects, right? You have to be in a hospital. Be killed by a hospital error. Exactly, right? That's why lifestyle medicine is so important because the most common reasons people are on drugs or in.
All's is for diseases that can be prevented with a healthy diet and lifestyle as I've covered before. The best way to avoid. The adverse effects of Medical Care is to not get sick in the first
place. Finally. Today. We look at the medical community's reaction to being named the third leading cause of death in the United States. Previously. I profiled a paper that added up all
the deaths caused by Medical
Care in this country. The hundred thousand.
Deaths from medication side effects, plus all the deaths caused by errors, Etc, concluding.
That the third leading cause of
death in America was American Medical system. What was the medical community's reaction to this revelation? After always publish some of the most prestigious medical journals, the Journal of the American Medical Association by one of our most prestigious Physicians Barbara, Starfield who literally wrote the book on primary care when she was asked in an
View what the response was. You replied that her primary care work has been widely
embraced, but her findings on how harmful and ineffective
Health Care, could be received, almost no attention. We're calling the dark dystopia of George Orwell's
1984, where awkward facts are swallowed
up by the memory hole as if they never existed at all. Report after
report has come out in the response, has been a deafening sounds both indeed.
And inward failing to even openly discuss the problem leading to
thousands of deaths. We can't just keep putting out reports, we have
to do something.
The first report was in 1978 suggesting about 120,000 preventable Hospital death. The
response silence
for another 16 years, you know, if you multiply 120,000 by those 16 years, you get one point nine million preventable deaths about which there was near total. Dr. Silence silence.
No substantial effort to reduce. The number of those deaths. The Institute of medicine, then release this Landmark study in 1999 allowing for another 600,000 deaths to take plays. Now. Some things have finally changed work. Our limits were instituted for medical trainees interns and residents could no longer be worked. More than, you know, 80 hours a week at least on paper and the shifts couldn't be longer than 30 hours. Long may not sound like a big.
A big step. But when I started my internship, I was working 36-hour shifts. Every three days. That's 117 hour. Work weeks. What's the big deal? Well, when interns and residents are forced to pull all-nighters, they make 36 percent more
serious, medical errors, five times, more diagnostic errors and have twice as many attentional
failures. That doesn't sound so
bad Until you realize that means like nodding off during
surgery.
The patient is supposed to be asleep during surgery. Not the surgeon comparing performance as
much as a blood-alcohol level that would have made it illegal to
drive a car, but can still do surgery. So no surprise 300%. More patient, deaths residents consider themselves. Lucky, they get through training without killing anyone. Not that the family would ever find out doctors with rare exceptions are
Notable for their actions, The Institute of medicine report did break the silence and prompted, widespread Promises of change, but
what they did not do is act as if they really believe their own findings for. If they really believe that a minimum of 120 people
every day were dying. Preventable deaths in hospitals. You
draw a line in the sand. Like, even airliner was crashing
every day. You'd expect the FAA would step in and do something The Institute of Medicine.
Ian
could consistently demand. The doctors and hospitals immediately adopted, at least a minimum set of preventable preventive practices, like
for example, barcoding drug, so there's no Mix-Ups,
you know, like they do for even a pack of Twinkies at the grocery
store.
Rather than just going on to write another report.
They could bluntly warned colleagues that they would publicly sensor. Those who resisted implementing, these minimum practices calling for some kind of stringent sanctions, but
instead, we get the silence.
Dr. Starfield didn't stay sound, but she is, unfortunately no longer with us. Ironically. She may have died from one of the adverse drug reaction. She's so vociferously, warned us about. She's placed on aspirin and a blood thinner Plavix to keep a stent. She had placed in her coronary artery from clogging up. She told her Cardiology. She was bruising or bleeding longer, but that's the risk. You hope doesn't outweigh the benefits until she apparently hit her head while swimming and bled into her brain.
The question for me is not whether she should have been on two blood thinners for that long or had the stent inserted in the first place, but
whether or not she could have avoided the
heart disease in the first place, which is
96% avoidable in women. The number one killer of women need
almost never happen.
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