Doctor’s column: Why don’t doctors tell patients to go vegan?
ABOUT THIS COLUMN
Greg Feinsinger of Carbondale, who retired in February from Glenwood Medical Associates after 41 years as a family physician, is writing a 10-week series.
• Diabetes and prediabetes
• What causes heart attacks
• How to prevent heart attacks
• What diet is most healthful?
What if there were a pill that prevented and reversed heart disease, hypertension, high cholesterol, and Type 2 diabetes; prevented up to 60 percent of cancer; prevented kidney stones, osteoporosis and gout; reduced the incidence of inflammatory diseases such as rheumatoid arthritis; reduced dementia including Alzheimer’s; and reduced the incidence of autoimmune diseases such as Type 1 diabetes and M.S.?
And what if it had no side effects and cost no more that what people already spend on groceries every day?
Health-care providers would all know about this drug due to marketing by the company that made it, and the public would be aware of it and demand it. Obviously health-care providers would prescribe it and would be accused of malpractice if they didn’t.
Well, there is such a treatment, but it isn’t a pill. Rather it’s lifestyle modification consisting of a plant-based, whole (unprocessed) foods, low-fat diet, plus regular exercise. Unfortunately, most people don’t know about this option and their health care providers don’t educate them about it. According to Dr. Michael Greger (nutritionfacts.org), here are some of the reasons:
• Performing surgical interventions such as stents and bypass have the potential for enormous financial reward for hospitals and for the providers who do them.
• Doctors don’t get training in nutrition in medical school and most don’t know much, if anything, about it. A recent study compared doctors’ knowledge to patients’ knowledge about nutrition, and the patients won.
• Even if a doctor does know something about nutrition, he or she doesn’t get paid much for counseling and is often rushed and doesn’t have the time to do it.
• Doctors assume that patients won’t adopt lifestyle modification, but that is the old, paternalistic way of practicing medicine. Our job should be to present the various options to patients and let them decide what they want to do.
• Medical studies, medical schools, medical journals and medical conferences often get funding from the pharmaceutical and food industries.
• Committees that make up national guidelines on nutrition and medical practice (e.g. hypertension, cholesterol, diabetes guidelines for physicians) usually have members who represent the pharmaceutical and food industries.
• These days, physicians who give presentations at medical conferences must disclose what ties they have to pharmaceutical and other companies, and it’s amazing how long the list often is.
• Doctors often have a “slavish devotion to orthodoxy.” The average time it takes for medical practice to change from the time the science tells us we should change is 17 years.
In the setting of a heart attack, a stent can save your life. But other than that, stents and bypass surgery have not been shown to save lives or improve quality of life when compared to lifestyle modification, and they don’t treat the cause of the disease. Stents are invasive and occasionally can result in serious complications. Bypass surgery is much more invasive and can result in complications including permanent brain damage and death. Furthermore, these procedures cost the medical system billions of dollars a year. And although modern drugs such as antibiotics have saved many lives, and we’re lucky to have them, 100,000 people die in America every year from adverse reactions to drugs, so if you can achieve the same benefit from lifestyle modification, it is safer.
In addition, eating a plant-based diet is better for the planet. Producing 1 pound of beef takes 1,847 gallons of water; producing 1 pound of broccoli takes 34 gallons. The C02 footprint in C02 equivalents to produce 1 pound of beef is 39.2, whereas for lentils it is 0.9. And then there is the issue of inhumane treatment of animals in factory farming.
So clearly, all doctors should feel obligated to learn about nutrition and to discuss lifestyle intervention as an option with their patients. This is the right thing for them to do for their patients, to help with our unsustainably expensive medical system, and for the planet. Sure, not all patients are going to be willing to go totally plant-based and to exercise regularly, but in my experience many will, and the rest will at least make some changes. There is some hope. The current president of the American College of Cardiology became vegan after looking at the facts and determining this was the healthiest way to go. And a colleague of mine recently attended a conference for plant-based cardiologists.
To find out more about local support for adopting plant-based nutrition, contact Ardis Hoffman, at 303-305-9664, or firstname.lastname@example.org.
Dr. Feinsinger is a retired family physician who is available for free consultations about heart attack prevention, plant based nutrition, and other health issues. Call 379-5718 for an appointment.
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