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Doctor’s Tip: Is unhealthy eating the new tobacco?

Dr. Greg Feinsinger
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In last week’s column I talked about Kaiser Permanente, the largest HMO in the U.S., encouraging its 15,000 doctors to counsel their patients about the health benefits of plant-based nutrition. So why do most non-HMO doctors fail to talk to their patients about this?

Let’s look at the history of medical practice and smoking for an answer. In the mid-20th century, evidence gradually accumulated that smoking was unhealthy, causing lung and other cancers, emphysema, and heart attacks and strokes. However at that time, essentially everyone smoked, doctors and patients alike.

It took some 7,000 studies and tens of thousands of preventable deaths over several years before doctors finally “got it.” Part of the reason it took so long is that doctors want controlled studies before they really believe something, but controlled studies of smoking would have been unethical once the dangers became apparent.



In spite of the lack of controlled studies, doctors finally did get it, because the evidence of harm from smoking became so overwhelming it was impossible to ignore (the tobacco industry did its best to hide negative evidence and came up with new marketing ploys such as “organic tobacco” and “filtered cigarettes with fewer carcinogens”). Now, very few doctors smoke, and they counsel their patients who smoke to quit.

We now have a very similar situation with unhealthy eating. The food industry has people hooked on salt, sugar and fat, and does its best to sow seeds of doubt about settled science that shows that these things are unhealthy. The evidence has become overwhelming that meat (including chicken), dairy, eggs, oils, refined food, sugar and salt contribute to many of our health problems: obesity, hypertension, cardiovascular disease, diabetes, inflammatory conditions, autoimmune disease, dementia and many forms of cancer.



However, doctors don’t receive training in nutrition in medical school, and they don’t learn about it at most medical conferences, which are often sponsored by pharmaceutical companies. And doctors themselves don’t yet understand the power of healthy nutrition, which along with exercise is more effective than any pill we have. So most doctors eat the unhealthy S.A.D. (standard American diet). Furthermore, doctors (and hospitals) make huge profits by doing procedures such as stents and bypass surgery, but payment for counseling is low. (Kaiser is based on a different system, which benefits financially when patients stay healthy).

There’s an interesting phenomenon in medicine: The advice doctors give their patients is often based on what they do or don’t do themselves. If a doctor exercises he or she will advise their patients to exercise, but if they don’t they won’t. If a doctor is a skier and their ob patient asks if she can ski while pregnant, the doctor will say it’s OK; if the doctor does not ski they will tell their ob patient it’s too dangerous. Then there’s the joke about how doctors determine if someone has an alcohol problem: anyone who drinks more than they do. The point is that if doctors don’t eat a healthy diet they won’t counsel their patients to do so.

There are signs of hope though. Kim Williams, the current president of the American College of Cardiology, adopted a plant-based lifestyle after evaluating the options a few years ago, saying that he didn’t mind dying so much but he didn’t want it to be his fault. My wife and I became plant-based four years ago, after a nurse practitioner recommended that we read the book “The China Study.” Other plant-based physicians that I’m aware of are Kim Scheuer and Chris Miller in Aspen; Laurie Marbas, who used to practice in Rifle and is now in Grand Junction; internist Dennis Lipton in Vail; orthopedist Richard Cunningham in Vail; and Andrew Freeman, who is a cardiologist at National Jewish in Denver.

It will take time, but eventually, doctors will “get it” and start eating a healthy diet themselves, and counsel their patients to do the same thing.

If any readers are interested, there is a Colorado Veg Fest in Denver on July 23-24, and I’m sure there will be many more plant-based providers there.

Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, now has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and any other medical concerns. Call 970-379-5718 for an appointment. For questions about his columns, email him at gfeinsinger@comcast.net.


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