It’s Time To Re-Frame Nutrition In Medicine

This was an article I wrote for one of my nutrition classes, but I think it’s appropriate for my blog as well. I’m very passionate about applying nutrition in a medical setting. We know it can be beneficial for certain medical conditions and it may save a lot of money for the patient as well. Who doesn’t want to keep some extra dough?? This article is a bit more science-y than my typical posts, so I tried my best to touch it up for y’all so it’s easier to read and understand. If you have any questions on something, contact me and I’d be happy to clear up any confusion.

Re-framing Nutrition In Medicine

Western medicine has been the go-to approach for treating illness and health conditions. The process is the patient sees a physician; they explain the symptoms they are experiencing. Then, the doctor then runs a series of tests to determine the proper diagnosis. Once the illness is discovered, the patient is likely prescribed pharmaceuticals (drugs) to improve their conditions and get them better. This is an effective process as drug companies would not be so profitable if their products did not work. Prescription drugs are effective for treating the conditions that they were created for; however, this often comes with a few consequences.

First, the cost of the drug itself can vary. Some are inexpensive whereas others may break the bank and insurance may not fully cover the cost, leaving the patient to pay out of pocket, causing additional financial stress for them.

Second, drugs may have side effects that could make the patient even sicker than they were before beginning the treatment. In that case, they may need to take even more drugs to treat those side effects, and the cycle-and financial stress-could perpetuate.

Finally, drugs don’t encourage habits. This is a problem often overlooked. If left alone to improve their conditions without proper education, the patient may bounce back if they don’t understand how to stay healthy. Habits allow for that long-term improvement in health, as the patient becomes more independent in caring for their self.

Nutrition is one solution that should be explored in greater detail to avoid the excessive costs of western medicine and the side effects of drugs. This article IS NOT saying traditional medicine does not work or that we’re making people worse off. That is not my belief at all. I have no doubt in my mind that western medicine is effective. However, I think we have been under-utilizing our Registered Dietitians for treatment of medical conditions that are preventable with nutrition and lifestyle changes. I’m not one of those tinfoil hat wearing people that think doctors want us to get sicker so we have to pay them more. That’s absurd and please don’t fall into that conspiracy-theory trap.

To date, much of the research on Medical Nutrition Therapy (MNT) has been conducted on diabetic patients, but the findings are promising.

In particular, one study found not only significant improvements in diabetic health markers, but some of the patients were also on an oral agent and still saw improved conditions1. This implies that nutrition may be just as effective as some drugs at treating Type 2 diabetes and possibly other preventable conditions like hypertension or obesity. In this study published by the Journal of the American Dietetic Association, 247 participants were randomly assigned (random assignment allows for greater accuracy in the results) to two MNT groups that differed on the degree of care provided by the RD while there was an additional comparison group of 63 individuals who received no MNT1. All the participants were diagnosed with Type 2 Diabetes.

At 6 months, both MNT groups had experienced statistically significant improvements in HbA1c and fasting plasma glucose1. When results in scientific research are statistically significant, it means that there is a strong likelihood that we know a certain treatment has a direct effect on something else, and it wasn’t just by chance we got a certain result. Also, HbA1c and fasting plasma glucose are markers for tracking diabetics’ ability to control the spikes in blood sugar. As they improve, patients’ ability to manage their blood sugar improves. The comparison group saw no changes.

Often, Registered Dietitians and other nutrition professionals take a back seat to the physician and other primary care providers, boxing nutrition services into “complementary” or “alternative” medicine. With this comes a connotation that RDs aren’t as competent or capable of treating certain illnesses than typical health care providers.

It’s time to refrain nutrition care and dietitians into the same box that medical doctors are in. For conditions such as Type 2 diabetes, Medical Nutrition Therapy has been shown frequently to be effective. In addition, cost savings may occur as well due to elimination or reduction of pharmaceutical bills.

While there are not as many studies available that demonstrate the effectiveness of nutrition as medicine for other conditions like heart disease and obesity, it can be implied that MNT would be effective for these conditions because they fall under the same category as Type 2 Diabetes: preventative and highly influenced by lifestyle factors.

Just as lifestyle behaviors can lead to these conditions, so too can they lead away from them. It’s important to understand the value that nutrition has in healthcare and medicine. Patients and healthcare professionals alike should educate themselves on the advantages of a healthy eating pattern (diet). This way, success for you, the patient, can be lifelong, and free of dependence on a pill for life.

References:

  1. Franz MJ, Monk A, Barry B, et al. Effectiveness of Medical Nutrition Therapy Provided by Dietitians in the Management of Non–Insulin-Dependent Diabetes Mellitus. Journal of the American Dietetic Association. 1995;95(9):1009-1017. doi:10.1016/s0002-8223(95)00276-6.

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