“Huston, we have a problem” is an understatement. When one side is falling miserably, we must look for change, and this is where integrative medicine comes into play.”

How do you teach algebra to those who only know their ABC? The problem rests on a lack of oversight. Farmers are growing crops by using heavily sprayed pesticides and herbicides, and we have been told that they cause no harm. Food manufacturers are packaging processed foods empty of nutrition but laced with pesticides and herbicides. Animals and farmed fish raised for food are given antibiotics and estrogen stimulants to help them grow quicker, and are fed toxic GMO crops. And wouldn’t you have it, all the poisons carry on up the food chain and into the population?

The Lack of Nutrition Education in Medical Schools

When sickness arises, a visit to the doctor is in order and because of his lack of nutrition education in medical school, rudimentary at best, he gives out what he has been taught. Beginning with medical school, the time devoted to nutrition is limited, with an average of 19 total hours over 4 years, and is focused largely on biochemistry and vitamin deficiency states.[1]

Following medical school, nutrition education during the 3 or more years of graduate medical education is minimal or, more typically, absent. This lack of education in training is reflected in what physicians report about the quality of it. In a 2017 survey of 646 cardiologists, 90% reported that they had not received adequate nutrition education to counsel their patients, even though 95% believed it was their personal responsibility to do so.[2]

Unfortunately, it’s not just the question of personal responsibility. According to the US Burden of Disease Collaborators “health in the United States improved from 1990 to 2016 (…) but the probability of death between ages 20 and 55 years has increased more than 10%”[3] because of the poor-quality diet that has been identified  as the leading cause of death in the United States. So who should be responsible for providing the information?

According to a study of 1500 health care practitioners, 97% responded that they have a responsibility to ensure that patients are counseled about obesity.[4] Another study of 606 clinicians showed that 96% ‘agree’ or ‘somewhat agree’ that they should contribute to patients’ weight management, 88% acknowledged that moderate weight loss is ‘extremely beneficial’ for patients with obesity, and 80% recognized obesity as a disease.[5] Though, based on the current situation, recognizing the problem is still not enough.

True Cost of Health Care

As we can see, each sector is broken, the food chain, the education system, and disease treatment. Is it any wonder why disease is raging out of control and spending with it? The US spends more on health care than most other countries at 3.5 trillion. Spending per person in the US was $10,224 in 2017, which was 28% higher than Switzerland, the next highest per capita spender.[6] With this spending, are Americans healthier from this investment? As you could see, they are far from it. American heath is, by most metrics, worse than all the other rich countries. US child mortality, for example, is about seven per 1,000 children. Compare this to Finland, where child mortality is two per 1,000 children. Then there is life expectancy. A Japanese child born today can expect to reach the age of 84, while an American child can expect to reach age 79. This gap exists despite the fact that the US spends about 7% more on health than Japan. It is also worth factoring in the unique health challenges the US faces, such as the obesity epidemic—which costs the nation between $147 and $210 billion per year—and adds to the burden of chronic illnesses, such as diabetes and heart disease. Would a truly healthy nation have such morbidity in its midst?[7]

Unless Americans make changes in their lifestyles and food industry changes from the way food is prepared and marketed, the number of people with chronic diseases—and the cost of treating them—will continue to rise. The US Chronic Disease estimates that by 2030, 83 million people in the US will have three or more chronic health conditions, up from 31 million in 2015 with a projected cost of 42 trillion, and 5% of population will account for 50% of the spending.[8]

Integrative Medicine as the Solution

“Huston, we have a problem” is an understatement. When one side is falling miserably, we must look for change, and this is where integrative medicine comes into play. As the above shows, there has been an evolution, but without balance. Today, things need to be integrative. The people want choices and convenience, but they don’t want disease and sickness. Let’s face it: the health industry is rapidly growing, selling vitamins of various quality levels when we should be concentrating on USP pharmaceutical grade raw materials. Most grocery store chains have separate health sections with an impressive assortment of organic produce. The one thing missing in this model is expertise, and at the moment, this is where the health food stores excel. Each and every time an antibiotic is prescribed, a probiotic should also be recommended by the prescribing naturopath, medical doctor and/or the pharmacist. This would help with the immune system and overall recovery, and could become an integral part of prescribing antibiotics. The worldwide nutraceutical market was estimated to reach $204 billion in 2015, of which the United States has a 39% market share and Canada a 3.9% market share.

For far too long, we have maintained two very distinct camps concerning healthcare and lifestyle preferences, and because of this, patients have suffered. Today, ‘integration’ is the new buzzword, uniting healthcare treatment options between the pharmaceutical approach and the naturopathic holistic approach, as well as between compounding pharmacies and health food stores. The time has come for the integrative, complementary approach: the marrying of what is best from each treatment modality and preference in lifestyle choices.

References:

  • Adams, Kelly M., Butsch, W. Scott, Kohlmeier, Martin. (2015) The State of Nutrition Education at US Medical Schools.

http://dx.doi.org/10.1155/2015/357627

  • Devries, Stephen MD, Agatston, Arthur MD, Aggarwal, Monica MD and coll. (2017) A Deficiency of Nutrition Education and Practice in Cardiology. https://www.amjmed.com/article/S0002-9343(17)30527-2/fulltext
  • Galea, Sandro. (2017) America Spends The Most On Healthcare But Isn’t the Healthiest Country. http://fortune.com/2017/05/24/us-health-care-spending/
  • Kaplan LM, Golden A, Jinnett K. and coll. (2018) Perceptions of Barriers to Effective Obesity Care: Results from the National ACTION Study. Obesity (Silver Spring). 2018 Jan;26(1):61-69.
  • Petrin C, Kahan S, Turner M, and coll. (2017) Current attitudes and practices of obesity counselling by health care providers. Obesity Research & Clinical Practice. 2017 May – Jun;11(3):352-359.
  • Sawyer, Bradley. Cox, Cynthia. Kaiser Family Foundation. (2018) How does health spending in the U.S. compare to other countries?

https://www.healthsystemtracker.org/chart-collection/health-spending-u-s-compare-countries/#item-start

[1] Adams, Kelly M., Butsch, W. Scott, Kohlmeier, Martin. (2015)

[2] Devries, Stephen MD, Agatston, Arthur MD, Aggarwal, Monica MD and coll. (2017)

[3] The US Burden of Disease Collaborators. (2018)

[4] Petrin C, Kahan S, Turner M, and coll. (2017)

[5] Kaplan LM, Golden A, Jinnett K. and coll. (2018)

[6] Sawyer, Bradley. Cox, Cynthia. Kaiser Family Foundation. (2018)

[7] Galea, Sandro. (2017)

[8] http://www.fightchronicdisease.org/sites/default/files/pfcd_blocks/PFCD_US.FactSheet_FINAL1%20%282%29.pdf