YOU, YOUR. DOCTOR, AND NUTRITION

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MEDICAL SELF-CARE

by Tom Ferguson, M.D

This issue's column is an edited version of a conversation I had with Marion Nestle, an associate dean and lecturer in medicine and biochemistry at the University of California School of Medicine in San Francisco. Dr. Nestle teaches nutrition to health science students, as well as to resident physicians, and she coordinates nutrition education within the School of Medicine. A Ph.D. in molecular biology from the University of California at Berkeley, Dr. Nestle is also a contributing editor of Medical Self-Care.

FERGUSON: Many people say that medical schools generally ignore the area of nutrition science. Do you agree?

NESTLE: Yes . . . and even when the subject is included in a curriculum, the classes tend to be inadequate.

FERGUSON: Why?

NESTLE: Well, first of all, many people who teach biochemistry, physiology, or other "hard" sciences are a bit contemptuous of nutrition . . . they don't consider it a real science. After all, because of the field's relative newness, nutrition researchers don't have the huge body of well-controlled corroborating data that most other sciences can call upon . . . so it's often difficult to make a convincing scientific argument for the importance of diet in medicine.

FERGUSON: Is there any other reason why many medical students receive little or no practical nutrition training?

NESTLE: Probably the biggest reason is that we all—doctors and laypersons alike—tend to view medicine as a curative, rather than a preventive, science. Most people see a physician only when they're sick and need immediate help. They don't come to get advice on nutrition . . . they come to get treated for an illness.

FERGUSON: Recently, I saw a quote by Harvard nutritionist jean Mayer, who said—in effect—that the average doctor knows little more about nutrition than the average nonphysician.