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Nutrition matters

BMJ 2014; 349 doi: (Published 27 November 2014) Cite this as: BMJ 2014;349:g7255

Re: Nutrition matters

Nutrition matters? Of course it does - but 'Man trained to use a hammer sees many the things as a nail' (Chinese proverb). So, doctors trained in pathology of illness, not the physiology of vibrant health, and trained to use pharmacological interventions may not appreciate that nutrition matters. Farmers, however, to whom the health of their stock means their livelihood, pay great attention to nutrition, to feed quality, to soil mineral content, and so on.
Our bodies were developed over millions of years for a diet of roots, shoots, nuts fruit, vegetables, raw meat, and so on - a diet far removed from the agrarian diet that includes large quantities of grain - and even more removed from the diet encouraged by big business with advertorial half-truths and the seduction of Buy One Get One Free. Our bodies also developed, along with the rest of nature, to be self-healing organisms with a default setting of a high level of health and vitality - unless adverse factors impaired that state of health.
In helping myself and patients to understand the topic, the best introductions I have found are 'Doctor in the Wilderness' by Scottish GP Walter Yellowlees, and The Holistic Doctor by Deborah McManners, GP and Naturopath, which covers the subject in breadth and reasonable depth. Especially relevant are the seven principles of health Dr McManners outlines: Do No Harm, Nature has healing powers, Identify and treat the cause of illness, not just symptoms, Treat the whole person, and treat them as an individual, The physician is teacher, Prevention is the best cure, and Establish and maintain health and wellness.
What is certain, is that the failure to include more than a single day on nutrition in medical school curricula compared to hundreds of hours on interventions, pharmacological or otherwise - is an abrogation of responsibility in which our profession unfortunately colludes. That the nutrition of health has passed by the notice, until now, of those who set and implement curricula, is unfortunate. The explanation of course is simple - the wonders of science and progress continue to dazzle us, and make us forget basic principles of health and wellbeing. However, as the Chinese proverb says, man who looks at sky from bottom of well sees only small part of sky.
Ref: Doctor in the Wilderness, Yellowlees W, 1993, Janus Publishing.
The Holistic Doctor, McManners D, 2004, Piatkus London

Competing interests: I have given many copies of The Holistic Doctor to medical students and GP colleagues

07 December 2014
Andrew Tresidder
GP, GP Educator and Gp Patient Safety Lead
NHS Somerset CCg
Yarn Barton, Sea, Ilminster, TA19 0SB UK