Have you heard about the French woman who died at age 122, noted for her habits of cigarette smoking (which she did for almost 100 years), and her enjoyment of olive oil, wine, and chocolate? How about the 104 year old woman in Texas who has been drinking three sodas a day for decades?
I wouldn’t be surprised to know that you’ve heard about these women with super longevity. It’s more “good news about our bad habits,” to use Dr. McDougall’s popular phrase. These women survived all the things the “diet police” say will kill us, so clearly our health is all up to chance, so let’s go to the steakhouse tonight for a juicy ribeye!
Conscience clear. But wait…
Have you heard about the 58 year old man with lifelong weight struggles, back and knee pain, high blood pressure, borderline diabetes, high cholesterol, worries about his high risk for heart attack and stroke, a pillbox with 5 different prescription drugs a day, and fears for the health surprises his “golden years” have in store?
Chances are you haven’t. That man didn’t make the news. He was too normal.
I see adults, many of whom are quite young, struggle with these problems every day. 70% of Americans are overweight or obese, one in three Americans may have diabetes by 2050 and total national medical expenditures are now, on average, over $9,000 per person per year. Among adults aged 55-64, 75% have taken a prescription drug in the past 30 days and 20% are on 5 or more prescription drugs.
The US Preventive Services Task Force recently recommended that all overweight and obese patients with cardiovascular disease risk factors (which seems like most of the patients in our system) be referred to intensive behavioral counseling programs to help them modify their diet and lifestyle risk factors. Is this happening? Not much, at least from what I’ve seen.
The Center for Nutrition Studies has been tackling this problem for years now, educating thousands, including laypeople and professionals seeking continuing education credits, through the Plant-Based Nutrition Certificate program offered in partnership with eCornell. The books I co-authored, The China Study, or authored, The Campbell Plan, have put education directly into the lay public’s hands. But there remains a gulf between the “institution of medicine” and the known benefits of a whole food, plant-based diet, for many reasons. As a practicing family physician in a very traditional academic medical practice, I’ve been straddling that gulf now for several years.
The situation has been improving, though. I have come across many practitioners who are integrating diet into their practice. Here in Rochester, NY, at my home institution, my wife Erin Campbell MD, MPH and I are co-founders and directors of a clinical initiative called the University of Rochester Program for Nutrition in Medicine. It is a comprehensive offering for patients to learn about optimal nutrition as treatment in a medically-supervised, physician-led setting at a major academic medical center. This program will be housed within the university primary care system.
We will see patients for in-person consultation visits, providing them with tailored action plans and resources, and also hold 8-week lifestyle intensive group programs as well as shorter immersion programs. All of our programs will be medically-supervised, with laboratory and medication monitoring. In addition, we will hold regular “Lunch with Docs” programs for the community to learn about nutrition topics and try some delicious food. What will the main “medicine” be? A whole food, plant-based diet.
10 years ago, I don’t think a program like this could have been started, but times are indeed changing. Diets emphasizing unrefined plant foods have been recognized as beneficial by the Dietary Guidelines Advisory Committee, the president of the American College of Cardiology, the American Institute for Cancer Research, the American Cancer Society and many others in the professional and popular spheres. A growing number of individual doctors are advocating for good nutrition in clinical settings.
The motto at the University of Rochester is “Meliora”, meaning “ever better,” and it is our hope that with our own initiative, the University of Rochester Program for Nutrition in Medicine, we can add to the work of others and the institution of medicine in a way that is “ever better” for our patients, our community, and our medical system.
Update 11/15/17: The UR Program for Nutrition in Medicine is now part of the Weight Management & Lifestyle Center at Highland Hospital. Click here for more information.
- Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Population health metrics 2010;8:29.
- National Center for Health Statistics (U.S.). Health, United States, 2014: With Special Feature on Adults Aged 55-64. Hyattsville, MD. 2015.
- LeFevre ML, Force USPST. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: U.S. preventive services task force recommendation statement. Ann Intern Med 2014;161:587-93.