Do your doctors ask what you eat?

Alisande

As far as I can recall, the only one of my doctors who has ever asked about my diet was Dr. Robert Atkins in NYC. No one else over the years--internists, cardiologists, OB/GYNs, a rheumatologist--has ever shown the slightest interest in what I eat. I find this appalling.

Food is what fuels us and impacts us in so many ways, and its influence on disease (certainly some diseases) is incalculable. Yet, it seems to be largely ignored by the medical community.

I've been aware of this for a long time but thought of it recently when a diabetic friend told me his new doctor, an endocrinologist, is changing his meds and putting him on insulin. Knowing there was a chance he could avoid insulin if he'd only give up all the sweets he's so fond of, I asked if the doctor had inquired about his diet. No, he hadn't.

It's possible the doctor took one look at his patient and figured out what he ate, but still...

I have an appointment next week with an MD who specializes in tick-borne illness. I'm told by friends who go to him that he will cut me off sugar, wheat and alcohol. I started this on my own a few weeks ago after one glass of punch made with pineapple juice, triple sec, and spiced rum made me feel bad for most of a week. Apparently the spirochetes went into a feeding frenzy. I wish I'd known about this a few years ago.


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chisue

Of course they don't. AFAIK there are no courses on diet in med school.

Hope the specialist can help get all that Tick-ICK out of your system.

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vicsgirl

When I was first diagnosed with kidney disease my docs put me on a strict diet- low salt, low protein. low potassium and low phosphorous. They sent me to a nutritionist . Almost everything I enjoy contains those nutrients. No pickles, no beer, no oranges, no bananas) But I was very good at limiting myself. I was scared I would need dialysis. My strict eating worked for seven years but I watched my kidney function decline every month until I needed dialysis (aka The Torture of the Damned) for nearly 5 years and I fortunately got a kidney transplant in 2012. Docs told me I can now eat whatever I want, as long as I drink plenty of water. Problem is, I've put on some weight (like 20 pounds) so now I need to watch my food intake in other ways- no soda, less of everything.

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User

Yes, mine does. Also if I exercise and what kind of exercise, how much. She asks if I'm stressed. If I have any problems or complaints...

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rob333 (zone 7b)

Um, does it count when I work with many MDs and PhDs, and they walk by saying, You're not really going to eat that are you? And it's because it's junk food?

I do laugh every year I go and he tells me I need to lose weight, because I actually hired him to tell me this? Yep, that's what a doctor is for ;)

For real though, when my vision improved, my eye doctor was dumbfounded. Until I told him my sugar intake had been nonexistent for the preceding month. There is surely a correlation in what we eat and how we feel.

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User

I've only had one doctor ask about diet and what I eat. She went over some foods with me and told me specifically some foods not to eat, how to substitute for healthier foods and what portion sizes I can have of healthy and non-healthy foods. I wish I still had her because she was the best doctor I have had. I went for my checkup last week. This doctor told me to lose 20 lbs by exercising and eating non-processed foods as close to the raw form they come in.

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party_music50

No, they don't -- but they should!!! I once had a skin problem and asked my doctor about it... as usual, he said "it's normal". I mentioned it to his nurse practitioner and she said "you're missing one of the B vitamins -- just take multi-vitamins and it will clear right up". She was right and she was better than ANY doctor I've ever had.... especially him. Unfortunately, she left him and he had the audacity to complain to me about her after she left! :p

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pipsmom49

At my recent physical, not only did my dr. not talk about what I ate, she also blew off most of what I asked her about. Seemed to be more interested in typing into her computer than addressing my issues. I also got the impression she didn't know even know who I was, and I've been seeing her, altho not often, for over two years now. Is this what HMO's are coming to? Not happy.

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Kathsgrdn

Most patients don't listen anyway. They don't listen to the doctors, dietitians, or us nurses. People will do the opposite of what they're told is good for them, even if it means they're killing themselves. Families of patients are just as bad, low salt, low fat diet? They bring in KFC or some giant burger and fries for their family member. See it every day I work.

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grandmamary_ga

No my doctors have never asked me what I eat. Not even the nutritionist I went too a couple of weeks ago. Of course I told them one of my favorite things to I eat is the cardboard box that comes with my fluids for peritoneal dialysis. We put a few spices on it to make it more tasty. lol I guess they can look at me and know I haven't eaten the way I should. I loved sweets in the past and have cut them out and now eat more veggies and cook my meats differently than I used to.

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blfenton

Why would they bother? Most patients are going to lie or exaggerate as to how great their diets are anyway. They are going to lie about the amount of exercise they get, the amount of alcohol they drink and the amount of water they don't drink.

Even if they are told to eat low salt or low fat or low sugar diets most people don't know how to or can't be bothered to read the ingredient list of a food. They don't know what processed food is, they don't know what added sugars are.

I do put part of the blame on the scientific, medical and the pseudo-scientific community. Every time I turn around something else is bad for me and something else is good for me. This diet is better because....oh and that diet - it is so last year. The latest theory that I read last week in the paper, something that has been pooh-poohed for years is to (drum roll, please) count calories. I have been doing that for years and it seems to do the trick.

My comments are not addressed to those with celiac, lactose intolerance or other allergies and health issues.

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Texas_Gem

My pediatrician always asks me what my kids are eating and drinking when I take them in.

The only doctor I've seen in years was my ob/Gyn who didn't ask what I was eating, but did give me a list of foods not to eat while pregnant and when I would complain of nausea, made suggestions for what to eat.

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rob333 (zone 7b)

count calories. I have been doing that for years and it seems to do the trick.

Ditto! that does work for me.

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jim_1 (Zone 5B)

I could write long comment, but I'll try to keep it simple.

High BP, cholesterol a bit high (not outrageous), overweight - aha, I have diabetes. Of course my A1C was a bit high (6.3), but not in a real bad way. So, diabetes is on my chart. However, he did not put me on any meds. Told me to lose weight, exercise more and don't eat so many processed foods.

He ordered labs for 90 days. I got them done and about 4 weeks after that, his office sent me a note that I should get my labs done. Duh! Evidently someone was not looking at things. So, I wrote a not-so-nice letter to the doc, criticizing all the procedures at his office. He fired me. The patient liaison person at this clinic (about 120 providers) sent a note to relate that all of his office procedures were reviewed and changes were made.

It has been one year and I have not seen anyone for primary care. I am happy. I lost some weight and feel good. I'll wait for my next crisis.

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Elmer J Fudd

My second-hand info on this subject is that nutrition science is only lightly covered (mostly not covered) in medical school. The best reason why is that the academic period of medical school (the first 18-24 months) focuses mostly on human biology and related sciences that are tested on the USMLE Step 1 test, the national "boards".

Post-med school training, the internship and residencies for whatever specialty the doc is pursuing, would include education on whatever dietary science is relevant to the specialty. It's very relevant for some, and not relevant at all for others.

Physicians are individuals as in any other type of job or profession. Some were great students, some weren't. Some are conscientious and stay current on developments, some aren't and don't so much. And the big one - some are really good, and some aren't.

Too many of well known "movements", "programs", popular diets, supplements, etc. are touted by people more interested in their own financial well-being than in the health of their patients or customers. Too many of these approaches, while appealing to some, are just the unsupported claims of snake oil salesmen and hucksters. Not infrequently, some of whom are MDs. No better example of this than Dr. Oz, a high profile individual who frequently gets called out by other docs and medical organizations for making unsupported claims and recommendations.

Whenever something is recommended, even if by a physician, the first question should always be - is this approach or this treatment a consensus view supported by studies?

Everyone should see a primary care physican annually. If you don't like your doctor's manner or approach to treating you, find another one. A bad experience isn't a good excuse for being inattentive to one's own health.

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marilyn_c

No. All my doctor wants to talk about is animals. He asked me to bring a baby raccoon. I said they are too hard to handle and too big to smuggle past the receptionist, so we settled on me bringing a baby possum. I kid you not.

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angelaid_gw

That gave me a good chuckle, Marilyn.

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rhizo_1 (North AL) zone 7

I have a gem of a primary care physician/internist. When I realized that I had inherited the family curse of high BP, high cholesterol, and diffulty in maintaining healthy blood sugar numbers.....all without a weight problem, I knew that I was in trouble.

Initially put on four different meds to control all of those problems, I developed a severe reaction to Crestor, the cholesterol med. That was several years ago and I still haven't and probably won't recover from the Crestor.

BUT, I have gained good control over the high cholesterol through diet and exercise, and since then have slowly been taken off every one of those medications.

You bet that she asks me about what I eat, how I shop, and what I eat at restaurants. Two years ago, she had me bring in my NutriBullet and to whip up some 'sludgies' for her whole staff before the office opened one morning, lol. No one would believe how delicious they could be.



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pipsmom49

rhizo, would you share some "sludgie" recipes?

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rob333 (zone 7b)

Two thoughts:

"Whenever something is recommended, even if by a physician, the first question should always be - is this approach or this treatment a consensus view supported by studies?" Actually, that doesn't even matter. If you had any idea how easily it was demonstrated the extent an aspirin helped with ER visits, but how long it took to get it into practice, you'd really shake your head at them!

I think medicine is coming around to the nutrition thoughts, though. Many talks I've heard in the past couple of years have really shown this. I didn't hear them all that often before, but now, gut bacteria are thought to play a roll in many disorders, and I know, personally, a study got funded at a teaching hospital (ivy league) recently to show the interaction of magnesium and asthma.

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Elmer J Fudd

Nutrition wasn't an area that historically got a lot of research attention. Much more work is being done now, and I think some of the new knowledge and advances you mention, rob, are because of that. Including but not limited to the tie in of the gut microbiome to the immune system and other matters of health.

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graywings123

How very cool that you met and were treated by Dr. Atkins!

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chisue

JIM! I thought *I* was the only patient ever 'fired' by an MD! I really liked him, but when his office staff kept mixing up my med orders, I had the gall to complain. (Guess we know who ran that practice.)

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User

I've posted about my husband's doctor several times but feel I should again because he is (IMO) amazing....He's an internist who years ago became interested in diet, nutrition and a more natural approach to health. I know lots and lots of doctors but he's the ONLY one who actually follows his own advise. I met him through work and after my husband's Multiple Myeloma was diagnosed, I asked if he would see my husband. He did and immediately had my husband stop eating foods that can harm like meat proteins, sugar, yeasty foods and most dairy. He instead put him on a diet of what's call the GBombs (Greens, Beans, Onion, Mushrooms, Berries, Seeds) which are foods that help build immunity and fight cancer. My husband has been pretty good about adhering to the diet and it shows in his day to day living. Most people on chemo get sick pretty easily due to their fractured immune system, but my husband has been taking chemo now for 3 years and the one time he got sick with a cold he had fallen off the diet for a couple of months during the holiday. He hasn't missed a day of work because of illness in over 2 years and he actually works in a hospital setting around sick people.

After many conversations with my husband's doctor and seeing the results of how a simple change in diet can help, I believe most doctors are making a huge mistake by not taking more of an interest in diet. But on the flip side, it can be a defeating thing for the medical profession as many people aren't ready to change their diet. This doctor told me recently that he has many patients with a diagnosis he believes diet can help keep at bay or even cure and my husband is the ONLY one of his patients who has shown much interest and made lifestyle changes.

"Whenever something is recommended, even if by a physician, the first question should always be - is this approach or this treatment a consensus view supported by studies?"

Our experiences reflect that Rob is right in this regard and I too think that some of the industry is starting to come around a little. Years ago, this doctor's views about nutrition were not taken very seriously however, he was recently approached by another hospital to head a department focused on Nutrition. So far he isn't interested (thankfully for us!) Actually, the Oncologist's still don't believe that food can help (help being the key word) to keep a cancer from returning, but then they are amazed at my husband's health over all and the lifestyle he is maintaining.

For anyone who is interested, he basically follows the philosophies of Dr. Fuhrman for a healthier diet and lifestyle. This is a link to his website, some of it is really interesting. Links aren't working, but here's the website

http://www.drfuhrman.com/

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User

Kathsgarden, I agree, for the most part people don't listen however, I am in clinics day in and day out where lunch is provided courtesy of the reps. KFC, pizza and don't forget the morning Panera and donuts. The lunchrooms are seldom void of something sweet to munch on. Doctors for the most part do not practice what they preach; patients see that and sometimes that is a little defeating too....

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jim_1 (Zone 5B)

I am gonna get on my soapbox:

Along with many other shortcomings in the preparation of medical students to become doctors the lack of addressing the needs and the special care of geriatric people is almost non-existent.

When I worked in the county-owned nursing home, Family Practice residents came in as part of their rotation. What got me when I chatted with them was their thought that they would not have to treat geriatric patients. I did not challenge them. However, Family Practice includes treating people of all ages. These docs just didn't get it.

I don't know what they were thinking when they decided that Family Practice medicine was their chosen field. If the new docs coming out of school don't realize the scope of their practice, then how the heck are they going to honestly assess their patients when it comes to eating habits.

Off the soap box.

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Chi

No. They do offer me all sorts of drugs to help me lose weight, though!

I think it's a combination of things. Improper nutritional education is one, but society is another. People will lie about what they eat, or they will nod and say things will change and they won't. Or some even get mad when they are told they are obese and to lose weight.

I don't think many people these days can claim pure ignorance about nutrition. Most people understand what you should and shouldn't eat. And it's not even about specific diets or whether eggs are good for you this week or not, but more the things everyone agrees with: avoid processed foods and eat more vegetables. Two areas where most people are very sorely lacking, and where improvement in both would likely show big health benefits.

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blfenton

Just wait until us baby-boomers hit their offices in the numbers that are projected. They won't know what hit them.

I do take care of myself. I eat properly 90% of the time, I run, I go to a strength gym, I walk,...why? because if I don't take care of myself I'm not deluding myself into thinking that the medical system will be doing so. They will be taking care of all those who can't be bothered to take care of themselves.

It just annoys me so much that this happens and that if people just spent a little time taking care of themselves the costs and drain to the medical system would be lowered.

Having said that, could I be diagnosed with cancer tomorrow? sure, could I have a heart attack tomorrow? sure, but I'll be able to weather both those experiences a whole lot better and I will be a compliant patient.

Again, my comments are not addressed to those with ongoing medical issues or allergies.

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Kathsgrdn

You're right, Lurkkiirish, nurses are horrible too. You should see the crap we eat. Sometimes it's hard to make something good at home and bring it in when you work long hours several days in a row. Most of us go for convenience over healthy choices.

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Elmer J Fudd

lukirish, I wish you and your husband continued good health and the deserved payoffs that come from the efforts being made. However, a click on the Dr Furhman link suggests that he may be one of the hucksters I had generically mentioned. Note that he has salad dressing on sale today, reduced from $15.25 to $11.44 per bottle. How about $12.95 for a bottle of ketchup. If your pantry is in good shape, he also sells monthly memberships and overpriced vitamins and supplements too. This isn't the kind of physician that anyone should take seriously in my opinion, no matter what else he says.

Jim, a Family Medicine residency touches on pediatrics, OB/GYN, internal medicine, etc., as I'm sure you and most others know. Geriatrics is a separate training fellowship, usually done after completing a residency in Internal Medicine. If a Family Med doctor prefers to not include a significant component of older folks in his/her patient pool, s/he doesn't have to. Sounds like they were just suggesting their interests were with other kinds of patients, nothing wrong with that in my mind. An important element many young docs consider in choosing the specialty they train for involves factoring in what kind of patients they do or don't want to deal with, what kind of procedures they do or don't want to do, etc.

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User

Mine does. I have a GREAT GP. I love her and am so scared she's going to retire.

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User

Snidely, sorry, maybe I need to clarify. We don't follow Fuhrman or buy his products, but if you can sift through the hype, the diet information about foods, organic and healthy store bought foods and how they benefit our bodies is worth investing the time to read. I'm turned off by the whole celebrity thing too and at first I was very skeptical. However that said, my husbands doctor uses good medical practices in tandem with the basics of the diet (something he was into long before Fuhrman hit the circuit). He just uses the articles on the site as an easy guide for his patients. I probably should have pointed the link to the library instead. Library We found articles like these to be interesting and helpful for our situation. G-Bomb foods

Fuhrman's claim that a good healthy diet and exercise can reverse disease has been known for a long time when it comes to diabetes or high blood pressure but I think he is over reaching in many of his claims. That said, I do believe that eating more foods that support the immune system (for example) can help a patients body to fight the disease over all. My husband is proof of that. We know that the cancer will return, history has proven that. However the foods we incorporate into his daily diet has absolutely helped his immune system fight common illnesses that most people on chemo are super susceptible to; like flu's or a cold. Obviously, every time someone with cancer gets sick they are at risk. Not only can those things flare in to something worse, but they weaken their bodies making it harder for them to fight the cancer. The chemo can also play havoc with the kidney's or other organs. A bean/legume based diet is healthier not only nutritionally but because it provides proteins the kidney's can process. My husband was on strong chemo treatments for many months before he went into remission. Now he's on maintenance chemo, he takes it every single day. His immune system should be extremely weak but it's not and his diet is the only thing he does different from most patients. His energy should be very low, yet it's not. We totally believe that the diet and vitamin regimen he's on has been a big factor.

When I told the doctor I was turned off by the celebrity, he chuckled and said, "get passed the celebrity and focus on the information. There is no dispute that much of it, when practiced in our daily routine can be beneficial in a variety of ways."

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User

I want to add too that when when my husband was first diagnosed and I first met his doctor (through work) I knew very little about cancer, the treatments and only the basics of nutrition. Nutrition has also gained more attention so for many a lot of the information may not be new.

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Elmer J Fudd

I don't want to be misunderstood with this, so please let me just say that I see the gist of your message as being that you and your husband have found a number of paths to follow, your husband's health has been remarkable, and you're very satisfied with what you've chosen to do. It's a wonderful experience you've related and I think that's great. That I personally might have made other choices doesn't matter, because those choices were yours to make. Continued best wishes.

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User

Mine asked how I lost 45 pounds. I told her I was eating the Ketogenic way (stricter form of Atkins). She didn't know what it was, so I told her. She just smiled because my cholesterol came down, my arteries are getting healthier, my triglycerides are better and I'm down 45 pounds.

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User

By the way, a co-worker was diagnosed as a type2 diabetic last week. I told her many many people have great success on the keto way of eating and don't even need insulin anymore. She would rather have the insulin that eat right. sigh........ I even mentioned Dr Bernstein (sp?) whose patients are both type 1 and 2 diabetics who have wonderful success and again: not interested. I'm in the mind set that if a proper diet can keep you off expensive drugs, why not eat a proper diet and keep your money? The only people winning are the pharmaceutical peeps.

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jemdandy

Nope. Mine did not ask e what I ate, but said I must be eating the wrong things and eating too much, and then sent me to a dietitian for several 'lessons'. He did this ti help me get control of my blood glucose level.

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