Positive Health Update, Physician Nutrition Education

Bob Crowther (68) highlights further lowered health risk factors during the past twelve months along with quotations from a recent opinion article about nutrition in The Journal of the American Medical Association (JAMA).

Encouraging Health Status From Lifestyle Choices

Senior Yoga Mobility
In
Hanumanasana

2013 
Making Progress 
In
Upright Forward Split

Demonstrating
Whole Body Range Of Motions, Limitations
Of
Muscles, Joints, Connective Tissues

 Seeking 
to
Improve
 Extending Legs Forward & Backwards
Raising Torso Towards Full Upright Position
 Shoulder Mobility, Having Arms Up Straight 


During 2018 -2019

• This Asana Is Included During Each Evening Yoga Session
• Yoga Blocks Are Used Often To Facilitate My Movements
• Have Been Experiencing Decreasing Lower Back Mobility Limitations 
• Enhancing Pelvic Girdle, Spinal & Shoulder Girdle Muscle Flexibility

Remaining focused on my daily yoga activities during this past year have contributed to the positive health outcomes I share below.

Fourth Annual Meeting With Dr. Jarrod Faucher
(Geriatric Specialist, St Vincent's Hospital)

[127.7 POUNDS]

Since March (2016), after reviewing my first blood and urine assay data in approximately 9 years, I significantly modified daily nutrition habits and made better and more informed food selection decisions.

As a consequence, both 2017 and 2018 lab assay data reflected improved health outcomes from the daily lifestyle choices I made.

My 2019 April 26th conversation with Dr. Faucher provided an opportunity to inquire about various evaluation numbers including data from four assays of blood samples after fasting 15+ hours (a urine sample analysis was not deemed necessary). 

MY FOCUS

This past year I remained relatively healthy, free of any illness, and only began experiencing nasal congestion during the two weeks before our meeting.

I was able to further enhance various health indicator values realized during the past two years without taking any prescribed medications, vitamins or supplements from: 

[1] two a day (morning, evening) yoga sessions in my condo

[2] adding hiking to my yoga, walking as physical activities of choice

[3] preparing most meals at home from nutrient-rich, high quality food sources to obtain proteins, carbohydrates and fats

 CONSEQUENCES OF ADDRESSING
 POSSIBLE
 HEALTH RISK FACTORS:

• Maintained Weight in 120's  
• Lowered Heart Rate, Maintained High Blood Oxygen Level
• Decreased Systolic Blood Pressure (Best In 4 Years)
• Reduced Triglycerides Value 
• Lowered LDL Cholesterol, Increased HDL Cholesterol
• Improved Cholesterol/HDL Ratio (Lowest To Date)
• Good Glucose, Electrolyte (sodium, potassium, chloride) Values
• Likely Enhanced Immune Protection  
• Limited Dupuytren's Contracture Mobility Impairment

By:

• Eating real food, restricting consumption of processed sugars in various forms and moving my body (yoga, hiking)
• Consuming mostly plants (vegetables, fruits, grains, seeds, legumes, spices, herbs), some seafood, occasional dairy and meat
• Limiting daily salt intake, drinking water at each meal & throughout the day
• Daily preparing own food, consuming small portions at each meal
• Monitoring weight daily, keeping (incomplete) food logs
• Receiving flu, pneumonia, recombinant shingle vaccines
• Having regular dental cleanings, good daily dental hygiene practices
• Stretching palms each day multiple times

I intentionally ate more during the past twelve months yet maintained a desired weight range to enable more challenging yoga whole body mobility. 

For several years I have commented on various nutrition topics - sharing information from various sources (personal, articles and books) - most recently in January, February and March. 

These posts may have influenced my friend Arno Tilles, MD to share a link to a published report on medical nutrition education in the April 9, 2019 issue of JAMA.
[My conversations with Arno on yoga fitness, nutrition, overall health and wellness topics over many years have been appreciated, valued.]

I have cited some of the author's words for your consideration.

TITLE
Nutrition Education In Medical School, Residency Training, and Practice
by
Stephen Devries, MD 
Walter Willett, MD
 Robert O. Bonow, MD

FIRST PARAGRAPH

"Nutrition education in medical school is rudimentary, at best, and limited for the duration of graduate medical education for many specialties. Requirements for meaningful nutrition education in all phases of medical training are long overdue."

FOUR REASONS

 Why Nutrition Education Deserves Special Attention:

[1]

"A 2018 report by the US Burden of Disease Collaborators identified poor-quality diet as the leading cause of death in the United States. The prevalence and cost of diet related diseases are predicted to climb if left unchecked."

[2]

"There is a renewed interest in a shift in health care from disease management to health promotion and prevention, areas that physicians will find difficult to adequately advance without a solid foundation in clinical nutrition.

[3]

"Patients are barraged by information on diet and health from the media, and physicians need to be knowledgeable in this area to help patients interpret and act on the confusing, and often contradictory, nutrition messages in the public domain." 

[4]

"There is increasing attention on the wellness and self-care of residents and fellows. Lessons learned by physicians-in-training about clinical nutrition might not only serve to improve patient health, but also have the potential to enhance physician self-care through greater awareness and knowledge of the dietary influences on well-being. This knowledge in turn can help make physicians more effective counselors."

SOME OBSERVATIONS

'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. ... Following medical school, nutrition education during the 3 or more years of graduate medical education is minimal or, more typically, absent."

" ... both residency and fellowship training ... lack a requirement for physician-in-training to learn about nutrition or diet. Similarly, requirements for nutrition education are lacking in speciality training programs

AND

The authors make a case that " ... guiding patients to make dietary changes is a team effort and can include appropriately trained dietitians, nutritionists, nurses, health coaches, and chefs. ... currently, most physicians do not have enough education in nutrition to contribute meaningfully to that team."

"Problems related to poor-quality diet and obesity are the result of many complex personal and societal factors that extend far beyond the the influence of physicians and hospitals. But physician visits are ideal opportunities to reinforce the message that attention to nutrition and lifestyle are critically necessary for optimal health and that medications alone, however important, will rarely be sufficient. Importantly, adequately trained physicians also may be stronger and better-prepared advocates for public policy that addresses the underlying causes of poor nutrition and food insecurity."

SUGGESTIONS
[1]

"The most useful approach to including meaningful nutrition education into all phases of medical training is not to consider nutrition a new unit in curriculum but, rather, to integrate concepts related to nutrition within the existing content. In this way nutrition can be more appropriately understood as a vital, practical determinant of health rather than an isolated discipline." 

[2]

"Physicians and health care organizations can collectively begin to emphasize their seriousness about nutrition in health care by practicing what they (theoretically) preach ... At minimum, a consensus to align food served in medical training programs and conferences with the Dietary Guidelines for Americans would be a welcomed approach."

LAST PARAGRAPH

"An emphasis on nutrition is not only good medicine, but is also becoming sound economics. As new value-based models for payment of medical services take hold, financial incentives in medicine will increasingly align with prevention-oriented services, and among them should be a greater focus on nutrition."

FUTURE WELLNESS ROADMAP

Daily lifestyle choices made these past years as a senior will continue during 2019 into 2020 and undoubtedly contribute to the relatively good health, mobility I now enjoy.

Share your reactions to my comments. 

#BobCrowther #Nutrition #Yoga