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Why doctors need to know about nutrition – the health specialists’ perspectives

This dialogue between health specialists points out the current shortcomings in the medical doctor education regarding nutrition.
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Should nutrition be a fundamental part of health care? Do GPs really know enough about it? And do the general public have enough access to nutritional advice? Hi, everyone. I’m Matt Eastland. And I’m Lukxmi Balathasan. And this is what we’re discussing today on the Food Fight podcast. We’re from EIT Food, Europe’s leading food innovation community– working hard to make the food system more healthy, sustainable and trusted. And thanks to our soon-to-be-released online course on nutrition for health and sustainability, this episode will explore whether doctors receive enough training and education around nutrition and the challenges and opportunities to making nutrition a more fundamental part of our health care. For this conversation, we’re joined by two health specialists– first, Margherita Ronco.
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Margherita studied medicine in Turin, and after university she’s then trained for three years to become a GP. She’s been working as a GP for a couple of years and has recently opened her own practise. Thank you for joining us today, Margherita. Hi, everybody. Thank you. We’re also joined today by registered nutritionist Hannah Baugh. With seven years of experience, Hannah has worked in food manufacturing deriving nutritional improvements in ready meals for retailers such as Marks and Spencer’s and Iceland in the UK. And more recently Hannah has worked in the catering sector, where she’s led healthy eating initiatives in the workplace. Thanks for joining us today, Hannah. Thank you for having me. Brilliant. Thanks for that.
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And coming to you, Margherita, so you are obviously trained for multiple years to become a GP, and during that time you probably received the fundamentals of biology and anatomy. But how does nutrition, nutritional training, and food fit into your training programme as a GP? Actually there wasn’t any programme about nutrition. When you learn biochemistry you have to learn about nutrients and the chemical reaction, but then it’s their own thing, so you just forget two days after the exam. And nutrition as lifestyle, as diet, and so on are not really part of any programme. Yeah. And can you bring this to life for us and maybe bring people into your office for our listeners?
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So when– you’re obviously seeing patients all the time, maybe now a bit more virtually. Can you give us some examples of patients’ questions with regards to nutrition, if they even ask? And how maybe you see that that has evolved since you’ve started, if you’re able to offer that? They don’t ask anything actually. They actually don’t ask any questions. No. No. That’s interesting. And do you think– is that because they’re not aware enough themselves? Or because they might feel embarrassed or they don’t want to be talking about these sorts of things with a GP? What’s your sense? I think it’s both of them. Then it depends on the person.
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Because if you have, for example, an obese– I had sometimes ago a guy of 24 years old whose BMI was 42. And– That sounds high. –and he had just one kidney. He came to me because he had a urinary infection, and he was worried about the kidney. Then I solved the problem of the kidney. Then I looked at him. I said, you realise you weigh too much with just one kidney. And it was like it wasn’t his problem. I don’t know how to explain it. He wasn’t even aware, or maybe he didn’t want to face it. I don’t know.
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And then I made all the speech and I sent him to the biggest hospital here in Turin where they had the obesity centre, but he didn’t come for nutritional advice. It wasn’t his main problem. Yeah, thank you, Margherita. Hannah, I could see you wanted to add something. Yeah. So it’s a really, really interesting point.
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There’s a study just been released about the impact of COVID on school food in secondary schools in particular, what the provision is. Obviously it’s changed a lot because they’ve got to shorten lunch breaks, they’ve got to keep the bubbles, all of that sort of thing. But one of the quite I guess opposite ends of the scale really– there was a noticeable increase in junk food being sold. Because it’s quick, it’s grab and go, it’s easy. But also there is still very much a perception that healthy eating is uncool. And there is still a perception amongst younger generations. So I think you just mentioned then that your patient was 24 years old. There’s still very much a culture of “I’m invincible.”
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Like food, it doesn’t matter what I eat. It’ll be fine. And that’s a really hard attitude to combat. Coming back to your point about that word “healthy” almost having a negative connotation, Hannah, is really interesting. So Margherita, what’s your take on that? Do you find that your patients are coming to you because they feel unwell? They have a specific diagnosis– you know, they expect a diagnosis, a referral, or a prescription from you. Is your impression very similar to what Hannah said? Do you feel like if you start to talk health that they might kind of switch off from what you’re trying to– the advice you’re trying to give them? Not really, actually.
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So I think people come to me, they do not expect nutritional advice. They just expect me to give them drugs. Yeah. Right. So that’s a point. Quick fix. Yeah. And so if they have, for example, high fats in blood, they expect me to give them medicine. Yeah. And as I prescribe the medicine I say, but you should also be careful about your diet, because medicine will not be enough. Or maybe in two years it won’t be enough anymore. So– and they are kind of surprised. So should doctors be the ones who are giving out nutrition advice? Or should nutritionist and GP working side by side to look at the patient holistically? What are your thoughts on that, Hannah?
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I would like to see working side by side, but then I also think a GP needs to have that information to then be able to point their patients in the right direction. Because there will be situations where nutritional intervention doesn’t work, and you will still need that clinical support. So I absolutely think that GPs should have that information. But I also appreciate they have to hold a lot of information. So in terms of doing everything, they should have that in their portfolio, if you will, but then have access to other specialists that they can then refer on to. Because like we’ve said already, people are specialised in different areas.
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We should be able to access the different support systems that are there. Do you agree, Margherita? I agree. Yes. I think the ideal office is an office where there is a GP, a nutritionist, a psychologist, and something else– Wow. –altogether. Does that exist? No. No? Not here at least. I don’t know in other countries. But that would be great. Wonderful. All right. Well once again, just wanted to say huge thanks for your time today. Really interesting topic. I think there was probably a number of areas we could have just kept going on that. So we appreciate your time. And I just wanted to say that this has been the Food Fight podcast.
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So as ever, if you’d like to find out more, head over to the EIT Food website at www.eitfood.eu and join the conversation via #eitfoodfight on our Twitter channel @EITfood. And if you haven’t already, please hit the follow button so you never miss an episode. That’s it for now. Thanks, everybody for listening.

In this video, Matt Eastland and Lukxmi Balathasan, EIT Food staff members and co-presenters of the Food Fight podcast, have a discussion with Dr. Margherita Ronco, GP at the municipality of Torino, Italy and Hannah Baugh, Registered Nutritionist in Birmingham, United Kingdom.

This dialogue between health specialists points out the current shortcomings in the medical doctor education regarding nutrition, nutrition counselling and more generally lifestyle intervention.

You can find the link to the full podcast episode (42mn) in the See also section below.

Please note that due to Covid-19, the video recording had to be made via Zoom. As a result, the audio quality is not optimal. We apologise for the inconvenience. Should you want to better understand the video content, we have provided the English audio transcript in the Downloads section below.

As always, share your thoughts in the comments area, below and don’t forget to ‘Like’ or ‘Reply’ if you read an interesting comment.

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