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Comment by cwmoore

4 hours ago

When medicine ignores nutrition entirely, and nutrient supplements are still complete unknowns, you have to wonder who the FDA is working for.

8 comments

cwmoore

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array_key_first  1 hour ago

Medicine doesn't really ignore nutrition, but the problem is:

1. Most people don't believe it anyway. People want to hear they can eat hamburgers and milkshakes and be healthy. Telling them "we know that gives you heart disease and cancer" does nothing.

2. Nutrition is complicated and different for every person, because everyone has different things they can tolerate. The "perfect" diet is actually worthless because it has a 0% success rate. Really, we have to optimize for how miserable people are willing to be.

3. Most people are unhealthy enough that nutrition is the least of their concerns. That sounds crazy, I know, but if you're obese (which most people are!), then priority is being not obese. Not your nutrition. I know those sound related but they're way less related than you think.

  • hammock  29 minutes ago

    > Most people don't believe it anyway

    Maybe because so much of it is wrong, or (very charitably, as much is industry-biased) outdated?

    Lifestyle modification is a definite challenge and I’m not dismissing it.

    Still, hamburgers and milkshakes don’t give you heart disease and cancer. Overeating, oxidative stress from low-quality ingredients, etc might.

hammock  4 hours ago

You don’t have to wonder. It’s public record that 45% of the FDA’s budget incomes from user fees that companies pay when they apply for approval of a medical device or drug.

In the drug division specifically, the number is about 75%.

Simulacra  4 hours ago

But there's a core problem with this, in many states doctors are legally forbidden to give nutrition advice. The academy of nutrition and dietetics has worked very hard to make it so that only dietitians can provide nutrition advice. Take Ohio for example, a medical doctor in Ohio is legally forbidden and actually in jeopardy of losing their license and going to jail if they were to provide nutrition advice without a dietetics license. Dietitians are not doctors, but the academy of nutrition and dietetics wants you to think they are.

  • tzs  3 hours ago

    > Dietitians are not doctors

    And doctors are not dietitians.

    Doctors in the US receive an average of under 20 hours of training in nutrition over four years of medical school. What little they do receive is often focused on nutrient deficiencies rather than on meal planning for health and chronic disease prevention. Less than 15% of residency programs include anything on nutrition.

    To become a registered dietician requires at least a Master's degree in dietetics or nutrition or a related field, and at least 1000 hours of supervised internships.

    PS: before any Europeans hold this up as an example of the poor US health care system, doctors in Europe average 24 hours of nutrition training.

  • rootusrootus  3 hours ago

    Aren't doctors actually exempted specifically from such regulations in almost all states? AFAIK they can actually give nutritional advice legally in nearly every jurisdiction in the US.