THE UNEXPECTED RISE OF THE DOC-TRITIONIST S
Frustrated by the gaping nutrition-shaped hole in their medical training, some doctors are pushing the healing and preventative power of food to the fore. WH catches up with medicine’s new wave
You couldn’t swing a kettlebell for all the selfstyled foodie influencers in 2017, but the past 10 months have most definitely belonged to the ‘slashies’. With their job titles spilling over three lines on Linkedin, punctuated by slashes or hyphens, their many roles used to be of the best-life millennial variety – healthy chef/supper club host/dj/brand consultant. But there’s been a shift of late. Turn to the health and lifestyle shelves at your local Waterstones and you’ll find a new breed. One that includes a very authoritative title: Dr.
Medical professionals, flush with five-plus years of training and subsequent front-line experience of treating patients, are adding nutritional nous and culinary skills to their arsenal. Take Dr Rangan Chatterjee,
GP, TV presenter and author of The Sunday Times bestseller The 4 Pillar Plan and the upcoming The Stress Solution (both £16.99, Penguin Life). He views the holistic quartet of nutrition, physical activity, relaxation and sleep as the solution for many of today’s common ailments, dishing up recipes for golden buckwheat bread and apple cinnamon breakfast bowls alongside practical advice on managing stress and catching quality zeds. Dr Rupy Aujla, GP and author of The Doctor’s Kitchen (£14.99, Harper Collins) is part of the same squad. His website features images not of pill packets or stethoscopes, but of nutritionally dense dishes more colourful than Danny Dyer’s vocab and more mouthwatering than an M&S advert.
FRIDGE THE GAP
Why is it that these professionals with tightly squeezed schedules are choosing to add yet another string to their bow? Because, in a nutshell, mainstream medicine doesn’t tally up with modern healthcare needs. ‘I’ve been seeing patients for nearly 20 years, and the vast majority of ailments presented to me are in some way related to our collective modern lifestyle,’ says Dr Chatterjee. ‘If 80% of the problems patients present are related to lifestyle, but doctors aren’t taught lifestyle fixes, how can they provide the best service possible?’ This disparity between what training doctors are given and the treatment current health conditions demand is growing. ‘Medical training hasn’t really kept up to date with the changing health landscape,’ he adds. ‘I don’t remember receiving any significant nutrition training at medical school.’
And so the medical/lifestyle guru is born. Dr Chatterjee, Dr Aujla and co are taking it upon themselves to bridge the gap, by educating themselves – and then the public – on the benefits of good nutrition and a healthy lifestyle. ‘Forty years ago, I think the current model worked well,’ says Dr Chatterjee. ‘Now, it doesn’t.’ Essentially, a lifestyle more geared around sedentary jobs and highly processed food – as well as persistent low-level stress and constant stimulation by technology – has left you susceptible to chronic diseases, such as type-2 diabetes, obesity, migraines and gut problems.
WELLTH OF KNOWLEDGE
There’s every chance you know more about what to eat to improve your health than your GP does. Current UK medical students only receive between five and 20 hours of nutrition education during their training,
depending on where they study. That’s according to Ally Jaffee and Iain Broadley, medical students at the University of Bristol and co-founders of Nutritank, a network of doctors and medical students aiming to promote the need for greater nutrition and lifestyle medicine education within formal training. Those few hours are mostly taken up with the biochemistry of individual macronutrients – proteins, carbs and fats – and advice on vitamin and mineral deficiencies. ‘We’re hardly taught about the role of nutrition in preventing, treating or managing chronic disease,’ says Jaffee. ‘Or even the science behind positive dietary patterns for health, like the benefits of a Mediterranean-style diet.’ Dr Harrison Carter, junior doctor and British Medical Association spokesperson, agrees. ‘We’re at the stage where receiving any nutrition education at medical school is good,’ he says, never mind a robustly taught curriculum aligned with patients’ needs. While certain institutions are leading the way (Dr Carter references the University of Cambridge’s medical school, which works with the Need
For Nutrition Education/ Innovation Programme, a local training academy providing nutrition training to their medical students), the general picture looks, well, weak.
The fact that the medical training model is so traditional and unresponsive means that, despite all the recent research into digestive health, nutrition
and its direct impact on general wellbeing, it can take ages for the cutting-edge science to inform the treatment and advice doctors give. ‘It takes around 17 years for research to get translated into clinical practice,’ says Dr Megan Rossi, researcher at King ’s College London and registered dietitian (@theguthealthdoctor). ‘That’s to make sure treatments are safe and cost-efficient. So there are reasons for the barriers, but it’s far too long to wait.’
DOCTORS WITHOUT BORDERS
Some naysayers might suggest that it’s not a general doctor’s place to wade in on nutrition. After all, dietitians go through extensive training (either a stand-alone bachelor’s degree or a life sciences degree plus
post-grad qualification) to gain insight into why certain foods are a balm to some health concerns and others fan the flames. (Side note: the term ‘nutritionist’ isn’t as tight. The title isn’t legally protected, so people with varying qualifications can adopt the moniker.) Should med school grads stick to pills and surgery and leave the cruciferous veg chat to their colleagues?
With the NHS as stretched as it is, doctors are in no position to be turning people away. So says Dr Hazel Wallace, who has authored two recipe and lifestyle books. ‘We need to know the basics,’ she says. ‘There’s a pandemic of chronic conditions and diseases, and dietitians don’t see patients first. Within the NHS, it’s not always possible to refer patients to one.’
Dr Rossi isn’t worried about generalists stepping on her turf. ‘While medical professionals need to be aware of their limits [when it comes to deep nutritional expertise], I believe they should have fundamental knowledge.’ Dr Aujla is similarly dismissive of the idea that he should stay in his lane. ‘It’s like saying that doctors should stick to what we did 100 years ago –
‘We should have been doing this 30 years ago’
using leeches or blood-letting,’ he says. ‘This is modern science and something we should have adopted 20 or 30 years ago when the evidence about the benefits of eating a Mediterranean diet first came out.’
COURSE OF TREATMENT
Nodding vigorously? Be assured that this is more than wellintentioned chat. These doctors want change and they’re not waiting around for an invitation. Inspired by the culinary medicine course at Tulane Medical School in New Orleans – on which medical students are taught kitchen skills alongside the science of how certain foods can be used to alleviate and prevent chronic disease – Dr Aujla has created his own course for a UK audience. July 2018 saw the first batch of students enrol in the pilot scheme at Bristol Medical School. At this stage, it was an elective that future doctors could choose to do, allowing them to delve into something that isn’t on the mandatory curriculum. Yet.
Nutritionally savvy future doctors Jaffee and Broadley worked to get Dr Aujla’s course to their Bristol campus – and both enrolled. The lengthy waiting list for places is testament to the appetite for these skills among medical students. Given that the course has been licensed for more than 35 medical schools in the US, Dr Aujla hopes this sets a precedent for it to be introduced in the UK. Ultimately, he wants this stuff to be mandatory. ‘The longer we take to adopt it, the more the public will suffer as a result,’ says Dr Aujla, before hanging up and nipping back to his London GP clinic for the afternoon’s appointments. With such a collaborative mindset and sense of purpose, the future of your health is in safe, if perhaps beetroot-stained, hands.