Nutrition Education in U.S. Medical Schools (1985) / Chapter Skim
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3. Rationale for Including Nutrition Instruction in Medical Education
3. Rationale for Including Nutrition Instruction in Medical Education
Pages 29-56
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From page 29... ...
Major developments in medical research and technology in recent decades have led to the conquest of many diseases with nutritional or infectious origin. For example, the isolation and identification of many essential nutrients and the elucidation of their roles, together with the enrichment and fortification of selected foods and the availability of nutrient supplements, have resulted in the virtual elimination of vitamin and mineral deficiency disease in the United States.
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From page 30... ...
The role of diet in both the prevention and treatment of many conditions, such as obesity, osteoporosis, gastrointestinal disorders, low birth weight, dental caries, irondeficiency anemia, and certain vitamin and mineral deficiencies, is clearly documented (DREW, 1979; DHHS, 1983~. Advances in basic nutrition knowledge and medical technology have also dramatically affected health care in the United States.
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From page 31... ...
. These staggering economic and social consequences still exist despite the steady decline in death rates due to coronary heart disease in the United States since the late 1960s (NHLBI, 1981a; Stamler, 198 5b; Walker, 1983~.
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The National Institutes of Health (NIH) Consensus Development Conference on Lowering Blood Cholesterol to Prevent Heart Disease concluded that the blood cholesterol level of most Americans is undesirably high (NHLBI, 1985~.
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From page 33... ...
In adults, it reduces performance in the workplace. Results of animal studies and clinical data indicate that some specific nutritional deficiencies as well as general malnutrition may alter immune function' thereby affecting response to infection and disease in both children and adults (Beach _ al., 1982; Gershwin et al., 1985;_ _ Suskind' 1977~.
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From page 34... ...
reported that the lower the nutritional status of hospitalized patients, the worse the prognosis for recovery from the primary disease. There is evidence that a patient's nutritional status may influence the outcome of cancer therapy (Donaldson and Lenon, 1979~.
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From page 35... ...
The metabolic stress of cancer, interactions between nutrients and drugs, and the hosttumor relationship are subjects of active research. It is important that medical education emphasize the relevance of nutrition principles to cancer prevention and treatment and that students are prepared to assess new findings regarding the relationships between diet, nutrition, and cancer and their implications for patient care.
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From page 36... ...
Thus, poor nutritional status before pregnancy and inadequate weight gain and nutrient intake during gestation may negatively affect fetal weight gain, thereby increasing the risk of low birth weight and neonatal mortality (Dobbing, 1981; NRC' 1970; Worthington _ al.
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From page 37... ...
In addition, the pediatrician should be able to guide parents in the selection of diets adequate in energy, protein, iron, and other essential nutrients to promote optimal growth throughout infancy and childhood. Increasing numbers of children with genetic disorders and other disabilities are now kept alive and often require complex nutritional care.
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From page 38... ...
Although some vegetarian diets may be consistent with good health, others, if not supplemented, may increase the risk of specific nutritional deficiencies (Goldsmith, 1983; Herbert, 1983~. Still other self-restricted diets, such as many of the popularly promoted weight reduction diets (Dwyer, 1980)
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From page 39... ...
A low-fat' high complex carbohydrate diet providing frequent meals and controlled intake of refined sugar helps to stabilize the level of blood sugar' minimize the danger of cardiovascular complications, and is a fundamental part of the treatment of diabetes (Bierman, 1985; Zeman and Hansen, 1983~. Gastrointestinal Disorders Dietary fiber may play a role in both preventing and managing gastrointestinal disorders (Inglett and Falkehag, 1979~.
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From page 40... ...
In_ addition to minimizing postoperative starvation and infectious complications associated with malnutrition and impaired immune function, these techniques also provide nutritional support for patients with a catabolic response to injury, burn, stress, and infection. Parenteral nutrition therapy and the use of defined formulas are also important tools in the treatment of patients with renal disease and patients suffering from the cachexia frequently associated with cancer.
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From page 41... ...
Proper nutritional management is exceedingly important in the treatment and management of both these eating disorders. It may also assist in reducing the potential secondary medical complications associated with them.
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From page 42... ...
The importance of the team approach is best exemplified by its use in the field of total parenteral and enteral nutrition. These teams include a physician (often more than one)
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From page 43... ...
Therefore, physicians must be able to incorporate nutrition principles into their patient care and must be prepared to assess the clinical implications of future advances in nutrition-related research. Medical students will have difficulty fulfilling these expectations unless their professional training provides them with a sound unders Landing of the relationship of nutrition to metabolism, physiology, toxicology, pharmacology, and the other basic sciences, as well as to clinical medicine.
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1973. Evaluation of nutritional status of selected hospitalized patients.
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1984. Epidemiology of coronary heart disease: The Framingham Heart Study.
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Monthly Vital Statistics Report 32~13) , National Center for Health Statistics, Public Health Service, U.S.
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1976. Total Parenteral Nutrition.
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1983. Bulimarexia and related serious eating disorders with medical complications.
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A symposium held September 13-15, 1982, Arlington, Virginia.
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1980. Reduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support.
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1985. Lowering blood cholesterol to prevent heart disease.
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1985. Cholesterol and coronary heart disease: A perspective.
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1985. Nutrient deficiencies during total parent eral nutrition.
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1985b. The marked decline in coronary heart disease mortality rates in the United States, 1968-1981; Summary of findings and possible explanations.
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SP Medical & Scientific Books, New York. Veterans Administration Cooperative Study Group on Antihypertensive Agents.
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From page 56... ...
56 Zohman, L
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