Does Your Doctor Really Understand Your Diet?
Disclaimer - this is not meant to serve as medical advice or replace consulting with a licensed health care provider.
Current State of US Health
Before we dive into answering the original question, let’s take a moment to examine the current US health crisis among different age groups (specifically those categorized as overweight, obese, or diabetic):
| Population | Overweight (%) | Obese (%) | Diabetic (%) |
|---|---|---|---|
| Adults (18+) | 43% (2.5 billion) | 16% (890 million) | 11.1% (589 million) |
| Children (Under 5) | ~5.6% (37 million) | Not separately reported | Not applicable |
| Children/Adolescents (5–19) | ~20% (390 million) | ~8% (160 million) | ~0.35% (estimated, limited data) |
Data from the National Health and Nutrition Examination Survey (NHANES) shows obesity prevalence among adults was about 13% in the early 1960s, rising to 15% by 1980, 31.3% by 2000, and 40.3% by 2021–2023. This steady rise, tripling over 60 years, started accelerating notably after 1976–1980, driven by factors like increased consumption of ultra-processed foods, higher caloric intake, and reduced physical activity.
For additional context, we should also take a look at our healthcare spending - the United States ranks first in healthcare spending worldwide, both per capita and as a percentage of GDP. The U.S. spent 16.7% of GDP in 2023, nearly twice the average of comparable high-income countries, which was around 8-12%.
We spend the most in the world, but what results are we getting?? And who are we listening to for nutritional advice?
Let’s get back to the topic - Does Your Doctor Really Understand Your Diet?
Let’s Look at Two Factors
We’re going to explore 2 factors that have a huge impact on a doctor’s ability to provide nutrition advice - the US healthcare framework and a doctor’s nutritional education.
US Healthcare Framework
You might be surprised to learn that doctors today are being “guided” by a policy that dates back to the 1900s. Let’s take a look…
The Flexner Report, written in 1910 by Abraham Flexner, reviewed medical schools and pushed for a science-based, drug-focused approach to medicine. It caused many schools teaching natural remedies to close, making pharmaceutical treatments the main solution in modern medicine. This shift, backed by Rockefeller and Carnegie, led to today’s reliance on pills and medical technology for treating illnesses.
The recommendations from the Flexner Report were turned into law through state and federal legislation that aligned medical licensing with its standards, requiring physicians to graduate from accredited, science-based medical schools. By the 1920s, state medical boards, influenced by the American Medical Association and supported by congressional actions, enforced these regulations, effectively mandating allopathic training and marginalizing alternative medical practices.
Allopathic medicine is a system of medical practice that uses drugs, surgery, and other interventions to treat symptoms and diseases, often focusing on alleviating specific conditions rather than addressing underlying causes.
While not diminishing the value the Flexner Report had on improving consistency in medical education, looking back…I’m not sure that shifting the focus exclusively towards pharmaceutical treatment and away from holistic or alternative treatments has had the best outcome.
Why Does the Healthcare Framework Matter?
Nutrition would typically fall into the category of preventative care, or it might even be classified as a “holistic” approach. Either way focusing on root causes and the nutritional component of health isn’t consistent with allopathic treatments that rely on identifying symptoms or conditions and treating them with drugs. This concept is a major factor in doctors identifying a condition or a symptom and selecting a pharmaceutical treatment path that seems to help patients with those symptoms.
Remember that a doctor’s standardized education that was addressed in the Flexner report…let’s take a look at the education that doctors receive related to nutrition.
Nutrition Education Among Doctors
In the U.S., medical doctors receive an average of about 19-25 hours of nutrition education during their initial medical school training (typically four years). This varies by institution, with some schools offering as little as 10 hours and others up to 50 hours. Data from a 2015 study in Academic Medicine noted that only 29% of medical schools meet the minimum 25-hour recommendation set by the National Academy of Sciences.
Let’s compare the average medical school education about nutrition versus pharmacology:
With such an unbalanced education slanted towards drugs as compared to nutrition, our original question starts to answer itself.
Based on the policies set forth in by the Flexner report (back in 1910!!) and subsequent laws, it seems like doctors might not be as well equipped to discuss nutrition while they seem to be more than well equipped to discuss pharmaceutical interventions.
What’s the Bottom Line?
I hope you’ve managed to read this far - it’s important to understand these topics, not only as a medical consumer…but also if you’re relying on nutrition advice from doctors for the health of you and your loved ones!
Given the framework in which most doctors work and their nutrition education, I’d suggest that there are better people than your doctor to ask about nutrition!
Alternatives for Nutrition Advice
What alternatives are there for nutritional advice other than your doctor?
Glad you asked!
If you are seeking specific medical nutrition advice to treat or recover from diagnosed medical conditions, then a Registered Dietitian (RD) is probably your best choice. RDs are necessary since you are trying to “treat” a diagnosed condition with food.
However, if you’d like some general guidelines about healthy nutrition and optimizing your health - you might explore “alternative” health guidance from well-trained health coaches.
Finding a knowledgeable health coach to help with general nutrition advice might be a great alternative - there are several reputable health coaching certification programs which provide coaches with sufficient education to help clients make informed dietary decisions based on their age and lifestyle. Examples of certifications include the Primal Health Coaching Institute, Precision Nutrition, and National Board Certified Health & Wellness Coaches.
Now you are armed with this knowledge knowing that there are alternatives to asking your primary care physician about nutrition advice.
Finally, this is by no means a “flex”, but keeping in mind that the average doctor has 22 hours of nutrition education (from medical school), below is the collection of my nutrition education I’ve received as a result of a Bachelor’s of Science degree program, National Academy of Sports Medicine (NASM) certification, Precision Nutrition PN1 Certification, and Primal Health Coach Institute certifications (Primal Health Coach Certification & Gut Microbiome Specialist Certification).
Note - this a graph of my total education hours (not all courses are part of college programs and aren’t measured as “credit hours” or “semester hours”) This organized education was accumulated since approx. 2009 as compared to medical schooling (but also doesn’t include books, articles, and research papers or seminars I’ve attended).
The point of above graphic is to illustrate that there are alternative sources of high-quality guidance about nutrition (outside of mainstream medical doctors) and in many circumstances their education outweighs what is received in most traditional medical schools.
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