I'm going back to school
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I have decided to officially go back to school.
I never thought I would say those words. That's not to say I thought I was done learning. On the contrary, I believe I am learning more now than I ever did as a student.
However, I have realized that a significant knowledge gap exists that is essential in helping my daughter live a long and healthy life. I used to believe that I had a solid understanding of nutrition. But as I began studying the interplay between genetics and nutritional biochemistry, I became aware of how uninformed I was. But this isn’t just about my daughter.
According to the CDC, 60% of adults in the US have one chronic disease, while 40% have two or more. Chronic disease is the leading cause of death and disability, with 70% of annual deaths attributed to a chronic disease. It is estimated that 50-80% of chronic diseases are related to or at least affected by nutrition.
Unfortunately, nutrition isn’t truly prioritized in medicine, and it’s often an afterthought. I didn't have any nutrition courses in PA school, and medical schools are only recommended to offer a minimum of 25 hours of nutrition education. Despite this, 75% of medical schools do not meet this minimum requirement. On average, students receive 19 hours of nutrition education during their four-year program.
Our life expectancy has gradually decreased in the United States over the past few years. Here is a summary of how life expectancy has changed based on data from the CDC:
1900 = 47 years
1950 = 68 years
1960 = 69 years
1970 = 70 years
1980 = 73 years
1990 = 75 years
2000 = 77 years
2010 = 78 years
2019 = 79 years
2020 = 77 years
2021 = 76 years
The CDC has not published any data after 2021, but a few sources I have seen indicate an uptick. Nevertheless, considering all the advances in medicine, it is still astonishing that there has only been a 6-year increase in lifespan over the past 50 years (1970 - 2021).
I understand this is just an average, but it still doesn't look reassuring. Lifestyle changes are often "recommended", but how many clinicians are skilled enough to provide the detailed guidance patients need? How many work in a system that encourages this to take place?
Here's a blurb from an article in Medscape titled "How PCPs Are Penalized for Positive Outcomes From Lifestyle Change":
“However, no current quality measures consider lifestyle interventions. In fact, some quality measures unintentionally penalize physicians for successfully treating or reversing disease through lifestyle behavior interventions while rewarding clinicians for meeting process measures — usually adherence to medication — regardless of whether health outcomes improved.
Rewarding medication adherence for the treatment of diseases in which lifestyle is a primary therapy (such as hypertension), combined with other healthcare constraints (lack of lifestyle education, time to spend with patients, and infrastructure support) incentivizes physicians to skip the conversation about lifestyle changes and go straight to medication prescription. Meanwhile, the clinician who takes the extra time to guide a patient toward lifestyle interventions that could treat their current disease and prevent future diseases — without side effects — is penalized.”
Now imagine the pediatric patients whose only option to mitigate disease is through nutrition. Should they be dismissed until an ICD-10 code or until pharmacologic treatment can be prescribed?
This is why I’m going back to school.
I am applying to the University of Connecticut's Master of Personalized Nutrition Program. As always, I’ll share everything I learn with the Medgeeks community.
Cheers to the never-ending quest for knowledge!