An Apple a Day

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It is always interesting when the bright beam of modern research turns to highlight age-old wisdom. Since my childhood, I have been familiar with the adage that says, “You are what you eat,” but it wasn’t until adult years that I realized the real truth of the phrase.

In the process of digestion, the body breaks down food and beverages we consume. Digested components are, in turn, incorporated into the cells of our bodies. In principal, this is not so different from the way that a building could be demolished and the bricks reused to build a new structure. The molecules of life – the bricks – exist in the food, and in the processes of eating and digestion the food product is broken down then repurposed to form our very selves. Thus, what we take in does, literally, become part of us. We are what we eat.

A 20-year epidemiological survey by the U.S. Burden of Disease Collaborators emphasizes the negative impact of unhealthy food choices. The study found that dietary risk factors are the number one negative influence on life expectancy and quality in the United States. For perspective, this means that poor diet does more to harm our health than myriad traditionally scary risk factors: lead exposure, air pollution, alcohol use, and even tobacco smoking.

When researchers broke “diet” down in to multiple components, the leading problems were low intake of fruits, nuts and seeds, and high intake of sodium and processed meats. Here comes that age-old wisdom again: could it be true that an apple a day really contributes to keeping the doctor away?

It might not be quite that simple, but it would be good to know that our doctors could reliably advise us on making good dietary choices. Unfortunately, doctors themselves receive disturbingly little training with regards to nutrition.

A 2004 survey of medical schools reported that of 106 accredited institutions, 93 percent require “some form of nutritional education” but 88 percent of instructors cited the need for more training in nutrition. While the National Academy of Sciences recommends at least 25 hours of training in nutrition, only 38 percent of medical schools reached this goal in 2004. When the survey was updated in 2008/2009, the percentage meeting the recommendation had dropped to 27 percent.

Thankfully, numerous Chicago-area institutions are starting initiatives to incorporate nutritional training into medical school curricula. The Northwestern University Department of Preventative Medicine provides hands-on clinical nutrition training to medical students via an advising program for underserved hospital patients. Data from this program could serve as the basis to secure future NIH-funding for similar plans. Further south, the University of Chicago has partnered with Kendall College to provide a course on Culinary Medicine. These types of initiatives aim not only to fill a knowledge gap, but also to help doctors feel more comfortable incorporating dietary recommendations as key elements in patient treatment plans.

Meanwhile, it seems we could each benefit from taking matters into our own hands – or mouths, as it were – by thoughtfully considering the molecular building blocks we provide for the construction of our bodies…and maybe picking up a few apples the next time we are at the grocery store.

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