Little Change Since 1987 ~ Does MAHA Have A Chance?
Perhaps you have noticed that there are very few physicians identified with the practice of Nutrition Medicine, and even fewer who use the title, Orthomolecular. Only about one doctor in a thousand is actively involved in general nutrition medicine. That’s 1/10 of 1%. Yet there is such great public interest that almost half of all Americans take vitamin supplements, and a single magazine article on nutrition medicine brought a landslide of over 20,000 letters requesting referral to the office of the Orthomolecular Medical Society. How can it be that the public demand can so outpace the medical world in this regard?
The "Nutrition Death Sentence" is reason number one. This is the sentence that says: "The average American diet is adequate in nutrients." That idea has been sacrosanct in the medical establishment since the 1940’s, after the enrichment of white flour with vitamins B1, B2 and B3 and iron and fortification of milk with Vitamin D.
The sanctity of the American diet has been so sacred at the FDA that purveyors of vitamins and health products were forbidden to make any statement to the contrary. Until recently it was forbidden to claim that the American diet was inadequate or that foods grown in depleted soils might be lacking nutrients. However, scientific studies show conclusively, for example, that soils low in copper produce plants low in copper and animals foraging in such territory become copper deficient.
With the advent of agribusiness and mass farming we are subject to chemical fertilizers and other practices that can create soil depletion on a massive scale. Air pollution and its consequence, acid rain, also washes the minerals out of the soil in large areas of this continent. But to point this out in detailing physicians about the need for nutrient supplementation would be in violation of the FDA rules and could lead to seizure of products and labeling materials, including books, by the FDA. This posed an economic risk that few were willing to take, and so physicians have not been detailed about nutrition products the same as they have about drugs.
Instead, most practicing physicians have been trained to believe that nutrient deficiency is rare except in alcoholism and chronic intestinal malabsorption. It is not easy to change the mind of a physician. Even double blind studies do not change established medical practices overnight. Thus, in spite of many scientific nutrition surveys which document widespread deficiencies of iron, zinc, magnesium, vitamin B6 and folate, most physicians are not prepared to change either their thinking or their prescribing habits.
In the first place, in order to prescribe nutrients, the physician must know a great deal about the vast number of products that might be useful or that his patients may bring for an opinion. How does a physician learn about these things? Who is qualified to teach these practical things?
Sadly, because of the neglect of nutrition research for so many years, there now exists a real shortage of experienced faculty to bring nutrition medicine to life in our medical schools. Few doctors have studied the vast nutrition literature or acquired the practical Orthomolecular experience to be able to teach the practical details about nutrition against disease.
Suppose that a doctor does get interested in nutrition. How can he learn of the diagnostic tests, the best laboratories in which to do them and the range of products and services that are available? Acquiring practical information about nutrient therapy is not easy. And the basic science information, the medical nutrition literature, is vast and overwhelming. Much of it forces a reconsideration of the disease model of medicine and challenges the validity of drug treatment as practiced now without nutrient support. Certainly these are big questions and their very magnitude is sufficient to persuade a physician, busy with day-to-day life and death decisions, to wait for confirmation from some higher authority before putting nutrition first.
It is much easier to find higher authority willing to teach AGAINST nutrition therapy. The medical establishment actively promulgates the idea that nutrients are; dangerous and can cause illness. Therapeutic doses, i.e., Megavitamins, are considered unproven at best and dangerous at worst. In general, the dangers of vitamins, minerals, fats and proteins are widely discussed; but their therapeutic benefits are still disputed and even ridiculed.
I am sorry to say that for too many physicians, nutrient therapy means expensive urine and nutritionists are lumped together with chiropractors and quacks. In fact, the National Council Against Health Fraud regards nutrition therapy as the number one problem of quackery in America today.
In short, nutrient therapy presents the physician with much new information to study, more procedures to master, many more questions from the patients, more time required in running the practice and, in general, a greater load on the doctor. All this extra work with no increase in income because the public at large does not fully appreciate either the scientific advances or the healing powers that this new medical specialty offers.
In fact, it seems that most people don’t really distinguish between an unlicensed (though not necessarily uninformed) lay nutritionist and an Orthomolecular physician. The status of the nutrition physician is not yet well respected by the very public that is clamoring for the service. Add to this list the fact that alternative medicine carries a distinctly higher risk of peer review, i.e. criticism by one’s colleagues and attack by state medical licensing boards, and you can see why the nutrition doctor remains a rare bird: more work, less pay and more danger of criticism and scorn, even loss of income.
Is the situation likely to change? Not in the near future, although to be fair, the medical establishment is slowly becoming nutrition oriented. Within the past month the JAMA featured a research entitled "Nutrition Therapy of Hypertension". I don’t recall seeing a similar reference to nutrition therapy in the past 20 years of pursuing that journal each week.
There is a saying: "If you are too far ahead of your time you are considered a quack. When the rest of the world catches up, they claim the credit and say that they have been doing it all along." Are they really doing it? I think not. Here’s why:
This just crossed my desk: "Prevention 87" is the title of the fourth annual National Preventive Medicine Meeting in Atlanta, scheduled for April this year. This is sponsored by the American College of Preventive Medicine and co-sponsored by the Centers for Disease Control, Office of Disease Prevention and Health Promotion, Aerospace Medical Association, American Academy of Occupational Medicine, American Association of Public Health Physician’s, American Medical Association, American Public Health Association and the U.S. Conference of Local health Officers. This is a partial listing just to indicate that this meeting represents the majority of today’s medical authorities.
So, what is on the program? Is there a single title addressed to nutrition medicine? No. There is a paper on tobacco advertising and one on "Reducing Cancer Mortality" and one on Prevention through Health and Fitness, and there is a luncheon speaker. That’s probably the closest to nutrition that this meeting will get. Let’s hope it’s a healthy lunch.
Copyright @ Dr. Richard A. Kunin, 1987
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