Author Archives: Wayne B Jonas

Nutrition Education: The Doctor is Out

Fruits and Veggies

Having a healthy, flourishing life is often as simple as eating right. Yet, many people lack the knowledge, resources and access to healthy food they need to ensure their own wellbeing. About 38 percent [i] of Americans admit to not maintaining healthy diets. This has lead to more than half of the population being classified as obese in previous years and a surge in cardiovascular and endocrine diseases. What’s worse is that the healthcare specialists they go to for help often lack basic nutrition training themselves.

As a result, many populations are at odds with health and wellbeing. According to the 2016 Global Nutrition Report produced by the World Health Organization (WHO), 44 percent of the 129 countries surveyed had severe malnutrition and obesity. [ii] The United States is among 14 nations that have the highest rates of obesity and malnutrition.

These results come after years of implementing developmental project models. Some have been successful, but considering the current state of health in America, it is clearer than ever that we need to take more innovative measures.

Modernizing Medical Education

Disease and premature death have both been linked to nation-wide problems with proper nutrition.[iii] This phenomenon is closely related to the limited or lack of nutrition training for doctors. Some experts refer to this void as a “deficiency of nutrition education.” [ii]

Medical students receive less than two hours of nutrition education over a four-year period. [ii] Most of their essential nutrition training is from basic classes, which occur in the earlier years of medical school. [ii] A Samueli Institute article capped the medical school hours dedicated to nutrition at 19.6 hours, in 2013. [iv] That is less than 1 percent of students’ total lecture hours. In a study conducted by researchers at the University of North Carolina, Chapel Hill, 80 percent of medical schools provide inadequate nutrition training for future doctors. [v] Once these doctors begin practicing, they usually receive no additional nutrition training.

A 2010 survey revealed that only 14 percent of physicians considered themselves adequately trained to counsel patients on nutrition. [v] Still most of the general public is willing to consult their doctor for advice on healthy eating. One survey calculated that figure to about 61 percent. [ii] In light of these statistics, Samueli Institute recommends:

  • Provide nutrition education to medical students in the first two years of training
  • Repeat nutrition education once medical students begin a specialty
  • Pass the training from properly trained physicians to patients.

Making Information Available

Nutrition education is not readily available for the general public. This is true for adults and school-age children alike. For children, however, the truth is much harsher. More than 17 percent of children in the United States are obese. [vi] This number increases when factors like race/ethnicity and economics come into play.

Socioeconomics determines not only what people know about nutrition, but access to nutritious foods in their communities. [vii] Considering this reality, teaching nutrition alone cannot solve the country’s problem. As a nation, we must pass policies that promote health and human flourishing in our neighborhoods.

Nutrition and National Security

The United States military is already making strides to improve the resilience and readiness of service members by implementing dietary changes for active duty service members. Working with Samueli Institute, the Teaching Kitchens framework provided a training approach to cooking in a military environment. In just three phases, orchestrators of the Teaching Kitchens could help make healthier I’ve tied it to Teaching Kitchens. foods accessible, change eating behaviors and improve the overall quality of life to military servicemembers.

The Department of Defense (DoD) has now made regulations for the use of dietary supplements in meals. [viii] Some food additives, even those that come from natural sources like plants, have been found to have no nutritional significance. The DoD decided that what doesn’t help one’s diet, should not be consumed. More importantly, the DoD is educating service members on the reasons behind these nutritional regulations.

Nutrition starts with education. Health policies should be in education policies, and this education should be for everyone.

[i] Matthews J, (2011). 2011 Food & Health Survey: Consumer Attitudes Toward Food. International food Information Council Foundation.
[ii] Global Nutrition Report (2016). From Promise To Impact: Ending Malnutrition by 2030. World Health Organization.
[iii] Devries S, Dalen J, Eisenberg D, Maizes V, Ornish D, Prasad A , Sierpina V, Weill, A, and Willett W. (2014) A Deficiency of Nutrition Education in Medical Training, The American Journal of Medicine. Vol. 127, I-9, PP 804-806.
[iv] Eisenberg D, and Burgess J (2013). Nutrition Education in the Era of Global Obesity and Diabetes: Thinking Outside the Box. Journal of the Association of American Medical Colleges. Vol 90-I:7 pp 854-860.
[v] Adams K, Kohlmeier M, and Seisel S (2010). Nutrition Education in the U.S. Medical Schools Latest Update of a National Survey. Acad Med. Doi: 10.1097/ACM.0b013e3181eab71b.
[vi] Cluss P, Ewing L, King W, Reis E, Dodd J, and Penner B (2013). Nutrition Knowledge of Low-Income Parents of Obese Children. Society of Behavioral Medicine. Doi: 10.1007/s13142-013-0203-6.
[vii] Food Research & Action Center (FRAC) (2015). Why Low Income and Food Insecure People are Vulnerable to Obesity.
[viii] Department of Defense (2013). Dietary Supplements: Policy, Science and the DoD.

Individualizing Prevention: A Response to Obama’s Precision Medicine Initiative

A message from Wayne B. Jonas, MD

A message from Wayne B. Jonas, MD

Samueli Institute has long supported the exploration of how healing happens. But exploring the linked question—how preventable disease happens—is also a priority. Diseases don’t merely pick and choose individuals. They arise when our continuous healing processes breakdown.

Scientists are searching for an answer to the question of why some people are affected by diseases like addiction, diabetes and cancer, while others are not. What’s the interplay between genes, behavior, social determinants of health and perhaps as of yet unknown factors? Could we prevent chronic illnesses if we could track and enhance how the body operates to keep us free of them?

Current statistics suggest that white Americans are more susceptible to certain diseases like breast cancer and addiction, according to the Department of Health and Human Services. Individuals who are African American, Mexican American, American Natives, or Asian American and Pacific Islander are more likely to suffer from Diabetes (Type II), Hypertension, Heart Disease and Stroke. Race/ethnicity is only one of the many factors that contribute to one’s chances of contracting diseases. The issue is that no one knows what the definitive factors are and why they matter.

To finally find an answer, the White House has launched the Precision Medicine Initiative (PMI), a new research effort to improve the American healthcare system. The initiative will include studies, infrastructure building, and health policy efforts to streamline preventative healthcare measures and uncover the many determinants of health.

The PMI, which President Obama first announced in 2015, was launched in response to the upsurge of preventable disease in the country. Obama stated that the idea of there being an “average patient,” is unrealistic and that “one size does not fit all,” when it comes to both preventative care and treatment for disease. The PMI study will be one of the first studies to look at disease prevention in such a broad way.

One cohort that has emerged as a result of Obama’s PMI, is a series of studies conducted by the National Institutes of Health (NIH), who have contributed $55 million to the study of disease prevention that focuses on the genetic and biological differences in humans. Perhaps this part of PMI should be called Precision Prevention.

“This range of information at the scale of one million people from all walks of life will be an unprecedented resource for researchers working to understand all of the factors that influence health and disease. Over time, data provided by participants will help us answer important health questions, such as why some people with elevated genetic and environmental risk factors for disease still manage to maintain good health, and how people suffering from a chronic illness can maintain the highest possible quality of life. The more we understand about individual differences, the better able we will be to effectively prevent and treat illness.” –NIH Director, Francis S. Collins, M.D., Ph.D.   

Past Research

Previously, large studies like the Human Genome Project (HGP) discovered that it was possible to activate and deactivate genes by changing lifestyle. This means that the pre-existing genes for conditions like obesity can be redirected by nutrition and exercise. The question that the PMI cohort seeks to answer that the Genome project did not is, does this remain true when factors like ethnicity, location and culture are brought into the equation?

The widespread belief is that these differences do contribute to health. But so far, the only issue researchers have looked into is health disparities associated with ethnicity and income.

Creating Human Flourishing

At Samueli Institute we acknowledge health disparities as issues that can, for the most part, be solved with health policy change and through advocacy, and multi-sector involvement in the promotion of health and wellbeing. Also, through integrating more holistic and integrative practices into everyday care, more Americans can be resilient and remain healthy throughout their life. Most of our work in this area falls under one important initiative, Wellbeing in the Nation (WIN).

Wellbeing in the Nation (WIN)

The Institute has gathered leaders from all levels of the public and private sectors to write recommendations for improving the health and wellbeing of the nation. This includes fusing health with determinants like socioeconomics, providing recommendations for leadership and deciding which healthcare costs are essential and which can be eliminated with preventative health measures.

The Creating Wellbeing Leadership Group, which oversees WIN, not only identifies the key problems with the American healthcare system but also recommends ways to improve it. Part of that is through advocating for evidence-based research for individualized care.

What is Precision Medicine?

The White House has described precision medicine as “healthcare tailored for you.” This description is important, as it recognizes people’s unique characteristics, which often contribute to their health and wellbeing.

NIH hopes to draw participation from various agencies in the federal government to ensure its success. The PMI study will begin in late 2016 and is expected complete by 2020.

We at Samueli Institute are pleased that our continued priority of health prevention and healthcare improvement are priorities of the White House as well. When patients receive individualized, patient-centered care in a health system in which preventative health measures are just as important as the treatment of disease, we will all prosper.

New Legislation to Address Opioid Crisis

Congress banner: Samueli_photos-880x290-28
A message from Wayne B. Jonas, MD

A message from Wayne B. Jonas, MD

Each day more than 50 people in the U.S. die from prescription pain relievers. When you add the deaths related to heroin, that number jumps to 80 per day.[i]  Last week Congress passed legislation that hopes to reduce those figures. The Comprehensive Addiction and Recovery Act (CARA), S. 524 was passed by the Senate in a nearly-unanimous (92-2) vote.  Having been previously passed by the House, it was recently signed by President Barack Obama.

Update: President Obama signed the Comprehensive Addiction and Recovery Act of 2016 on July 22nd. Read the White House press release.

In these days of bipartisan politics, passage of the act shows the depth and breadth of the opioid crisis. No one is safe from the opioid epidemic as it crosses both racial and socio-economic lines.

What New Opioid Legislation Means for Pain Care and Integrative Medicine

According to the Community Anti-Drug Coalitions of America (CADCA), the Comprehensive Addiction and Recovery Act is long overdue. But with it comes a solution that encompasses what CADCA refers to as the “six pillars.” Continue reading “New Legislation to Address Opioid Crisis” »

The 3 a.m. Grandpa: A Father’s Day Blog

Holding hands
A message from Wayne B. Jonas, MD

A message from Wayne B. Jonas, MD

I love 3 a.m. It was probably ingrained in me from my medical practice. Thirty years ago, during residency, I was on call every third night and I got up multiple times at 3 a.m. to attend to patients. Even later, after the training, if a patient called, I got up and went in to see them. I am used to getting up at 3 a.m. and, frankly, I love that time; a time so silent and calm, when most humans are asleep. Continue reading “The 3 a.m. Grandpa: A Father’s Day Blog” »

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