Meta description: Did you know that poor diet is now the global leading cause of early death?
Currently, around 20% of all deaths globally are linked to poor diet (more than tobacco!). Paradoxically, a worrying percentage of medical students and doctors report receiving less than 2 hours of formal nutrition training. Medicine today is as much about how to prevent disease as it is about diagnosing and treating patients, yet there is this huge disconnect between what we are learning about and what is silently claiming lives. Food systems, corporate marketing, and economic inequality shape public health, but they remain virtually invisible in medical education. This article explores why keeping informed and spreading awareness about nutrition is not just an option, but a moral duty.
If we want to become effective doctors in a world battling an epidemic of non-communicable disease, we need to care about nutrition research.
To make our case, we spoke with Dr Aygul Dagbasi - a registered Dietitian and Postdoctoral Researcher at Imperial College London - who provides expert insights to this article.
Just like any other industry the food industry runs on profit, but what is less obvious is some of the unethical ways in which that profit is generated.
One shocking example is this recent investigation by Public Eye which revealed an unacceptable double standard in the sugar content of Nestle infant formula sold in lower income countries and in Europe.
The only possible aim here is “to get children accustomed to a certain level of sugar at an early age, so that they prefer products high in sugar”. As companies capitalise on confusion around nutritional research, patients get caught in the crossfire. Dr Dagbasi highlighted that “some fat-free and no-added-sugar products - such as certain yogurts are actually still quite high in sugar” are easily misunderstood and “dangerously marketed” as very healthy alternatives.
Obesity is often framed as a failure of willpower. But as Dr Chris Van Tulleken aptly puts it, the global surge in obesity rates cannot be explained by a worldwide synchronised drop in willpower, offering cheap energy for a hidden price:
In a landmark 2019 randomised control trial, participants consuming a UPF diet ate around 500 extra calories per day and gained weight within two weeks, compared to those on unprocessed diets. In the last 15 years, the prevalence of obesity in children aged 10-11 has risen by 10% in the most deprived areas of the UK but the change in the least deprived areas is negligible. In adults, the difference in the least and most deprived deciles is **14%.** This inequality is systemic.
Dr Dagbasi shared an impactful story of a patient who “lost 6kg and reduced their blood pressure and cholesterol simply by following a balanced diet, without any medication”. Sustained change is possible with the right guidance - health behaviours are significantly influenced by education and health literacy - but to teach our patients about these risks we need to understand them ourselves.
There are unique social justice issues to consider. Even within countries, the food environment is not equitable, and food outlets in disadvantaged neighbourhoods are often dominated by UPFs with limited access to minimally processed foods due to cost and other barriers. UPFs are an important source of calories for many people faced with food insecurity, and this must be acknowledged. Simply creating “UPF phobia” is not productive. Particularly for those who depend on these foods, cutting out UPF altogether is not realistic but reducing their consumption can have the greatest impact. Education and increasing awareness can prevent vulnerable people from developing patterns of overconsumption or even addiction.