Here’s a typical scene in any American checkup: The doctor walks in to find the patient sitting on the table. “Well, your cholesterol is too high,” the doctor tells the patient. “I can prescribe something for it, but the real solution will be diet and exercise.”
The patient leaves that day with a bottle of Lipitor and maybe a pamphlet about healthier living habits.
How many times do you think the patient responds by saying, “Really, doc? Diet and exercise? I had no idea! I think I’ll take Papa John’s off my speed dial, start training for the next Boston Marathon, and gorge on kale.”
Most doctors care about their patients, but they’re treating them with one hand tied behind their backs. They can prescribe drugs, write referrals, and order procedures. But as for actual advice, well…they’ve only got a few minutes to get in and out of the exam room before they need to see the next patient.
Besides, doctors get very little nutrition training in medical school. Because hey, what does food have to do with health? Oh. Yeah.
Moreover, simply telling people to eat better isn’t enough. They already know they’re supposed to swap out fast food and sweets for fruits and veggies. There are other reasons why they can’t do it.
One reason is cost. Junk food is often cheap, ready to eat, accessible everywhere, and shelf-stable. You can eat it without silverware, and you can get it from a drive-thru or in individually wrapped packages.
Healthy food is often more expensive — and it’s perishable. Calorie for calorie, fresh fruit and veggies usually cost more than fruit snacks and potato chips. You might need to prepare them too, and that requires time, skill, and cooking equipment. You’ll need to sit down to eat them — probably with a fork — and they aren’t individually wrapped.
With these barriers to eating well, simply telling patients to change their dietary ways often doesn’t work. But some hospitals are helping to address the problem.
In New York City, some hospitals are now giving children prescriptions for fruit and vegetables. The prescriptions can be exchanged at farmers’ markets for fresh produce, allowing low-income families to stretch their food budget and provide their kids with healthy options.
Patients in the program return monthly to meet with their doctors and/or nutritionists. At these visits, they receive nutritional counseling and renew their prescriptions.
So far, the program appears successful, with most participating families reporting that they visit farmers markets several times a month.
Programs like this one can help people beat diet-related chronic illness in this country.
Starting with children is best, because it helps them build healthy habits for life.
Subsidizing healthy food for low-income families is a great start and worth replicating. We need more initiatives that address the true reasons why people do not eat healthier — whether it’s the availability of fresh foods, cooking skills, economic hardship, or something else.
Otherwise, chronic illnesses like heart disease and diabetes will only become more common, and doctors will continue to push prescription drugs while casually reminding all of us to eat our fruits and veggies.