The disease merry-go-round

Is anyone really teaching our kids nutrition?

The other day I decided to change the world, but the world wasn’t interested. It told me so, and well within the statutory 14-day notice period.

The big idea was simple enough: Teach the kids about nutrition, and the next generation won’t be such a strain on health services. In my ideal world, nutrition would become a mandatory subject taught in all schools; if the doctor knew nothing about nutrition, at least the patient would.

I created a petition on the UK Parliament website, where as a nod to the democratic process, any that garner at least 100,000 signatures will be discussed in Parliament.

The petition had to first pass muster with the Parliamentary goon squad that weeds out any petitions that are racist (not us), inspire violence (again, not us) or insurrection (if only), or are asking for something that already exists (yes, that was us). And so, well within the 14-day review period, I was sent a firm rejection.

Yes, folks, nutrition is already taught in schools across the UK. I should have guessed from the number of slim kids walking around snacking on lentil salads and the “Going out of business” posters plastered across the windows of McDonald’s.

But then, when I say “nutrition,” I may be conjuring up a completely different universe from the type of nutrition being taught in schools. For them, it’s a subject touched on every other Thursday afternoon by the gym teacher, whose idea of a balanced diet is a variation of Seriously Salt & Vinegar and Saucy Tomato Ketchup crisps (US: potato chips).

At least in the US, health secretary Robert F. Kennedy Jr is taking the subject seriously and mandating that medical schools start teaching nutrition at a substantial level. Previously it warranted just nine hours of the roughly 50,000 hours required to train a doctor.

It’s a crucial point. If the doctor and patient together know little or nothing about nutrition, we’re condemned to eternally circle the doom loop of health services that devour more and more money. The UK currently spends around £210 billion ($280 billion) a year on disease care, which is dwarfed by the US’s $4.3 trillion (£3.2 trillion) spend—that’s around $13,432 (£9,990) for every American—on drugs prescribed for chronic problems that have been wrongly blamed on us having the temerity to live too long rather than living poorly.

As every hardened WDDTY subscriber knows, very few drugs cure. Most instead merely manage symptoms, and so every year the drugs bill increases as the population requiring remedies to ease chronic symptoms grows.

The UK’s National Health Service (NHS) is funded by the public purse and is close to its breaking point, as every fool can see. One clever ruse to keep things functioning is to stop the sick getting to see a doctor in the first place, and this has worked remarkably well and kept the sick at bay.

The gatekeeper to the fabulous world of NHS services is the family doctor, or GP (general practitioner). As most Brits know, there’s a golden window—which lasts roughly four minutes—when everyone in the neighborhood phones in to grab that coveted five-minute appointment with the doctor.

With everyone phoning at the same time, few, if any, actually get through. Those who have well-honed Darwinian survival instincts and get their call answered then face the next hurdle: the Dragon at the Gate (DG). She (for sure—it’s invariably a fire-breathing female) needs to be convinced that you deserve to see the doctor.

The DG is very familiar with the science of regression to the mean. This concept recognizes that most ailments will disappear, often in 14 days or so, without any drugs or other medical intervention. Knowing this, the DG will suggest an appointment in, say, 14 days’ time.

If the caller counters that they may be dead by then, the next phase of questions is triggered: What are the symptoms? How long have you had them? Ever thought of taking out private health insurance?

The government wants GPs to embrace the technology of online booking forms. But GPs have made it abundantly clear that if they have to see patients, they’ll go on strike. The doctors’ trade union, the British Medical Association (BMA), has said it will take industrial action if the government goes ahead with plans to improve access to online booking systems.¹

And so the merry-go-round of disease management goes on. Did anyone mention nutrition?

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