In our flagrantly obese country, doctors can forget about encouraging a patient to lose weight if the patient isn’t interested in doing so.
But physicians still can do a much better job of encouraging their patients to simply maintain their current weight.
That was part of the message in a lecture given at the 2017 American College of Physicians Internal Medicine Meeting in San Diego on Friday. Dr. Marijane Hynes discussed “Nutrition and the Gut: You Are What You Eat.”
“The microbiome is sexy,” said Hynes. “And the medical students are very interested in nutrition, because nutrition is exciting.” She described the microbiome in our guts as an environment teeming with bacteria, viruses and other organisms. “Diversity in the gut is good, and diversity in the gut is decreasing over time.”
People who are obese or who suffer from inflammatory bowel disease are known to have less diversity in the gut.
Our guts are “sterile” when we’re born and are then colonized by age three, Hynes said. The gut adapts quickly when a diet is radically changed. Some people may immediately feel better after switching to a vegetarian diet, for example. But the microbiome takes time to alter its makeup, she said.
‘Little Pets’ in Gut Need Fiber for Food
Hynes referred to probiotics as “the little pets that live in our guts” and prebiotics as food for our little friends.
She stressed the importance of fiber in the diet, particularly in the form of at least two servings of vegetables per day. She joked that many of her patients dislike vegetables. “It’s childhood memories of green beans cooking on the stove for three hours, bad memories,” she said. “We need to teach them that if you put them in the oven, some olive oil, herbs, vegetables really do taste delicious. You have to really work with your patients on that.”
She said a great source of nutrition and fiber is beans, which are packed with protein. Flaxseed and oranges also are good.
Hynes noted time and again that the benefits of fiber are numerous. One of many studies she cited showed that among women at elevated risk for breast cancer, the risk created by drinking alcohol is mitigated if there is a high-fiber diet on top of the booze.
Losing Weight: Don’t Make It Harder Than It Is
Hynes said her passion is helping her patients lose weight. She explained how even a 10-pound drop in weight can translate to incredible health benefits for patients. Most patients can’t see the forest for the trees when it comes to diet and exercise.
She said patients fret over “gym guilt” when all they need to be doing is taking a five-minute brisk walk every couple of hours or so. The American workforce is chained to their desks and computers, and the sedentary lifestyle is making our country fat.
But that’s not always the case, Hynes said. People gain weight after car accidents, during bouts of depression, or when they go on certain medications, such as antipsychotics like Abilify.
Hynes noted that with weight gain comes its own set of negative mental health impacts. She believes that people put on certain antipsychotic medications that cause massive weight gain should also be put on Metformin at the same time for weight control.
As far as studies that talk about how the microbiome can be altered to treat obesity, “The problem with the studies is one obese guy is not the same as the other obese guy,” Hynes said.
Professor Takes on Processed Foods, GMO Reps at Convention
Hynes recommends the book “Food Rules” to her patients. She said she’s excited that more money is being put toward funding research that “treats food as the medicine it is.”
More than 8,000 physicians, including 800 doctors from outside the U.S., have descended upon downtown San Diego this week for the ACP’s annual internal medicine meeting. Hynes said the exhibit hall includes representatives from companies that use GMOs, or genetically modified organisms, in food. GMOs help make farming and the raising of livestock a more efficient process, but the long-term effects on people who eat crops and livestock with GMOs is unknown. Dozens of countries prohibit the use of GMOs in food, but not the U.S.
“They’re scared we’re going to tell our patients this stuff and they’re sending people here,” she said. “They gave me a lot of information from ‘the other side’ and I’ll look at it when I get home.”
Hynes railed against processed meats and said they need to be avoided, including all that tasty smoked and barbecued variety. “Yes, even turkey bacon,” she said. “It’s funny how patients think that turkey bacon is really healthy.”
According to the World Health Organization, there is no evidence that GMOs pose a health risk. “GM foods currently available on the international market have passed safety assessments and are not likely to present risks for human health,” WHO reports on its website. “In addition, no effects on human health have been shown as a result of the consumption of such foods by the general population in the countries where they have been approved.”