{"id":17591,"date":"2021-06-28T09:00:04","date_gmt":"2021-06-28T13:00:04","guid":{"rendered":"https:\/\/www.vrg.org\/blog\/?p=17591"},"modified":"2021-06-08T10:17:32","modified_gmt":"2021-06-08T14:17:32","slug":"nutrition-is-the-main-determinant-of-health-interview-with-jay-lavine-md","status":"publish","type":"post","link":"https:\/\/www.vrg.org\/blog\/2021\/06\/28\/nutrition-is-the-main-determinant-of-health-interview-with-jay-lavine-md\/","title":{"rendered":"\u201cNutrition is the main determinant of health\u201d: Interview with Jay Lavine, MD"},"content":{"rendered":"\n
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By Shantika Bhat, VRG Intern<\/p>\n\n\n\n

Shantika Bhat is interested in the intersection of ethics and medicine so she decided to ask Jay Lavine questions about his experience as a doctor. \u00a0Dr. Lavine, a retired opthamologist, answers questions about promotion of healthy diets and the medical system. <\/em><\/p>\n\n\n\n

The current medical\nsystem<\/strong><\/p>\n\n\n\n

The current medical system focuses a lot on trying to fix people,\nwhich can be problematic in the long run, said Lavine. Prevention of diseases\nand solving them at the root cause should be the main focus of the medical\nsystem. However, according to Lavine, he thinks that the medical system is too\nfocused on giving drugs. Thirty-seven\npercent of all deaths in the United States are attributable to four health\nbehaviors: smoking, unhealthy diet, lack of physical activity, and problem\ndrinking according to an article in the J<\/a>ournal\nof the American Medical Association<\/a>.<\/a><\/em> To Lavine the healthcare system\nhas turned to more of an economic standpoint of trying to gain profit rather\nthan doing what\u2019s in the best interest of the patient. According to Lavine this\nis why patients he had were scheduled for unnecessary surgeries and given drugs\nwhen they could\u2019ve fixed their problem by simple diet changes. However, when\nfocusing on the diet aspect often doctors don\u2019t have time to follow through\nwith such lifestyle changes. A study titled Time Allocation in Primary Care Office Visits<\/a><\/em>\nfound that doctors spend a median of 16 minutes with patients age 65 and older,\nwhich isn\u2019t enough time to explain diets, answer questions or concerns, and\nmore. Lavine says the systematic approach to earning the most money for the\nmedical industry has been to make doctors see more patients in less time to\nmaximize profits which has hindered many physician and patient relationships. Relationships\nare key for trust between the patient and doctor so that positive change can be\nmade, but the system needs to be changed to allow for more productive time. <\/p>\n\n\n\n

Educating and\nAdvocating for Vegan\/Vegetarian Diets<\/strong><\/p>\n\n\n\n

Note from Shantika<\/em>:\nI discussed several of the following topics with Dr. Lavine. From all the\nbooks, shadowing experiences, and more that I have experienced, I have seen\nthat implicit bias, patient autonomy, and cultural competency have always been\na huge struggle and influence in the medical industry. These three factors all\ncome into play when it comes to lifestyle changes such as diet. Implicit bias\nis when we\nhave attitudes towards people or associate stereotypes with them without our\nconscious knowledge. Patient autonomy is about patients\u2019 ability to\nadvocate for their self-interest. Cultural competency is about where doctors\nunderstand different cultures and can advise with that in mind. <\/p>\n\n\n\n

In Lavine\u2019s description of medical school he believes that one\u2019s\nperspective and exposure plays a huge role in the way they treat their\npatients. For example, doctors who are vegan\/vegetarian themselves have more\ntips and advice to give patients because they are themselves vegan\/vegetarian;\nhowever, a non-vegan and vegetarian will only learn those tips from exposure in\nmedical school. If doctors who don\u2019t follow a vegan or vegetarian diet don\u2019t\nget exposed well enough during medical school about implicit bias and effective\ndiet teaching, then their way of explaining to patients about diet change might\nbe less well rounded. From what Lavine witnessed he saw that everyone gets\ndifferent level exposures to different procedures in medical schools. This is\nwhy he saw peers with negative biases about suggesting vegetarian and vegan\ndiet change. Since there is no standard that each gets, bias can seep through\nwhen the doctor advises the patients. Jay Lavine once attended a lecture and it\nwas about the prevention of heart diseases and the speaker was only talking\nabout different medicines. Lavine asked about diet changes and then the doctor\nmade jokes about the diets with negative connotations. Overall that action\nhighlights that different doctors may say negative comments like that because\nof their own dietary preferences or they believe that the patients won\u2019t follow\nthrough. This is where better training on bias and preventive techniques should\nbe taught more. <\/p>\n\n\n\n

\u201cMy adoption of the vegan\/vegetarian diet symbolized to me the\nphilosophy that one should conduct one’s life in a way that doesn’t cause harm\nto other beings both human and not human,\u201d said Lavine. His perspective and\nexposure to a vegan\/vegetarian diet helped change the way he treated patients\nto a more preventive route compared to other colleagues who didn\u2019t have the\nsame lifestyle. \u201cWe should all be for ourselves but that shouldn\u2019t be at the\nexpense of using others,\u201d said Lavine. In terms of education, there could be\nmuch done to improve the way doctors educate patients on diet changes. Jay\nLavine would explain and suggest dietary changes and give recipes to help\npatients figure out a plan to adopt it. He thinks the best way for doctors to\neducate is to 1) repeat terms a lot so that the patients can internalize it; 2)\ngive handouts and articles that the patient should read because it allows\npatient autonomy to choose what\u2019s best for themselves; and 3) give people the\nbenefit of doubt and not assume that they will not change. Those are his three\ntips to start when suggesting a change to a patient. In addition, patients have\nthe responsibility to try to understand what the doctors say and go for the\nchange if they can do so.<\/p>\n\n\n\n

It\u2019s good to acknowledge that not everything is easy when it comes\nto switching to a healthier diet, says Lavine. One is the fact that many\nAmericans in poverty may not be able to access healthy options, which is why\nsocial history, follow-ups, and support programs should be implemented. Health\ndisparities are a huge issue that society needs to fix for healthier\ncommunities. Another fact is that cultural differences can cause some conflicts\nbetween the diet change if the doctors don\u2019t educate themselves about their\npatients. There needs to be more diversity and cultural competency training in\nmedical school as well. \u201cYou can turn any cultural foods vegan\/vegetarian if\nthe knowledge is applied,\u201d said Lavine. Finally, the topic of the younger\ngeneration of kids wanting to change diets can cause conflicts in the household\nif parents don\u2019t agree. Each parent responds differently but, highlighting the\nparents who may think a vegan\/vegetarian diet can cause a lack of\nnutrients;  Lavine suggests giving\nparents literature and tips to read to help mediate between kids and parents.<\/p>\n\n\n\n

\u201cI think that there is too much judging and the lack of open\nmindedness in seeing things in the way that patients might see them,\u201d said\nLavine. He believes that doctors should try to understand how patients may feel\nand try to help them rather than quickly assess that patients will not follow\nthrough on diet changes. <\/p>\n\n\n\n

\u201cNutrition is the main determinant of health,\u201d said Lavine.\nPrevention and the focus on changing diets should be more advocated in the\nhealthcare industry. Overall, training on implicit bias, patient autonomy, and\nmore exposure in medical schools are ways to improve doctors\u2019 ways of educating\npatients\u2019 healthier diets. <\/p>\n\n\n\n

Dr. Lavine is author of the Eye\nCare Sourcebook<\/em>. See https:\/\/www.amazon.com\/Eye-Care-Sourcebook-Jay-Lavine\/dp\/0737303956<\/a>\n<\/p>\n","protected":false},"excerpt":{"rendered":"

By Shantika Bhat, VRG Intern Shantika Bhat is interested in the intersection of ethics and medicine so she decided to ask Jay Lavine questions about his experience as a doctor. \u00a0Dr. Lavine, a retired opthamologist, answers questions about promotion of healthy diets and the medical system. The current medical system The current medical system focuses […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-17591","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/posts\/17591","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/comments?post=17591"}],"version-history":[{"count":1,"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/posts\/17591\/revisions"}],"predecessor-version":[{"id":17593,"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/posts\/17591\/revisions\/17593"}],"wp:attachment":[{"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/media?parent=17591"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/categories?post=17591"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.vrg.org\/blog\/wp-json\/wp\/v2\/tags?post=17591"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}