The Authors Reply to Comment on the Importance of Physicians' Nutrition Literacy in the Management of Diabetes MellitusDr. Alan Dugdale raises an excellent point worthy of emphasis. False knowledge about the role of nutrition in medicine represents a significant obstacle that we neglected to mention in our original article. We heartily agree that it is more challenging to correct false knowledge than it is to fill a knowledge void with correct knowledge. Indeed, historical examples testify to the potentially devastating consequences of ignoring this challenge. Surgeon Joseph Goldberger, for example, proposed in 1915 that pellagra, a skin condition widely considered to be infectious, was in fact the result of a nutrition deficiency. Through multiple studies, Goldberger demonstrated that pellagra was indeed associated with poor nutrition. Accepting Goldberger's theory would have forced physicians to master another field. Because the U.S. had at the time recently entered the bacteriological phase of medicine, physicians discounted his findings for decades. As a result of the same kinds of resistance, even today there remain many known nutrition-related issues (e.g., diabetes, obesity, lactation) about which numerous physicians are ignorant or hold serious misinformation. Thus, we appreciate Dugdale's comments and applaud his research team efforts in this area. All of this further suggests how strong the obstacles are to nutrition literacy for practitioners and how crucial it is to improve nutrition education and training in U.S. medical schools and residency programs. Jessica A. Schulman, PhD, MPH, RD, LD/N Correspondence
Jessica A. Schulman |