Whether it’s on TikTok, WhatsApp, Instagram or Facebook, the latest “diet” trends are hard to escape. There’s paleo, keto, macros, intermittent fasting, vegan, Mediterranean, low-carb and so many other programs inundating individuals every day, and many turn to their favorite social media influencers for “expert” opinions on what works and what doesn’t. In fact, social media is so prevalent today that one study showed 85% of people relied on it as a source for trusted health information.

But when it comes to improving and maintaining health, there are several misconceptions and myths swirling around the social media universe. And most of them center around proper nutrition since many of these promoted posts and programs offer recommendations that can result in an unbalanced, unsustainable eating approach. Given this level of information, it’s critical for today’s clinicians to play a more active role in educating patients about the facts vs. fiction when it comes to nutrition. 

Understanding the Definition of Malnutrition

It may be hard to believe that patients on these so-called healthy diets can be malnourished. No doubt, when thinking about malnutrition, the first images that likely come to mind are adults and children who live in developing countries or underserved communities where food is scarce. But the truth is, nearly one-third of people globally suffer from some form of malnutrition – whether it’s undernutrition marked by stunted growth, fasting and being underweight, or overnutrition, which can result in obesity, according to the World Health Organization

Malnutrition encompasses a broad range of disorders. It may not be as obvious as someone being extraordinarily thin or someone having a body mass index (BMI) of over 25 and considered overweight or obese. For example, consider the case of an elderly person with a healthy BMI, but who has been diagnosed with chronic obstructive pulmonary disease (COPD) and only eats ultra-processed foods. Despite a “normal” BMI, this eating approach may ultimately result in malnourishment and cause further health complications, in addition to COPD.

Another contributing factor to malnutrition today is the trend of using weight loss medications, to control appetite. When patients aren’t hungry anymore, they may undereat and lose muscle mass. Then, when they transition off the medication, they may be in worse shape metabolically than before they lost weight.

Fad diets or weight loss medications do not solve malnutrition. The key is eating a balanced diet of fruits, vegetables, lean protein and healthy fats, while also trying to limit ultra-processed foods wherever possible. Today, almost 60% of the calories consumed by American adults are from ultra-processed foods, which contain unhealthy levels of added sugar, sodium and fat. And the American Medical Association notes that such a diet significantly increases a person’s risk of health complications, including cardiovascular disease, certain cancers, obesity and type 2 diabetes, to name a few.

Tackling Obesity with the Proper Medications

Much of the discussion about nutrition centers around the obesity epidemic, and rightfully so, since it’s estimated that approximately 42% of Americans have obesity. But while diet and exercise are important for good health, for many people, lifestyle choices alone are not enough to reach a healthier weight.

While nutrition is important from an overall health standpoint and can help minimize the risk of developing many chronic diseases, simply making better nutritional choices is not the way to manage other health conditions, such as type 2 diabetes, hypertension, or high cholesterol. The same holds true for exercise. While exercise is one of the most important things patients can do for their overall health, it’s not a particularly effective weight loss strategy – which makes obesity particularly complex to address.

Because nutrition and exercise alone are not effective long-term strategies for weight loss for many people, physicians need to consider the availability of medications to make lifestyle choices easier.

For example, clinicians are seeing this issue arise within pediatric obesity guidelines, which include medication and bariatric surgery along with a healthy diet and exercise for patients. While these guidelines have been criticized, arguing that kids just need to exercise more, scientific evidence shows that diet and exercise alone may not be sufficient to address this medical condition for all children. Therefore, alternatives like medication and surgery should be on the decision tree to ensure that pediatric patients are presented with evidence-based options to address their individual needs. Evidence also shows that children who struggle with malnutrition and obesity can face lifetime consequences for cardiovascular risk and other health problems. 

A Proactive, Population Health Approach to Malnutrition

While dietitians are a great source of information, clinicians need to play a vital role in countering malnutrition.

Direct conversations about weight and malnutrition as a medical condition can help de-stigmatize and normalize the discussion. Being able to have candid discussions can help aid in managing a patient’s misconceptions about nutrition, diet and exercise. Clinicians should also look to implement healthcare technology, such as patient-reported outcomes (PROs) and remote patient management (RPM)  to extend patient care outside the doctor’s office walls. Doing so helps clinicians better understand the everyday challenges their patients face and enables them to more efficiently and effectively provide insights on what steps should be taken next to achieve the best outcome. 

To do this successfully, patients also need access to tools and smart devices, such as connected scales and blood pressure cuffs, that can be integrated into additional EHRs to help clinicians better track patient care and improve outcomes.

When it comes to addressing nutritional health concerns with patients, it’s important to provide them with the proper education and resources that best suit their needs. By helping patients understand the basics of proper nutrition, they can address the issues of being underweight or overweight and ultimately make improvements that can counter other associated health problems like heart disease, cancer and diabetes. 

About Lucienne Marie Ide, M.D., PH.D.

Lucienne Marie Ide, M.D., Ph. D., is the Founder and Chief Executive Officer of Rimidi, a leading clinical management platform designed to optimize clinical workflows, enhance patient experiences and achieve quality objectives. She brings her diverse experiences in medicine, science, venture capital and technology to bear in leading Rimidi’s strategy and vision. Motivated by the belief that we can do so much better as individuals, in industry and society, Lucie left clinical medicine to join the ranks of healthcare entrepreneurs who are trying to revolutionize an industry.

About Ansley Dalbo
Ansley Dalbo is the founder and CEO of Diabetes – What to Know and My Weight – What To Know, educational resources for people living with type 2 diabetes and obesity. She is focused on how we can make health education both relevant and engaging for people living with chronic disease, and passionate about using social media and digital tools to help people get the information they need to live long, healthy lives. 

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