How often have you discussed nutrition with your primary care doctor? For many of us,

the answer is never. Intake forms ask about smoking and alcohol, but skip over diet. With poor nutrition fueling diabetes and obesity epidemics, and with research confirming the disease-fighting and health-promoting effects of many foods, good nutrition is simply too important ignore. And it’s a huge lost opportunity for physicians to take a leadership role in encouraging patients to live healthier lives. “

Three cheers, then, for the current issue of San Francisco Medicine, which is devoted to helping busy doctors close the medical-nutrition gap. “Poor nutrition is a risk factor for four of the six leading causes of death in the United States: heart disease, stroke, diabetes, and cancer,” writes Brian Raymond, MPH, in the report. “Fortunately, it doesn't take long to tell patients that what they eat matters to their health,” writes nutrition professor, advocate, and bestselling author Marion Nestle, PhD, MPH.

Three nutrition rules

Pay attention to variety. People who eat lots of different rarely have nutrient deficiencies, says Nestle. (One exception, vitamin D, actually a hormone.) People on restricted diets may need to supplement.

Go for minimal processing.Processing (changing a food from its natural state) usually removes nutrients and adds salt, sugar, and/or calories, according to Nestle.

Practice moderation.To manage weight, people need to balance the food they eat with their physical activity, she adds.

More practical nutrition highlights for physicians:

Encourage patients to invest in higher-quality foods, writes David Wallinga, MD, MPA. Junk foods have gotten cheaper while fresh fruits and vegetables have gotten more expensive. Buying organic foods is one way to avoid excess pesticides, antibiotics, and the other hazards that lead to health problems.

Advocate for positive change in U.S. food and agricultural policies, which link directly to poor nutrition in America, writes Raymond. Key issues: Help influence the 2010 Farm Bill; promote sustainable agriculture; support improved food safety; and promote subsidies for healthy foods, such as fruits and vegetables.

Refer patients to certified nutritionists or dieticians when needed, writes Erica Goode, MD, MPH.