Kelly Dorfman’s recent book What’s Eating Your Child? is an exploration of how food affects the physical and emotion health of children. She uses anecdotal pseudo-case studies to demonstrate how particular children had improvement focusing on particular nutritional changes.
Throughout her book she helps parents and practitioners alike understand better ways to involve their children in meal time decisions and allow them to buy-in on health food choices. Her E.A.T program to make health food changes I think will be particularly helpful in my practice.
I have three main problems with her book. First, each chapter is focused around a particular problem in a child in which the answer is an addition or subtraction of a nutrient. I think the best quote that sums up what is lacking in these chapters is from one of my former residency attendings who said “The eye cannot see what the mind doesn’t know.” Mrs Dorfman’s training lacks the depth and breadth necessary to take into account a more full understanding of the health of these children. Don’t get me wrong some of the points she makes are very insightful from having investigated many different children but her differential diagnosis only includes food treatable illnesses.
The second point of contention is the use of physician ad hominem arguments throughout. Too many of her chapters base her success on the fact that so many physicians have ‘failed’ before her. If a therapy or treatment is true and right and valid for children it is true and right and valid all the time not just when it helps show the perceived failures of other medical professionals. True medical therapy doesn’t require this type of argument.
The last and most problematic issue of her book is the lack of evidence on which to base her claims. She uses reasoning such as milk produces mucus in the respiratory track. This child doesn’t have a runny nose any more, therefore the mucus must be someone were else like the lungs. There is no commentary on evidence supporting the milk does or does not produce mucus nor that it can change where it produces mucus over time. Likewise there is not evidence to support her therapy options. No trials, no studies, not even a peer reviewed journal to point to. She uses a long bibliography in the back of the book but never correlates these references to particular points of evidence within the book. For the medical professional this is just unacceptable. I can in no way go to my patients and tell them to pursue a course of therapy where there is no evidence that it is beneficial let alone safe. We need science to lead us to the next step in medical therapies not false logic and trial and error. Lets take the next step with nutrition therapy and perform blinded trials of nutrient intervention on particular well defined disease states. With that we can then guide our patients into better health with clear evidence.