Diet-Related Diseases Leading Cause of Death in US, Doctors Suffer from Lack of Nutrition Education

On television series like “Grey’s Anatomy,” “The Resident” and “Chicago Med,” doctors always seem to know the right answer.

However, when it comes to nutrition and diet advice, this may not be the case.

One of us is an assistant professor of nutrition and dietetics, and the other is a medical student pursuing a master’s degree in nutrition.

We both understand the powerful effects that food can have on your health and longevity. A poor diet can lead to cardiovascular disease, diabetes, obesity, and even psychological conditions like depression and anxiety. Diet-related diseases are the leading cause of death in the United States, and a poor diet causes more deaths than smoking.

These health problems are not only common and debilitating, they are also expensive. Treating high blood pressure, diabetes, and high cholesterol costs an estimated $400 billion a year. Within 25 years, these costs are expected to triple to $1.3 trillion.

These facts support the need for physicians to make accurate dietary recommendations to help prevent these diseases. But how much does a typical physician know about nutrition?

What doctors don’t know

In a 2023 survey of more than 1,000 U.S. medical students, nearly 58% of respondents said they had not received formal nutrition education during their four years of medical school. Those who did received an average of three hours of nutrition education per year.

That’s a far cry from the goals set by the U.S. Committee on Nutrition in Medical Education in 1985: Medical students should receive a total of 25 hours of nutrition education while in school, a little more than six hours a year.

But a 2015 study showed that only 29% of medical schools met this goal, and a 2023 study suggests the problem is getting worse — only 7.8% of medical students reported receiving 20 or more hours of nutrition education during their four years of medical school. This, if representative of medical schools across the country, is despite efforts to support nutrition education through numerous government initiatives.

Not surprisingly, lack of training has a direct impact on physicians’ nutritional knowledge. In a study of 257 first- and second-year osteopathic medical students who took a nutritional knowledge exam, more than half failed the exam. Before the exam, more than half of the students (55%) felt comfortable counseling their patients on nutrition.

Unfortunately, this problem is not limited to U.S. medical schools. A 2018 global study concluded that nutrition education for medical students is inadequate worldwide, regardless of country.

We’re bringing back nutrition education

While there is evidence to suggest that nutrition education can be effective, there are many reasons why it is lacking. Medical students and physicians are some of the busiest people in society. The amount of information taught in medical curricula is often described as overwhelming – like drinking from a fire hose.

First- and second-year medical students focus on intensive topics such as biochemistry, molecular biology, and genetics while learning clinical skills such as interviewing patients and understanding heart and lung sounds. Third- and fourth-year students practice in clinics and hospitals while learning from physicians and patients.

As a result, their schedules are already jam-packed. There’s no room for nutrition. And once they become physicians, it doesn’t get any better. Providing preventive care, including nutritional counseling, to patients will take up more than seven hours of their time per week—and that’s not counting the time they must spend in continuing education to keep up with new findings in nutritional science.

Moreover, the inadequacy of nutrition education in medical schools is attributed to the lack of qualified instructors for nutrition courses because most physicians do not understand nutrition well enough to teach it.

Ironically, many medical schools are part of universities that have nutrition departments staffed by professors with doctorates; these professors can fill this gap by teaching nutrition to medical students. But these courses are often taught by physicians who have not received adequate nutrition training—meaning that the truly qualified instructors that most medical schools have access to are left out of the process.

Finding the right advice

The best source of nutrition information, whether for medical students or the general public, is a registered dietitian, certified nutritionist, or other nutrition professional with multiple degrees and certifications. They have years of practice and log many practical hours providing dietary advice.

While anyone can make an appointment with a nutritionist for dietary counseling, a referral from a healthcare provider, such as a physician, is usually required for the appointment to be covered by insurance. Therefore, seeing a physician or other primary care provider is often a step before meeting with a nutritionist.

This extra step may be one reason why many people look elsewhere for nutrition advice, such as their phones. However, the worst place to look for accurate nutrition information is social media. There, approximately 94% of posts about nutrition and diet are low-value—either false or lacking sufficient data to support the claim.

Remember, anyone can share nutrition advice on social media, regardless of their qualifications. Good nutrition advice is personalized and takes into account a person’s age, gender, goals, body weight, goals, and personal preferences. It’s hard to capture this complexity in a short social media post.

The good news is that nutrition education is effective when it is provided, and most medical students and physicians recognize the critical role nutrition plays in health. In fact, nearly 90% of medical students say nutrition education should be a required part of medical school.

We hope that nutrition education will soon become an integral part of every medical school curriculum after decades of being devalued or ignored. However, given its history and current status, this is unlikely to happen anytime soon.

In the meantime, those who want to learn more about healthy eating should consult a nutritionist or at least read the 2020–2025 Dietary Guidelines for Americans or the World Health Organization’s healthy eating recommendations.

The authors do not work for, consult, own shares in, or receive funding from any company or organization that would benefit from this article, and they have disclosed no affiliations beyond their academic appointment.

/Courtesy of The Conversation. This material from the source organization/author(s) may be of a particular time period and may be edited for clarity, style, and length. Mirage.News does not take institutional positions or parties, and all opinions, positions, and conclusions expressed herein are solely those of the author(s).