Photo above: Almost 60% of respondents to a medical school survey said they had received no nutrition education. Image Bank via Peter Dazeley/Getty Images
On television shows like “Grey’s Anatomy,” “The Resident” and “Chicago Med,” doctors always seem to give 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; the other is a medical student with a master’s degree in nutrition.
We both understand the powerful effects food can have on your health and longevity. Malnutrition can lead to cardiovascular diseases, diabetes, obesity, and even psychological conditions such as depression and anxiety. Diet-related diseases are the leading cause of death in the United States, and poor nutrition is responsible for 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 approximately US$400 billion annually. These costs are expected to triple in 25 years, reaching $1.3 trillion.
These facts support the need for doctors to provide accurate dietary recommendations to help prevent these diseases. So 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 in four years of medical school. Those who did received an average of three hours of nutrition training per year.
This falls woefully short of 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, just over six hours per year.
But a 2015 study showed that only 29% of medical schools met that goal, and a 2023 study shows the problem is getting worse; Only 7.8% of medical students reported receiving 20 or more hours of nutrition education during four years of medical school. If this is representative of medical schools across the country, it is despite efforts to promote nutrition education through numerous government initiatives.
It is not surprising that lack of education has a direct impact on physicians’ nutritional knowledge. In a study of 257 first- and second-year osteopathic medical students who took a nutrition knowledge exam, more than half failed the test. Before testing, more than half of students (55%) felt comfortable counseling patients about nutrition.
Unfortunately, this problem is not limited to medical schools in the United States. A 2018 global study concluded that nutrition education for medical students is inadequate worldwide, regardless of country.
Bringing back nutrition education
Although evidence shows that nutrition education can be effective, there are many reasons for its lack. Medical students and doctors are some of the busiest people in society. The amount of information taught in medical curriculums is often described as overwhelming, like drinking from a fire hose.
While first- and second-year medical students focus on intense topics like biochemistry, molecular biology and genetics, they also learn clinical skills such as interviewing patients and understanding heart and lung sounds. Third and fourth year students practice in clinics and hospitals by getting information from doctors and patients.
As a result, their schedules are already tight. There is no room for nutrition. And once they become doctors, it doesn’t get any better. Providing patients with preventive care, including nutritional counseling, will take more than seven hours per week, and that doesn’t take into account the time they will have to spend on continuing education to keep up with new findings in nutritional science.
Furthermore, the lack 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 with nutrition departments staffed by doctoral-trained professors; These scholars can fill this gap by teaching nutrition to medical students. However, these classes are often given by doctors who do not have adequate nutrition training; This means that truly qualified instructors available to most medical schools are left out of the process.
Finding the right advice
The best source of nutrition information for medical students or the general public is a registered dietitian, certified nutritionist, or another type of nutritionist with multiple degrees and certifications. They study for years and log many practical hours to give dietary advice.
Although anyone can make an appointment with a nutritionist for dietary counseling, a referral from a healthcare provider, such as a doctor, is usually required for the appointment to be covered by insurance. Therefore, consulting a physician or other primary care provider is often one step before seeing a nutritionist.
This extra step may be one reason why many people look elsewhere, such as the phone, for nutritional advice. But the worst place to look for accurate nutrition information is social media. There, about 94% of nutrition and diet-related posts are low-value; is either inaccurate or lacks sufficient data to support the claim.
Remember that anyone, regardless of their qualifications, can post nutrition advice on social media. Good nutrition advice is personalized and takes into account a person’s age, gender, body weight, goals and personal preferences. It’s difficult to capture this complexity in a short social media post.
The good news is that nutrition education is effective when it occurs, and most medical students and doctors 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, which has been devalued or ignored for decades, will soon become an integral part of every medical school curriculum. But given its history and current situation, that seems unlikely to happen anytime soon.
In the meantime, those who want to learn more about healthy eating should talk to a nutritionist or at least read the 2020-2025 Dietary Guidelines for Americans or the World Health Organization’s healthy eating recommendations.
Nathaniel Johnson, Assistant Professor in the Department of Nutrition and Dietetics University of North Dakota and Madeline Comeau, Medical Student, University of North Dakota
This article is republished from The Conversation under a Creative Commons license. Read the original article.