Diet-related diseases are the 1st cause of death in the US – yet many doctors receive little nutrition education in med school

In television shows like “Grey’s Anatomy,” “The Resident” and “Chicago Med,” doctors always seem to have the right answer.

But when it comes to nutrition and diet advice, that 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 that food has on health and longevity. Eating poorly can lead to heart disease, diabetes, obesity and even mental conditions such as depression and anxiety. Diet-related diseases are the leading causes of death in the US, and poor diet is responsible for more deaths than smoking.

These health problems are rare and debilitating, but costly. Treating high blood pressure, diabetes and high cholesterol costs US$400 billion a year. Within 25 years, that cost is expected to triple, to $1.3 trillion.

These facts support the need for doctors to provide proper dietary advice to help prevent these diseases. But how much does the average doctor know about nutrition?

What doctors don’t know

In a 2023 survey of more than 1,000 US medical students, nearly 58% of respondents said they received no nutritional education during their four years of medical school. Those who did average about three hours of nutrition education per year.

That falls woefully short of the goals set by the US Committee on Nutrition in Medical Education back in 1985: for med students to receive a total of 25 hours of nutrition education while in school – hours more than six a year.

But a 2015 survey showed that only 29% of medical schools met this goal, and a 2023 survey suggests the problem is even worse – only 7.8% of med students reported 20 or more hours of nutrition education across four years of med school. If this is representative of medical schools across the country, it happened despite efforts to strengthen nutrition education through many government initiatives.

It is not surprising that the lack of education has had a direct effect on the nutritional knowledge of doctors. In a survey of 257 first- and second-year osteopathic medical students who were asked nutrition knowledge questions, more than half completed the test. Before the test, more than half of the students – 55% – felt comfortable giving nutritional advice to patients.

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

Bringing back nutrition education

Although evidence suggests that nutrition education can be effective, there are many reasons why it is lacking. Medical students and doctors are some of the busiest people in society. Much of the information taught in medical courses is often described as overwhelming – like drinking from a fire hose.

First- and second-year medical students focus on dense topics, including biochemistry, molecular biology and genetics, while learning clinical skills such as communicating with patients and understanding the sounds of heart and lungs. Third and fourth year students practice in clinics and hospitals while learning from doctors and patients.

As a result, their schedules are already overcrowded. There is no place for nutrition. And once it’s doctors, it’s no better. Providing preventative care including nutritional counseling to patients will take them more than seven hours a week – and that’s not counting the time they’ll have to spend on continuing education to keep up with the research. the latest in nutritional science.

In addition, the lack of nutrition education in medical schools is due to the lack of qualified instructors for nutrition courses, as many doctors do not understand nutrition enough to teach it.

Surprisingly, many medical schools are part of universities with nutrition departments and Ph.D.-trained professors. Those academics could fill this gap by teaching nutrition to medical students. But those classes are often taught by doctors who may not have enough training in nutrition — which means that truly qualified instructors, within reach of most medical schools, are left out of the job. .

Getting the right advice

The best source of nutrition information, whether for medical students or the general public, is a registered dietitian, registered dietitian or other type of nutritionist. with multiple degrees and certifications. They study for many years and log many hours of practice in order to give dietary advice.

Although anyone can make an appointment with a nutritionist for dietary counseling, a referral from a health care provider such as a doctor is usually required for the appointment to be covered by insurance. So seeing a doctor or other primary care provider is often the first step before seeing a nutritionist.

This extra step may be another reason why many people look elsewhere, like their phones, for nutritional advice. However, the worst place to look for proper nutrition information is social media. In contrast, nearly 94% of messages about nutrition and food are of poor quality – either inaccurate or lacking sufficient data to support the claim.

Remember that anyone can post nutritional advice on social media, regardless of their qualifications. Good dietary advice is individualized and takes into account a person’s age, sex, weight, goals and preferences. This complexity is difficult to capture in a short social media post.

The good news is that nutrition education, when it does, is effective, and many medical students and doctors believe in the important role of nutrition in health. In fact, nearly 90% of med students say that nutrition education should be a mandatory part of medical school.

We hope that nutrition education, after being neglected or ignored for decades, will soon become an important part of the curriculum of every medical school. But given its history and current situation, this doesn’t seem likely to happen anytime soon.

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