Medical education not covering basics of nutrition


Although diet plays an outsize role in health and wellness and can be crucial to managing many common chronic conditions, medical schools tend not to devote much time to teaching future doctors about nutrition, a recent research review suggests.

Researchers analyzed data from 24 previously published studies that focused on medical students’ nutrition knowledge and confidence in their ability to counsel patients on diet. Overall, nutrition was insufficiently incorporated into medical education regardless of country, setting, or year of education, the review team found.

“Insufficient nutrition education, impacts on students’ knowledge, skills and confidence to include nutrition care into patient care,” said Jennifer Crowley, a researcher in nutrition and dietetics at the University of Auckland in New Zealand.

“When students do not witness nutrition counseling by senior doctors, it does not become part of holistic patient care and continues into their medical practice,” Crowley said. “Also, the importance of nutrition for a healthy lifestyle is not reinforced with patients.”

Worldwide, obesity rates have nearly tripled since 1975, according to the World Health Organization. As of 2016, some 650 million adults worldwide were obese, and 381 million children and teens were overweight or obese.

While many factors have fueled rising obesity rates, physical inactivity and diets loaded with too many calories and fats are a big part of the problem, according to WHO.

Obesity is a major risk factor for many of the leading causes of death and disability worldwide, including heart disease, diabetes, arthritis and certain cancers.

The current analysis examined smaller studies of nutrition training in the U.S., Europe, the Middle East, Africa, Asia, New Zealand and Australia.

Even when curriculum initiatives focused specifically on educating doctors about nutrition, the analysis found that these efforts had only a “modest effect” on doctors’ sense that they could competently provide nutrition counseling or advice to patients, the study team reports in The Lancet Planetary Health.

Medical students in many of the smaller studies expressed an interest in nutrition and a willingness to learn about it, but generally perceived their training in this topic as inadequate.

Ideally, medical schools should be graduating new doctors who are well versed in the basics of nutrition and weight management and able to steer patients to the right specialists as needed for extra help making lifestyle changes, the study team argues.

“This study matters because it speaks directly to the type of medical care we can expect to receive,” said Dr Stephen Devries, author of an editorial accompanying the study and executive director of the nonprofit Gaples Institute for Integrative Cardiology in Deerfield, Illinois.

“If physicians worldwide are not meaningfully educated about nutrition, how can we expect them to emphasize anything besides drug and devices,” Devries said.

Moreover, efforts by a growing number of clinicians and public health efforts to promote a plant-based diet for both patient and planetary health are not going to succeed unless doctors can address diet and nutrition issues during exams, Devries said.

Patients who need help eating well may need to advocate for themselves to get the support they need to succeed, Devries added.

“Whether you are concerned about maintaining your good health, responding to some early warning sign, or treating a specific problem, ask your practitioner about opportunities for bettering your situation with diet and lifestyle,” Devries advised. “And if they can’t help, request a referral to a skilled professional who can.”

© Thomson Reuters 2019.

©2019 GPlusMedia Inc.

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Of course, it's the industry's interest that the mass keeps eating crap. Patients develop life long conditions that are roughly manageable. Jackpot ! That makes them visit doctors often and get prescribed huge amounts of drugs.

Devries advised. “And if they can’t help,

It's not if. It's the case. The article is right. They don't know more about exercising or psychology.

request a referral to a skilled professional who can.”

As if they knew those pros. Let's hope they can help with the flu or give a referral for cancer screening.

2 ( +3 / -1 )

In the hospital the other day, the doc wanted me to take some medicine, but he said I should eat something first. So I went to the canteen. I couldn't believe it! Coke! Diet Coke! In fact a wide selection of fizzy sugar water. Anemic looking white bread sandwiches. Cakes with sugar icing. The only vegetables in sight had been stewed to within an inch of their lives. And the TV blaring out rubbish about what particular snake oil stops those "aches and pains" because it contains, wait for it, "vitamins!"

The patients are being duped because they know nothing about nutrition either. And this should be a vital part of any school curriculum for boys or girls. The girl at the counter at the shop in the hospital thought I was some kind of loony and saw nothing wrong with sugary sodas and starchy snacks. There has to be a whole education programme, not just for medical people but for all, from children to adults. Food quality gets worse and worse.

3 ( +3 / -0 )

It's not just the doctors and other medical staff who don't recognize the role of good food/nutrition plays in a patient's recovery. Certainly here in Australia hospital food is a nightmare, often stodgy, half-cooked and tasteless, seemingly taking its inspiration from the worst of Anglo cooking from the last century. That's because hospital administrations operate more with an eye on their finances than on patient health when it comes to providing food services.

As for GPs, in a busy clinic with just a few minutes per patient, even for those who come in specifically for a nutrition problem (e.g help with obesity) there just isn't time for a meaningful discussion about dietary solutions to the problem. Referral to a nutritionist would be the answer.

2 ( +2 / -0 )

I don't know much about discussing diets with Japanese doctors, but I once spoke to a nutritionist in Japan about the lack of proper food labeling in Japan (lots of stuff doesn't seem to adequately mention the exact amounts of sugar). She basically told me that "if something tastes sweet, then there's probably sugar in there". Her answer baffled me and I began to wonder about the state of Japan's general knowledge of nutrition. I must admit they've done a surprisingly good job with keeping their people generally healthy so far with their eating habits.

2 ( +2 / -0 )

I suffer with gout or tsufu and need to take pills daily to reduce the uric acid levels. When I visit the doctor he also discusses my diet.

This week spend time in hospital for a biopsy. Soon after arriving a nurse came and asked questions about food and allergies. Diary products ok. I had an evening meal which I was really in need of since I hadn't eaten anything for 24 hours. It was well prepared and tasty even if not at restaurant standards. I also had breakfast before leaving. I was happy with it.

The traditional Japanese diet has opposed to the fast food western one is part of the reason people live long lives. Younger people are dying before their parents from eating the fast foods.

0 ( +1 / -1 )

The post does not mention Japan. There are less obese people but I think the numbers have increased over the last two decades. When I read my UK papers I am shocked to see so many photos of obese people especially younger one and especially young women with legs the size of tree trunks.

0 ( +1 / -1 )

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