Nearly 60% of respondents to one medical school survey said they received no nutritional education at all. Peter Dazeley/The Image Bank via Getty Images

We often look to doctors for the correct answers regarding our health. However, when it comes to nutrition, the unfortunate reality is that many doctors need more training to guide their patients toward healthy eating. Even though diet-related diseases like heart disease, diabetes, and obesity are the leading causes of death in the U.S., nutrition education in medical school remains shockingly limited.

Anyone concerned about their health must realize they must be their own advocates. This responsibility is not a burden but a proactive step toward better health. Numerous reputable sources, such as the Mayo Clinic, Cleveland Clinic, and Johns Hopkins, offer valuable nutrition guidance, but the responsibility for implementing change falls largely on individuals. The most impactful step anyone can take toward improved health is dietary adjustment.

At the forefront of healthy eating is the Mediterranean diet. This time-tested eating pattern emphasizes whole, unprocessed foods, healthy fats, and fresh produce. The diet's emphasis on these foods, which are rich in nutrients and antioxidants, has been shown in numerous studies to lower the risk of chronic diseases, improve mental health, and increase life expectancy. The diet encourages consuming vegetables, fruits, legumes, whole grains, fish, and olive oil while reducing the intake of red meats, sweets, and ultra-processed carbohydrates.

Speaking of processed foods, minimizing or eliminating ultra-processed carbohydrates from your diet is essential. These foods, such as sugary cereals, white bread, packaged snacks like potato chips, and sweetened beverages, are often stripped of their nutritional value and packed with additives that can wreak havoc on our health. They are designed for convenience and taste, but their long-term impact includes increased risks for obesity, heart disease, and type 2 diabetes.

While crucial for diagnosing and treating diseases, the medical field still needs to catch up with the knowledge required to guide people toward healthier lifestyles. However, in the meantime, armed with the wealth of accessible online information from reputable institutions, individuals can take charge of their own well-being. The key to lasting change is making simple but consistent adjustments to our eating.

Consider starting with a basic principle: avoid ultra-processed carbs and lean toward the Mediterranean way of eating. By doing this, you're already on the right track to preventing chronic diseases, improving your quality of life, and taking control of your health.

You don't need to wait for the medical system to change; you can start changing today by focusing on the food you eat. - Robert Jennings, InnerSelf.com

 In this Article:

• Why are diet-related diseases the leading cause of death in the U.S.?
• How much nutrition education do doctors receive in med school?
• Can better nutrition training reduce preventable diseases?
• How can following a Mediterranean diet help prevent diet-related illnesses?
• What can you do to be your own advocate for better health?

Diet-related Diseases Are The No. 1 Cause Of Death In The US – Yet Many Doctors Receive Little To No Nutrition Education In Med school

by Nathaniel Johnson and Madeline Comeau, University of North Dakota

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

But when it comes to nutrition and dietary 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.

Both of us understand the powerful effects that food has on your health and longevity. A poor diet may lead to cardiovascular disease, diabetes, obesity and even psychological conditions like depression and anxiety. Diet-related diseases are the leading causes of death in the U.S., and a poor diet is responsible for more deaths than smoking.

These health problems are not only common and debilitating, but expensive. Treating high blood pressure, diabetes and high cholesterol costs about US$400 billion per year. Within 25 years, those costs are expected to triple, to $1.3 trillion.

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

The deficiencies in nutrition education happen at all levels of medical training.

What doctors don’t know

In a 2023 survey of more than 1,000 U.S. medical students, about 58% of respondents said they received no formal nutrition education while in medical school for four years. Those who did averaged about three hours of nutrition education per year.

That is woefully short of the goals set by the U.S. Committee on Nutrition in Medical Education back in 1985: that med students should receive a total of 25 hours of nutrition education while in school – a little more than six hours per year.

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

Not surprisingly, the lack of education has had a direct impact on physicians’ nutrition knowledge. In a study of 257 first- and second-year osteopathic medical students taking a nutrition knowledge quiz, more than half flunked the test. Prior to the test, more than half the students – 55% – felt comfortable counseling patients on nutrition.

Unfortunately, this problem is not limited to U.S. medical schools. A 2018 global study concluded that no matter the country, nutrition education of med students is insufficient throughout the world.

Bringing nutrition education back

Even though evidence suggests that nutrition education can be effective, there are many reasons why it’s 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 out of a fire hose.

First- and second-year medical students focus on dense topics, including biochemistry, molecular biology and genetics, while they learn clinical skills such as interviewing patients and understanding heart and lung sounds. Third- and fourth-year students are practicing in clinics and hospitals as they learn from physicians and patients.

As a result, their schedules are already jammed. There is no room for nutrition. And once they are physicians, it gets no better. Providing preventive care including nutrition counseling to patients would take them more than seven hours per week – and that’s not counting the time they would have to spend on continuing education to keep up with new findings in nutrition science.

On top of that, the lack of nutrition education in medical schools has been attributed to a dearth of qualified instructors for nutrition courses, as most physicians do not understand nutrition well enough to teach it.

Ironically, many medical schools are part of universities that have nutrition departments with Ph.D.-trained professors; those academicians could fill this gap by teaching nutrition to medical students. But those classes are often taught by physicians who may not have adequate nutrition training – which means truly qualified instructors, within reach of most medical schools, are left out of the process.

This doctor said he learned virtually nothing about nutrition in medical school.

Finding the right advice

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

Although anyone can make an appointment with a nutrition professional for dietary counseling, typically a referral from a health care provider like a physician is needed for the appointment to be covered by insurance. So seeing a physician or other primary care provider is often a step before meeting with a nutrition professional.

This extra step might be one reason why many people look elsewhere, such as on their phones, for nutrition advice. However, the worst place to look for accurate nutrition information is social media. There, about 94% of posts about nutrition and diet are of low value – either inaccurate or lacking adequate data to back up the claim.

Keep in mind that anyone can post nutrition advice on social media, regardless of their qualifications. Good dietary advice is individualized and takes into account one’s age, sex, goals, body weight, goals and personal preferences. This complexity is tough to capture in a brief social media post.

The good news is that nutrition education, when it occurs, is effective, and most medical students and physicians acknowledge the critical role nutrition plays in health. In fact, close to 90% of med students say nutrition education should be a mandatory part of medical school.

We hope that nutrition education, after being devalued or ignored for decades, will soon be an integral part of every medical school’s curriculum. But given its history and current status, this seems unlikely to happen anytime soon.

In the meantime, those who want to learn more about a healthy diet should meet with a nutrition professional, or at the very least read the 2020-2025 Dietary Guidelines for Americans or the World Health Organization’s healthy diet recommendations.

Nathaniel Johnson, Assistant Professor of Nutrition and Dietetics, University of North Dakota and Madeline Comeau, Medical Student, University of North Dakota

Article Recap

Diet-related diseases are the top cause of death in the U.S., yet doctors receive little formal nutrition education in medical school. With fewer than 25 hours of training, physicians are often ill-equipped to provide critical dietary advice. This gap in education contributes to the prevalence of preventable illnesses. The Mediterranean diet and reducing ultra-processed carbs are key steps toward healthier living. Be your own advocate by seeking accurate, evidence-based nutrition information.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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