Global Deficiency of Nutrition Education in Physician Training

Per the Global Burden of Disease Study, which examines data from 195 countries, dietary factors are the single leading cause of death and contribute to higher mortality rates than smoking. Worldwide, obesity affects hundreds of millions of people, and the rates have tripled since 1975, according to data from the World Health Organization.

Many factors contribute to the rising prevalence of obesity, including physical inactivity, poor dietary choices, and high processed food consumption all of which are major risk factors for many leading causes of death and disability in the United States, such as cardiovascular disease, diabetes, arthritis, and certain cancers.

A nutrient-dense, healthy diet plays a significant role in the maintenance of overall health and physical wellbeing; it is vital to managing many common chronic diseases as well. Underscoring the importance of weight management, especially in high-risk patients, experts point out the evident gaps in education that challenge many physicians today.

The current medical curriculum does not adequately cover nutrition education, according to a recent research review, which found a lack of sufficient dietary training both regionally and across the globe. While in many countries doctors are encouraged to provide dietary counseling to their patients in order to improve nutritional risk factors on both an individual and population level, the contemporary medical approach is disease-focused and rescue care-based, lacking strategic intervention and prevention efforts – as well as comprehensive nutrition training.

Nutritional Education Lacking in Medical Curriculum

Conducted by Dr. Jennifer Crowley from the University of Auckland, New Zealand, a systematic review of several studies examined nutrition training in medical schools around the globe. Results revealed that many physicians enter the workforce feeling inadequately prepared to counsel patients on dietary strategies, despite the obvious need for them to possess substantial skills in clinical nutrition.

Published in The Lancet Planetary Health, the 2019 review aims to synthesize the current level of nutrition education provided to medical students worldwide. In their analysis, Dr. Crowley and her colleagues examined 24 smaller trials of physician training in the United States, Europe, the Middle East, Africa, New Zealand, and Australia. These included 16 quantitative studies, 3 qualitative studies, and five curriculum initiatives. The studies focused on medical students’ nutrition knowledge, confidence in their ability to provide dietary counseling to patients.

Researchers evaluated literature published between November 1, 2012 to December 31, 2018 on medical students’ nutrition education, skills, and confidence levels. The studies included evaluated nutrition knowledge in recently graduated or current medical students, their perception of the nutrition curriculum, and their attitudes toward nutrition education initiatives.  During their analysis, the investigators found that nutrition is not incorporated into education sufficiently, regardless of the geographic location, setting, or year of clinical education.

Re-evaluating the Nutrition Curriculum

Deficits affect not only students’ knowledge and confidence but also their ability to deliver effective, systematic care to their patients. “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,” Dr. Crowley told Reuters. “Also, the importance of nutrition for a healthy lifestyle is not reinforced with patients.”

Even with tailored initiatives focused on physician nutrition education, these efforts only revealed a “modest effect” on doctor’s sense that they could provide nutrition counseling in the review, according to the research team. However, most medical students expressed interest in nutrition and a willingness to learn about it despite feeling inadequately prepared throughout their clinical education.

Today, most medical education is not focused on the needs of the patient or widespread population health. Instead, it takes on a rescue care- and disease-based approach. Rather than adopting a preventative strategy against obesity and its multitude of health complications, current curricula do not meaningfully educate physicians on nutrition. Increased efforts to support weight management and promote plant-based diets for both individual patient and population health are not likely to succeed in this environment, unless physicians are able to competently address dietary concerns and techniques. As part of the 27th Annual World Congress sessions will focus on providing valuable nutritional education for attendees to combat the deficit in the medical curriculum, teaching strategies dietary strategies for patient health optimization.