Expert panel calls for excellence in nutrition in US medical education

A group of medical and nutrition experts recommends 36 skills to address concerns that many US doctors are not trained to advise patients on nutrition and food choices.

For immediate release: September 30, 2024

Boston, MA—A multidisciplinary team of medical and nutrition experts has developed a set of recommended nutrition skills for medical students and trainees. The study addresses a long-standing issue that many doctors in the US are not equipped to advise patients on proper nutrition and food choices.

The proposed capacity is a petition for action pursuant to the United States House of Representatives’ resolution H. Res. 1118, which requires “purposeful education of physicians and health professionals about nutrition and food.” The decision cited concerns about the rise in food-related illnesses and Medicare costs, which totaled $800 billion in 2019. Annual funding for medical students at hospitals The US is estimated at $16.2 billion in 2020.

“It’s surprising that there is no nationally required nutrition skills within medical education,” said lead author David Eisenberg, associate professor of nutrition and director of nutrition at Harvard’s TH Chan School. of Public Health. “This is a surprising and significant gap, given the epidemic of obesity, diabetes, and other diet-related chronic diseases in this country, as well as their growing financial and social costs. .My guess is that many patients assume that their doctors are trained to advise them on nutrition and food choices, but this is simply not part of their training.”

The study was published September 30 in JAMA Network Open.

The researchers—Eisenberg, Alexis Cole at Tufts University, and Edward Maile and Matthew Salt, both of UK-based consultancy Sprink Ltd—compiled a list of 354 nutrition skills included in textbooks and recruited a panel of experts. in 37 medical. educators, nutrition scientists, practicing physicians, medical residency directors, and registered dietitians from around the country. During the four rounds, the panelists ranked the skills and provided feedback and ideas.

After reviewing the results of the research, the researchers found 36 nutritional skills that the team reached consensus on and recommended for undergraduate and graduate medical school and training. The competency covers six areas: basic knowledge of nutrition (“Shows knowledge of the nutritional content of foods including major food sources of macronutrients and micronutrients); assessment and evaluation (“Assess the patient’s nutritional status with a brief diet and food history/questionnaire, anthropometric measurements, and appropriate laboratory tests”); communication skills (“Listening attentively, empathetically, and impartially while taking a nutritional history”); public health (“Demonstrates knowledge of public health nutrition, including public health practices, and how they can reduce the burden of disease and improve access to adequate, nutritious food healthy”); collaborative support and treatment for specific conditions (“Works with other health professionals to provide a multidisciplinary approach to nutritional care”); and referral indicators (“Makes appropriate referrals to multiple professionals to support the patient in achieving his or her life goals”).

In addition, 97 percent of the panel members requested a nutritional assessment on warnings and certification exams for future physicians. Some important information is included:

• 95% of investors agreed that institutions should report on their education related to nutritional competence.
• 92% agreed that student surveys should be used to assess their competence and confidence in this area.
• 73% of panelists recommended skills related to the environmental and planetary health impact of food choices for inclusion.

The research team also identified 12 potential unaddressed gaps in the recommended science, as these were not identified in the review of the existing medical literature. These included topics such as when and how to discuss glucagon-like peptide 1 (GLP-1) agonists (anti-obesity drugs) with patients and how to use artificial intelligence in a responsible approach to providing patients with practical advice on nutrition and food choices.

“Capability represents the largest effort to date to address H. Res. 1118, and its adoption will undoubtedly greatly improve public health,” said Eisenberg. “Ensuring that doctors have the necessary knowledge to effectively advise patients on nutrition and food choices will increase referrals and collaboration with professionals and multiple nutrition programs, promoting a balanced and healthy lifestyle beauty, and improving planetary health.”

The researchers noted that the overall international competence could be reduced,​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​ had a US-based panel. However, the process of building a consensus in which the recommended skills are developed can inform the common efforts of medical educators and authorities worldwide, since health problems related to proper nutrition and limited training of Nutrition for doctors is a global problem.

The study was supported by the Vitamix Foundation, the David R. and Margaret C. Clare Foundation, the Shaich Family Foundation, and the Ardmore Institute of Health. These grants were provided, administered by the Teaching Kitchen Collaborative.

“Nutrition Skills for Medical Students and Physicians,” David M. Eisenberg, Alexis Cole, Edward J. Maile, Matthew Salt, Elizabeth Armstrong, Emily Broad Leib, Trevor Findley, Jennifer Massa, Jaclyn Albin, Meredith Alston, Hope Barkoukis, Fred Buckhold, Robert Danoff, Helen Delichatsios, Stephen Devries, Stephanie Dewar, Jennifer DiRocco, Christopher P. Duggan, Kofi Essel, Elizabeth Frates, Pamela Hansen, Aviad Haramati, Timothy S. Harlan, Michelle E. Hauser, David Leopold , Joanna Lewis , Amy Locke, Joshua R. Mann, Auden McClure, John Wesley McWhorter, Saroj Misra, Tiffany Murano, Amy Oxentenko, Stacey Pierce-Talsma, Stacy Potts, Jo Marie Reilly, Melinda Ring, Suzanne Sampang, Kate Shafto, Linda Shiue, Wendelin Shiue, Slusser, Terri Stone, Karen Studer, Olivia Thomas, Jennifer Trilk, Laura Edgar, JAMA Network Open, September 30, 2024, doi: 10.1001/jamanetworkopen.2024.35425

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image: iStock/Chinnapong

For more information:

Maya Brownstein

mbrownstein@hsph.harvard.edu

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The Harvard TH Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and generate powerful ideas that improve the health and well-being of people everywhere. As a community of leading scientists, educators and students, we work together to take new ideas from the laboratory to people’s lives—not only to advance science, but also to change behavior. individual, public policies, and health care systems. Each year, more than 400 faculty members at the Harvard Chan School teach 1,000 full-time students from around the world and train thousands more through online and graduate courses. Founded in 1913 as the Harvard-MIT School of Public Health Officers, the School is considered to be America’s oldest professional training program in public health.