Dietary changes are recognized to be a leading risk factor for premature death and disability in the U.S., yet medical students spend an average of just 19 hours over the course of four years in medical school learning about nutrition.
That statistic, said Stephen Devries, MD, has got to change.
"Nutrition just hasn't been recognized as a priority in medical education," said Dr. Devries, executive director of the nonprofit Gaples Institute and adjunct associate professor of nutrition at the Harvard T.H. Chan School of Public Health. "Medical educators often report that they just don't have enough time in the curriculum, and my response is: What deserves more attention than the leading risk for premature death and disability?"
Dr. Devries talked through that question and explained why physicians need to better emphasize good nutrition—for themselves and their patients—in a recent episode of “AMA Update.”
Taking small steps
Dr. Devries still remembers early in his career as a cardiologist seeing return patients facing acute cardiac problems.
"We would patch them up, send them out, and very often, they would come back again," he said.
It was then that he realized medicine and technology could not be the only option to stop these recurring problems. Over the course of his career, he's seen a decline in mortality rates from cardiovascular disease, but in recent years, he said the rate has plateaued despite continued technological advances.
"What is the reason?" he asked. "It's the growing prevalence of overweight and obesity, and with that, type 2 diabetes that comes with it."
That growing prevalence cannot singlehandedly be offset by physicians and other health professionals, Dr. Devries said, but they can certainly help. He knows that doctors often have limited time with patients, but he believes a few steps can make a big difference.
"What is very possible for clinicians is to at least emphasize that, although taking their medications is a critical part of their health care, [patients] will never achieve optimal health without more attention to nutrition and lifestyle," he said.
Teaching the principles of healthy eating
The Gaples Institute has made it easier for health professionals to gain the nutrition knowledge they're not getting during medical school with a collection of courses available on the AMA Ed Hub™.
Earlier this year, the Gaples Institute launched an updated edition of "Nutrition Science for Health and Longevity: What Every Physician Needs to Know." The course teaches unbiased nutrition fundamentals based on recent and clinically-relevant research. It also touches on:
- The influence of diet on COVID-10.
- Physician self-care.
- The dangers of ultraprocessed foods.
- Counseling patients with food insecurity.
Dr. Devries said that more than 3,000 medical students and clinicians have taken the nutrition course to date, and 97% of those who took the test reported that what they learned will help them change their practice.
"The aim of the course is not to steer physicians or patients toward any one specific type of diet," he said. "Our goal is to teach solid, evidence-based principles. Then we encourage the physician to apply them individually as is appropriate for each patient."
Also included in the course is how to perform a rapid dietary assessment for a patient. Dr. Devries said that the course teaches how health professionals can work with their patients once the assessment is done to explain any deficiencies and understand patient priorities moving forward.
"Having the knowledge is not going to be impactful unless you apply it, and apply it in a very busy clinical setting" Dr. Devries said. "That's what we set out to help clinicians do."
“AMA Update” covers health care topics affecting the lives of physicians and patients. Hear from physicians and experts on public health, advocacy issues, scope of practice and more—because who’s doing the talking matters. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.
