Doctors and other health professionals get little training in nutrition in medical training and other education, despite overwhelming evidence that poor diets contribute to preventable illness and many leading causes of death — including heart disease, cancer and Type 2 diabetes.
That could be easily corrected, says a recent Bipartisan Policy Center report that urges increased nutrition education and attention to the Food is Medicine (FIM) concept to help prevent many diet-related diseases. FIM interventions include medically tailored meals and food prescriptions, increasingly seen as a way to reduce health care costs.
“Government spending to treat cardiovascular disease, cancer and diabetes accounted for more than half of the $383.6 billion spent on diet-related diseases in 2018,” says the BPC report, written by a working group co-chaired by former Agriculture Secretaries Dan Glickman and Ann Veneman, former Health and Human Services Secretary Donna Shalala, and former Senate Republican Leader Bill Frist of Tennessee.
“How do I address my health with food choices?” is a question that patients ask but which health clinicians are unable to answer, BPC Public Health Director Shana Christrup told Agri-Pulse. Physicians don’t have the competence to answer such a basic question because they lack the education to adequately discuss nutrition and the role of different foods and the effect on a patient’s diet, she said.
A doctor before his time in Congress, Frist said his medical training “barely scratched the surface when it came to nutrition’s impact on health.”
Speaking at a BPC event, Veneman cited a 2019 report, Doctoring Our Diet, by the Harvard Law School’s Food Law and Policy Clinic that found only 14% of resident physicians felt they had received adequate nutrition education.
Former Ag Secretary Ann Veneman“Patients overwhelmingly trust their primary care providers to provide up-to-the-date actionable health care advice,” Veneman said, yet “primary care providers are not traditionally trained to educate patients on healthy eating.”
If doctors don't give patients good advice, people may turn to less reputable sources for nutrition information, Veneman warned. “Proper physician advice and guidance can empower patients to change their eating habits and improve their health.”
Last year’s White House Conference on Hunger, Nutrition and Health put a spotlight on Food Is Medicine interventions, said Dr. Kofi Essel, FIM director at Indianapolis-based Elevance Health, which owns several health insurance companies. Building on that momentum to increase adoption and use of medically tailored meals, produce prescriptions, federal nutrition programs, high-quality nutrition education and public policy to support these programs, Essel said, requires improved health care education.
“We have to have health care providers and future providers know how to use the proper tools,” he said.
The Harvard Law School report found nutrition education amounts to less than 1% of total lecture hours and less than half of all medical schools defined nutrition education as foundational to clinical practice.
Researchers found more than 70% of medical schools failed to provide at least 25 hours of nutrition education — the amount recommended by the Committee on Nutrition in Medical Education, Commission on Life Sciences and the National Research Council.
“Current medical schools will oftentimes just have eight hours of training on nutrition education,” BPC’s Christrup said. That amount of nutrition education, she added, fails to equip those clinicians with the understanding of how to have conversations about the impact of diet and exercise on health.
BPC called for medical school accreditation bodies to establish nutrition-specific competencies and require compliance beginning in 2025. It also urged state medical licensing boards to require minimum hours of continuing medical education on nutrition counseling for licensing and board certification.
Another recommendation seeks an independent organization, such as the National Academies of Sciences, Engineering and Medicine, to establish baseline nutrition education standards for clinicians.
The Harvard report also suggested ways to tie government funds for medical schools to nutrition education. For example, support could be contingent on whether the schools require or provide nutrition education credit hours or curricular requirements. The government can also offer grants for nutrition education at medical schools.
Veneman said lawmakers must come together and address diet-related diseases and lack of nutrition education.
Reps. Jim McGovern, D-Mass., and Michael Burgess, R-Texas, proposed a House resolution in the last Congress, calling on medical schools as well as residency and fellowship programs to strengthen nutrition education for physicians. The resolution was adopted, and BPC said it “signaled congressional interest in nutrition education.”
A spokesperson for McGovern's office said the resolution passed in May 2022 prompted action by the Accreditation Council for Graduate Medical Educate (ACGME) - the voluntary organization that accredits and improves the quality of graduate medical education programs and resident physicians in the U.S.- that "sparked a larger conversation about this issue among stakeholders and lawmakers."
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