Nutrition Education in Medical Schools: Trends and Implications for Health Educators

Abstract

With 20% of deaths in the U.S. attributed to improper diet and lack of exercise, renewed interest has emerged in nutrition education for medical professionals. Sociopolitical factors are exerting a profound influence on changes in medical curricula, moving medicine away from traditional biomedical cur-ricula and toward more comprehensive programs of study. This paper explores how public demand for nutrition information, inadequate nutrition training among physicians, changes in health care, and medical education reform are influencing the evolution of nutrition in medical schools. This paper also discusses barriers, possible solutions, and specific actions for health educators. To achieve nutrition-literacy among prospective physicians, the following elements must be developed and established: 1) adequate organizational and administrative supports, 2) continuity in credentialing nutrition specialists, 3) innovative nutrition curricula, 4) committed faculty nutrition mentors, 5) clear nutrition education goals, 6) methods for evaluation of program activities/outcomes, 7) substantive research agenda, 8) multidisciplinary medical curricula, and 9) collaboration. Nutrition interventions can decrease morbidity, mortality, human suffering, and medical costs 1-4 , yet only recently have U.S. medical schools begun to integrate nutrition into bedside and case-based teaching. 5 With nearly 20% of deaths in the U.S. attributed to improper diet and lack of exercise 6 , renewed interest has emerged in nutrition education, and many medical schools are reconsidering their positions on the role of nutrition education in medical education. 7-10 However, social and political factors have had the most profound influence on recent changes in medical school curric-ula. 11-12 As we enter a new millennium, sociopolitical variables , and not public health programs, are moving medicine away from the traditional medical school curricula. 13-14 Substantive research in social and be-havioral sciences can help us to identify unique factors that mediate, or forestall, nutrition education in medical curricula. 15 This paper explores how sociopolitical factors are influencing the evolution of nutrition education in medical schools in the U.S. Specific factors include: 1) public demand for nutrition information coupled with a negative perception of physicians' nutrition expertise, 2) inadequacies in nutrition education among medical students, and 3) changes in health care and medical education reform. This portion of the paper is followed by a discussion of how health educators are uniquely positioned to develop rationale nutrition education programs.