Diet-Related Diseases Lead to Deaths in US, Malnutrition Drs Ed

On television shows like “Grey’s Anatomy,” “The Resident” and “Chicago Med,” physicians always seem to have the right answer.

But when it comes to nutrition and diet advice, that may not be the case.

One of us is an assistant professor of nutrition and dietetics; the other is a medical student with a master’s degree in nutrition.

We both understand the powerful effects that food has on your health and longevity. A poor diet can lead to cardiovascular disease, diabetes, obesity and even psychological conditions such as depression and anxiety. Diet-related diseases are the leading causes of death in the United States, and poor diet is responsible for more deaths than tobacco.

Not only are these health problems common and debilitating, but they are expensive. Treating high blood pressure, diabetes and high cholesterol costs around US$400 billion per year. Within 25 years, those costs are expected to triple, to $1.3 trillion.

These facts support the need for physicians to give accurate advice about diet to help prevent these diseases. But how much does a typical doctor know about nutrition?

What doctors do not know

In a 2023 survey of more than 1,000 US medical students, about 58% of respondents said they received no formal nutrition education while in medical school for four years. Those who did average about three hours of nutrition education per year.

That’s short of the goals set by the US Committee on Nutrition in Medical Education back in 1985: for medical students to receive a total of 25 hours of nutrition education while in school – slightly more than six times the hours per year.

But a 2015 study showed that only 29% of medical schools met this goal, and a 2023 study suggests the problem has gotten even worse—only 7.8% of medical students reported 20 hours or more nutrition education over all four years of med school. If this is representative of medical schools across the country, it has occurred despite efforts to strengthen nutrition education through numerous government initiatives.

Not surprisingly, the lack of education had a direct impact on physicians’ nutritional knowledge. In a study of 257 first and second year osteopathic medical students taking a nutrition knowledge quiz, more than half passed the test. Before the test, more than half of the students – 55% – felt comfortable counseling patients regarding nutrition.

Unfortunately, this problem is not limited to US medical schools. A global study in 2018 concluded that, regardless of country, the nutrition education of medical students around the world is insufficient.

Bringing back nutrition education

Although evidence suggests that nutrition education may be effective, there are many reasons why it is lacking. Medical students and physicians are some of the busiest people in society. The amount of information taught in medical curricula is often described as overwhelming – like drinking from a fire hose.

First- and second-year medical students focus on dense topics, including biochemistry, molecular biology and genetics, and learn clinical skills such as interviewing patients and understanding heart and lung sounds. Third and fourth year students practice in clinics and hospitals while learning from physicians and patients.

As a result, their schedules are already jammed. There is no room for sustenance. And when they become physicians, it doesn’t get any better. It would take them more than seven hours a week to provide preventive care, including nutritional counseling, – and that’s not counting the time they have to spend on continuing education to keep up with new findings in nutritional science.

Additionally, the lack of nutrition education in medical schools has been attributed to a shortage of qualified nutrition instructors, as most physicians do not understand nutrition well enough to teach it.

Ironically, many medical schools are part of universities that have maintained departments with Ph.D. trained professors; those academies could fill this gap by teaching nutrition to medical students. But those classes are often taught by physicians who lack adequate nutrition training—which means that truly qualified instructors, who are within most medical schools, are left out of the process.

Getting the right advice

The best source of nutrition information, whether for medical students or the general public, is a registered dietitian, certified nutrition specialist or some other type of nutrition professional with multiple degrees and certifications. They study for years and record many hours of practice to give nutritional advice.

Although anyone can make an appointment with a nutrition professional for nutritional counseling, a referral from a health care provider such as a doctor is usually required for the appointment to be covered by insurance. So seeing a doctor or other primary care provider is often a step before meeting with a nutrition professional.

This extra step may be one reason many people look to other people, such as their phones, for nutritional advice. However, the worst place to look for accurate nutrition information is social media. Here, about 94% of posts about nutrition and diet are of low value – either inaccurate or lacking sufficient data to support the claim.

Keep in mind that anyone can post nutrition advice on social media, regardless of their qualifications. Individual diet is well advised and age, sex, goals, body weight, goals and personal preferences are taken into account. It’s hard to capture this complexity in a short social media post.

The good news is that nutrition education, when it occurs, is effective, and most medical students and physicians acknowledge the critical role nutrition plays in health. In fact, close to 90% of med students say that nutrition education should be a mandatory part of medical school.

We hope that nutrition education, after being devalued or ignored for years, will become an integral part of the curriculum of all medical schools. But given its history and current status, this is unlikely to happen anytime soon.

In the meantime, those who want to learn more about a healthy diet should meet with a nutrition professional, or at least read the 2020-2025 Dietary Guidelines for Americans or the World Health Organization’s healthy diet recommendations.

The authors do not work for, consult with, or own shares in, or receive funding from, any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

/Courtesy of The Conversation. This content from the original organization/author(s) may be of a point-in-time nature, and has been edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and the opinions, positions and conclusions expressed here are solely those of the author(s).