Medical education contains insufficient training in nutritional advice
Nutrition is not sufficiently built into medical education. As a result, doctors and general practitioners have few opportunities to give their patients adequate advice about foods and eating patterns. This applies not only in the Netherlands, but worldwide and is independent of country, health care system or year of medical education. All this is the conclusion of Prof. Gert Jan Hiddink, emeritus professor of Nutrition Communication through Health Professionals at Wageningen University & Research, together with international colleagues.
Although diet is a central component of a healthy lifestyle, over the past fifty years diets have been characterized by low levels of important nutrients (such as protein) and foods (such as fruits and vegetables) and high levels of salt, sugar and fat, which contribute to poor nutritional intake of a large part of the world's population. This has resulted in an increasing number of public health ailments such as diabetes, obesity, cardiovascular disease and a growing demand for health care.
Eleven million people worldwide die from dietary factors each year, making poor nutrition the single most important risk factor for death, ahead of all other risk factors. In many countries, GPs have the task of advising their patients on proper nutrition. They are usually the most trusted source of patient health information. But when graduates begin their careers as medical professionals, the question is whether they are (and if so, to what extent) they are well prepared to engage with patients about nutrition and dietary patterns.
Little progress in 50 years
Internationally, for 50 years, inadequate nutritional training, dissatisfaction with nutritional training received, and a feeling of being unprepared to provide nutritional counseling to patients have been reported as themes in medical nutrition training studies. Little progress has been made in recent years. Medical graduates have also consistently reported that they lack nutritional knowledge and skills to effectively support patient nutrition behavioral change.
Therefore, the researchers say, there must be an institutional commitment to mandate nutritional training. The overcrowded medical education program requires innovative teaching practices so that the subject can be incorporated into the existing time frame. Furthermore, nutrition should be included early in medical education and more extensively in the subsequent training program. There are roles for medical nutrition experts or dieticians in addition to other systems experts, such as cardiologists. Furthermore, agreement is needed on the content of a nutrition curriculum and the level of nutrition knowledge of graduates.
No nutritional training in patient care
The lack of nutritional training of medical students affects their knowledge, skills and confidence to incorporate nutritional advice into patient care. This means that they miss opportunities in cases where such advice might help. More broadly speaking, failure to prioritize nutrition during medical training does not reinforce the relevance of nutrition to a healthy lifestyle.
The fact that medical graduates do not feel adequately prepared to provide nutritional care to patients is in stark contrast to the expectation that physicians provide nutritional information to patients to support management of conditions in which poor nutrition is an important risk factor. Such 'nutrition care' is recommended in many countries by health authorities and their own professional organizations.
To provide even basic nutrition care, physicians need to have adequate nutritional knowledge and skills, and the necessary attitudes to support their integration into daily practice with patients. They should also be able to refer to another health professional, such as a dietitian or nutritionist.
Source: WUR