Nutrition instruction declining steadily at medical schools

Nutrition education in U.S. medical schools is lacking, leaving new physicians unprepared to counsel patients about obesity and related health issues, according to a study in the September issue of Academic Medicine.

A steady decline in nutrition instruction is alarming, given rising obesity rates and proven links between dietary habits and chronic disease risk, said Kelly Adams, MPH, one of the study's authors and an assistant project director of the University of North Carolina at Chapel Hill's Nutrition in Medicine program.

"Nutrition is a core component of modern medical practice, especially with the obesity epidemic," Adams said. "It's clear that medical students are not getting what they need."

Though 94% of 109 medical schools responding to a 2009 survey said nutrition was required in their curriculums, only a quarter of schools had a course dedicated to the subject.

There has been a trend away from designated nutrition courses as instruction becomes more integrated and medical schools add new subject matter, Adams said. "There are so many competing demands. As more things are added, sometimes nutrition is pushed out," she said.

More than half of medical school graduates rate their nutrition knowledge as inadequate, according to a 2005 survey by the American Assn. of Medical Colleges. Studies also have shown that physicians believe they lack adequate training to counsel patients on nutrition.

The Academic Medicine study found in 2009 that medical students averaged 19.6 hours of nutrition instruction throughout medical school, down from 22.3 hours in 2004 (link).

Twenty-seven percent of schools met the minimum 25 hours recommended in a 1985 report by the National Academy of Sciences.

Started in 1995, UNC's Nutrition in Medicine program is a free online curriculum used by more than 130 medical schools. A similar program for residents, fellows and practicing physicians is being developed, Adams said.

The university has been collecting data on nutrition education in medical schools since 2000.