Nutrition education

[premed1234567891011]

Why is there so little emphasis on nutrition in medical schools? It seems like the doctors I've been to know surprisingly little about proper nutrition and how to counsel patients on diet.

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[787593]

Why is there so little emphasis on nutrition in medical schools? It seems like the doctors I've been to know surprisingly little about proper nutrition and how to counsel patients on diet.

Because google?

 

[anonymoose1640]

I disagree with the above poster in saying "because google" - many patients can have very complicated and nuanced diets due to serious diseases. At my school, they stress the importance of the patient's care team and in that team is usually a registered dietician who can help physicians, nurses, PT, OT, etc. navigate complicated diets for their patients. For the every day patients (an uncontrolled type II diabetic trying to lose weight, for example), they require more of the black and white, simplified nutrition information the above poster shows in his picture. And even that has come up in a few discussions in school and I've been able to counsel patients on healthy diets and habits they can follow (with a preceptor observing, of course). Should we be taught more? Probably. Is there time to teach it all and everything else we need to know? Not really.

If you want to learn more and be more educated, there is nothing stopping you from doing your own reading and research and teaching your classmates. Be the change you want to see in the world

 

[787593]

I disagree with the above poster in saying "because google" - many patients can have very complicated and nuanced diets due to serious diseases. At my school, they stress the importance of the patient's care team and in that team is usually a registered dietician who can help physicians, nurses, PT, OT, etc. navigate complicated diets for their patients. For the every day patients (an uncontrolled type II diabetic trying to lose weight, for example), they require more of the black and white, simplified nutrition information the above poster shows in his picture. And even that has come up in a few discussions in school and I've been able to counsel patients on healthy diets and habits they can follow (with a preceptor observing, of course). Should we be taught more? Probably. Is there time to teach it all and everything else we need to know? Not really.

If you want to learn more and be more educated, there is nothing stopping you from doing your own reading and research and teaching your classmates. Be the change you want to see in the world

Exactly why we have dietitians.
I didn't mean to be snarky. For most patients, there is plenty of good information already out there.

 

[tf21594]

Doctors wouldn't have jobs if people ate right and exercised

 

[787593]

Doctors wouldn't have jobs if people ate right and exercised

That's a stretch haha

 

[mistafab]

Amazon product

 

[libertyyne]

Doctors wouldn't have jobs if people ate right and exercised

I didnt know there was a relationship between eating right and becoming immune to bullets.

 

[tf21594]

It was a joke

 

[premed1234567891011]

View attachment 212547
Because google?

there's a lot more to nutrition than that screenshot. you could say "google" to a lot of things you learn in medical school. my confusion is that given how crucial nutrition is to leading a healthy and fulfilling life, why aren't med schools doing more to convince their students just how important it is.

https://wire.ama-assn.org/education/whats-stake-nutrition-education-during-med-school - "In fact, among entering medical students, “71 percent think nutrition is clinically important. Upon graduation, however, fewer than half believe that nutrition is clinically relevant. Once in practice, fewer than 14 percent of physicians believe they were adequately trained in nutritional counselling,” the authors wrote."

http://www.nytimes.com/2010/09/16/health/16chen.html

 

[Med Ed]

Why is there so little emphasis on nutrition in medical schools? It seems like the doctors I've been to know surprisingly little about proper nutrition and how to counsel patients on diet.

Define proper nutrition.

 

[sullen-burger]

I didnt know there was a relationship between eating right and becoming immune to bullets.

It's a proportional relationship, food intake to bullet immunity.

 

[kb1900]

Many med schools I've visited on the trail (esp the ones with more personalized educatuon) emphasize/advertise their nutrition preclinical electives so that future physicians can learn how to properly and effectively talk about dieting with their patients.

 

[kb1900]

It's a proportional relationship, food intake to bullet immunity.

The more layers of fat u have the lesser depth a bullet can penetrate

Come at me bullet bro

 

[premed1234567891011]

Define proper nutrition.

in a nutshell, the following is what i've always considered a healthy diet:
avoiding foods with tons of sugar or high fructose corn syrup (i always check labels at the store)
avoiding sodas (diet and regular)
eating mainly fruits and vegetables (raw and cooked)
eating whole grains, nuts, legumes
eating as little processed food as possible
i'm a vegetarian, but even if you're not, my understanding is that red meat and pork should be limited

 

[Med Ed]

in a nutshell, the following is what i've always considered a healthy diet:
avoiding foods with tons of sugar or high fructose corn syrup (i always check labels at the store)
avoiding sodas (diet and regular)
eating mainly fruits and vegetables (raw and cooked)
eating whole grains, nuts, legumes
eating as little processed food as possible
i'm a vegetarian, but even if you're not, my understanding is that red meat and pork should be limited

One of the persistent problems in nutrition is that the definition of a healthy diet is a moving target. I am old enough to remember when the concept of "good cholesterol" entered the public consciousness. This was around the time that low fat, high carb diets were all the rage. A few years later carbs became evil and protein was king (still is, in my estimation). So everyone jumped on the Atkins or Sugar Busters bandwagon. Then the glycemic index allowed complex carbs to creep back in, and fats became more nuanced, so South Beach came into vogue. Later came Paleo, and the associated primal fitness movement that encourages (or at least does not discourage) consumption of red meat. And this is to say nothing of the persistent cycling of Ornish-style diets in the background. Proving soda causes weight gain? Harder than you might think. Pushing whole grains? Not if someone has celiac or gluten sensitivity (whatever that means). Limiting pork? You must be a terrorist. Should we spring for the organic, hormone and antibiotic-free meat? What about cage-free eggs? Are those healthier? Is there evidence to back it up?

 

[787593]

there's a lot more to nutrition than that screenshot. you could say "google" to a lot of things you learn in medical school. my confusion is that given how crucial nutrition is to leading a healthy and fulfilling life, why aren't med schools doing more to convince their students just how important it is.

https://wire.ama-assn.org/education/whats-stake-nutrition-education-during-med-school - "In fact, among entering medical students, “71 percent think nutrition is clinically important. Upon graduation, however, fewer than half believe that nutrition is clinically relevant. Once in practice, fewer than 14 percent of physicians believe they were adequately trained in nutritional counselling,” the authors wrote."

http://www.nytimes.com/2010/09/16/health/16chen.html

That's interesting

 

[787593]

in a nutshell, the following is what i've always considered a healthy diet:
avoiding foods with tons of sugar or high fructose corn syrup (i always check labels at the store)
avoiding sodas (diet and regular)
eating mainly fruits and vegetables (raw and cooked)
eating whole grains, nuts, legumes
eating as little processed food as possible
i'm a vegetarian, but even if you're not, my understanding is that red meat and pork should be limited

Red meat is amazing though. I'd prescribe a bone-in ribeye for depression.

 

[premed1234567891011]

That's interesting

Isn't it? I thought so

 

[premed1234567891011]

*

 

[premed1234567891011]

One of the persistent problems in nutrition is that the definition of a healthy diet is a moving target. I am old enough to remember when the concept of "good cholesterol" entered the public consciousness. This was around the time that low fat, high carb diets were all the rage. A few years later carbs became evil and protein was king (still is, in my estimation). So everyone jumped on the Atkins or Sugar Busters bandwagon. Then the glycemic index allowed complex carbs to creep back in, and fats became more nuanced, so South Beach came into vogue. Later came Paleo, and the associated primal fitness movement that encourages (or at least does not discourage) consumption of red meat. And this is to say nothing of the persistent cycling of Ornish-style diets in the background. Proving soda causes weight gain? Harder than you might think. Pushing whole grains? Not if someone has celiac or gluten sensitivity (whatever that means). Limiting pork? You must be a terrorist. Should we spring for the organic, hormone and antibiotic-free meat? What about cage-free eggs? Are those healthier? Is there evidence to back it up?

I understand that nutrition is a relatively new field. Aside from all the fad diets that come and go, I think there's still a lot in the field that is of high consensus with experts. Is there doubt about soda being unhealthy? Yeah, there are diseases to be considered like Celiac disease, but that's part of what I think should be addressed in med school nutrition classes (m0st whole grains are actually gluten-free and if student doctors were taught what those were they could promote them to patients).
Yeah, the definition of a healthy diet changes a lot, but healthcare is constantly changing. I just think if more emphasis was placed on nutrition in med school future doctors would be better equipped to advise patients about diet. The fact that many doctors don't think nutrition is of clinical relevance is crazy, in my opinion.

 

[Goro]

Barbeque prime rib or tri-tip is more efficacious.

Red meat is amazing though. I'd prescribe a bone-in ribeye for depression.

 

[787593]

Barbeque prime rib or tri-tip is more efficacious.

Several studies support your claim, but you can't ignore the ribeye-cebo effect. Eat good, feel good!

 

[Med Ed]

I understand that nutrition is a relatively new field. Aside from all the fad diets that come and go, I think there's still a lot in the field that is of high consensus with experts. Is there doubt about soda being unhealthy? Yeah, there are diseases to be considered like Celiac disease, but that's part of what I think should be addressed in med school nutrition classes (m0st whole grains are actually gluten-free and if student doctors were taught what those were they could promote them to patients).
Yeah, the definition of a healthy diet changes a lot, but healthcare is constantly changing. I just think if more emphasis was placed on nutrition in med school future doctors would be better equipped to advise patients about diet.

Soda is not thought to be healthy, but there is a difference between labeling something unhealthy and developing practical guidelines for its consumption. Someone who drinks 12 Cokes a day is clearly an outlier, but what about someone who drinks one? Should that person cut it out? Is there evidence to suggest one soda per day is harmful?

You are right, most whole grains are gluten-free, but the most commonly consumed whole grain in the country (not counting animals) is wheat, which most definitely has gluten.

I'm not arguing that nutrition is adequately covered in medical school, its treatment is clearly variable. But it's a whole lot easier to point out a deficiency than it is to craft a durable solution.

The fact that many doctors don't think nutrition is of clinical relevance is crazy, in my opinion.

The cited numbers were derived from a 2006 survey (abstract here) that was trying to determine opinions about the value of nutrition counseling, not nutrition itself. My interpretation is that opinions about such counseling likely deteriorate because few patients are willing to actually make substantial changes to their diets, which in turn feeds provider cynicism.

 

[sullen-burger]

Soda is not thought to be healthy, but there is a difference between labeling something unhealthy and developing practical guidelines for its consumption. Someone who drinks 12 Cokes a day is clearly an outlier, but what about someone who drinks one? Should that person cut it out? Is there evidence to suggest one soda per day is harmful?

You are right, most whole grains are gluten-free, but the most commonly consumed whole grain in the country (not counting animals) is wheat, which most definitely has gluten.

I'm not arguing that nutrition is adequately covered in medical school, its treatment is clearly variable. But it's a whole lot easier to point out a deficiency than it is to craft a durable solution.



The cited numbers were derived from a 2006 survey (abstract here) that was trying to determine opinions about the value of nutrition counseling, not nutrition itself. My interpretation is that opinions about such counseling likely deteriorate because few patients are willing to actually make substantial changes to their diets, which in turn feeds provider cynicism.

I see what you did there!

 

[whistleberries]

There are a lot of clinical reasons why an awareness of more than basic nutrition is important for a physician to have, if only to know when to consult the RD. Food drug interactions, liver/kidney/pancreatic failure, care of the elderly, and then obvious things like Crohn's, short bowel, etc. all require a working knowledge of nutrition. The knowledge in the field definitely surpasses fad diets and macros.

 

[Med Ed]

There are a lot of clinical reasons why an awareness of more than basic nutrition is important for a physician to have, if only to know when to consult the RD. Food drug interactions, liver/kidney/pancreatic failure, care of the elderly, and then obvious things like Crohn's, short bowel, etc. all require a working knowledge of nutrition. The knowledge in the field definitely surpasses fad diets and macros.

Most nutrition in medical school actually is centered on disease states and drug interactions. That's a big part of the problem. It usually approaches nutrition from the standpoint of biochemistry and cell/molecular biology, which is of limited value when you an obese patient in front of you who smells of fried lard.

The criticism of medical school nutrition curricula has more to do with its inadequacy in addressing disease prevention.

 

[Ebenezer12]

Nutrition education is not just learning about foods and nutrients but learning what to do and how to act to improve nutrition.

The Nutrition Education and Consumer Awareness Team provides technical support to countries to develop policies and programmes to increase public awareness of the importance of eating well, foster food environments that enable healthy food choices and build the capacities of individuals and institutions to adopt food and nutrition practices that promote good health.