Diet-related diseases are the leading cause of death in the US, doctors lack nutrition education

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

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

One of us is a university lecturer in nutrition and dietetics, the other is a medical student with a master’s degree in nutrition.

We both understand the powerful effects that nutrition has on your health and longevity. A poor diet can lead to heart disease, diabetes, obesity, and even psychological conditions like depression and anxiety. Diet-related diseases are the leading cause of death in the U.S., and a poor diet is responsible for more deaths than smoking.

These health problems are not only common and debilitating, but also expensive. Treating high blood pressure, diabetes and high cholesterol costs about US$400 billion per year. This cost is expected to triple to $1.3 trillion within 25 years.

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

What Doctors Don’t Know

In a 2023 survey of more than 1,000 U.S. medical students, about 58% of respondents reported having no formal nutrition education in four years during medical school. Those who did received an average of about three hours of nutrition education per year.

That’s pitifully little compared to the goals set by the American Committee on Nutrition in Medical Education in 1985: that medical students should receive a total of 25 hours of nutrition education during their studies. That’s a little over six hours per year.

But a 2015 study found that only 29% of medical schools met this goal, and a 2023 study suggests the problem has gotten worse—only 7.8% of medical students reported 20 or more hours of nutrition education across all four years of medical 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 training has had a direct impact on physicians’ nutrition knowledge. In a study of 257 first- and second-year osteopathic medical students who took a nutrition knowledge quiz, more than half failed the test. Before the test, more than half of the students—55 percent—felt comfortable advising patients about nutrition.

Unfortunately, this problem isn’t limited to U.S. medical schools. A 2018 global study concluded that, regardless of country, nutrition education for medical students is inadequate across the globe.

Bring back nutritional education

While evidence suggests that nutrition education can be effective, there are many reasons why it is lacking. Medical students and physicians are among 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 complex topics including biochemistry, molecular biology, and genetics while learning 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 doctors and patients.

As a result, their schedules are already full. There’s no room for nutrition. And once they become doctors, it doesn’t get any better. Providing preventive care, including advising patients on nutrition, would take them more than seven hours a week—and that’s not to mention the time they’d have to spend on continuing education to stay up to date on new findings in nutritional science.

Furthermore, the lack of nutrition education in medical schools is attributed to a shortage of qualified instructors for nutrition courses, as most physicians do not have sufficient knowledge of nutrition to teach the subject.

Ironically, many medical schools are part of universities that have nutrition departments with professors who are Ph.D.-trained; those academics could fill this void by teaching nutrition to medical students. But those classes are often taught by physicians who may not have adequate nutrition training—meaning that truly qualified faculty, within reach of most medical schools, are left out of the process.

Finding the right advice

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

While anyone can schedule an appointment with a nutritionist for dietary advice, a referral from a healthcare provider such as a physician is typically required for the appointment to be covered by insurance. Therefore, it is often a step to see a physician or other primary care provider before meeting with a nutritionist.

This extra step may be one reason why many people look elsewhere, like on their phones, for nutrition advice. However, the worst place to find accurate nutrition information is social media. On it, around 94% of food and diet posts are 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. Good nutrition advice is individualized and takes into account a person’s age, gender, goals, body weight, objectives, and personal preferences. This complexity is difficult to capture in a short social media post.

The good news is that nutrition education, when it happens, is effective, and most medical students and physicians recognize the critical role that nutrition plays in health. In fact, nearly 90% of medical students say that nutrition education should be a required part of medical school.

We hope that nutrition education, after decades of being devalued or ignored, will soon be an integral part of every medical school curriculum. But given its history and current status, it seems unlikely that this will happen anytime soon.

If you want to learn more about a healthy diet, it’s best to consult a nutritionist or at least read the Dietary Guidelines for Americans 2020-2025 or the World Health Organization’s recommendations for a healthy diet.

The authors are not employees of, consultants to, 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 material from the original organization/author(s) may be at a moment in time and edited for clarity, style, and length. Mirage.News takes no institutional positions or sides, and all opinions, positions, and conclusions expressed herein are solely those of the author(s).