Preparing Doctors to Be Fluent in Nutrition and Lifestyle Medicine By Abi Felsted, MS4, University of Utah School of Medicine Medical school at its core is four intense years of language courses, training future professionals to enter residency with an advanced comprehension of the complex linguistics, jargon, and terminology used to diagnose and treat illness, as well as support and maintain health for our patients. Teaching students how to also communicate about, and adequately research, the nutritional factors which prevent the very diseases we treat is imperative. The discussion about how nutrition should be taught to medical students in the United States has been ongoing for many years.1 Student physicians receive many formal years of training about basic and clinical biological sciences as they pertain to human health. However, the debate about if, and when, medical students should study nutrition widely varies. Yet, there is substantial data to support the importance of nutrition, as well as its vital nature within the field of medicine. The NIH estimates that at least 45% of deaths due to chronic illness each year are related to overconsumption of processed foods and inadequate intake of vital vitamins and nutrients.2 Beyond this, there is strong evidence for whole food plant-based nutrition (WFPBN) being both a treatment and prevention for at least six of the top 10 causes of death in the United States. These include heart disease,3 a variety of malignancies,4 cardiovascular disease (CVD),5 diabetes,6 dementia,7 and kidney disease.8 In addition to mortality benefits for these chronic diagnoses, WFPBN plays a significant role in reversing obesity and its related cardiometabolic disorders such as hyperlipidemia and hypertension.9 Establishing the discussion about nutrition relevance naturally prompts the question if these data should be a prominent part of a medical school education. There is increasing evidence and literature demonstrating that practicing physicians are hesitant to provide education for patients about nutrition. Vetter et al. published a study in 2008 among internal medicine resident doctors and 77% expressed the belief that nutrition assessment was a necessary component in primary care. Another 94% confirmed it was the duty of a physician to direct this education, but only 14% believed they personally had adequate training to provide it.10 These findings were similarly demonstrated through the SIS International Research Study among attending primary care physicians where only 15% reported feeling “totally prepared” to offer specific nutrition guidance to their patients.11 Furthermore, a study done in 2019 among medical residents, cardiology fellows, and faculty in Internal Medicine and Cardiology at a single healthcare center provided additional evidence to this topic. Of 248 physicians, 78.4% agreed that additional training in nutrition would allow them to provide better clinical care because, within their practices, pharmacologic and surgical interventions were more common referrals (70% and 86%, respectively) than lifestyle interventions (43% for diet, 50% for physical activity).12 | 38
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