International Study Finds Medical Training Lacking Proper Nutrition Education

A recent analysis that included 2 dozen studies from multiple continents found that education on nutrition is lacking in medical training across the globe and suggest it could adversely impact the standard of care a patient receives.

An international team of investigators performed that study, which involved current or recently graduated medical students, and found that medical students in countries examined including the United States, the United Kingdom, and Australia lacked sufficient education when it came to nutrition education during medical training.

"It is clear that despite the importance of nutrition for healthy lifestyles, graduating medical students are not supported with the required nutrition knowledge to be able to provide effective nutrition care to patients--a situation that has gone on for too long,” said study investigator Lauren Ball, PhD, of Griffith University, Australia.

To develop a better understanding of nutrition education provided to medical students, investigators performed a search of published work pertaining to the subject in MEDLINE, PubMed, Cumulative Index of Nursing and Allied Health Literature, and Scopus published between November 1, 2012 and December 31, 2018. Investigators used search terms including “nutrition in medical education”, “medical nutrition education”, “undergraduate medical nutrition education”, “nutrition”, “knowledge”, “skills”, and “nutrition counselling”.

Studies included in the current analysis if they examined any aspect of recent graduates, which was defined as 4 years or fewer, or current medical students knowledge of nutrition, attitudes, skills, or confidence in nutrition counseling, evaluated nutrition curriculum initiatives for medical students, or assessed perceptions of nutrition education.

A total of 66 studies were screened by investigators, of which 35 were assessed for eligibility. A final group of 24 full-text articles were included in the systematic review. All of the studies included were published between 2013 and 2018.

Studies were performed in various locations across the globe, including the United States (11), Europe (4), Australia (4), New Zealand (2), the Middle East (1), Africa (1), and Asia (1). Investigators noted that 1 European study was performed in Italy, 1 was done in Albania, 1 from the United Kingdom, and the 1 included multiple regions in Europe. Additionally, the Middle East study was from the United Arab emirates, the study from Africa was performed in Ghana, and the Asian study was performed in Japan.

Upon analyses, investigators found that medical students desired to receive additional nutrition education but believed their education did not equip them to do so. Students cited quantity and quality of their education, including lack of interest and expertise in nutrition among faculty members. Additionally, investigators noted in one study where students were assessed via an exam on nutrition knowledge 50% of students scored below the exam’s pass rate.

In a cohort of 5 studies that analyzed curriculum initiatives, investigators found initiatives had a modest positive effect on nutrition knowledge. However, investigators also noted the majority of these initiatives were opportunistic and not integrated in an effective manner.

In a related commentary, Stephen Devries, MD, of the Gaples Institute for Integrative Cardiology in Deerfield, Ill., wrote the findings of the current study underscore a need for increased nutrition education and that failing to meet this need could have negative impacts on patient health. 



“Promising approaches to enhance nutrition education in medical education include integration of nutrition-related topics in lectures on disease pathogenesis and treatment, self-paced online curriculum, teaching kitchens, and greater utilization of inter-professional education,” Devries wrote. “Identification and training of clinical mentors in nutrition is a key challenge. But what is already crystal clear, is that the worldwide state of nutrition education in medicine is inadequate. Our patients deserve much better.”

This study, “Nutrition in medical education: a systematic review,” was published online in The Lancet Planetary Journal.