It is depressing how often people laugh when I mention that I am trying to teach doctors about nutrition. The scant amount doctors learn about nutrition has been an embarrassment for at least 120 years. In fact, W.G. Thompson, a famous medical educator, complained about it in the introduction of his medical textbook on nutrition in 1895.
Not only are we doctors poorly educated in nutrition, but there is a serious absence of funding to properly answer some of the most important questions that all nutrition specialists are being asked. The result is an unremitting epidemic of obesity and a multitude of preventable nutrition-related diseases on the one hand, and “experts” promoting opinion as fact, guidelines that are moving targets, and a public expecting to be able to rely on nutritional supplements as magic cures on the other.
The fact that obesity is one of the most devastating health crises we have recently faced is no secret. Recent estimates put the incidence of being overweight in the U.S. at near 70 percent, and obesity (medically significant overweight) above 35 percent of adults. Obesity was already adding an estimated annual $147 billion and approximately $1,500 per person to medical costs in 2008. Add a slew of diseases believed to be preventable by proper nutrition, and our healthcare system cannot afford not to find solutions and train practitioners in effective nutritional interventions. Research has already shown that overweight patients were more likely to be aware of their obesity and to have attempted weight loss if their physician had discussed it with them, but only 45 percent of overweight people report that their physicians had done so.
The ability of doctors to counsel patients on nutrition has only gotten worse. In a recent survey, physicians reported that fewer than 25 percent felt competent to discuss diet and exercise, and that fewer than one in eight visits included nutritional counseling. The most recent survey on nutrition education in medical schools, which is being done every five to six years, found that only 25 percent (down from 30 percent in 2006) of medical schools provided a required nutrition course, and that students received on average 19.6 hours of nutrition instruction (down from 22.3 hours in 2004). The next survey is being compiled. I am not optimistic. The National Academy of Science has recommended that students receive a minimum of 25 hours of nutrition-related content during the four years of medical school.