It has become more and more apparent through the years that the strong majority of medical doctors are not properly trained to understand nutrition. Instead of learning its necessity and importance, medical doctors have been conditioned to readily prescribe pharmaceuticals drugs, potions, and vaccines; versus a healthy and sustainable diet, adequate exercise and movement, proper sleep, and so forth.
This has led to an ever-increasing number of patients all over the world to debate and fight with the doctor tooth and nail on proper treatment, usually resulting in the patient many times deciding to disregard their doctor’s advice and prescriptions, and take their health into their own hands. And when the patient demonstrates improvement, the doctors many times will still fight with their own patients.
Many may recall the widely popular documentary “Supersize Me,” where Morgan Spurlock went on a 30-day McDonalds diet to demonstrate what their food would do to his health, while investigating the status of health and nutrition across the nation. Early in the film, Spurlock visited with several doctors before he began the diet, and all of the doctors said that Spurlock would be fine and nothing significant would happen to him, whereas the nutritionist was highly cautious from the get-go. When it was all said and done, the doctors were shocked to see just how much Spurlock’s health deteriorated.
A big reason why medical doctors do not understand proper nutrition is because they were never adequately trained to understand it. As a matter of fact, the strong majority of medical doctors receive less than a complete day’s worth of nutritional education, per a study published by the National Institutes of Health (NIH).
The following is that study:
Status of nutrition education in medical schools
Introduction
The adequacy of nutrition instruction in undergraduate medical education remains an issue of concern. Although the scientific principles related to nutrition have been taught in medical schools since the early 20th century, the latter part of that century was characterized by increasing concern over the amount of nutrition education provided to medical students. Early pioneers in this field made great strides in incorporating nutrition into undergraduate medical education. However, in its 1985 survey, the National Academy of Sciences (NAS) found that, overall, an average of 21 h of nutrition instruction was required in medical schools, but only 34 of the surveyed US medical schools (27%) had a separate, required nutrition course. The NAS report concluded that “Nutrition education programs in US medical schools are largely inadequate to meet the present and future demands of the medical profession.” This report has been called groundbreaking because it was the first comprehensive and systematic assessment of the status of nutrition education at medical schools that helped to identify the deficiencies. Publication of the report prompted the inclusion of medical education in the National Nutrition Monitoring and Related Research Act of 1990 and emphasized the need for physicians to be educated on nutrition topics.
Patients routinely seek physicians’ guidance about diet, and the relation of nutrition to the prevention and treatment of disease is well known. However, practicing physicians continually rate their nutrition knowledge and skills as inadequate. It also is no surprise that more than one-half of graduating medical students report that the time dedicated to nutrition instruction is inadequate.
Nearly 20 y have passed since the NAS issued its landmark report. Although the status of nutrition education in medical schools has undergone some change over the past 2 decades, it remains unclear whether this change has increased the hours of nutrition instruction. Some surveys of this topic report the number of nutrition courses at US medical schools. However, an exclusive focus on nutrition courses misses a large amount of nutritional science that is integrated into other courses—a trend that appears to be increasing. Indeed, with the widespread movement to more integrated curricula and problem-based learning, the pressure currently is to reduce the number of hours that students spend in traditional lectures. Thus, an increase in the total number of dedicated nutrition courses is not likely to be seen now or in the foreseeable future. Documenting any improvement in the number of nutrition contact hours must attempt to quantify the hours of all nutrition instruction.
To help guide further content development and delivery, Nutrition in Medicine (NIM) periodically conducts a survey of US medical school instructors to obtain information about: 1) required nutrition instruction in the curriculum, and 2) use of the NIM series. We have a database of contacts at each medical school; in most cases our contact is the person who is actually providing nutrition instruction to medical students.
Our survey is unique in that it quantifies the hours of nutrition instruction that are provided across the entire 4-y curriculum. Furthermore, rather than rely on curriculum administrators or deans, we surveyed the nutrition educators, who are most knowledgeable about the required nutrition content of the curriculum. Indeed, some researchers have found contradictory information regarding the extent of nutrition instruction in the curriculum when the same questions were posed to administrators and nutrition educators.
Methods
Surveys we developed and administered in 1999–2000 and in 2001 served as pilot tests. In February 2004 we e-mailed our current survey to all of our medical school contacts. Our database contains one designated contact person at each US medical school; in most schools, this is the person who actually teaches nutrition. In the few instances in which we did not have the name of the nutrition instructor, we contacted the dean’s office or the medical curriculum office. Follow-up calls, faxes, and e-mails continued through September 2004 until we had contacted all 126 US medical schools accredited by the Association of American Medical Colleges (AAMC) at that time. [Note that there are now 125 schools with AAMC accreditation. The Duluth and Twin Cities campuses merged under the umbrella of the University of Minnesota in 2004.]
The 2-page survey contained 12 questions. Respondents were asked to estimate the number of contact hours of required nutrition education at their medical schools, to indicate in which years (1st-2nd or 3rd-4th) and in what type of course nutrition was taught (nutrition, physiology, biochemistry, etc), and to provide specific information about course titles, instructors, hours, and year in the curriculum. In addition, respondents were asked their opinion as to whether students needed more nutrition instruction. Other questions covered issues relating to computer-assisted instruction and implementation of the NIM curriculum.
Recipients returned the survey via regular mail, fax, or online. Eighty-eight respondents (83%) chose to fill out the survey directly by using the website form. The rest were entered manually. We generated a data set from the entries and used standard spreadsheet software (EXCEL 2003; Microsoft Corp, Redmond, WA) for all calculations.
Results
Representatives from 106 medical schools responded, resulting in an 84% response rate. A total of 103 surveys (97%) were filled out by the person who was responsible for nutrition education of medical students at the time. Academic administrators completed the other 3.
According to the 106 respondents, the curricula of 99 schools (93%) provided required nutrition instruction. Five schools (5%) offered optional instruction only, and another 2 (2%) reported that they did not offer any nutrition instruction. The schools requiring nutrition instruction provided an average of 23.9 (range: 2–70) contact hours. Remarkably, less than one-half (41%) of the responding schools provided the minimum 25 h or more recommended by the NAS in 1985 (3). Also surprising was the finding that 17 schools (18%) required only ≤10 h of nutrition instruction (Figure 1).
Analysis of the data to determine where the instruction was occurring in the curriculum showed that most of these contact hours occurred during the first and second years of undergraduate medical training (Table 1). On the basis of the responses from the 32 schools indicating that instruction occurred, at least in part, in a required nutrition course, students received an average of 17.7 contact hours of nutrition instruction taught in a dedicated nutrition course (Table 2). The nutrition hours that are integrated into the basic science courses, such as physiology or biochemistry, accounted for <7 h each of required nutrition on average.
| Curriculum year | Contact hours |
|---|---|
| h | |
| Years 1 and 2 | 18.9 ± 1.2 |
| Years 3 and 4 | 5.1 ± 0.7 |
| Total | 23.9 ± 1.5 |
| Type of course | Number of schools providing part of their required nutrition instruction in this format | Contact hours of nutrition teaching provided in this format |
|---|---|---|
| n | h | |
| Nutrition | 32 | 17.7 ± 1.82 |
| Physiology, pathophysiology, pathology | 36 | 6.9 ± 1.0 |
| Biochemistry | 44 | 6.8 ± 0.7 |
| Integrated curriculum | 58 | 13.1 ± 1.4 |
| Clinical practice | 42 | 8.0 ± 1.0 |
| Other3 | 13 | 8.4 ± 1.9 |
1n = 97; note that schools could offer nutrition in >1 type of course.2x̄ ± SE (all such values).3For example, complementary alternative medicine courses (n = 2), clerkship lectures (n = 2), clinical foundations, reproduction, endocrinology, systems course, preventive medicine and genetics, pharmacology, metabolism.
In US medical schools, the bulk of nutrition education continues to be taught in the basic science courses or in an integrated format (Figure 2). This means that three-quarters of the nutrition instruction in medical schools is not specifically identified as nutrition in the curriculum. In the clinical years (3rd-4th), 38/106 schools (36%) offered ≥5 h of nutrition teaching. Five schools provided us with details documenting nutrition teaching during clerkship rotations in pediatrics and family medicine.
An overwhelming majority (93/106, or 88%) of instructors indicated that students at their medical schools need more nutrition instruction, whereas only 8/106 (8%) said that they did not. Six of these 8 were at schools offering much more than the national average number of nutrition hours. The remaining 4% of schools responded that they did not know whether their students needed more nutrition instruction.
Discussion
Is the national average of 23.9 h found in our survey adequate to properly train future physicians about nutrition? We realize that the definition of adequate is open to interpretation, but we used 2 major recommendations reported in the literature as a benchmark. The current 23.9 h fall just short of the NAS 1985 minimum recommendation and far short of the American Society for Clinical Nutrition (ASCN) 1989 recommendations. The ASCN recommendations were based on a survey of curriculum administrators and nutrition educators; the former group suggested 37 h (median: 32), whereas the latter suggested 44 h (median: 40) be devoted to nutrition instruction.
By either criterion, less than one-half of the surveyed medical schools (41%) provided the minimum of 25 h of medical nutrition education; compared with the later recommendations of 37–44 h, the percentage of schools meeting the recommendation falls below 20%. This means that roughly 60–80% of schools are teaching far less nutrition than is recommended. In addition, nutrition education typically occurs during the first 2 y of medical school when the basic sciences are being emphasized; nutrition does not appear to get much emphasis during the clinical years when nutrition concepts and skills could be applied more directly to clinical problem-solving. Because the number of schools requiring a nutrition course (32 versus 34) and the overall number of hours of nutrition teaching (23.9 versus 21) has changed little over the past 2 decades, it is not surprising that most medical students continue to assess the time devoted to nutrition as inadequate. From our surveys, it seems that instructors are even more dissatisfied with the hours of nutrition in the curriculum than medical students are. Thus, it appears that we are producing a pool of physicians who feel largely unprepared to counsel their patients about nutrition and to make appropriate clinical decisions on nutrition-related issues. Surveys in the literature show that practicing physicians feel inappropriately prepared to address the growing problem of obesity, particularly in children. With the rising epidemic of obesity in the US population and the knowledge that prevention is more likely to be successful than treatment, it is clearly imperative to ensure that medical students are adequately prepared.
Limitations
Does our survey present an accurate picture? We believe it to be a representative snapshot. Although 16% of the US medical schools were unaccounted for, our response rate of 84% is high compared with many surveys of this type. Another strength of our method is that we surveyed nutrition educators at medical schools in an attempt to assess the total picture of nutrition instruction. It is possible that the instructors who are most likely to respond to our survey are those who we have established a relationship with through correspondence about our curriculum. Instructors who are not using our instructional materials may feel no obligation to complete the survey; if anything, however, this selection bias should overestimate the hours devoted to nutrition. Furthermore, in schools in which nutrition is not well established, instructors may have felt insufficiently knowledgeable about the number of nutrition contact hours and may have been less likely to respond to our survey. Again, this potential bias would probably overestimate the amount of nutrition education in medical schools. On the other hand, despite our best efforts to capture nutrition taught outside any dedicated course, it is possible that we are still missing some data in areas that are not readily identified as nutrition instruction. Indeed, instructors of first- and second-year students admitted that they may not know about all the instruction occurring during later years. We acknowledge that estimating nutrition contact hours in the required curriculum is difficult; what constitutes “nutrition education” can be open to interpretation. It can be argued, for example, that teaching the role of niacin in energy production is biochemistry—not nutrition—because it says nothing about dietary needs, food composition, or clinical applications. Given the current constraints, however, our findings may still be the most comprehensive to date.
Conclusion
With the move to an integrated curriculum and problem-based learning at many medical schools and the pressure to teach more in the same time, a substantial portion of total nutrition instruction is occurring outside designated nutrition courses. The results of our recent survey show that most medical schools are not providing adequate nutrition instruction.
AUTHOR COMMENTARY
But ye are forgers of lies, ye are all physicians of no value.
Job 13:4
I am not a licensed and accredited medical doctor, but through my personal studies, I have VASTLY more knowledge on real nutrition compared to the strong majority of witch doctors and sorcerers in this country – who just peddle cheap, ineffective, toxic, and addictive drugs.
Ever since I took health into my own hands (with the Lord’s discretion of course), I have not been sick once in years, I lost a significant amount of weight, I sleep like a baby, I can push my exercises longer and harder and recover faster, and so on.
Medical treatment in this country is a joke, if you did not already know. Notwithstanding a lot dietitians and nutritionists are bunk too, and so finding a good one can be tough at times. But if the doctor promotes natural cures from God’s creation, the need for properly raised agriculture and livestock, specifics on food’s functionality, then you’ll be good. Be careful with doctors that promote fad diets (Vegan, Carnivore, Keto, Paleo, Atkins, low-fat, counting calories, etc.). They can be learned from, but they may also have some under-the-table kickback and sponsorship.
Beloved, I wish above all things that thou mayest prosper and be in health, even as thy soul prospereth.
3 John 2
[7] Who goeth a warfare any time at his own charges? who planteth a vineyard, and eateth not of the fruit thereof? or who feedeth a flock, and eateth not of the milk of the flock? [8] Say I these things as a man? or saith not the law the same also? [9] For it is written in the law of Moses, Thou shalt not muzzle the mouth of the ox that treadeth out the corn. Doth God take care for oxen? [10] Or saith he it altogether for our sakes? For our sakes, no doubt, this is written: that he that ploweth should plow in hope; and that he that thresheth in hope should be partaker of his hope. (1 Corinthians 9:7-10).
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What are the best resources on nutrition that you have found? I would love to learn more about this.
There’s a lot of them, some of which are good but do flirt with some of the fad diets, but overall, I like:
Sten Eckberg
Eric Berg
Dr. Josh Axe
Jason Fung
Health Coach Kait
Frank Tufano
Natural News
Examine.com
AthleanX
High Intensity Health
The Bioneer
Shredded Sports Science
There’s others I am sure I am forgetting, but these were just some of the ones that have come to mind. I have other books I have researched as well. The old saying goes, “Eat the meat, spit out the bones.” Sometimes they’ll say something that I think is incorrect and starts to fade into the “fad” trends, but overall these guys and gals tend to be good from what I have seen.
True. But someone can’t “eat the meat and spit out the bones” until they learn the basics.. Just like when someone comes to faith in Jesus.
“I have fed you with milk, and not with meat: for hitherto ye were not able to bear it, neither yet now are ye able” 1 Corinthians 3:2 KJV
There is also a great nutritional book that came out in the early 80s called “The Vitamin Bible” by Dr Earl Mindell. It was very popular and is good for grassroots learning. I still highly recommend it. In fact, there is a revised updated edition (2021) on Amazon. Very well written easy to understand and apply.. Cheers!
Let food be your medicine.
That doesn’t apply to these glorified legalized drug pushers who choose that sorcery they call medicine.
You’re dealing with a bunch of drug dealers in white coats with doctoral degrees.
Instead of the shady looking guy in the alleyway saying “I’ll hit ya up,” it’s the prestigious looking “doctor” in the office or hospital saying “I’ll fill ya a prescription.”
Less than 24 hours of nutrition training, that’s pathetic, and I bet they only get like 6 hours of herbal training at best that, or they’ll mock that and call that “superstitious.” Wicked quacks!
This has been an economically manipulated thing like everything else, & is now being used politically and propagandistically to make the same people who participated in ‘transforming’ medicine for power the supposed ‘heroes’….as in, those pagans were right all along by quoting ad nauseum what Hippocrates’ got right out of the context of his overall pagan superstition and evolutionary philosophy….the connection to Alexandria and Babylon via Pergamum and serpent gnosis & craft; and Rome was ‘right’ all along for ‘harmonizing’ with rather than calling out & separating from the pagan world & practices.
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Those who use the King James Bible as their proving measure & who pursue whole truth will avoid dialectic manipulation & demonization of all or nothing thinking by manipulating sin and destructive roots of bitterness. Once the Holy Spirit of truth convicts such a righteous soul on this issue as any other, than that person is responsible for either pursuing or turning from truth….and the word of God is a double-edged sword cutting both ways. God is merciful to the truly repentant, giving peace to the soul even where the law of consequence plays out & this temporary abode & tabernacle is not miraculously or medically healed, and the Lord takes us home.
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That picture heading this article is too easily employed by those who would see this nation dissolve into lawlessness & chaos as the French Revolution, the American Civil War fought mainly over states rights though made out by the worst slavers of all as being about race & rights, or the Asian & African brutalities like Pol Pot’s or Yale-educated Mao’s murderous regimes making no true or Christian distinctions in their demonizing and marginalization, ghettoizing etc.
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Jesus said offenses would come….but woe to those by whom they come. We do not want to aid and abet the enemy, or to lack caution about being drawn into their nets and webs and used to our mutual destruction with the compromisers & fallen. The best source for nutrition & health are old turn of the nineteenth and twentieth century books and publications from back when Rome was still marginally involved & just beginning the building of her hospital state-charity model. From back when King James Bible influence was still strong & hindering those Protesting and Reforming Catholics & builder types tempted to follow her ‘successful’ model, the Kellogg and Proctor & Gamble type cults, and before the monopolists such as Rockefeller followed that Romish & cultic model, and centralized the control of health & medicine systems and education. Ultimately steering it into the easy money of promoted sin and addictions, & the obscene & illegit markups of drugs….along the way of centralizing & illegitimately centralizing the food and farming industries.
The best sources for those types of materials are library archives, and older college level nutrition books from collegiate libraries, and biblically influenced institutions (at least in the beginning) best of all. They still haven’t purged all of those as they have in public libraries. A bit like they back-room and basement file the pro-biblical and out-of-place (OOPS) artifacts of history that support the King James Bible rather than the apocryphal and septuagint and evolved Alexandrian versions.
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If you listen carefully to those pushing vitamin D, the B vitamins and so forth, you will learn that it was by perusing those old ‘out of date’ ideas where they learned what’s now being promoted as ‘new’ in nutrition and health. Beware of spin & note the Romish, cultic and antichrist centralizing roots and attachments of these new websites that are so easily controlled. Use mature Christian biblical discernment and not politicized and conditioned emotion….or else you’ll be led right into the antichrist unity by another route. God will allow the presumptuous to be tried and the visual….lust of the eyes, and subtly sensual and idolatrous …lust of the flesh, and pride of life…gnosis, knowledge are subtle traps. This is why ‘social media’ and digital is so powerful, & why Rome & her associated managing partners already in concordat are dumping so much money and effort into moving souls from true literacy to ‘useful’ and limited, barely functional literacy.
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Such people cannot handle a complex doctrinal Pauline sentence, let alone discern & unravel the subtilties in the crafted webs and nets of the wicked. And remaining in that dumbed down and dependent condition is disobedience to God and his word as surely as any other byway from the strait gate and/or the narrow way that leads to trouble and shipwreck.