Euan Cook explores the importance of nutrition education for medical students to ensure patients are better treated for malnutrition.
Photo by Toni Osmundson
In January 2019, the National Health Service (NHS) published a long term-plan for preventing disease and prioritising public health, calling for frontline staff “to feel equipped to talk about nutrition” with patients. However, students remain dissatisfied with the inadequacy of nutritional education in medical schools.
Malnutrition is estimated to be as high as 30% in UK hospitals, where 11 million deaths are attributable to dietary factors annually. These fatalities can be linked to diets high in salt and fats which have contributed to poor dietary intake. The economic consequence of this malnutrition has cost NHS England approximately £25.7 billion between 2011-2015, outlining an urgent need to formulate an effective nutrition education for aspiring healthcare professionals.
Modernising Medicinal Education
Nutrition simply does not fit into the traditional medicinal model, which teaches students to treat disease through pharmaceutical or surgical means. Instead, the fight against malnutrition can be tackled with improved training in non-communicable diseases (such as Type 2 Diabetes) and evidence-based lifestyle interventions. The inability for nutrition to fall naturally into an outdated academic curriculum is the reason that 70% of surveyed UK students received less than two hours of nutrition teaching throughout the entirety of their medical school education.
Dr. Fiona Godlee, the editor of the British Medical Journey, urges that it is “time we recognised that food and nutrition are core to health” which requires a unified endeavour amongst medical schools. Currently, institutes are independently setting their curriculum around nutrition, threatening the quality of consistent nutrition education across the nation and sidelining the subject as an optional course.
However, this problem is not endemic to the UK. In the U.S., only one-fifth of medical schools have established nutrition education as mandatory. David Eisenberg of Harvard T.H. Chan School of Public Health outlines the “outrageous” nature of this neglect, stating that:
What Needs to Change?
Within the workplace, a lack of a ‘nutritious' education has led to a mere 26% of doctors feeling confident in their knowledge about nutrition and 74% giving nutritional advice less than once a month. Indeed, poorly trained professionals could be seen as “one structural contributor to diet-related diseases”, indicating that it is time for medical schools to consider the “global standards” of nutrition education to ensure a “patient’s right to preventive health care”. So, what needs to be done within medical schools to allow students to conduct efficient scientific research?
Frequent limitations include an absence of control groups and validated survey instruments, insufficient study samples and representativeness of the population and ultimately poor response rates. Therefore, teaching nutrition should exercise National Institute for Health and Care Excellence (NICE) guidelines to emphasise that lifestyle interventions are first-line, not medical or surgical avenues. A push towards these guidelines is most concentrated amongst the student population in the UK.
The Student Vanguard
The pulsing heart of this revolution lies at the University of Bristol, where third-year medical students Ally Jaffee and Iain Broadley founded Nutritank, an online organisation promoting nutrition science research. Jaffee’s expanded on the genesis for the organisation, reporting that:
“There’s just about a society at medical school in everything from sexual health to orthopaedics to dermatology. But there just wasn’t a nutrition and lifestyle or a preventative medicine society. We’re taught about 10 to 24 hours over five to six years in medical school on nutrition” – Ally Jaffee, BBC News
Nutritank has conducted research at 25 medical schools in the UK. Over 500 students and doctors have subscribed to their webinar lectures, inspiring 15 other student-led groups across the country and encouraging the University of Cambridge to double the amount of core course content on nutrition. Dr. Rupy Aujla has even been invited to host the first UK course in culinary medicine for medical students, as he insists that we “need to teach doctors how to cook and the value of evidence-based nutrition”.
The task ahead of medical schools is a daunting, yet necessary one. An increasing volume of health information on social media proves it is vital for doctors to provide reliable, evidence-based sources of information to patients. Doctors who have received a judicious nutrition education are expected to not only become better advocates for healthy eating, but also adopt healthier dietary habits themselves.
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