The Future of Nutrition Education in Medicine

By Casey Paton

As previously discussed, nutrition and lifestyle interventions have been shown to improve patient outcomes, yet only 27% of United States medical schools offer at least 25 hours of nutrition education in their four year curriculum1. So what is the future of nutrition education in medical schools, residencies, and medical systems, more broadly? What programs are under development and do they hold promise?

One creative solution to the dearth of nutrition knowledge is the development of new culinary medicine courses. A few medical schools are pioneering these classes that teach medical students to empower their future patients; the goal is to encourage smart personal medical decisions about accessing and enjoying nutritious meals that help prevent and treat disease. This mission is fueled by numerous factors: the appeal of easy dining-out options, the ubiquity of hyper-palatable and high calorie options, boredom with strict conventional dietary recommendations, the rising healthcare costs of obesity and heart disease, and the emerging enthusiasm for home cooking, farmers markets, and personal gardens2.

With this ethos, SUNY Upstate was the first medical school to integrate a nutrition elective in 2003. Harvard took an extracurricular approach to fill this need by founding its annual Healthy Kitchens, Healthy Lives postgraduate course for clinicians in 20073. In 2018, this five day conference still unites physicians of all specialties, nurses, dietitians, and other health and culinary professionals. The multifaceted goals of the conference include: educating clinicians on the current trends in American food consumption, providing advice for thoughtful conversations about behavior change, discussions of access and affordability challenges, presentation of emerging nutrition research, and many culinary sessions that teach cooking skills and share recipes. In fact, these Kitchen Sessions include topics such as knife skills, spice usage, plant-based cooking, and meal prepping for a family3. Many other nutrition conferences are well-attended such as the International Congress on Nutrition and Health, the International Society for Sports Nutrition, and the American Society for Nutrition meeting, but Healthy Kitchens, Healthy Lives was the first to focus on physicians and other clinicians.

Tulane was the first American medical school to open a culinary medicine center in 2013. The Goldring Center for Culinary Medicine at Tulane University is a teaching kitchen that offers elective coursework and seminars for medical students as well as continuing education for clinicians4. Medical students take courses on nutrition and cooking techniques. They later volunteer in the kitchens, teaching free community cooking classes and educating their peers. Students also organize local community health fairs that offer BMI, blood pressure, and blood glucose readings and partner with local organizations to support good nutrition. Additionally, the Goldring Center offers an expansive online recipe book and facilitates a month-long away rotation at its partner culinary school, Johnson and Wales. By partnering with an established culinary school, Tulane’s medical school is able to offer students an innovative four week rotation that pairs medical pathologies with cooking and nutrition concepts.

Building on these foundations, at least ten US medical schools, including the George Washington University School of Medicine, now teach culinary medicine to third and fourth year medical students as elective courses in their curricula. Tulane has developed and distributed a culinary medicine curriculum to multiple additional schools2. Continuing Medical Education (CME) courses in Culinary Medicine have been created; a few are now offered through the North American Center for Continuing Medical Education2. A few hospitals are realizing the benefits of these programs as well and have started classes for clinicians and the community on health and nutrition.

An interesting parallel theme of physician self-care is emerging with the rise of culinary medicine. More frequently physicians are required to contemplate the effects of the “hidden curriculum” bridging the gap between their work and personal lives. This theory posits that the behaviors a physician engages in— their own food, exercise, drinking, smoking, sleeping, hygiene, and self-care habits— are likely to influence the delivery and reception of health recommendations to patients5. Thus, the development of physician wellness programs have expanded greatly in the past few years. Culinary medicine offers an excellent supplement to the nutrition portion of wellness.

Historically, practical nutrition education has received little emphasis in the medical school curriculum. While opponents may stress the availability of other health professionals to focus on nutritional requirements, the plethora of evidence linking nutritional behaviors to positive or negative outcomes suggests that physicians need to hold a seat at the table. The expansion of programs such as culinary medicine electives, conferences, and continuing education credits offer hope that access to nutrition education will continue to grow.

About the Author

Casey Paton, BS, MA, is a first year medical student at the University of Rochester School of Medicine. She graduated from Cornell University in 2015 with a degree in Human Biology, Health and Society and four years of biomedical research experience. She earned a Master of Arts degree from Fisk University, analyzing the effects of oxidative stress on dopamine neuron degeneration.  She has worked as a Research Assistant at Vanderbilt University Medical Center, studying the epigenetics of learning and memory. Casey has been the recipient of two national research fellowships including the National Science Foundation’s Graduate Research Fellowship. She is an enthusiastic power lifter, distance runner, and a Certified Personal Trainer with the American College of Sports Medicine.  Casey is passionate about basic science research and hopes to lead her own research lab in the future.

Sources:

  1. Paton, Casey. “Doctor, What Should I Eat?” Student Doctor Network, 18 Oct. 2018, www.studentdoctor.net/2018/10/25/doctor-what-should-i-eat
  2. Puma, J. L. (2016). What Is Culinary Medicine and What Does It Do? Population Health Management, 19(1), 1-3. doi:10.1089/pop.2015.0003
  3. Healthy Kitchens, Healthy Lives. What You’ll Learn – Healthy Kitchens, Healthy Lives
  4. Goldring Center for Culinary Medicine at Tulane University. Elective Options – CulinaryMedicine.org
  5. McClafferty H, Brown OW. Physician health and wellness. Pediatrics. 2014;134:830–835

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