Nutrition against chronic disease: What should be part of the medical school curriculum?

The Liaison Committee on Medical Education has opened a public comment period for a revision to medical school curricula to include more training about the role of nutrition in prevention and management of chronic disease.

It’s the latest move in the continuing evolution of connections among food, diet, disease, medicine and health care. All of those have a role in the new effort to Make America Healthy Again, the initiative of Health and Human Services Secretary Robert F. Kennedy, Jr., under President Donald J. Trump.

In this video, three experts discuss the state of dietary and nutrition education for physicians, what might change, and how doctors must meet patients where they are to effect change for better health.

David M. Eisenberg, MD, is director of culinary nutrition and adjunct associate professor of nutrition at the Harvard T. H. Chan School of Public Health. A longtime internal medicine physician, he is one of the nation’s leading experts on lifestyle medicine.

Jennifer L. Trilk, PhD, FACSM, DipACLM, is professor of biomedical sciences at School of Medicine Greenville (SOMG) at the University of South Carolina. She and Eisenberg are among the co-authors of “Proposed Nutrition Competencies for Medical Students and Physician Trainees,” a consensus statement on medical education, published last year in JAMA Network Open.

Krista Blackwell, PhD, is clinical assistant professor of biomedical sciences at SOMG. This year, she spoke to Medical Economics about two new analyses about ultraprocessed foods in the American diet, published by the American Heart Association and the U.S. Centers for Disease Control and Prevention.

The video transcript is below.

The Liaison Committee on Medical Education has opened a public comment period for revision to medical school curricula to include more training about the role of nutrition and prevention and management of chronic disease. The move already has the endorsement of the American Medical Association, and for some a requirement is long overdue. The announcement came a year after physicians and nutrition experts published a new consensus statement proposing nutrition competencies for medical students and physician trainees,

David M. Eisenberg, MD: In addition to identifying 36 competencies, which we can talk about in a minute, it also asked the question: Should these be optional, recommended or required? And 97% of the voters, regardless of whether they taught nutrition or they were a residency director, said these have to be required on licensure certifications. The time has passed for this to be a nice-to-have. This has to be part of being credentialed as a physician. We also realized when we wrote up the competencies, which include things like, doctors need to know nutrition facts; doctors need to identify food and nutritional insecurity; doctors need to be able to talk to patients where they are in a nonjudgmental way about whether they want to change their relationship to food, and to do that without shaming them and to realize how difficult that is.

Some medical schools, such as the School of Medicine Greenville, already have introduced more nutritional and dietary research into their curriculum.

Jennifer L. Trilk, PhD, FACSM, DipACLM: Our admissions committee tells me constantly that the vast majority of candidates who apply to our medical school apply because they want to get this training in lifestyle medicine so that they can adequately care for their patients as they become doctors and have those competencies. We also have a culinary medicine lecture and we also have an elective in the first year and in the fourth year where students get into a teaching kitchen, and this is really, really near and dear to our heart, where the students learn how to cook, they learn how to prepare, they understand cultural competent food patterns. They understand it from a chronic disease food pattern. And they also understand that they need to meet their patients where they are in terms of changing dietary patterns. And then they have a capstone. The first-years have a capstone in food insecurity. So they're given boxes of foods that you would get maybe at a food pantry, or a WIC box or a SNAP box, and they're required to make meals out of those boxes. And then the fourth-years, they bring actual patients into the kitchen, and they teach the patients how to cook and how to improve their cooking habits and their lifestyle habits through nutrition and through cooking. So we've got what I consider a classroom-clinic-community model, where the students learn it in the classroom, they apply it in the clinic, and then they really work with the community to be those end-users to improve population health.

The need for physician training on diet and nutrition may be growing more urgent. In 2025 the American Heart Association and the Centers for Disease Control and Prevention published reports about high levels of ultraprocessed foods in the American diet. So what is the best approach for physicians to apply this information with patients in the exam room?

Krista Blackwell, PhD: One of the practices that our students learn is motivational interviewing, where they're focusing on helping the patient, you know, if there's a food dietary recall helping the patient identify a place that they can make small changes in their diet that can also improve their health. And I could give you an example, if a person was to have soda with their breakfast, lunch and dinner, we know that soda is not healthy, but if that is in that person's diet, we could, individuals could make recommendations of replacing the soda with a healthier beverage option. I think, in general, with what our students have seen and observed is that motivational interviewing allows individuals to take small steps. But if you walk into a room, and I've even had this conversation myself, is, if you have a conversation and somebody says, well, you need to consider a vegetarian diet, or you need to consider this diet or that diet without any solutions or suggestions, it may be harder for that individual to figure out what steps to take. So sort of meeting people where they are figuring out how to make those small changes, are things that I think have been very successful with students who are working or individuals that are trying to help their patients make change.