Nutrition in medical education: How to approach patients with dietary advice

Where does applied nutrition fit into discussion with patients in the examination room? A good way to start is to meet patients where they are at, dispel misinformation patients often find on social media, and talk about their own food patterns. School of Medicine Greenville Professor Jennifer L. Trilk, PhD, FACSM, DipACLM, explains more.

Trilk is a co-author of “Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement,” published in JAMA Network Open. The authors’ goal was to recommend nutrition competencies in medical education to improve patient and population health. She is the co-founder of the Lifestyle Medicine Education Collaborative, which has published free medical education curriculum materials on lifestyle medicine.

Jennifer L. Trilk, PhD, FACSM, DipACLM: So I would encourage our doctors, our readers, to say, you don't necessarily need to be dogmatic of one particular food pattern or one particular diet. The very first thing you need to do is meet their patient where they are. You need to dispel the misinformation that you see all over Google and Tiktok, and Instagram and influencers that say that they lost 20 pounds in five days by using a particular diet. We know that those are things that are attention seekers, and they're not founded in evidence. The most important thing is to take a look at, again, reducing the processed foods. All of the evidence is there for reducing of processed foods, reducing of the sugars, reducing of some of the saturated fats. You know this is more recently, dietary cholesterol has not been as demonized as it has in the past, in terms of raising blood cholesterol levels, because it used to be, well, you can't have as much cholesterol because it raises dietary cholesterol levels. It does in individuals who are sensitized to cholesterols, but if an individual takes in too much saturated fat, that also can be converted to cholesterol. So they're all of these just ways that our doctors are needing to navigate what is out there in the community. And again, to just dispel that misinformation, that in itself, is why we published the competencies paper led by wonderful Dr. David Eisenberg on really looking at what are the information that the doctors need to know, and what are the competencies that they need to be able to have as they graduate their medical school and get into working with their patients. And a lot of that is really understanding that applied nutrition base, which is far less than understanding everything about a micronutrient that goes through the Krebs cycle. It's much more about, really, that applied nutrition and meeting the patient, and understanding, to talk about a patient, about their food pattern.