Nutrition in medical education: ‘Let food be thy medicine, and medicine be thy food’

In recent times there has been a shift in the emphasis of the need for dietary and nutrition training in medical education. School of Medicine Greenville Professor Jennifer L. Trilk, PhD, FACSM, DipACLM, discusses the history on food and medicine, a topic that goes back at least to the ancient Greeks.

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.

Medical Economics: It seems as though, up until recent times, doctors received relatively little instruction about diet and nutrition in medical schools. Can you explain why that is?

Jennifer L. Trilk, PhD, FACSM, DipACLM: We've talked about that for years, like, why aren't doctors trained in nutrition in order to have the competencies to speak with their patients about nutrition, because we now have the term diet-related diseases, as opposed to chronic diseases. And I will mention the medical students again, right as I meet them, Hippocrates said, let food be thy medicine, and medicine be thy food. If that was said so long ago, how did we miss that in the treatment of our patients? And now we really talk more about chronic diseases being diet-related diseases. I mean, that's now a new terminology, because we know that the evidence is there, that most of our chronic conditions are related to a poor diet. And patients aren't taught that, none of us were really, really taught that, but patients aren’t taught that by their physicians because physicians aren't trained in medical education. In the 90s, the nutrition academic award came out, and there were certain medical schools that were chosen for the nutrition academic award and given funding, federal funding, to implement 25 hours of nutrition into medical education. And unfortunately, as what happens with funding and with grants, is as that funding was completed and expired, those medical schools, lost hours of nutrition, so they weren't required anymore to have that, that 25 hours of nutrition.