Washington, D.C. – All medical students and physicians should be trained in nutrition and physical activity to help combat America’s growing obesity challenge. That’s the message of a new white paper, Teaching Nutrition and Physical Activity in Medical School: Training Doctors for Prevention-Oriented Care, released today by the Bipartisan Policy Center (BPC), the American College of Sports Medicine (ACSM) and the Alliance for a Healthier Generation (Alliance) at the Institute of Medicine’s Roundtable on Obesity Solutions. The paper shows that current training for medical professionals in nutrition and exercise is inadequate to cope with the nation’s obesity epidemic, and offers recommendations on how to remedy that deficit.
Today, two in three Americans are overweight or obese. The high incidence of obesity has also caused increased incidence of metabolic diseases such as diabetes and hypertension. Yet only one in eight visits with a doctor involves counseling on the benefits of a healthy diet.
The paper points to a skills and knowledge gap among medical professionals; more than 75 percent of physicians felt they had received inadequate training to be able to counsel their patients on changing diet and increasing activity levels. It also highlights that fewer than 30 percent of medical schools meet the minimum number of hours of education in nutrition and exercise science recommended by the National Academy of Sciences.
In October of 2013, BPC, ACSM, and the Alliance held a conference in Washington, DC to gather input from medical school representatives, insurance providers, medical licensing and certification boards, and community-based organizations, as well as recent and current medical students and practitioners. “We agreed that obesity and related chronic diseases represent enormous challenges for our nation,” said Dan Glickman, former Secretary of Agriculture and Co-chair of BPC’s Nutrition and Physical Activity Initiative. “We concluded that an effective way to address those challenges was to encourage medical schools to help integrate nutrition and physical activity into mainstream medical training and practice.”
“Health care professionals are on the front lines of the battle against obesity and metabolic disease,” said Donna E. Shalala, former Secretary of Health and Human Services and President of the University of Miami, who also serves as Co-chair of the BPC Nutrition and Physical Activity Initiative. “They are uniquely positioned to prompt change among individuals, families and society as a whole. That’s why we need to ensure that they have the tools to help their patients practice healthy lifestyles.”
“In medical school and as practicing physicians, we focus so much on disease and cure,” says Senator Bill Frist, MD, Co-chair of BPC’s Health Project. “But when the biggest killers in our country are diseases related to lifestyle choices – specifically cardiac disease and obesity – it does not make sense to know how to do a heart transplant without also knowing how to prevent the potential need for one. While this proposal is not meant to be a cure-all, addressing nutrition at an education level for physicians who lead healthcare teams is an essential element of a broader effort to address the obesity epidemic.”
Some schools are already making strides in this effort. The University of North Carolina offers an online curriculum entitled Nutrition in Medicine. At Boston University, students started their own group, called The Student Nutrition Awareness and Action Council (SNAAC) to develop extracurricular training opportunities for themselves and their classmates. And the University of Colorado School of Medicine has taken steps to integrate nutrition education across all four years of its undergraduate curriculum.
Teaching Nutrition and Physical Activity in Medical School also suggests how other sectors can support the trend toward preventive medicine. For example, the report stresses that insurers should expand reimbursement for evidence-based preventive services that incorporate nutrition and physical activity, such as diabetes prevention programs offered through community organizations like the YMCA. “The health care marketplace needs to place greater value on preventive care,” says Jim Whitehead, Chief Executive Officer and Executive Vice President of the American College of Sports Medicine. “Doing so will provide medical schools with the incentive to train their students accordingly. And it will give medical professionals the leverage they need to address healthy lifestyles with their patients.”
“We’ve seen firsthand the value of expanding reimbursement for evidence-based preventive services through our Healthier Generation Benefit,” says Howell Wechsler, EdD, MPH Chief Executive Officer of the Alliance for a Healthier Generation. “We are proud to be working alongside the Bipartisan Policy Center and the American College of Sports Medicine to bring attention to medical education reform and provide actionable recommendations to move this topic forward.”
Paper’s top findings include:
- Medical schools should develop and implement a standard nutrition and physical activity curriculum.
- Licensing and certification exams, as well as residency and continuing education programs should include more nutrition and physical activity content to reinforce its importance to treatment.
- Board-accredited advanced training programs should work to expand the cadre of experts in nutrition and physical activity who can teach health professionals.
- Federal and state governments should provide support for reforms in medical education and health care delivery that can help providers better meet patient needs with respect to nutrition, physical activity, and other lifestyle factors.
- Public and private insurance should provide reimbursement for health services that target lifestyle factors such as nutrition and exercise.
To learn more about BPC’s Nutrition and Physical Activity Initiative, click here.
To download the full Medical Education Infographic, click here.