By Dr. Bret Scher
Certified Specialist
The Department of Health and Human Services recently announced an initiative to improve nutrition education across every stage of physician education and training. As part of the effort, dozens of medical schools have pledged to include 40 hours of nutrition training — or a competency-based equivalent — in their graduation requirements.
Those pledges take aim at a longstanding gap. Medical schools currently devote less than 1% of lecture hours to nutrition, and until recently, roughly three-quarters of schools didn’t require a dedicated nutrition course at all.
As a cardiologist, I welcome this initiative.
But adding hours alone won’t be enough. More nutrition education won’t meaningfully improve our nation’s chronic disease crisis unless medical schools also rethink what they teach. For decades, medical and dietetic societies — even the government — have promoted similar dietary guidance, yet metabolic disease continues to rise.
Rather than repeat the same nutrition mantra, schools should focus on two priorities: teaching physicians how to evaluate nutrition evidence and translate it into individualized patient care.
Since diet is first-line therapy for many of the most common chronic diseases afflicting Americans, physicians should be as comfortable evaluating nutrition evidence as they are interpreting the science behind the medications they prescribe. That starts with understanding how nutrition research differs from many other areas of medicine.
A conventional drug trial can often isolate a single intervention and compare it with a placebo under tightly controlled conditions. Nutrition rarely fits that model.
Nutrition science therefore relies on observational studies, controlled feeding trials, mechanistic research, and clinical interventions.
Medical schools must teach future physicians how to weigh these different forms of evidence and understand what each study design can — and cannot — tell them.
Evaluating the evidence is only half the job — physicians also need to know how to apply it to the patient in front of them.
For decades, major medical groups have recommended a one-size-fits-all approach to healthy eating: reduce saturated fat, increase whole grains, eat less, and move more. But that conventional advice has failed to stem the rise of metabolic disease.
Today, approximately 90% of Americans show at least one sign of suboptimal metabolic health, while obesity and type 2 diabetes have steadily increased. It’s increasingly clear that a dietary strategy that works for a metabolically healthy patient may not be the best starting point for someone whose body is struggling to regulate glucose and insulin.
Future physicians need a toolkit that recognizes a range of evidence-based dietary approaches. For instance, research routinely shows that low-carbohydrate and ketogenic diets can improve glycemic control, weight, and other metabolic markers for many patients. Mediterranean-style or plant-based dietary patterns that emphasize whole, nutrient-dense foods can also offer benefits.
Medical schools must therefore teach future physicians how to match the right strategy to the right patient.
With this initiative, HHS has created an opportunity to rethink nutrition education for the next generation of physicians. Now it’s up to policymakers and accrediting bodies to ensure that the new requirements define competencies, not merely hours.
Get that right, and those 40 hours can produce better doctors — and healthier Americans.
Bret Scher, MD, is a board-certified cardiologist and lipidologist, and the founding medical director of the Coalition for Metabolic Health.
Leave a Reply