Championing Nutrition in Medical Education

We are facing a double burden of malnutrition – a large proportion of the worlds’ population are overweight or obese and yet others struggle to get enough food. Non-communicable diseases are now the leading cause of death worldwide and numbers are increasing.

Knowledge of and access to healthy food is critical for reducing this global burden. Twelve of the 17 Sustainable Development Goals depend on nutrition and the United Nations has declared 2016–2025 the Decade of Nutrition. The WHO has identified nutrition as one of the most modifiable determinants to reduce non-communicable diseases and in Australia, the Global Burden of Disease study has identified “dietary risks” as the leading risk factor for death and disability.

Because they are at the frontline of healthcare, doctors should have sufficient nutrition knowledge and skills to prevent disease, provide appropriate and targeted advice to patients and to know when to refer to other health professionals for specialised nutrition care. The development and integration of nutrition competencies into medical curricula will ensure that medical graduates become nutritionally competent practitioners. Yet medical education globally has failed to provide graduates with the nutrition competencies they need to assist populations and patients to implement positive dietary modifications.

At Deakin University, Prof Caryl Nowson has championed the importance of embedding nutrition into medical education both nationally and internationally. She has engaged in research in the area since 2010 and authored key publications outlining opportunities for innovation in medical education, exploring the nutrition practice and knowledge of medical students and assessing the nutrition content of exam questions in the medical course at Deakin.

Central to this work was a three year Office for Learning and Teaching Department of Industry, Innovation, Science, Research and Tertiary Education grant bringing together four key universities providing medical training: Deakin University; University of Queensland; University of Tasmania and; Monash University as well as the Dietitian’s Association of Australia. These partners worked together to develop a web-based nutrition competency implementation toolkit (WNCIT).  As part of this project, the first Australian nutrition competencies for medical education were developed as well as a bank of nutrition resources, nutrition based course content and a nutrition curriculum mapping tool.

Important work still needs to be done to have these nutrition competencies mandated in all Australian and New Zealand medical courses and to recruit appropriately trained staff to teach them. The popularity of Lifestyle medicine medical education offers an opportunity to strengthen nutrition in the curriculum.

For now, most medical schools approach to nutrition is piecemeal. Often sessional staff are called on to provide lectures that are disconnected from a curriculum that scaffolds students learning on nutrition and integrates it into all domains of medical education. We need to do better than this if the disease burden associated with unhealthy diets is to be addressed. We are grateful Caryl has started us on this journey.

Robyn Perlstein is an Accredited Practising Dietitian who has been working alongside Caryl for the last 8 years at Deakin University.

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