How Much Your Doctors Know (or Don’t) About Nutrition?

4 min

The sad truth is that your doctors probably don’t know much about that. Medical education doesn’t pay much attention to nutrition, so most practicing physicians don’t, either.  That’s a shame, since nutrition is foundational to health and can be as effective as medication (or more so) for many conditions without the side effects that some drugs cause. I have long believed that dietary advice should be the very first part of most treatment plans, and I wish more of my colleagues felt the same.

As of 2024, nearly 130 million Americans have a chronic disease, such as heart disease, cancer, diabetes, obesity, or hypertension (high blood pressure).  Many people with these conditions would benefit from improvements in diet, but instead we have come to rely on medicine. A 2020 survey showed that nearly half of all Americans had taken a prescription medication in the previous month. More than 20 percent of Americans had taken three or more prescription medications, and nearly 12 percent had taken five or more.  That’s an expensive approach to health: one study showed that poor diet accounted for nearly one fifth of all spending on ischemic heart disease, stroke, and type 2 diabetes in the United States.

Unfortunately, prescribing drugs is what our medical school graduates have been trained to do. We have known for decades that physicians need more education about nutritional health, but that change has been slow to happen. A 2018 advisory from the American Heart Association noted that most medical schools were not providing even the minimum 25 hours of classroom nutrition education that had been established in 1985. More than a third of medical schools provided less than half of that minimum. In a 2021 survey of 1,182 medical students, respondents reported an average of 1.2 hours of nutrition education a year. More than half reported no formal education in nutrition at all.

The long overdue good news is that there seems to be a new momentum around the issue. Reacting to astronomical Medicare costs, the U.S. House of Representatives passed a 2022 resolution calling for improved nutritional education for medical students. In response, a research team set out to identify the nutritional competencies that should be required. The team focused on core competencies rather than on number of classroom hours, with a recommendation that the competencies be tested on within the medical licensing and board certification processes.

The result was a 2024 consensus statement published in the Journal of the American Medical Association that listed 36 nutritional competencies that every medical student should have, noting that they should be taught in both medical school and graduate medical education. They seem eminently sensible to me — every doctor should understand the role of macro- and micronutrients in health, be able to evaluate a patient’s nutritional status, and provide sound and appropriate food recommendations to patients. The list also includes the ability to guide patients toward making better choices, identifying dietary risks for disease, and evaluating lab results with an eye toward nutritional health.

This is so important — and so sensible — that I hope we take the next step immediately. That would be implementing a new curriculum for medical students that ensures new graduates enter practice with these competencies in place. I would also encourage physicians already in practice to develop these skills. Their patients deserve it.

Please visit the Diet and Nutrition section of my web site for information about the role of nutrition in your health.

Andrew Weil, M.D.

Sources
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Jardim TV, Mozaffarian D, Abrahams-Gessel S, Sy S, Lee Y, Liu J, Huang Y, Rehm C, Wilde P, Micha R, Gaziano TA. “Cardiometabolic disease costs associated with suboptimal diet in the United States: A cost analysis based on a microsimulation model.” PLoS Med. 2019 Dec 17;16(12):e1002981. doi: 10.1371/journal.pmed.1002981. PMID: 31846453; PMCID: PMC6917211. pubmed.ncbi.nlm.nih/31846453/

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Eisenberg DM, Cole A, Maile EJ, Salt M, Armstrong E, Broad Leib E, Findley T, Massa J, Albin J, Alston M, Barkoukis H, Buckhold F, Danoff R, Delichatsios H, Devries S, Dewar S, Di Rocco J, Duggan CP, Essel K, Frates B, Hansen P, Haramati A, Harlan TS, Hauser ME, Leopold D, Lewis J, Locke A, Mann JR, McClure A, McWhorter JW, Misra S, Murano T, Oxentenko A, Pierce-Talsma S, Potts S, Reilly JM, Ring M, Sampang S, Shafto K, Shiue L, Slusser W, Stone T, Studer K, Thomas O, Trilk J, Edgar L. “Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement.” JAMA Netw Open. 2024 Sep 3;7(9):e2435425. doi: 10.1001/jamanetworkopen.2024.35425. Erratum in: JAMA Netw Open. 2025 Oct 1;8(10):e2541219. doi: 10.1001/jamanetworkopen.2025.41219. PMID: 39348126. pubmed.ncbi.nlm.nih/39348126/