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By Matthew Rees

Food and Health Fact #164: A glimmer of hope from the House of Representatives

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In the longstanding battle to improve the American diet, the U.S. Congress has traditionally been hostile territory. This has reflected the overwhelming influence of food and beverage companies, agricultural interests, and retailers – none of whom have any interest in (and are often opposed to) legislation that would help modify Americans’ eating habits.

There’s no evidence that any of that has changed. But a tiny little measure that passed the House last week suggests that there’s at least awareness of the need to do something about Americans’ deficient diets. (And yes, it’s a sign of how low dietary issues rank on the public policy agenda that there’s reason to celebrate mere awareness from Congress.)

The measure was a resolution that called on medical schools, residency and fellowship programs, and other health professional training programs to include in their curricula nutrition education “that demonstrates the connection between nutrition and disease” and “raise awareness of the critical role that nutrition plays in the health of all patients and the responsibility of practicing physicians, health professionals, and healthcare administrators to assist in promoting healthy choices.”

The backstory to the resolution is one of the more remarkable shortcomings in the U.S. medical system. While physicians are among the most trusted professionals when it comes to providing counsel on dietary issues, they are woefully uninformed on the basics of nutrition.

The ignorance is not entirely their fault. Medical students receive little training in nutrition – less than 1 percent of lecture hours at medical schools, according to one study.

Even this time is of limited value, according to Lloyd Minor, dean of the medical school at Stanford. He has written that nutrition education is often focused on nutrients and not tools that patients could really use. As a result, “we physicians often sound like chemists rather than counselors who can speak with patients about diet, including how to make healthy, delicious foods on a budget or in ways that honor cultural traditions.”

Moreover, the curriculum at medical schools, points out David Katz (founder and former director of a research center at Yale), is based on a report issued in 1920, a time when “diseases of nutritional deficiency still prevailed, and the modern diseases of dietary excesses were inconsequentially rare.”

Getting medical schools and other entities to incorporate nutrition education into their training still faces enormous obstacles. Two stand out. One is figuring out what to remove from their curriculums in order to get nutrition in. The other is getting nutrition questions included on the board exams taken by all medical students.

The House resolution is just that – a resolution – and thus non-binding. But with luck it can help serve as a remedy for what Katz calls “an absurd anachronism” – that physicians are “ill trained in the very area most impactful on the rate of premature death.”